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Lyme & Dementia Code ICD-11

The great take-away from the following article is that if there is NO CODE, there is NO RECOGNITION OF DISEASE.

http://dermagicexpress.blogspot.com/2018/04/the-lyme-disease-dementia-code-icd-11.html  By Dr. Jose Lapenta

THE LYME DISEASE AND THE DEMENTIA CODE ICD-11

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Hello friends of the network, in this new edition of the DERMAGIC EXPRESS I will continue with the “saga” on the subject of LYME DISEASE, in this case THE ICD-11 DEMENTIA CODE, that I imagine you are wondering what it means, and now I will always explain it to you.

ICD stands for INTERNATIONAL CLASSIFICATION OF DISEASES which was implemented by the World Health Organization (WHO), and is used by this entity to classify diseases according to their signs, symptoms, abnormal findings, complaints, social circumstances and external causes of a certain disease. This system is published by WHO and is used worldwide for morbidity and mortality statistics.

The number that follows, in this case the No 11 means the year in which the revision is made, in this case ICD 11 codes, means INTERNATIONAL CLASSIFICATION OF DISEASES for the year 2108, that is to say the present year.

The ICD 10 was the previous one, made between 1983 and 1993 with updates and there we found the CODES OF LYME DISEASE REVISION YEAR 2016 by the WHO under the number A69.2, link: http://apps.who.int/classifications /icd10/browse/2016/en#/A69.2

Where few entities are recognized in relation to this disease, including:

  • LYME DISEASE or ERYTYEMA MIGRANS: A69.2
  • BASAL, CEREBRAL AND SPINAL MENINGITIS due to lyme disease: A69.2 and G01
  • CHRONIC, ACUTE AND SUBACUTE ARTHRITIS: lyme disease: A69.2 and M01.2
  • PERIPHERAL POLINEUROPATHY due to lyme disease: A69.2 and G63.0

icd10

This is the only thing found on that page of the ICD-10 year 2016. And below I will show you the update that took place on October 1 of the year 2017

LYME disease as I have said in many opportunities and with a “MOUNTAIN” of BIBLIOGRAPHICS REFERENCES and which published under the name of: UNDERSTANDING LYME DISEASE, CLASSIFICATION AND CODES, in the DERMAGIC EXPRESS web site, was also published in the online magazine INVESTIGATIVE DERMATOLOGY AND VENEREOLOGY RESEARCH on January 12, 2018, link:  https://www.ommegaonline.org/article-details/UNDERSTANDING-THE-LYME-DISEASE-CLASSIFICATION-AND-CODES/1769

In this CLASSIFICATION AND CODES the majority of CONDITIONS, VARIANTS, and DIFFERENT CLINICAL MANIFESTATIONS of LYME DISEASE are mentioned, many of which HAVE NOT BEEN RECOGNIZED OR INCLUDED OR CODIFIED nowadays, and must be included by THE WORLD ORGANIZATION OF HEALTH(WHO) in the REVISION No 11, for this year 2018, for that reason as I mention it is called ICD-11, in a few words an update of the CODES, which will be applied GLOBALLY. I hope you have understood what I mean.

If there is no CODE (recognition) for the clinical entity, read DEMENTIA due to LYME disease, for example. There will be no recognition of it, it will not be taken into account within the possible causes of dementia, there will be no treatment guidelines available for this pathology GLOBALLY and cases will increase. Now do you get it?

Then you will be asking why I chose DEMENTIA as a clinical manifestation of the LATE OR TERTIARY STAGE OF LYME DISEASE, of which I bring you more EVIDENCE, that this is true.

To begin the subject, remember that the BORRELIA is a SPIROCHETE, like the SYPHILIS, which has the same STAGES in its CLINICAL manifestations: LATENT, CONGENITAL, PRIMARY, SECONDARY AND TERTIARY OR LATE.

THE SYPHILIS, produced by the causal agent TREPONEMA PALLIDUM (ESPIROCHETE), is an ancestral disease, whose descriptions date from the HOLY BIBLE, chapter of the GENESIS, discovered by Fritz Schaudin and Erlich Hoffmann in the year 1905, in the year 1910 the German German Paul Erlich discovered the Salvarsan an arsenic derivative as the first treatment for this disease and won the Nobel prize for It. In 1928 appeared the “immortal” PENICILIIN discovered by ALEXANDER FLEMING and put into practice in the 40’s against this plague. Today, other antibiotics are used, such as Doxycycline, Clindamycin, Tetracyclines, and Ceftriaxone.

The LYME DISEASE or ERYTHEMA MIGRANS is also probably of ancestral origin because in the HOLY BIBLE also in the book EXODUS, the TICKS are mentioned as plague, which in the case of this disease is the transmitting VECTOR. Also described since ancient times and known in the town of LYME, Connecticut as JUVENILE LYME ARTHRITIS, and first described in 1764 by the Reverend John Walker on the island of Jura (Island of deer). It was in the year 1981-1982 that the scientist Willy Burgdorfer discovers the causal agent, this being the FEARED ESPIROCHETE BORRELIA BURGDORFERI (in honor of its discoverer).

Why am I telling you this story? because between these two diseases there are GREAT SIMILARITIES, and some DIFFERENCES.

