ELM Edge
Increase Standard National Surveillance of Lyme Disease L
yme is the most prevalent vector-borne illness with an annual treatment cost of $492 million and is often called the “Great Imitator” as there are numerous elusive symptoms involved
that can mimic various other diseases such as: Alzheimer’s, ALS, Chronic Fatigue Syndrome, MS, and Parkinson's. According to the CDC, approximately 30,000 cases of Lyme disease are reported to the CDC by state health departments annually. Standard national surveillance is one of the ways that public health officials are able to track the frequency of the disease and areas where they are occur- ring. It is estimated that actual cases of Lyme in the U.S. are closer to 300,000 people each year. Most cases occur in New England, the mid-Atlantic states, and the upper Midwest. Unfortunately, many health care providers are not reporting newly diagnosed lab-confirmed Lyme and/or co-infections. Surveillance is vital but not every illness is captured due to under-reporting. Researchers are often required to estimate the burden of illness as they measure the economic impact of disease in order to appropriately allocate funds and set public health goals. The CDC utilizes the best available data and makes adjustments based on this data and previous study results in order to account for lack of information.
The CDC is interested in the actual number of people diagnosed with Lyme disease in the U.S. annually. Reporting requirements for Lyme disease vary from state to state and are determined by state laws or regulations. Diagnostic laboratories, licensed health care providers, and hospitals report Lyme dis- ease cases in most states. All personal identifiable information is removed by the states and the District of Columbia. They then share their data with the CDC, which collects and publishes the information. Patient names are kept confidential and are not included in the published reports.
When clinicians diagnose their patients with Lyme based on suspected, probable, or lab-confirmed cases, they should fill out and submit the “LYME DISEASE CASE REPORT” to either the State or the CDC. Public health surveillance data depends on its
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timeliness, simplicity, and uniformity. Surveillance case definitions should not be used as the only criteria for determining a patient’s clinical diagnosis, standard of care, setting guidelines, or for providing standards for insurance reimbursement. It is vital that all clinicians who diagnose a patient with Lyme disease use the CDC reporting criteria as the current numbers do not reflect the actual severity of this increasing epidemic.
See “Case Classification” per CDC:
Suspected • EM where there is no known exposure and no laboratory evidence of infection OR
• A case with evidence of infection but no clinical information available (e.g., a laboratory report).
Probable
• Any other case of physician-diagnosed Lyme disease that has laboratory evidence of infection.
Confirmed
• A case of EM with exposure in a high incidence state (as defined above), OR
• A case of EM with laboratory evidence of infection and a known exposure in a low incidence state, OR
• Any case with at least one late manifestation that has laboratory evidence of infection.
Please visit the CDC website for “Case Classification” of Lyme disease and to retrieve the Lyme disease reporting form. https://
www.cdc.gov/lyme/stats/forms.html
Submitted by Gloria Oppen, MS, FNP-C, PhD Candidate (Public Health) of Southern Maine Integrative Health Center in Kennebunk. See ad on page 11.
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