Few Conn Physicians Treat Chronic Lyme Disease
Only a very small number of physicians in Connecticut the epicenter of Lyme disease diagnose and treat patients with the controversial chronic form of this tick-borne infection, a survey found.
Among 285 primary care physicians surveyed, only about 2% treat chronic Lyme disease, and almost 50% dont believe that chronic infection with the spirochete Borrelia burgdorferi exists, Michael Johnson, MD, and Henry M. Feder, Jr., MD, of the University of Connecticut in Farmington, reported online in the Journal of Pediatrics.
The remaining 48% were uncertain as to whether chronic Lyme disease is a valid condition.
Advocates of chronic Lyme disease believe that the infection can persist for months and even years, requiring long-term treatment with oral or intravenous antibiotics a stance counter to the recommendations of the American College of Rheumatology, the American Academy of Pediatrics, the American College of Neurology, and the Infectious Diseases Society of America .
They have formed their own society, the International Lyme and Associated Diseases Society , publishing their own guidelines, and refer to themselves as Lyme literate.
To see how widespread acceptance of chronic Lyme disease is among clinicians in Connecticut, which has the highest incidence of B. burgdorferi infection in the country, Johnson and Feder sent a survey to a random sample of more than 1,000 physicians. The survey had a 39.1% response rate.
Disclosures
What Is Chronic Lyme Disease
Lyme disease is an infection caused by the bacterium Borrelia burgdorferi. In the majority of cases, it is successfully treated with oral antibiotics. In some patients, symptoms, such as fatigue, pain and joint and muscle aches, persist even after treatment, a condition termed Post Treatment Lyme Disease Syndrome .
The term chronic Lyme disease has been used to describe people with different illnesses. While the term is sometimes used to describe illness in patients with Lyme disease, it has also been used to describe symptoms in people who have no clinical or diagnostic evidence of a current or past infection with B. burgdorferi . Because of the confusion in how the term CLD is employed, and the lack of a clearly defined clinical definition, many experts in this field do not support its use.
What Do I Expect During My Appointment
Your first visit with Dr. Daniel Cameron will begin with introductions to our staff, and will include a a comprehensive evaluation, which will include obtaining a thorough medical history, reviewing prior medical records and test results, and performing a physical exam. Additional laboratory and diagnostic tests and/or consultations with specialists may be needed.
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Westchester Infectious Disease Specialist On Lyme Disease Prevention
When heading out for a hike, the last thing you want to think about is getting sick. Unfortunately, anywhere there are deer ticks , theres a potential for contracting Lyme disease. Over 16,000 new cases of Lyme are reported each year, according to the Centers for Disease Control and Prevention, and Lyme isnt the only concern, saysDebra Spicehandler, MD, an infectious diseases specialist and co-chair of the Infection Control Committee atNorthern Westchester Hospital. Dr. Spicehandler shares a bit about Lyme disease, what to look out for, and how to stay safe while enjoying the outdoors.
Confronting The Misnomer Of Chronic Lyme Disease
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Studies suggest that around 300,000 people are diagnosed with Lyme disease each year in the United States, according to the CDC, with 14 states in the Northeast and upper Midwest accounting for 96% of reported cases. As the most commonly reported tickborne illness in the country, Lyme disease has grown in incidence and expanded beyond its historically endemic range in the last 2 decades.
The CDC estimates that 70% to 80% of patients with Lyme disease develop the telltale erythema migrans rash, but some patients may exhibit only symptoms of fever, fatigue or muscle/joint pain, which leaves physicians to piece together the diagnosis after confirming whether the patient was in a Lyme-endemic area. If symptoms are vague, physicians may order a blood test. If a diagnosis of Lyme disease is confirmed, patients should be prescribed a 2- to 4-week course of antibiotics, according to current Infectious Diseases Society of America guidelines.
H. Cody Meissner, MD,
The rise of chronic Lyme
First diagnosed in Connecticut in 1975, Lyme disease remained an etiologic mystery until the discovery of the spirochete, a corkscrew-shaped bacterium named Borrelia burgdorferi, which is primarily transmitted through the bite of the blacklegged tick, or deer tick .
Dangers of alternative therapies
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Lyme Disease Frequently Asked Questions
If you have not done so already, remove the tick with fine-tipped tweezers.
The chances that you might get Lyme disease from a single tick bite depend on the type of tick, where you acquired it, and how long it was attached to you. Many types of ticks bite people in the U.S., but only blacklegged ticks transmit the bacteria that cause Lyme disease. Furthermore, only blacklegged ticks in the highly endemic areas of the northeastern and north central U.S. are commonly infected. Finally, blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease. This is why its so important to remove them promptly and to check your body daily for ticks if you live in an endemic area.
If you develop illness within a few weeks of a tick bite, see your health care provider right away. Common symptoms of Lyme disease include a rash, fever, body aches, facial paralysis, and arthritis. Ticks can also transmit other diseases, so its important to be alert for any illness that follows a tick bite.
