This transcript has been edited for clarity.
Welcome Impact factor, Your weekly commentary on new medical research. Dr. F. Perry Wilson of Yale School of Medicine.
When the weather gets warmer, birds sing, grass grows, and shorts and skirts begin to appear, they cause the following rashes, like clockwork:
Target rash — Erythema miguran — Pathological signs Lyme diseaseNamed after the sleepy Connecticut town, less than 40 minutes’ drive from where I’m standing.
Lyme disease was first reported in 1975 after a series of cases, including: Juvenile rheumatoid arthritis Although it appeared in Lime, Connecticut in connection with a deer tick bite, the disease has been around for a long time. In fact, the oldest patient recorded could be Iceman Iceman, who died in the Alps between Italy and Austria over 5,000 years ago.Revealed by genetic analysis Borrelia sequence.You will remember it Borrelia burgundle ferri At least in North America, it is the most common spirochete that causes Lyme disease.
I have Borrelia Not only because my brain isn’t literally, but because the weather is nice and I tend to throw golf balls into tall grass. paper Appeared in BMJ Global Health The author has written numerous scripts to characterize the prevalence of exposure to the bacteria that cause Lyme disease worldwide. And that number is much higher than I expected.
This study is a meta-analysis, a compilation of papers from 1984 to 2021, which has one thing in common.Borrelia Antibodies in human blood.
These antibodies occur shortly after infection and can last for quite some time, perhaps even for a lifetime. After screening, 89 articles provided data on the number of people who had these antibodies, that is, the number of people infected with the antibodies. Borrelia Spirochetes.
result? Many people. Combined with the results of all these studies, one in six people worldwide — 14.5% of the population. That’s 1.2 billion people. This number seems to be quite large.
Lyme disease is a disease reported in the United States, where approximately 35,000 cases are reported annually to the CDC. However, the CDC acknowledges that the reporting system is passive and therefore significantly underestimates the entire case. Using management data based on the ICD-10 code, The CDC estimates the actual annual number of cases in the United States to be approximately 450,000...
It’s a lot of Lyme disease.Of course, it is not a coronavirus, but the annual infection rate is about 10 times that of a bad one. influenza Season.
The BMJ Global Health The paper will help you a little to tell you where to look for all these infections. It’s not rocket science. The authors have been bitten by high-risk occupations (farmers, soldiers, housewives (their words, not my words), retirees, etc.), more rural people, and recently ticks.
The study also shows that the prevalence of Lyme disease increased by about 50% from the 2000s to the 2010s. It’s not clear why that is, but as we invade more naturally, we cannot overlook the resonance with other infectious diseases that spread to human populations.
But if the coronavirus tells us something, it’s that we have some healthy skepticism about antibody testing. Eighty-nine studies were examined by the author, but tried to find everything Borrelia Antibodies, the method they used to do it, was throughout the map. The gold standard here is Western blotting, and studies using Western blots to confirm antibody testing have found that the prevalence of Lyme disease is significantly lower, in fact about 50% lower.
This, of course, means that antibody tests can give false positives. In fact, some studies have shown Epstein-Barr antibodies, which the majority of adults are roaming around, Cross-reactivity can lead to false positive lime tests..
Clinical lessons have been repeated by Infectious Disease Society For years: The lime antibody test is not a good test to guide treatment. At best, they may be used here to do what the author is doing: give a general estimate of the population load of the disease and trends over time.
However, using the lower bounds of the estimated prevalence of Lyme disease, it is clear that the disease has not received the attention it deserves. It is endemic to five of the seven continents and affects millions, if not billions, of people living today, and given its various expressions, 25 of children. % Does not even get a rash.
that’s why Borrelia To your brain as the weather warms. It’s the best time to become a tick.
F. Perry Wilson, MD, MSCE is an Associate Professor of Medicine and Director of Clinical and Translational Research Accelerators at Yale University. His science communication work can be found at the Huffington Post, NPR, and here in Medscape.He tweets @fperrywilson Hosts a repository of his communication work at www.methodsman.com..
