Shifting of Infectious Diseases Due to Climate Change

CDC (January 2022): Open Access PDF: Our Risk of Infectious Diseases Is Increasing Because of Climate Change

“Between 2004 and 2018, the number of reported illnesses from mosquito, tick, and flea bites more than doubled, with more than 760,000 cases reported in the United States. Nine new germs spread by mosquitoes and ticks were discovered or introduced into the United States during this period. The geographic ranges where ticks spread Lyme disease, anaplasmosis, ehrlichiosis, and spotted fever rickettsiosis have expanded, and experts predict that tickborne diseases will continue to increase.”

EPA: Climate Change Indicators: Lyme Disease This EPA website has links to many other climate change indicators.

The lack of dots in Massachusetts in 2018 is due to a difference in
reporting standards, not an absence of Lyme disease

Related blog posts:

Persistent Symptoms after Lyme Disease

A new study has shown that long-term antibiotic therapy for Lyme disease is not helpful.

Here’s a link to a quick summary (1:37 min): Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease

In the associated editorial (MT Melia, PG Auwaeter, NEJM 2016; 374: 1277-8), it is noted that 10-20% of treated patients (after initial antibiotics) “may have lingering symptoms of fatigue, musculoskeletal pains…The plausible idea that additional antimicrobial therapy for potentially persistent bacterial infection would foster improvement has been a touchstone of hope in the 40 years since discovery of the disease in the mid-1970s.”

My take (from editorial): “Prolonged antibiotic therapy is not the answer” for lingering symptoms after Lyme disease. “We do not know what is truly helpful”

Related blog post: Facts and fiction with Lyme disease gutsandgrowth

 

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Facts and Fiction with Lyme Disease and Picture of the Deadliest Animal

Since summer is around the corner, a recent article on Lyme disease may be of interest.  This clinical practice article on Lyme disease opens w/ case, reviews tx strategies & guidelines, ends w/ recommendations. Here’s a link to the article: 

Lyme disease is caused mainly by the spirochete Borrelia burgdorferi (and other related species outside of U.S.).  Pediatric gastroenterologists sometimes are asked to evaluate children with persistent symptoms attributed to Lyme disease.  This expert review makes a few key points:

  • Erythema migrans lesions often do not have central clearing; the majority are uniformly erythematous or have enhanced central erythema (pictures noted in Figure 1).  A useful differential diagnosis is noted in Table 2.
  • Antibody testing is not indicated routinely in patients with erythema migraines due to poor sensitivity in early infections.
  • Treatments are highly effective –mainly doxycycline, amoxicillin or cefuroxime
  • Prophylactic treatment with doxycycline can reduce risk of infection after tick bite, but usually not given.  “Even in areas where Lyme disease is highly endemic, the risk of disease transmission from a recognized bite is low (1 to 3%).”
  • “There is no evidence that patients treated for Lyme disease who have persistent, nonspecific symptoms (eg. arthralgia and fatigue) have persistent infection; the risks of prolonged treatment with antimicrobial agents far outweigh the benefit, if any.”
  • There is “extensive publicity as well as misinformation on the Internet about ‘chronic’ Lyme disease, a condition for which there is no clear definition or scientific evidence of its existence.”

My two cents: ‘an ounce of prevention is worth a pound of cure.’  If spending a lot of time outdoors, consider applying topical insecticides like DEET and/or wearing long sleeves/pants.

More important globally than Lyme disease is the deadliest animal in the world (from Bill Gates), http://b-gat.es/1kjGmpL :

Which animal kills the most people? Hint: It’s not sharks, lions, or even humans. Introducing Mosquito Week.