holly ahern - lyme disease: what you should know

Download Holly Ahern - Lyme Disease: What You Should Know

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  • 1. What you should know. Holly Ahern MS, BS MT(ASCP) Associate Professor of Microbiology SUNY Adirondack, Queensbury, NY

2. I say LYME DISEASE, you say. 3. *Borrelia burgdorferi Other Borrelia Babesia Bartonella Ehrlichia Anaplasma Mycoplasma Viruses 4. University of Rhode Island Tick Encounter Resource Center http://www.tickencounter.org/tick_testing 5. Lyme disease is an acute infectious disease, transmitted by nymph stage deer ticks, caused by one species of a specific bacterium named Borrelia burgdorferi Hard to catch and easy to cure 6. Tick must be attached for a minimum of 36 hours to transmit Lyme disease Current IDSA/CDC Standard of Care Peer-reviewed evidence NOT included in the IDSA/CDC guidelines Burgdorfer: transmission time for Borrelia is variable. Other TBDs transmitted quickly; viruses in 15 min. Borrelia may be sexually transmitted. Borrelia, Babesia, Anaplasma are transfusion transmitted. 7. Lyme disease is an acute infectious disease. Current IDSA/CDC Standard of Care Peer-reviewed evidence NOT included in the IDSA/CDC guidelines Lyme disease may be an acute disease. Lyme disease may also be a chronic disease. 8. A single FRONTAL pathogen, Borrelia burgdorferi, is responsible for Lyme disease symptoms. Ticks carry and transmit multiple STEALTH microbes. People infected with multiple pathogens have more severe disease. Current IDSA/CDC Standard of Care Peer-reviewed evidence NOT included in the IDSA/CDC guidelines 9. Diagnostic algorithm (ACP) includes patient history of tick bite, bulls-eye rash, AND laboratory evidence of infection (usually this means a two-tier system of antibody based blood tests for Borrelia burgdorferi ONLY) Current IDSA/CDC Standard of Care Peer-reviewed evidence NOT included in the IDSA/CDC guidelines Current diagnostic criteria EXCLUDE any form of the disease that does not meet the ACP/CDC/IDSA algorithm Therefore, you may not be diagnosed with Lyme disease, EVEN IF YOU HAVE IT, if: No bulls-eye at tick bite site First tier test doesnt meet a threshold level Second-tier test doesnt have enough bands You were infected with more than one microbe by the tick 10. Most infections resolve after short-term antibiotic treatment; 5% of patients may develop post-tx sequelae that are autoimmune. CDC survey - 61% require more than recommended antibiotic treatment. 30 50% have chronic symptoms persisting after antibiotics. Stealth pathogens are highly adapted survivors so persistent infection may be the cause. Reactivation of growth of spirochetes shown in most recent study. Current IDSA/CDC Standard of Care Peer-reviewed evidence NOT included in the IDSA/CDC guidelines 11. EASY to catch and HARD to cure! Ticks may transmit some pathogens RAPIDLY Study of Lyme patients: Only 50% developed any type of rash, of those, only 10% had a bulls-eye Symptoms may occur at ANY TIME of the year Symptoms are highly variable and may become CHRONIC Blood tests for Lyme disease are reliably INACCURATE 2-4 weeks of antibiotics MAY NOT cure Lyme disease 12. Disease New cases (annual) NIH funding (FY 2012) Hepatitis C 1,300 $112 million West Nile Virus 5,700 $29 million HIV/AIDS * 56,000 $3 billion (11% total NIH budget) Influenza * 73,000 $251 million Lyme disease 312,000 $25 million Source: http://report.nih.gov/PFSummaryTable.aspx * Considered epidemic by the CDC 13. Financial Burden of Lyme disease, BEFORE CDC Case Estimate Revision (2012) New York State 2,590 $10,429 $27,011,110 United States 27,313 $10,429 $284,847,277 Financial Burden of Lyme disease, AFTER CDC Case Estimate Revision (2012) New York State 25,900 $10,429 $270 million United States 312,000 $10,429 $3.25 billion Financial Burden of Lyme disease, based on probable number of cases (2012) New York State 44,030 $10,429 $460 million United States 445,714 $10,429 $4.65 billion