SIMILARITIES AND DIFFERENCES BETWEEN SYPHILIS AND LYME:
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  1. Both causative agents are ESPIROCHETES: TREPONEMA PALLIDUM (SYPHILIS), BORRELIA BURGDORFERI (ERYTHEMA MIGRANS OR LYME DISEASE)
  2. Both have the same stages: CONGENITAL, LATENT, PRIMARY, SECONDARY, TERTIARY OR LATE. (NEUROSYPHILIS, NEUROBORRELIOSIS)
  3. SYPHILIS is transmitted by sexual contact, SEMINAL fluid and blood transfusions. LYME DISEASE IS ALSO ASSOCIATED WITH SEXUAL TRANSMISSION and FLUIDS in recent studies, a fact that some scientists deny but there is EVIDENT PROOF that this event is true.
  4. Both ESPIROCHETES have been detected by simple optical microscopy: SYPHILIS (dark field), BORRELIA BURGDORFERI (blue staining), and both have been found in skin lesions: SYPHILIS (SYPHILITIC CHANCRE), BORRELIA (LYMPHOCYTOMA by BORRELIA).
  5. The causal agent of SYPHILIS is only one: THE TREPONEMA PALLIDUM, in the case of LYME DISEASE there are more than 50 species described, and more than 25 species for RECURRENT FEVER by Borrelia, having been shown susceptibility to some antibiotics according to the GEOGRAPHICAL SPECIES AND DISTRIBUTION, which complicates further the treatment of the latter.
  6. Both diseases when administered an EFFECTIVE TREATMENT can present patients the reaction of JARISCH-HERXHEIMER, produced by the death of the ESPIROCHETES and the release into the bloodstream of their toxins, being the main symptoms: fever, chills, hypotension, headache, tachycardia, reddening of the skin, pruritus (itching) and muscle pain. It is usually not fatal and not all patients manifest it.
  7. Both diseases respond to the same antibiotics: in SYPHILIS, even after years, TREPONEMA PALLIDUM remains sensitive to BENZYLPENICILLIN. In the case of BORRELIA BURGDORFERI there is resistance to PENICILLIN and many of the antibiotics, perhaps most of the discoveries that can eliminate it.  This is one of the points of conflict today with LYME DISEASE, resistance to antibiotic therapy even in the long term with subsequent multi organ involvement due to the survival of THE BORRELIA and its subsequent colonization of many organs inlcuded the BRAIN, and produce neurological manifestations, including DEMENTIA. The SYPHILIS can also reach the BRAIN in the late stage when it is not treated, producing DEMENTIA among its manifestations.
  8. Both SPIROCHETES: TREPONEMA PALLIDUM (SYPHILIS) and BORRELIA BURGDORFERI (LYME-ERYTHEMA MIGRANS DISEASE) have been detected in the CEREBROSPINAL FLUID and in the BRAIN.
  9. Both diseases are of WORLD DISTRIBUTION, the LYME disease that was believed to exist only in NORTH AMERICA, EUROPE, ASIA AND AFRICA, has also been described in THE SOUTHERN HEMISPHERE.
  10. Both diseases in their LATE STAGE: NEUROSYPHILIS AND NEUROBORRELIOSIS have produced brain illness: DEMENTIA and mimic ALZHEIMER DISEASE in other cases.
  11. Both ESPIROCHETES are detected by SEROLOGICAL TESTS, in the case of SYPHILIS, the known VDRL and FTA-ABS with more than 95% effectiveness, in the case of LYME, the situation is more difficult: the CDC (Center for Disease Control and Prevention) only two TESTs have been approved for this disease: IEA (enzyme immunoassay), but rarely IFA (indirect immunofluorescence), and if these are negative: WESTERN BLOT (IgG and IgM). The percentage of EFFECTIVENESS of these is highly questioned today because in many cases the result is NEGATIVE in both, and if the patient does not have money to perform a more effective PARTICULAR examination, he/she WILL NOT HAVE TREATMENT, the disease will progress over the years to multi organic condition included DEMENTIA.

Now I am going to place the manifestations of the LATE STAGE OF THE SYPHILIS, called NEUROSYPHILIS, so you can see that they are practically the same as the NEUROBORRELIOSIS:

These effects occur in a period ranging from 5 to 20 years after the patient has been infected, and they do not receive treatment.

In the case of LYME DISEASE, the period is the same, and two aspects are included: the ABSENCE of treatment, or INEFFECTIVE treatment even for years. Unlike SYPHILIS, borrelia becomes resistant for YEARS and then colonizes the brain, causing practically the same effects of NEUROSYPHILIS, nowadays called NEUROBORRELIOSIS, and within these is DEMENTIA.

SYMPTOMS OF LATE SYPHILIS OR NEUROSYPHILIS:
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1.) Abnormal reflexes
2.) Muscle atrophy
3.) Muscle contractions
4.) Abnormal gait
5.) Blindness
6.) Confusion, disorientation
7.) Sudden personality changes
8.) Changes in mental stability
9.) Dementia
10.) Depression
11.) Headache
12.) Fecal and urinary incontinence
13.) Irritability
14.) Memory problems
15.) Mood disturbances
16.) Numbness in the toes, feet, or legs
17.) Muscle weakness
18.) Poor concentration
19.) Psychosis[5]
20.) Seizures
21.) Neck stiffness
22.)Tremors
23.) Visual disturbances: ARGYLL ROBERTON PUPILS
24.) ALZHEIMER DISEASE LIKE (MIMIC)

NEUROSYPHILIS can also be presented ASYMPOMATIC, MENINGOVASCULAR, GENERAL PARESIA OR TABES DORSALIS.

Except for a few, most of these manifestations of NEUROSYPHILIS, also produced by NEUROBORRELIOSIS.

To not make it so long the ICD (INTERNATIONAL CLASSIFICATION OF DISEASES) was born in the years 1890 with the purpose of grouping and classifying the causes of death by the different diseases in the world. Later in 1983, the French doctor Jacques Bertillon, introduced the Classification of Causes of Death of Bertillon in a congress of the International Statistical Institute in Chicago.

In 1900 the first international conference was held to review the International Classification of Causes of Death, with reviews that take place every ten years. By then, the classification included an alphabetical index and a tabular list.

In 1948 the World Health Organization assumed the revisions and the ICD term was adopted officially when the first sixth (6) revisions had been made, and I propose the revision seventh ICD-7 that was carried out in Paris in February of 1955, where the SYPHLIS APPEARS IN THE LIST UNDER THE FOLLOWING CODES: (NEUROSYPHILIS DOES NOT APPEAR OR DEMENTIA BY SYPHILIS, Appear the term “Insane”)

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ICD-7 PARIS FEBRUARY 1955 CODES FOR THE SYPHILIS
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(020-029) Syphilis and its sequelae
020 Congenital syphilis
021 Early syphilis
022 Aneurysm of aorta
023 Other cardiovascular syphilis
024 Tabes dorsalis
025 General paralysis of insane
026 Other syphilis of central nervous system
027 Other forms of late syphilis
028 Latent syphilis
029 Syphilis, unqualified
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10 years later the World Health Organization met in Geneva in July 1965 for the eighth ICD-8 revision of the classification and codes. APPEARS THE SYPHILIS, AND THE AFFECTION OF THE CENTRAL NERVOUS SYSTEM, BUT NOT THE CODE DEMENTIA BY SYPHILIS, neither the JUVENILE ARTHRITIS OF LYME, nor the CODE LYME, because said disease as such, its causal agent as I said a thousand times was discovered in 1981 by Willy Burgdorfer, and Lyme Juvenile Arthritis was first described in 1975.