References:
Moody KD, Barthold SW, 1991. Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation.external iconAm J Trop Med Hyg 44: 135-9.
There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic thats safe for use when breastfeeding.
Stage : Early Disseminated Lyme Disease
Early disseminated Lyme disease occurs several weeks to months after the tick bite.
Youll have a general feeling of being unwell, and a rash may appear in areas other than the tick bite.
This stage of the disease is primarily characterized by evidence of systemic infection, which means infection has spread throughout the body, including to other organs.
Symptoms can include:
- disturbances in heart rhythm, which can be caused by Lyme carditis
- neurologic conditions, such as numbness, tingling, facial and cranial nerve palsies, and meningitis
The symptoms of stages 1 and 2 can overlap.
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Infectious Disease Physician & Travel Clinic Services Located In Lansdowne Va
Early signs of Lyme disease include fever, chills, fatigue and muscle aches. If youre experiencing any of these symptoms and youve been in an area known to have deer ticks, you should call the Infectious Diseases Tropical Medicine and Travel Clinic in Lansdowne, Virginia, for an appointment with specialist Sarfraz Choudhary, MD, FACS, right away. Its important to treat Lyme disease early because later symptoms can be more severe. Dr. Choudhary has extensive experience diagnosing and treating Lyme disease, which is often difficult to diagnose. Call or make an appointment online.
What Is Lyme Disease
Lyme disease is a bacterial infection transmitted to humans by an infected blacklegged or deer tick. Lyme disease is more common than you might think, affecting more than 300,000 people a year, although experts suspect the real number is higher since it is often misdiagnosed. Its important to see a specialist like Dr. Choudhary for an accurate diagnosis and early treatment so the disease does not progress.
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Payment Policies & Insurance
Payment is expected at the time of your visit either by cash, check, or credit card. Office charges may or may not be covered by your insurance plan. We are considered out of network so it will depend on your individual insurance policy and the coverage of that policy as to the services and amounts they may reimburse. If youd like to check with your insurance company prior to your appointment, visits are typically considered level 5 office visits.
Our office does not bill your insurance directly but we will gladly provide an invoice at the conclusion of your visit with your diagnosis codes, treatment codes and all pertinent provider information to you so that you may send it to your insurance company for reimbursement of billable services. We are also not a participating provider in Medicaid or Medicare.
Conversation: Good Bad And Ugly Side Of Post
We will discuss the good, bad, and ugly side of PTLDS. The good news is that a chronic manifestation of Lyme disease has been recognized. The bad news is that PTLDS is a serious illness that can last for years. The ugly news are the obstacles to solving the PTLDS. I dont even like the term PTLDS. I will explain in my next live Lyme Hangout Tuesday, March 13, 8PM EST.
I will start the discussion with a 23 year-old-woman with severe chronic pain due to PTLDS. Her functionality was severely affected she was bedbound for approximately 5 years and required a wheelchair, writes Lim from the Department of Anesthesia and Perioperative Care, University of California, San Francisco in the Saudi Journal of Anaesthesia.1 The case was initially described in the latest All Things Lyme Blog.
Host: Dr. Daniel Cameron
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Lyme Disease In An African American Child With Downs Syndrome
Welcome to another Inside Lyme Podcast with your host Dr. Daniel Cameron. In this episode, Dr. Cameron discusses the case of a 3-year-old African American child with Downs syndrome, developmental delays and disseminated Lyme disease. By Dr. Daniel Cameron “A case of disseminated Lyme disease in a child with skin of color” was published by Bax and colleagues in the journal Pediatric Dermatology.¹ The child, who had trisomy 21 (Downs
When Should You Call Your Doctor
- A tick is attached to your body and you are unable to remove the entire tick.
- You have a circular red rash that expands over the course of several days, especially if you know you were recently exposed to ticks. You may also have flu-like symptoms, such as fatigue, headache, stiff neck, fever, chills, or body aches.
- You feel very tired or have joint pain , irregular heartbeats, severe headache, or neck pain.
- You are pregnant or nursing and you think you may have been exposed to ticks.
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What Kinds Of Neurological Problems Are Caused By Lyme Disease
Typically, three main neurological complications develop in people with untreated Lyme disease.
- Cranial neuropathy: If the infection affects nerves of the face, some patients might experience cranial neuropathyor dysfunction of the peripheral nervescausing drooping or swelling. The most common form of cranial neuropathy is Bells palsy, which is muscle drooping on one side of the face.
- Meningitis: If the bacterial infection reaches the meninges, or the tissue lining the brain and spinal column, it may cause inflammation and tissue damage. Patients with meningitis are likely to experience fevers, headache, fatigue, and stiff neck.
- Radiculoneuritis: If the bacterial infection reaches the nerve root, or the part of the nerve cells that attaches to the central nervous system , it can cause severe pain, numbness, and other abnormal sensations.
