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Lyme Disease Cases Hit Record High in 2000

CDC finds 8% increase over 1999

THURSDAY, Jan. 17, 2002 (HealthDayNews) -- Continuing its balky trend upwards, the number of Lyme disease cases in the United States hit a record high in 2000, reaching 17,730, government officials report.

That's about 8 percent higher than the figure of 16,273 in 1999 for the tick-borne illness. Lyme disease is rarely fatal but has been linked to a chronic syndrome of diffuse aches, pains, memory trouble, and various other problems that wax and wane for months or even years. The average caseload since 1991, when the disease first became nationally notifiable, is 12,745.

The Centers for Disease Control and Prevention has been aggressively promoting Lyme-disease awareness efforts, especially in the endemic Northeast states of Connecticut (where the illness first appeared) New York, New Jersey and Massachusetts. Stacie Marshall, a CDC epidemiologist who helped announce the latest figures today, says the surge in 2000 doesn't reflect a failure of that initiative.

"The increase in cases is probably due to an increase in reporting [of the disease] and in an actual increase in the amount of contact people are having with the ticks," says Marshall. "More than ever, I think prevention efforts are working and are effective."

Lyme disease is a bacterial infection caused by Borrelia burgdorferi, a bug that hitches a ride in deer ticks and western black-legged ticks. The condition, whose symptoms include a signature bulls-eye rash and joint swelling, occurs mainly in the Northeast and Wisconsin and Minnesota, where deer ticks are prevalent. However, it does sporadically crop up elsewhere.

The vast majority of patients, chiefly children and older adults, respond well to antibiotics. However, perhaps 5 percent or so suffer the long-term complications. For these people, symptoms often improve with antibiotic therapy only to flare up when the drugs are stopped, leading some doctors and patients to conclude that the syndrome is a manifestation of hidden reservoirs of bacteria that can't be eradicated.

Lyme seems to surge every odd year and ebb in the even ones, thanks to the nature of its tick carriers' egg-laying cycles, says David Weld, executive director of the American Lyme Disease Foundation in Somers, N.Y. "They had a good egg laying year" in 1999, Weld says. Similarly, last year should have been a banner year for laying, which means 2002 could also set a record for cases.

"People have let down their guard [by] thinking there's a vaccine out there, and [they're] going out and being bitten," says Karen Forschner, chairwoman of the Lyme Disease Foundation, in Hartford, Conn. "With all the research and all the money we've put toward fighting Lyme disease, it still comes down to the free choice that individuals make, which is to do tick checks" after spending time outdoors.

Some people have fretted that the Lyme disease vaccine can cause serious side effects. But the CDC says it recently looked at reports among vaccine users and found "no unexpected pattern" of reactions, says Dr. Ned Hayes, a CDC medical epidemiologist, addressing reports at a press conference today. Hayes says the shot doesn't appear to cause arthritis. It is considered to be about 90 percent effective after three doses.

What To Do

Marshall agrees that the Lyme vaccine should be considered only another "weapon in the arsenal" against the infection, and not a safety net. Rather, she says, people who live in deer tick-infested areas should take the necessary precautions: Wear long clothing outside, and tuck your pants into your socks. Use a tick repellent, and do thorough tick checks when you come home. That way, if you find a tick on board, chances are it won't have had enough time to cause trouble.

Another tip: Make sure you clear bushes and other tick- and deer-friendly plants away from your house.

To learn more about Lyme disease, try the Lyme Disease Foundation, the American Lyme Disease Foundation, or the Centers for Disease Control and Prevention.

SOURCES: Interviews with Stacie Marshall, M.P.H., epidemiologist, and Ned Hayes, M.D., medical epidemiologist, Centers for Disease Control and Prevention, Atlanta; David Weld, executive director, American Lyme Disease Foundation, Somers, N.Y.; Karen Forschner, chairwoman, Lyme Disease Foundation, Hartford, Conn.; CDC teleconference transcript
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