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ICD-8 WORLD HEALTH ORGANIZATION in Geneva, July 6 to 12, 1965 ========================================================================
(090-099) Syphilis and other venereal diseases
090 Congenital syphilis
091 Early syphilis, symptomatic
092 Early syphilis, latent
093 Cardiovascular syphilis
094 Syphilis of central nervous system
095 Other forms of late syphilis, with symptoms
096 Late syphilis, latent
097 Other syphilis and not specified
==================================================================

The ninth revision of the ICD-9 CODES was made 10 years later in Geneva from September 30 to October 5, year 1975, and for the first time the term LYME appears under the code 088.81 WITH THE NAME OF LYME DISEASE OR ERYTHEMA CHRONICUM MIGRANS.

The JUVENILE PARALYTIC DEMENTIA CODE and NEUROSYPHILIS appears for the first time in the list due to SYPHILIS under code 0.90.40

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ICD-9 YEAR 1975 GENEVA SEPTEMBER 30 TO OCTOBER 5 1975 LYME AND SYPHILIS CODES
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088.81 Lyme disease
Erythema chronicum migrans

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090.40 Juvenile neurosyphilis, unspecified
Congenital neurosyphilis
Juvenile paralytic dementia
Youth:
general paresis
tabes
taboparesis
094.8 Other specified neurosyphilis
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The World Health Organization did not wait 10 years for the next revision and in 1983 began the tenth revision ICD-10, and took more time to complete it: year 1989-1993 with periodic updates between which highlight years 2010 and 2016 and 2017, Planning the 11th ICD-11 revision for the current year 2018. In this list, DEMENTIA BY SYPHILIS APPEARS with code A52.1+ for PARALYTIC DEMENTIA and A50.4 for JUVENILE PARALYTIC DEMENTIA due to SYPHILIS and all the clinical manifestations reported for this disease appear in the list.

The opposite occurred with the LYME DISEASE, which was already codified in the ICD-9 and that for 1993 and beyond 2016 almost ALL of its CLINICAL manifestations were already DESCRIBED as it is published in THE LYME CODES mentioned above. For the Update of 2016 and 2017 ICD- CODES the term LYME appears in the list in this way:

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ICD-10 years 1983-1993 WITH UPDATES 2010-2016 for LYME DISEASE
==================================================================

Lyme disease or erythema migrans: A69.2
Basal, cerebral ans spinal meninitis due to lyme disease: A69.2 and G01 
Chronic, acute and subacute arthritis: lyme disease: A69.2 and M01.2 
Peripheral Polineuropathy due to lyme disease: A69.2 and G63.0 

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ICD-10 OCTOBER 1, YEAR 2017 LYME DISEASE CODES UPDATE
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Source: http://www.icd10data.com/search?s=lyme

Lyme disease: Code A69.2

Relapsing fevers: Code A68
Lyme disease (A69.2-); recurrent fever

Arthritis due to Lyme disease: Code A69.23
– Lyme arthritis

Meningitis due to Lyme disease: Code A69.21
– Meningitis in lyme disease

Other conditions associated with Lyme disease: Code A69.29:
– Lyme myopericarditis; Myopericarditis due to lyme disease; Myopericarditis due to Lyme disease

Other neurologic disorders in Lyme disease: Code A69.22:
– Cranial neuritis due to lyme disease; Lyme cranial neuritis; Lyme meningoencephalitis; Lyme polyneuropathy; Meningoencephalitis due to lyme disease; Polyneuropathy due to lyme disease; Cranial neuritis; Meningoencephalitis; Polyneuropathy

Lyme disease, unspecified: Code A69.20:
– Acute lyme disease; Erythema chronica migrans; Erythema chronicum migrans (skin condition); Lyme disease.

Arthropathy in Lyme disease: Code A69.23

Immunity to lyme disease by positive serology; Immunity to lyme disease, positive serology: Code: R76.8

History of lyme disease: Code Z86.19
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As you may notice some of the “many of the clinical manifestations” recognized and published by the scientific society worldwide were INCLUDED in the ICD-10 and its updates, but also many others have not been included, among them the DEMENTIA by LYME DISEASE, SEXUAL TRANSMISSION, and CONGENITAL LYME (TRANSLPLACENTAL TRANSMISSION) taking into account that for the 80’s, 90’s and 2,000’s, there was already scientific evidence of these facts including the BRAIN affectation with neurological manifestations (DEMENTIA) and illness similar to ALZHEIMER’S.

It is for this year 2018 when the World Health Organization (WHO) publishes a “Beta Draft” where the DEMENTIA TERMS due to LYME DISEASE and NEUROBORRELIOSIS, CONGENITAL LYME BORRELIOSIS, LYME CARDITIS and others are finally included. (See photo) link:  https://icd.who.int/dev11/f/en#http%3a%2f%2fid.who.int%2ficd%2fentity%2f218492135

The growing worldwide increase in cases of LYME DISEASE, and its clinical manifestations that have led patients to even “wheelchairs” has awakened in society a “fight” for the TOTAL CLASSIFICATION AND CODES of this disease that will be included in this year’s list.

The simple question here is the following: why is SYPHILIS and its DEMENTIA CODE and the entire spectrum of the disease included in the list but LYME DISEASE does not? For the year 2017 when I repeat there is a “MOUNTAIN like the EVEREST” of scientific publications worldwide, on DEMENTIA, SEXUAL TRANSMISSION, CONGENITAL LYME, AND ASSOCIATION WITH ALZHEIMER’S DISEASE, AND OTHERS MORE ??? And nowadays, the year 2018 is when these CODES come to appear in a “beta draft”?

Almost more than 20 years have passed since these affectations were described scientifically due to LYME: CARDITIS, NEUROBORRELIOSIS, DEMENTIA, CONGENITAL DISEASE, TRANSPLACENTAL and SEXUAL TRANSMISSION and many more.

According to some experts in the field do not want to recognize these CODES because the treatments are long-term and INSURANCE COMPANIES do not want to know anything about this, because the costs of treatment would increase their expenses, so that the word “LYME” has been become a kind of generalized fear, there are even cases of persecuted doctors and removed their licenses for this cause.

Other scientists affirm: SYPHILIS with 3 doses of BENZYLPENICILIN or known antibiotics for 21-28 days heal the patient, and a simple VDRL or FTA-ABS (serological tests) make the diagnosis. In the case of LYME, the situation is more complicated due to RESISTANCE to antibiotics and the ability of BORRELIA to evade DIAGNOSTIC tests. But the CDC says that the two tests I mentioned are enough. Nothing could be more wrong!

Do you want my opinion? As always I will give it to you: Regardless of the causes, the fights between IDSA and ILADS, and CDC, The World Health Organization (WHO) MUST END AND THEY MUST RECOGNIZE THESE CODES, because they can no longer “cover the sun with a finger” – the evidence is too big.

