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Understanding Lyme Disease and Where It's Found

JUL 24, 2017 | PANELISTS: PETER L. SALGO, MD; ROBERT C. BRANSFIELD, MD, DLFAPA; SAMUEL SHOR, MD, FACP; LEONARD SIGAL, MD; PATRICIA V. SMITH


Peter L. Salgo, MD: Hello, and thank you for joining us today on this Contagion® Peer Exchange® panel discussion focusing on Lyme disease. With the recent explosion of growth in the tick population, states and providers that have not seen cases of Lyme disease in the past, are now being confronted with the illness. Moreover, the fact that some individuals experience lingering symptoms, beyond their initial course of antibiotics, has sparked international debate among experts and advocates alike over why this is occurring, and what should be done to help these patients. Today, we have brought together a panel of experts on both sides of the debate, to better understand their perspectives, and to shed light on the impact the controversy is having on patients and on the medical community.

I am Dr. Peter Salgo, and I’m a professor of medicine and anesthesiology at Columbia University College of Physicians and Surgeons, and I’m the associate director of Surgical Intensive Care at New York-Presbyterian Hospital. Participating today on our distinguished panel are Dr. Robert Bransfield, private practice in psychiatry, in Red Bank New Jersey, and associate professor of Psychiatry at Rutgers Medical School; Dr. Samuel Shor, president of the International Lyme and Associated Diseases Society, and associate clinical professor at George Washington University Health Care Sciences in Reston, Virginia; Dr. Leonard Sigal, past chief of the Division of Rheumatology and current clinical professor at Robert Wood Johnson UMDNJ Medical School, and founder of Gateway Immunoscience in Stockbridge, Massachusetts; and Patricia Smith, president of the national nonprofit Lyme Disease Association, which raises money for research, education, prevention, and patient support. Patricia is also a member of Columbia University’s Lyme and Tick-Borne Diseases Research Center Advisory Committee. She’s a member of the Congressionally Directed Medical Research Programmatic Panel on Tick-Borne Diseases.

Welcome to all of you joining us here today. Why don’t we get some of the basics established right off the bat? Simple question: What’s Lyme disease?

Samuel Shor, MD, FACP: Lyme disease is the most common vector-borne or tick-borne illness in the United States and in Europe that is caused by a spiral or spirochetal organism by the name of Borrelia burgdorferi senso lato complex. That being said, most of us in the field agree with the acute phases of Lyme disease, where it can present with an acute, viral-like illness. What is more contentious is the concept of chronic Lyme disease, which we’ll get into.

Peter L. Salgo, MD: We’re certainly going to get into that, but just for the sake of establishing some definitions—this is a tick-borne disease. It’s a spirochetal disease; it causes illness, and it causes a lot of symptoms. We’ll explore them as we go along. That being said, where is Lyme disease found?

Patricia V. Smith: Well, the current studies seem to indicate that Lyme disease is found in almost 50% of continental United States counties at this point in time, and that’s an increase of 45% since 1998. A lot of the concentration is in the Northeast and the upper Midwest. However, Lyme disease is found in 43 states, but part of the problem of that whole situation of looking for the ticks is that not enough money is being offered to states to do surveillance to find out, “Where are these ticks?â€
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