What you should know….

Holly Ahern MS, BS MT(ASCP)

Associate Professor of Microbiology

SUNY Adirondack, Queensbury, NY

I say “LYME DISEASE,”

you say….

*Borreliaburgdorferi

Other Borrelia

Babesia

Bartonella

Ehrlichia

Anaplasma

Mycoplasma

Viruses

University of Rhode Island

Tick Encounter Resource Center

http://www.tickencounter.org/tick_testing

Lyme disease is an acute infectious disease, transmitted by nymph stage deer ticks, caused by one species of a

specific bacterium named Borreliaburgdorferi

“Hard to catch and easy to cure”

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.

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.

A single “FRONTAL” pathogen, Borreliaburgdorferi, 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

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 Borreliaburgdorferi 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 doesn’t meet a

threshold level

“Second-tier” test doesn’t have

enough “bands”

You were infected with more

than one microbe by the tick

Most infections resolve after short-term antibiotic treatment; 5% of patients may develop post-txsequelae 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

EASY to catch and HARD to cure!Ticks may transmit some pathogens RAPIDLYStudy 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 yearSymptoms are highly variable and may become CHRONICBlood tests for Lyme disease are reliably INACCURATE2-4 weeks of antibiotics MAY NOT cure Lyme disease

DiseaseNew 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

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