CONCLUSIONS:
=============

“Beta draft” means NOT APPROVED by the WHO, I repeat NOT STILL APPROVED !

The term DEMENTIA by Lyme finally appeared in the “beta draft” of the ICD-11
The term CONGENITA LYME finally appeared in the “beta draft” of the ICD-11
The term NEUROBORRELIOSIS finally appeared in the “beta draft” of the ICD-11
The term SEXUAL TRANSMISSION due to Lyme does not exist in the previous ICDs or in the “beta draft” of the ICD-11

There I leave you more BIBLIOGRAPHIC REFERENCES that prove SCIENTIFICALLY that the BORRELIA BURGDORFERI ESPIROCHETE (LYME) as well as the ESPIROCHETE TREPONEMA PALLIDUM (SIFILIS), can colonize the BRAIN in its LATE STAGE and produce DEMENTIA in those affected and that must be included in the ICD -11 of the year 2.018, as well as many others.We can not wish for more, let this be true and fullfilled.

I am in the SOUTHERN HEMISPHERE, but I am part of the Ad Hoc committee of the ICD-11 as an expert reviewer. End of story.

Greetings to all

Dr. José Lapenta Dermatologist
Dr. José Lapenta Md. (Coworker)

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BIBLIOGRAPHICAL REFERENCES
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23.) Unraveling Diagnostic Uncertainty Surrounding Lyme Disease in Children with Neuropsychiatric Illness. Child Adolesc Psychiatr Clin N Am. 2018 Jan;27(1):27-36. doi: 10.1016/j.chc.2017.08.010. Epub 2017 Oct 21. [PUBMED] . Koster MP1, Garro A2.

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25.) Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Int J Neuropsychopharmacol. 2001 Jun;4(2):191-8. [PUBMED]. Leonard HL1, Swedo SE.

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27.) Psychological states and neuropsychological performances in chronic Lyme disease. Appl Neuropsychol. 1999;6(1):19-26. [PUBMED]. Elkins LE1, Pollina DA, Scheffer SR, Krupp LB.

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29.) Dramatic response to a 3-week course of ceftriaxone in late neuroborreliosis mimicking atypical dementia and normal pressure hydrocephalus. J Neurol Sci. 2016 Jul 15;366:146-148. doi: 10.1016/j.jns.2016.05.002. Epub 2016 May 4. [PUBMED]. Topakian R1, Artemian H2, Metschitzer B3, Lugmayr H4, Kühr T5, Pischinger B6.

30.) Transient worsening of optic neuropathy as a sequela of the Jarisch-Herxheimer reaction in the treatment of Lyme disease. J Neuroophthalmol. 1994 Jun;14(2):77-80. [PUBMED] Strominger MB1, Slamovits TL, Herskovitz S, Lipton RB.

31.) Delayed onset of the Jarisch-Herxheimer reaction in doxycycline-treated disease: a case report and review of its histopathology and implications for pathogenesis. Am J Dermatopathol. 2015 Jun;37(6):e68-74. doi: 10.1097/DAD.0000000000000093. [PUBMED] Kadam P1, Gregory NA, Zelger B, Carlson JA.

32.) Lyme disease complicated by the Jarisch-Herxheimer reaction. J Emerg Med. 1998 May-Jun;16(3):437-8.[PUBMED] Maloy AL1, Black RD, Segurola RJ Jr.

33.) Serological Evidence of Borrelia Burgdorferi Infection in Mexican Patients with Facial Palsy. Rev Invest Clin. 2017 Nov-Dec;69(6):344-348. doi: 10.24875/RIC.17002344. [PUBMED] Gordillo-Pérez G1, García-Juárez I1, Solórzano-Santos F2, Corrales-Zúñiga L3, Muñoz-Hernández O2, Torres-López J1.

34.) A simple method for the detection of live Borrelia spirochaetes in human blood using classical microscopy techniques. Morten Motzfeldt Laane, Ivar Mysterud. Published 2013. Semantic Sholar. Source: https://www.semanticscholar.org/paper/A-simple-method-for-the-detection-of-live-Borrelia-Laane-Mysterud/4f6251e40f196b094905d84e87b8b6fe8d1d1636

35.) Lyme disease: cause of a treatable peripheral neuropathy. Neurology. 1987;37(11):1700-6. [PubMed] Halperin JJ, Little BW, Coyle PK, Dattwyler RJ.

36.) Retrobulbar optic neuritis: a complication of Lyme disease? J Neurol Neurosurg Psychiatry. 2007;78(12): 1409–1410. doi: 10.1136/jnnp.2006.113761. [PubMed Central] Krim E, Guehl D, Burbaud P, and LaguenyA.

37.) Unusual manifestations of nervous system Borrelia burgdorferi infection. Arch Neurol. 1987;44(7):781-3. [PubMed] Midgard R, Hofstad H.

38.) Optic neuropathy in children with Lyme disease. Pediatrics. 200;108(2):477-81. [PubMed] Rothermel H, Hedges TR 3rd, Steere AC.

39.) Optic nerve involvement in Lyme disease. Curr Opin Ophthalmol. 2012;23(6):485-90. doi:10.1097/ICU.0b013e328358b1eb. (Pubmed) Träisk F, Lindquist L.

40.) Lyme disease –induced polyradiculopathy mimicking amyotrophic lateral sclerosis. Inter J of Neuroscience. 2014;124(11):859–862. doi:10.3109/00207454.2013.879582. [PubMed] Burakgazi AZ.

41.) Late Diagnosis of Early Disseminated Lyme Disease: Perplexing Symptoms in a Gardener, J Am Board Fam Med May-June 2008 vol. 21 no. 3 234-236 [PubMed] doi: 10.3122/jabfm.2008.03.070196 Brooke E. Salzman, MD, Amber Stonehouse, MD and James Studdiford, MD

42.) Borrelia arthritis and chronic myositis accompanied by typical chronic dermatitis. JBR-BTR. 2008;91(3):88-9. [PubMed] Brtkova J, Jirickova P, Kapla J, Dedic K, Pliskova L.

43.) Tick inoculation in an eyelid region: report on five cases with one complication of the orbital myositis associated with Lyme borreliosis. Klin Oczna. 2006;108(4-6):220-4. [PubMed] Holak H, Holak N, Huzarska M, Holak S.

44.) [Ocular manifestations of Lyme borreliosis in northwest Croatia]. Lijec Vjesn. 2004;126(5-6):124-8. [Article in Croatian] [PubMed] Golubic D, Vinkovic T, Turk D, Hranilovic J, Slugan I.