What Is A Lyme
A LLMD is a physician whose experience with Lyme disease patients makes them familiar with the vast range of symptoms, co-infections, and complications associated with the disease at various stages. Because of this knowledge and expertise, many patients also find LLMDs more open-minded and understanding of their experiences, especially if theyre having a hard time getting an accurate diagnosis from another physician.
But how do you know if you need to see a LLMD? Below are some common reasons, any or all of which may apply to you.
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Survey Data Collection And Analysis
The project team was unsuccessful in efforts to engage frontline clinicians via focus groups during the project period. After discussing barriers with clinic practice managers, our team determined that we would be unable to engage frontline clinicians in focus groups due to variable schedules and constraints among that population. The project team pursued an alternate approach to engage this group through an online survey questionnaire. Two project team members developed a survey questionnaire using validated questions from the published literature and focus group data to measure both baseline provider knowledge and the perceptions and experiences of frontline clinicians practicing in the studys geographic area. Project team physicians reviewed and beta tested the questionnaire prior to finalization. The questionnaire was open for responses from March to May 2019. Participants were invited via email invitation and informational flyers delivered to hospital and urgent care clinics in the small-town community. Despite several recruitment efforts, and a participation incentive in the form of gift cards to local restaurants, the number of responses to the survey in the targeted small-town community fell well short of the projects goal.
Protocols and procedures for this study involving human subjects were deemed exempt for review under criterion three by the Institutional Review Board of Cornell University, Protocol Numbers: 1806008097 and 1903008648.
What Kind Of Doctor Tests For Lyme Disease
In fact, any kind of doctor can test you for Lyme disease. However, that doesnt mean its a good idea to have your dermatologist or podiatrist order the diagnostic tests. Many people simply see their family physician or primary care doctor to get diagnosed and treated for Lyme.
There are also doctors who specialize in Lyme disease and other tick-borne illnesses, called Lyme-literate doctors, who you may want to consult instead more on that a little later in this article.
Finally, there are other types of specialists you may or may not need to consult with depending on the duration and severity of your symptoms.
For example, many patients wonder if they need to see an infectious disease specialist.
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In General Tick Borne Disease Or Lyme Disease Should Be Treated With Antibiotics Usually These Antibiotics Should Be Pharmaceuticals Although Augmentation With Botanical Antibiotics Can Be Even More Effective Than Pharmaceutical Therapies Alone
Unfortunately in late Lyme, antibiotics alone are often not sufficient. Some patients are genetically or epigenetically predisposed to chronic Lyme disease. Often the underlying conditions must be addressed along with the infection.
Borrelia burgdorferi has been called the second great pretender, after syphilis. Like syphilis it is a spirochete , and the spirochete goes to the brain and spinal cord as fast as it can get there. In addition like syphilis it grows very slowly. Unlike syphilis it is relatively smart in the bacterial world, having the largest genome of any other bacteria. Borrelia burgdorferi is able to crawl inside of cells, thus avoiding immune detection, hide in the brain and spinal cord, where our immune system is careful not to cause too much inflammation. More recent data suggests it may, like many of its co infecting microbes be able to fool the immune system and manipulate the immune response so that the immune system thinks that there is not an infection. In 3 animal models dog, mouse and monkey, chronic persistent infectious borrelia infection has been proven after short course antibiotic. This provides evidence that the cure of chronic Lyme disease in many patients will take more than 1-3 months of antibiotics.
What Is Infectious Disease
Infectious disease is a specialty that deals with the diagnosis and treatment of infections, including bacterial, viral, fungal, and parasitic infections. Infectious disease specialists are trained in the studies of immunology, or how the body fights off infections, as well as epidemiology, or how diseases spread.
Some infectious disease doctors further specialize within the field of infectious disease. For instance, pediatric infectious disease specialists treat children and teens with serious infections. Others focus specifically on patients who have HIV or AIDS, as these conditions commonly cause patients to contract unusual and severe infections.
Most common infections can be treated by a general physician without problems. A referral to an infectious disease specialist might be made in cases such as:
- An infection that is difficult to diagnose
- An extremely high fever
- An infection that is not responding to treatment
- A patient traveling to a foreign country where the risk for infection is high
- A patient with a chronic illness or infection that requires frequent treatment, such as HIV
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Identify Doctors Trained In The Diagnosis And Treatment Of Tick
You can access a variety of online resources and directories to locate doctors who are specifically trained in identifying and treating tick-borne illnesses. These do not have to be infectious disease specialists they can be physicians from any practice area who simply have extensive experience with tick-borne diseases.
It is particularly important to find a Lyme expert if you suspect that you may have Lyme disease, since it is the most frequently misdiagnosed of all tick-borne diseases. Finding a Lyme-literate medical doctor a physician who is familiar with the vast range of symptoms that may indicate infection at various stages of the disease, as well as potential coinfections and other complexitiescan help ensure that you get the right treatment, right away.
To find a doctor who is also a Lyme expert, you may want to explore the following resources:
Note: Some of these organizations may require you to submit a form or create a login to access their databases.