LEGISLATORS TICKED OFF ABOUT LYME DISEASE
Volume 28, Issue 496 July 23, 2007
Matthew Gever
Lawmakers around the country are looking for ways to bolster the fight against Lyme disease, just as new figures indicate that its incidence is increasing.
A new report from the Centers for Disease Control and Prevention (CDC) shows that the annual number of reported Lyme disease cases in the United States has more than doubled since 1991, when the disease first received a nationally recognized definition.
In 1991 and 1992, approximately 10,000 cases were reported each year to the CDC. By 2005, that number had risen to 23,000 cases nationally. “This increase in cases is most likely the result of both a true increase in the frequency of the disease, as well as better recognition and reporting due to enhanced detection of cases,” said Dr. Paul Mead of the CDC Division of Vector-Borne Infectious Diseases.
Of reported cases, 93 percent occurred in 10 states concentrated in the Northeast/Mid-Atlantic and Northern Plains regions (Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island and Wisconsin). These states have infections rates of 29.2 per 100,000 residents, compared to the national average of 7.85 per 100,000 residents. Rates were highest among children ages 5 to14 and adults ages 45 to 54.
Not surprisingly, legislators in New England have been especially active in trying to combat the disease. In Connecticut, lawmakers have introduced at least two bills intended to further prevention and treatment.
The first bill (HB 5747) would require laboratories to notify the Department of Public Health (DPH) of all cases of Lyme disease. Connecticut required mandatory reporting through 2002, but dropped this requirement in 2003. Since the requirement was dropped, the number of reported cases has decreased significantly. For example, in 2002, 4,631 cases of Lyme disease were reported in the state, whereas in 2005, that number was only 1,810, according DPH figures. This has lawmakers worried.
“Because of this lack of reporting, misleading statistics give the impression that Lyme cases are dropping in our state, when actually the opposite is true,” said Representative Jason Bartlett. “This not only prevents our state from receiving federal aid, but also prevents us from knowing if prevention methods are working.”
“Even worse, experts from the DPH and the CDC estimate that the actual reported cases comprise only 10 percent to 20 percent of the actual cases of Lyme disease,” said Representative William Tong, himself a former Lyme disease patient.
If HB 6701 is enacted, Connecticut will establish a state-wide task force to study methods for prevention and treatment. Rhode Island followed a similar path when it passed HB 5676 earlier in its most recent session, creating a seven-member commission that will produce a report for the legislature on all facets of the disease.
The Maine Legislature is requiring that insurance companies increase the resources devoted to treatment of the illness. “Insurance plans often do not cover Lyme disease, particularly the prolonged form, or (they) severely limit the length of treatment in an arbitrary manner,” said Representative Mark Bryant. To change that, the Legislature passed LD 1521, which requires insurers in the state to cover treatment of Lyme disease. The bill also requires employers in high-risk areas to provide educational materials to their employees. And it charges the Maine Center for Disease Control and Prevention with studying the incidence of the disease and the overall impact on the state and employers.
However, some challenge the necessity of prolonged treatment for Lyme disease. In September 2006, the Infectious Diseases Society of America issued treatment guidelines that discount the idea of Lyme disease existing in the long term and recommend against treating patients who still have symptoms after the recommended 2-4 week treatment period. Specifically, the guidelines state, “There is no convincing biologic evidence for the existence of symptomatic chronic B. burgdorferi infection among patients after receipt of recommended treatment regimens for Lyme disease. Antibiotic therapy has not proven to be useful and is not recommended for patients with chronic (>6 months) subjective symptoms after recommended treatment regimens for Lyme disease.”
Making a Federal Case out of It
As active as the states have been, there is hope that the federal government will help. The Maine Legislature passed HP 1318 and Vermont legislators introduced HR 15, resolutions that encourage the federal government to step up its role in prevention and treatment of the disease.
“The federal government has stood by and done little to help people infected with the disease, or educate the public,” said Representative Bryant. “The states are taking the steps they can but without the support of Congress, they cannot quell the rate of infection.”
The resolutions specifically reference S 1708, introduced by New York Senator Chuck Schumer, Connecticut Senator Chris Dodd and Nebraska Senator Chuck Hagel. The bill would create an advisory committee to develop new strategies to fight the disease, as well as appropriate $20 million per year over the next five years for research, treatment, education and prevention. “Lyme disease is a problem we’ve seen for decades, but we haven’t done nearly enough at the federal level to tackle it,” said Senator Schumer, a long-time proponent of Lyme disease awareness who contracted a case earlier this year while on a visit to upstate New York.
|
ABOUT LYME DISEASE
Lyme disease is caused by the bacterium B. burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful in the later stages of disease. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, landscaping and integrated pest management. The ticks that transmit Lyme disease can occasionally transmit other tick-borne diseases as well.
The above is taken from the CDC web page on Lyme disease, which can be found at http://www.cdc.gov/ncidod/dvbid/lyme/. |
SHN welcomes back Matthew Gever, who recovered from a case of Lyme disease contracted earlier this summer.
© Copyright 2007, State Health Notes
|