45.) Ocular Lyme borreliosis. Am J Ophthalmol. 1989;15;108(6):651-7. [PubMed] Winward KE, Smith JL, Culbertson WW, Paris-Hamelin A.

46.) Early disseminated Lyme disease: Lyme meningitis. Am J Med. 1995 Apr 24;98(4A):30S-37S; discussion 37S-43S. [PubMed] Pachner AR.

47.) Neurologic manifestations in children with Lyme disease. Pediatrics. 1995;96:1053-1056. [PubMed] Bingham PM, Galetta SL, Athreya B, Sladky J.

48.) Lyme disease: cause of a treatable peripheral neuropathy. Neurology. 1987;37(11):1700-6. [PubMed] Halperin JJ, Little BW, Coyle PK, Dattwyler RJ.

49.) Neuroborreliosis-associated cerebral vasculitis: long-term outcome and health-related quality of life. J Neurol. 2013 Jun;260(6):1569-75. doi: 10.1007/s00415-013-6831-4. [PubMed] Back T1, Grünig S, Winter Y, Bodechtel U, Guthke K, Khati D, von Kummer R.

50.) Cerebral vasculitis as the only manifestation of Borrelia burgdorferi infection in a 17-year-old patient with basal ganglia infarction. Eur Neurol. 2003;50:109–12. [PubMed] Heinrich A, Khaw AV, Ahrens N, Kirsch M, Dressel A.

51.) Borrelia rhombencephalomyelopathy. Arch Neurol. 1991;48:832–6. [PubMed] Kuntzer T, Bogousslavsky J, Miklossy J, Steck AJ, Janzer R, Regli F.

52.) Large cerebral vessel occlusive disease in Lyme neuroborreliosis. Neuropediatrics. 2002;33:37–40. [PubMed] Klingebiel R, Benndorf G, Schmitt M, von Moers A, Lehmann R.

53.) Systemic, secondary and infectious causes for cerebral vasculitis: clinical experience with 16 new European cases. Rheumatology International. 2009;30(11):1471-1476. doi:10.1007/s00296-009-1172-4. [PubMed] Kraemer M, Berlit P.

54.) Basal meningovasculitis and occlusion of the basilar artery in two cases of Borrelia burgdorferi infection. Neurology. 1988;38:1317–9. [PubMed] Veenendaal-Hilbers JA, Perquin WV, Hoogland PH, Doornbos L.

55.) Lyme-associated parkinsonism: a neuropathologic case study and review of the literature. Arch Pathol Lab Med. 2003;127(9):1204-6. [PubMed] Cassarino DS, Quezado MM, Ghatak NR, Duray PH.

56.) Genetics Underlying Atypical Parkinsonism and Related Neurodegenerative Disorders. Jellinger KA, ed. International Journal of Molecular Sciences. 2015;16(10):24629-24655. doi:10.3390/ijms161024629 [PubMed] Scholz SW, Bras J.

57.) Neuroborreliosis Presenting as Acute Disseminated Encephalomyelitis. Pediatric Emergency Care. 2012;28(12):1374-1376. doi:10.1097/pec.0b013e318276c51d. [PubMed] Rocha R, Lisboa L, Neves J, García López M, Santos E, Ribeiro A.

58.) [Chronic neuroborreliosis with gait ataxia and cognitive disorders]. [in German]. Praxis (Bern 1994). 1997;86(20):867-9. [PubMed] Pennekamp A, Jaques M.

59.) Central nervous system manifestations of Lyme disease. Arch Neurol. 1989;46:790–5. [PubMed] Pachner AR, Duray P, Steere AC.

60.) [Meningoencephalomyelitis caused by Borrelia burgdorferi: a case without epidemiologic history or chronic migratory erythema]. [in Spanish]. Med Clin (Barc). 1989;93:218–20. [PubMed] Ponz E, Graus F, Alvarez R, Sarmiento X, Vidal J, Grau JM.

61.) Alzheimers disease: A novel hypothesis integrating spirochetes, biofilm, and the immune system. Journal of Neuroinfectious Diseases. 2016;07(01). doi:10.4172/2314-7326.1000200.[https://www.researchgate.net/publication/294089000_Alzheimer’s_Disease_A_Novel_Hypothesis_Integrating_Spirochetes_Biofilm_and_the_Immune_System]Allen HB, Morales D.
62.) [Mental disorders in the course of lyme borreliosis and tick borne encephalitis] [in Polish]. Przeglad epidemiologiczny. 2002;56:37–50. [PubMed] Juchnowicz D, Rudnik I, Czernikiewicz A, Zajkowska J, Pancewicz SA.

63.) ) Multiple neurologic manifestations of Borrelia burgdorferi infection. Rev Neurol. 1988;144:765–75. [PubMed] Dupuis MJ.

64.) Concurrent neocortical borreliosis and Alzheimer’s disease. Human Pathology. 1987;18(7):759-761. doi:10.1016/s0046-8177(87)80252-6. [PubMed] MacDonald A, Miranda J.

65.) The underdiagnosis of neuropsychiatric lyme disease in children and adults. Psychiatric Clinics of North America. 1998;21(3):693-703. doi:10.1016/s0193-953x(05)70032-0. [PubMed] Fallon B, Kochevar J, Gaito A, Nields J.

66.) Distinguishing Lyme from septic knee monoarthritis in Lyme disease-endemic areas. Pediatrics. 2013;131(3):e695-701. doi:10.1542/peds.2012-2531. [PubMed] Deanehan JK, Kimia AA, Tan Tanny SP, et al.

67.) Temporomandibular joint involvement caused by Borrelia Burgdorferi. J Cranio-Maxillo-fac Surg Off Publ Eur Assoc Cranio-Maxillo-fac Surg. 2007;35(8):397-400. doi:10.1016/j.jcms.2007.06.003. [PubMed] Lesnicar G, Zerdoner D.

68.) Diagnosis and clinical characteristics of ocular Lyme borreliosis. Am J Ophthalmol. 1995;119(2):127-135. [PubMed] Karma A, Seppälä I, Mikkilä H, Kaakkola S, Viljanen M, Tarkkanen A.

69.) [Ocular manifestations of Lyme borreliosis in northwest Croatia]. [in Croatian]. Lijec Vjesn. 2004;126(5-6):124-128. [PubMed] Golubic D, Vinkovic T, Turk D, Hranilovic J, Slugan I.

