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How to battle Lyme disease: education, prevention



A recent article discussed one of the legislators struggle with Lyme Disease ("Retiring Legislator to Tell by Lending Its Story," Sturdevant column, July 22). Minnesota.

The financial and health-related costs of the disease are significant for individuals and society. Approximately 380,000 new cases of Lyme disease are diagnosed each year in the U.S. A 2015 Johns Hopkins study estimated the average expense of direct medical costs to be $ 3,000 per case, totaling $ 1.2 billion a year. While that alone is staggering, the average expense is $ 11,248. Most cases treated early in the illness cost far less;

That's why public health officials, physicians and the public must take every opportunity to encourage and engage in prevention practices. In the course of my work on tick-borne diseases, I provide accredited continuing medical education for physicians and speak to public audiences; I've published papers in peer-reviewed medical journals and served on a subcommittee of the congressionally mandated Tick-Borne Disease Working Group. Here are some suggestions:

• The Minnesota Department of Health should develop a year-round media campaign on the dangers of tick-borne diseases across all popular platforms. It should also be uncleared, such as campers, hunters, workers with occupational exposure, residents in wooded housing developments and people whose risk is often unrecognized, such as golfers who spend time in the rough.

• The campaign should strongly advocate the use of permethrin on clothing and gear with any potential exposure to this insecticide is highly effective, long-lasting, safe,

• Each Minnesotan must identify and minimize the potential for a prolonged illness.

• Each Minnesotan must identify and minimize potential sources of risk in his or her life by avoiding tick habitat whenever possible, using permethrin and repellents, performing careful tick checks and promptly reporting known bites and / or symptoms of Lyme disease to a doctor.

• Clinicians need to improve their diagnostic and therapeutic skills. Serologic testing, while highly specific, is insufficiently sensitive to rule out Lyme. This is true for early disease and neurologic presentations. The serology module on LymeCME.info lays out the details. Lyme disease is a multisystemic disease producing a wide array of symptoms. Clinicians who seek only swollen joints, AV conduction defects, facial nerve palsies, and bull's-eye rashes are in many cases, missing the target.

• Clinicians should not be relieved of trial findings while caring for individual patients, as Cochrane and GRADE analysis of the therapeutic evidence it is of low / very low quality. Single-dose doxycycline is approximately 50 percent effective for primary prevention of Lyme disease; Thus, high-risk bites may deserve a 1

0-day course. More aggressive management of early disease may reduce the risk of a prolonged illness (secondary prevention). Most U.S. Given that certain presentations – multiple EM lesions, the presence of neurological symptoms, more severe illness and ongoing symptoms at the end of active therapy – were associated with a higher risk of long-term failure, it seems prudent to consider the duration of treatment in these groups.

• Scientific understanding of tick-borne diseases has evolved over the 10 years that I've been writing and teaching about these illnesses. Yet vaccines for this group of infections are a long way off.

In the interim, an ounce of permethrin is worth a pound of antibiotics. Use it.

Elizabeth Maloney is a physician in Wyoming, Minn.

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