SUNY Adirondack professor: Lyme disease an epidemic
Excerpted from the Saratogian ( Posted: 10/08/2012)
SARATOGA SPRINGS — A SUNY Adirondack professor says Lyme disease has reached epidemic proportions in New York state.
Holly Ahern, an associate professor of microbiology, co-chaired a LymeNext Forum at Skidmore College in May that was attended by more than 500 people, including several experts on the disease.
The following are her responses to questions about the topic.
Q: Has Lyme disease reached epidemic proportions?
A: Lyme disease is absolutely an epidemic. Lyme disease is diagnosed by physicians at rates that vary from 10 to 50 times higher than what public health statistics show. New York state follows the recommendations of the federal Centers for Disease Control when it comes to diagnostic criteria for a case of Lyme disease. Those criteria are clinical evidence and laboratory evidence of infection.
These recommendations preclude diagnosis of Lyme disease more than half the time. Here’s why: According to the CDC, the only clinical evidence currently acceptable for diagnosis is appearance of a “bulls-eye” or erythema migrans (EM) rash. Studies have clearly demonstrated that the EM rash is not the most prevalent morphologic feature, nor does it appear in anywhere near the CDC-stated “60 to 80 percent” of cases.
As far as the lab tests go, all of the most widely used tests are indirect tests, meaning they look for antibodies produced by the patient against Borrelia burgdorferi. These tests are very insensitive, meaning that reported data has shown a less than 50 percent accuracy rate — as reliable as a coin toss.
And those are the only two criteria permitted for reporting. So physicians are diagnosing and not reporting, or not diagnosing at all because the CDC (and therefore New York state) are resolute in their opposition to changing those guidelines, even in the face of very strong data. My own data indicates that in this area, Lyme disease cases exceed reported cases by a factor of 80.
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