70.) Borrelia burgdorferi in a newborn despite oral penicillin for Lyme borreliosis during pregnancy. The Pediatric Infectious Disease Journal. 1988;7(4):286–288. doi:10.1097/00006454-198804000-00010. [PubMed] Weber K1, Bratzke HJ, Neubert U, Wilske B, Duray PH.

71.) Coronary aneurysm in Lyme disease: Treatment by covered stent. International Journal of Cardiology. 2008;128(2):e72–e73. doi:10.1016/j.ijcard.2007.04.163. [PubMed] Cuisset T, Hamilos M, Vanderheyden M.

72.) Coronary artery aneurysm in two patients with long-standing Lyme borreliosis. The Lancet. 1994;344(8932):1300-1301. doi:10.1016/s0140-6736(94)90789-7. [PubMed] Gasser R, Watzinger N, Eber B et al.

73.) Presence of Borrelia burgdorferi sensu lato antibodies in the serum of patients with abdominal aortic aneurysms. Eur J Clin Microbiol Infect Dis. 2012 May;31(5):781-9. doi: 10.1007/s10096-011-1375-y. Epub 2011 Aug 13. [PubMed] Hinterseher I1, Gäbel G, Corvinus F, Lück C, Saeger HD, Bergert H, Tromp G, Kuivaniemi H.

74.) Peroperative cardiogenic shock suggesting acute coronary syndrome as initial manifestation of Lyme carditis. J Clin Anesth. 2016 Dec;35:430-433. doi: 10.1016/j.jclinane.2016.08.005. Epub 2016 Oct 18. [PubMed] Clinckaert C, Bidgoli S, Verbeet T, Attou R, Gottignies P, Massaut J, Reper P.

75.) [Complete atrioventricular block as the first clinical manifestation of a tick bite (Lyme disease)] [in Italian]. Giornale italiano di cardiologia (2006). 2011;12(3):214–6. [PubMed] Bacino L, Gazzarata M, Siri G, Cordone S, Bellotti P.

76.) Peroperative cardiogenic shock suggesting acute coronary syndrome as initial manifestation of Lyme carditis. Journal of Clinical Anesthesia. 2016;35:430–433. doi:10.1016/j.jclinane.2016.08.005. [PubMed] Clinckaert C, Bidgoli S, Verbeet T, et al.

77.) [The Lyme carditis as a rare differential diagnosis to an anterior myocardial infarction] [in German]. Zeitschrift für Kardiologie. 2002;91(12):1053–1060. doi:10.1007/s00392-002-0873-4. [PubMed] Dernedde S, Piper C, Kühl U, et al.

78.) [Reversible complete heart block by re-infection with Borrelia burgdorferi with negative IgM-antibodies] [in German]. Deutsche medizinische Wochenschrift (1946). 2008;134:23–6. [PubMed]Guenther F, Bode C, Faber T.

79.) Lyme carditis: restitutio ad integrum documented by cardiac magnetic resonance imaging. Cardiology in Review. 2004;12(4):185-187. doi:10.1097/01.crd.0000123841.02777.5d. [PubMed] Karadag B, Spieker L, Schwitter J et al.

80.) Manifestations of Lyme carditis. International Journal of Cardiology. 2017;232:24-32. doi:10.1016/j.ijcard.2016.12.169. [PubMed] Kostic T, Momcilovic S, Perišic Z et al.

81.) Understandig the Lyme disease Classification and codes. Investigative Dermatology and Venereology Research. Review. Publish Date : 2018-01-12. dr. Jose Lapenta. Dr. Jose Lapenta.https://doi.org/10.15436/2381-0858.18.1769. Source:
https://www.ommegaonline.org/article-details/UNDERSTANDING-THE-LYME-DISEASE-CLASSIFICATION-AND-CODES/1769

82.) History of the development of the ICD.doc source: http://www.who.int/classifications/icd/en/HistoryOfICD.pdf

83.) International Classification of Diseases, Revision 8 (1965) Source:
http://www.wolfbane.com/icd/icd8.htm

84.) Online ICD9/ICD9CM codes. Source: http://icd9.chrisendres.com/

85.) ICD-10 Version 2.016. Source:
http://apps.who.int/classifications/icd10/browse/2016/en#/IX

86.) 2018 New ICD-10-CM Codes. Source:
http://www.icd10data.com/ICD10CM/Codes/Changes/New_Codes

87.) Information from World Health Organization (WHO): List of Official ICD-10 Updates. For the ICD-11 revision: The ICD 11th Revision is due by 2017 (Archived, Feb. 2014); ICD Revision Timelines and ICD-11 Beta Draft (online beta-version of ICD-11). Source:
https://icd.who.int/dev11/l-m/en

88.) Wikipedia.org: International Statistical Classification of Diseases and Related Health Problems. Source: https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems

89.) LYME DISEASE TRANSPLACENTAL TRANSMISSION AND FETAL DAMAGE. Dr Jose Lapenta. February 25,2.018. Source:
http://dermagicexpress.blogspot.com/2018/02/lyme-disease-transplacental.html

90.) LYME DISEASE, SEXUAL TRANSMISSION AND ARRIVAL TO THE SOUTHERN HEMISPHERE. Dr. Jose Lapenta. February 5,2.018. Source:
http://dermagicexpress.blogspot.com/2018/02/lyme-disease-sexual-transmission-and.html

91.) LYME, LEPROSY AND SYPHILIS, THE MISSING LINKS. Dr. Jose Lapenta. January 22, 2.018. Source:
http://dermagicexpress.blogspot.com/2018/01/lyme-leprosy-and-syphilis-missing-link.html

92.) UNDERSTANDIG THE LYME DISEASE, CLASSIFICATION AND CODES II. Dr. Jose Lapenta. December 28, 2.017. Source:
http://dermagicexpress.blogspot.com/2017/12/understandig-lyme-disease-codes-and.html

93.) THE LYME DISEASE, DEMENTIA AND ALZHEIMER. Dr. Jose Lapenta. May 7, 2017. Source:
http://dermagicexpress.blogspot.com/2017/05/the-lyme-disease-approach-to-effective.html

94.) Centers for Disease Control and Prevention. Two step Laboratoring Process. Source:
https://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/index.html

95.) Madison Area Lyme Support Group. Source:
https://madisonarealymesupportgroup.com/

96.) International Classification of Diseases, Revision 7 (1955) Source:
http://www.wolfbane.com/icd/icd7.htm

 

 

 

Category:

Uncategorized

You’re Not Crazy – You Have Lyme

MyLymeLife_2-62

By Jennifer Crystal

I knew there was something physically wrong with me, but when my blood work came back clean and I didn’t fit into any classic diagnostic box, the nurses decided the symptoms were psychosomatic.

