Lyme Disease, the Controversy and the Condition
May is Lyme Disease Awareness month, and each year the number of cases of Lyme disease has been increasing in some states, as already noted by Maine’s epidemiologist, Dr. Stephen Sears, in a recent press release. But whether it’s Maine or Minnesota or North Carolina, concern and controversy over Lyme disease is a significant challenge.
The Minnesota Department of Health reported in a recent article in the Minnesota Post that climate change is affecting both the range and dormancy of the deer tick, which carries the bacterial agent of Lyme disease, Borrelia burdorferi. The cold season is growing shorter, which means the tick season is getting longer, increasing the opportunities for people to come in contact with the tiny blood sucking creatures. Deer ticks can be dispersed by deer, rodents, and birds.
Because of its climate and environmental conditions, Hunterdon County, New Jersey, has one of the highest rates of Lyme disease in the United States. In that one county alone, more than 600 cases of Lyme disease were confirmed in 1996 and 1999, and in 2008 the number closed in on 400. In North Carolina, the state’s Department of Environmental and Natural Resources reports that the number of cases of Lyme disease is on the rise.
In North Carolina as in other states, Lyme disease has been the source of controversy. Public health officials and physicians in North Carolina “have been reluctant to diagnose Lyme disease, citing evidence that ticks carrying the bacterium are scarce here,” according to a recent article in the NewsObserver.com. Individuals who have insisted they had contracted Lyme disease in North Carolina have faced great difficulties finding doctors that would diagnose and treat them.
Within the past year, however, the disease has been documented in the state, which is critical because state and federal health officials can use this information “to alert doctors that they need to consider Lyme disease if patients suffer malaise, swollen lymph nodes and achy joints after a tick bite.” The characteristic bull’s-eye rash (erythema migrans) appears in 70 to 80 percent of infected persons, according to the Centers for Disease Control and Prevention. Other early symptoms include fever, chills, headache, and fatigue.
If untreated, Lyme disease can spread throughout the body within a few days to weeks. Symptoms can then include Bell’s palsy, neck stiffness due to meningitis, heart palpitations, dizziness, intermittent bouts of arthritis, numbness or tingling in the hands or feet, problems with concentration and short-term memory, and chronic neurological complaints that can exist for years after infection.
The accepted wisdom has been that a course of antibiotics can cure Lyme disease within about 30 days, but there is increasing controversy over the existence of chronic Lyme disease. Some patients continue to experience disabling symptoms after they have completed treatment with antibiotics and are so-called “cured.” These individuals are often prescribed a continuous series of antibiotics, which can go on for many months, even years.
According to an ABC news report, insurance companies prefer the 30-day treatment plan “in order to limit their liabilities.” The report noted that one major health insurance company promises to seek discipline against doctors who diagnose and treat ‘chronic’ Lyme disease.” The reluctance of health insurers to accept a diagnosis of chronic Lyme disease is understandable, as the ABC News report noted that treatment can cost as much as $70,000.
Many medical textbooks say that the lingering symptoms of an initial episode of Lyme disease are the result of something other than Lyme disease. And if it is, what is that “something”? Another Lyme disease season is upon us, and with continuing climate change it is very possible that the prevalence of this disease will increase. How long will the controversy continue? The Lyme and Tick-Borne Diseases Research Center at Columbia University Medical Center offers some more insight into the controversy.
Centers for Disease Control and Prevention
Hunterdon County, New Jersey
Minnesota Post, April 16, 2010
NewsObserver.com, May 10, 2010
North Carolina Department of Environmental and Natural Resources
Online Sentinel, May 5, 2010-05-10