When I first got sick during my sophomore year in college, the nurses at the health center ran the typical “college” tests: mono, strep, pregnancy. The results were negative, so they told me that my fever, low blood sugar reactions, flu-like aches, exhaustion, and pounding headaches were a result of stress. I rested as much as I could, tried meditation and deep-breathing techniques, and dragged myself to class. When my symptoms persisted, I returned to the health center. The nurses told me I was just run down.

But I’d been taking care of myself since that first visit. I was eating better and sleeping more than I had during my freshman year, when I’d stayed up late partying and subsisted primarily on pizza and beer, and yet had still been perfectly healthy. I did burn the candle at both ends, but sophomore year I couldn’t have done so had I wished. I was too tired to do any of my usual activities like running, skiing, and participating on committees. I knew there was something physically wrong with me, but when my blood work came back clean and I didn’t fit into any classic diagnostic box, the nurses decided the symptoms were psychosomatic.

“Maybe you should see someone in counseling about all of this,” one of them said.

At the impressionable age of nineteen, I worried the nurse was right; maybe these symptoms were all in my head.

Ironically, they were in my head, but not as a result of hypochondria or any mental illness. Tick-borne bacteria and parasites were attacking both my body and brain. There were real spirochetes in my head, not psychiatric illnesses. My fevers, body aches, and hypoglycemia were caused by Lyme disease, and two of its co-infections Babesia, and Ehrlichia. But it would be another eight years before a Lyme-Literate Medical Doctor would figure all of that out, and by that time, I would have been told “it’s all in your head” by more people than I can count.

Unfortunately, my plight is all too familiar to patients of late-stage Lyme disease complicated by co-infections. At some point in their journey to recovery, many have been told that they’re crazy, too. And not just by medical practitioners. Sick patients, needing only support and care, also heard this message from family members, friends and co-workers. So common is this write-off of those suffering from unknown ailments that there’s an entire chapter in Denise Lang and Dr. Kenneth Liegner’s book Coping With Lyme Disease titled “I’m Not Crazy, I Have Lyme!” When I first read that chapter after being accurately diagnosed with tick-borne diseases, I wept. I knew exactly what it felt like to be so misunderstood.

I also knew exactly what it meant to feel “crazy” from Lyme. As Lang and Dr. Liegner write,

“…talk to a thousand Lyme patients and you will get a thousand variations of the same story: people who are normally easy going become moody and belligerent; those who are outgoing become lethargic; mood swings cause the breakup of marriages and career relationships; the inability to concentrate results in job losses, plunging grades in school, and accidents; short-term memory loss affects habits and speech; and everywhere there is depression, a loss of self-esteem, and suicidal thoughts from people who have never had a history of such things.”[1]

The important thing to recognize is that these psychological manifestations are secondary to Lyme, not its root cause. At the 2017 International Lyme and Associated Diseases Society conference in Boston, Dr. Phillip DeMio of Ohio, who specializes in pediatric tick-borne illnesses and autism spectrum disorders, emphasized the fact that psychological symptoms of Lyme are not primarily psychiatric. He drew an analogy to head injuries, noting that a person acts strange because of a concussion, in the same way that a person with Lyme disease may exhibit unusual behaviors, but that’s not because either have a pre-existing psychiatric condition.

Mental illness is real, and should be evaluated and treated with respect when it actually is the root cause of a person’s unusual behavior. But a good doctor whose patient presents with a sudden onset of psychological symptoms, without precedent in their medical history, should look for all possible root causes, which could be psychiatric, but are more likely to be tick-borne illness, or some other disease.

No one should be written off as crazy, even those with mental illnesses. The word is pejorative. If you’re experiencing new symptoms, be they physical or psychological, or if you notice behavioral changes in a friend or family member, at least be open to the idea that the root cause might be other than psychological.  In my case, it was tiny spirochetes and parasites put in my system by a microscopic deer-tick. If my college health center nurses had considered tick-borne illnesses from the start my long-term health problems could have been a lot smaller, too.

[1] Lang, Denise and Liegner, Kenneth. Coping With Lyme Disease: A Practical Guide to Dealing with Diagnosis and Treatment. 3rd ed. New York: Henry Holt and Company, 2004 (70).

____________

**Comment**

Oh does this hit home…..

I’d like to say this is getting better, but I’d be lying.  College kids are still showing up at support group desperate because their own mothers won’t believe them.

Something has to change, and soon.

Lyme/MSIDS is a systemic infection that when it gets into the brain can cause untold damage – even suicide.

Please support those you know who are infected.  And if you are infected, develop skin of metal and do not let the nay-sayers bring you down.

Support:

https://rawlsmd.com/lyme-support?

https://www.ruschellekhanna.com/onlinetherapy

https://suicidepreventionlifeline.org

 

 

 

 

Category:

Activism, Uncategorized

April 2018 Support Meeting – Dr. Coleman

Our next meeting is Saturday, April 28, 2018 from 2:30-4:30 at Pinney Library.  Our speaker is:

robert-e-coleman-naturopathic-doctor-family-clinic-of-natural-medicine-madison-wi

Robert E. Coleman, Naturopathic Doctor

Dr. Robert E. Coleman, Jr. ND, LMT practices integrative medicine, environmental toxicology, and naturopathic physiatry. He began his life’s journey in Los Angeles, California where his passion for humanity, science, and technological innovation excelled. Dr. Coleman is an accomplished graduate of Bastyr University’s Naturopathic Medical School in Seattle, Washington. He has received advanced training in IV therapies, physical medicine, primary care, and integrated pain management. Dr. Coleman is the president of the Wisconsin Naturopathic Doctors Association (WNDA) and active member of the American Association of Naturopathic Physicians (AANP).
Dr. Coleman has proven himself through exceedingly challenging medical cases. He has collaborates with integrated physicians, surgeons, chiropractors, and other alternative medicine practitioners to reengineer a patient-centered approach to health care. Dr. Coleman continues to establish himself and encourages other primary care trained naturopathic doctors to practice in the state of Wisconsin. He perceives every moment in life to be a learning experience and blessing that he is most often able to incorporate into practice. Dr. Coleman participates in seminars, grand rounds, continuing medical education, webinars, and conferences in order to continuously enrich his clinical knowledge.

 

 

 

 

 

Category:

Meetings, Uncategorized

University of Maryland AIDS Expert Named New CDC Director

http://www.baltimoresun.com/health/bs-hs-cdc-director-20180321-story.html

University of Maryland AIDS expert named new CDC director

bs-1521667670-0qdzphhrow-snap-imageDr. Robert Redfield Jr. of the University of Maryland School of Medicine was named the new director of the Centers for Disease Control and Prevention, the federal government’s top public health agency. (Tracey Brown/University of Maryland School of Medicine via AP)
By Andrea K. McDaniels – Contact Reporter
The Baltimore Sun

March 21, 2018

A doctor with the University of Maryland School of Medicine, a longtime AIDS researcher who helped found the school’s prestigious Institute of Human Virology, has been appointed the new head of the U.S. Centers for Disease Control and Prevention.

The appointment of Dr. Robert Redfield Jr., an infectious disease expert, was announced late Wednesday by the U.S. Department of Health & Human Services.

Health Secretary Alex Azar lauded Redfield for his contribution to advancing the understanding of HIV/AIDS. His most recent work was running a treatment center for HIV and hepatitis C patients that Azar said will prepare Redfield for fighting the opioid epidemic, one of the CDC’s most pressing issues.

“Dr. Redfield has dedicated his entire life to promoting public health and providing compassionate care to his patients, and we are proud to welcome him as director of the world’s premier epidemiological agency. Dr. Redfield’s scientific and clinical background is peerless,” Azar said.

 

Redfield was not available for comment. He was also a finalist for CDC head in 2002 under the George W. Bush administration.

His appointment already was being met with criticism from people who said his background was mostly in research and that he lacked public health experience. He was also at the center of an experimental and controversial AIDS vaccine in the 1990s.

Sen. Patty Murray, a Washington Democrat, sent a letter to President Donald J. Trump, raising concerns about Redfield’s appointment that said his controversial positions on issues regarding HIV/AIDS raised questions about his qualifications about the job. Murray, ranking member of the committee that oversees CDC, also criticized his lack of public health experience.

“I believe the CDC Director must first and foremost be a champion of public health and ensure this Administration embraces the science around public health in both its domestic and global work,” Murray wrote. “I am concerned by Dr. Redfield’s lack of public health expertise and his failure to embrace the science underscoring critical public health work, and I urge you to reconsider him as a candidate for CDC Director.”

The Center for Science in the Public Interest also protested the selection of Redfield because of what it says is a history of scientific misconduct. The group said he doesn’t have important relationships with local health departments.

Dr. Peter Lurie, the organization’s president, called the appointment “disastrous.” He noted that Redfield was investigated by the military for scientific misconduct for exaggerating the benefits of a “putative” HIV vaccine. Researcher disputed his findings that the vaccine worked and Congress stopped plans for a large clinical trial. Smaller studies later proved the vaccine ineffective, but the investigation cleared Redfield.

“What one wants in a director of the Centers for Disease Control and Prevention is a scientist of impeccable scientific integrity,” Lurie said in a statement before the announcement, when Redfield was being considered.

Redfield also has supported a variety of policies related to HIV/AIDS that many public health professionals don’t support, including mandatory HIV testing, reporting of positive HIV results to public health authorities without the patient’s consent, and quarantining of HIV-positive individuals in the military, Lurie said.

Redfield suggested those policies in the 1980s and 1990s when researchers were still learning about the disease.

The Trump administration’s previous CDC director, Dr. Brenda Fitzgerald, resigned after questions were raised about conflicts of interests related to some of her financial investments.

Redfield began his career in the late 1970’s at the Walter Reed Army Medical Center and co-founded the Institute on Human Virology at Maryland in 1996. The institute’s patient base grew from 200 patients to more 6,000 in Baltimore and Washington under his tenure. It also has more than 1.3 million patients in African and Caribbean nations.

“Dr. Redfield was one of my early collaborators in co-discovering HIV as the cause of AIDS and demonstrating heterosexual transmission of AIDS,” said Dr. Robert C. Gallo, also co-founder of the human virology institute, in a statement. “He is a dedicated and compassionate physician who truly cares about his patients and is deeply committed to ensuring patients receive the highest quality of care possible. Dr. Redfield has served his country well, and consistently demonstrates strong public health instincts that are grounded in science and clinical medicine.”

Dr. E. Albert Reece, dean of the University of Maryland School of Medicine, said that Redfield is “eminently qualified for this critical position.”

“He has made a lifelong commitment to advancing biomedical research and human health through discovery-based medicine,” Reece said in a statement. “…. he has been one of the most accomplished scientists and public health advocates in the nation in increasing our understanding of the prevention and treatment of infectious disease. His significant contributions have led to the treatment of more than a million HIV patients by the Institute in the U.S. and around the world.”

Baltimore Sun reporter Meredith Cohn contributed to this article.

amcdaniels@baltsun.com

twitter.com/ankwalker

 

 

 

 

Category:

Activism, Uncategorized

LD in the U.S. – Looking for Ways to Cut the Gordian Knot

http://onlinelibrary.wiley.com/doi/10.1111/zph.12448/abstract;jsessionid=4442DBFE52618A3BD9A1C7356CB044C6.f03t03  OPINION

Lyme disease surveillance in the United States: Looking for ways to cut the Gordian knot

Authors:  M. L. Cartter, R. Lynfield, K. A. Feldman, S. A. Hook, A. F. Hinckley
First published: 12 February 2018
DOI: 10.1111/zph.12448

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Summary

Current surveillance methods have been useful to document geographic expansion of Lyme disease in the United States and to monitor the increasing incidence of this major public health problem. Nevertheless, these approaches are resource-intensive, generate results that are difficult to compare across jurisdictions, and measure less than the total burden of disease. By adopting more efficient methods, resources could be diverted instead to education of at-risk populations and new approaches to prevention. In this special issue of Zoonoses and Public Health, seven articles are presented that either evaluate traditional Lyme disease surveillance methods or explore alternatives that have the potential to be less costly, more reliable, and sustainable. Twenty-five years have passed since Lyme disease became a notifiable condition – it is time to reevaluate the purpose and goals of national surveillance.

_______________

**Comment**

Yes, please!  Cut the Gordian Knot!  Better yet, take an ax to the thing!

http://www.history.com/news/ask-history/what-was-the-gordian-knot

Thanks to the enduring popularity of the Alexander fable, the phrase “Gordian knot” has entered the lexicon as shorthand for an intricate or intractable obstacle. One of its earliest appearances came in the Shakespeare play Henry V, where the titular character is praised for his ability to “unloose” the Gordian knots of politics. Likewise, the saying “cutting the Gordian knot” is now commonly used to describe a creative or decisive solution to a seemingly insurmountable problem.

 

 

 

Category:

Activism, Lyme, research, Transmission, Uncategorized