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CDC EIS Officers Presented Emerging Vector-borne Disease Research at Recent Conference

Natalie A. Kwit, DVM, MPH and her co-authors assessed employer-insured patients with Lyme disease diagnosed with carditis, meningitis, facial palsy, and arthritis. They used MarketScan® insurance claims databases that contain diagnosis and treatment information for roughly 40 million employer-insured Americans under 65 and their dependents in the US and the District of Columbia. (
“Each year, an estimated 300,000 Americans are diagnosed with Lyme disease, a zoonotic infection caused by Borrelia burgdorferi and transmitted by certain species of Ixodes, blacklegged ticks,” Dr. Kwit said in her talk.
The researchers identified 93,981 patients diagnosed with Lyme disease. Their median age was 41 years and 51% were female. The mean annual incidence was 51 per 100,000 persons, and 3,406 (3.6%) patients had codiagnoses consistent with disseminated Lyme disease: 348 (0.3%) carditis, 451 (0.5%) meningitis, 447 (0.5%) facial palsy, and 2,160 (2.3%) arthritis. More than one disseminated co-diagnosis was reported in 174 patients and 35% of patients with disseminated disease were hospitalized.
Males between 17 and 33 were at significantly higher risk of both carditis (odds ratio [OR] 2.09; 95% confidence interval [CI], 1.87 to 2.30) and facial palsy (OR 1.26; 95% CI, 1.04 to 1.48); meningitis risk was highest among children of either sex aged 0 through 16 years (OR 1.90; 95% CI, 1.73 to 2.06); and arthritis most strongly affected females 34 to 50 (OR 1.18; 95% CI, 1.09 to 1.27).
Although the MarketScan® database may not be represent the entire US population and its codes designed for insurance reimbursement may not always reflect true disease, these findings may be used to help diagnose and prevent Lyme disease, the authors suggested.
Lorraine L. Janeczko, MPH, is a medical science writer who creates news, continuing medical education and feature content in a wide range of specialties for clinicians, researchers and other readers. She has completed a Master of Public Health degree through the Department of Epidemiology of the Johns Hopkins Bloomberg School of Public Health and a Dana Postdoctoral Fellowship in Preventive Public Health Ophthalmology from the Wilmer Eye Institute, the Johns Hopkins University School of Medicine and the Bloomberg School.

SOURCE: EIS 2016 Conference Program, pp 54-57: Concurrent Session F1: Vectorborne Diseases
Studies Presented:
Cara C. Cherry, DVM, MPH, EIS officer, Office of Public Health Scientific Services, Knowledge and Use of Prevention Practices for Chikungunya Virus Among Visitors — Virgin Islands National Park, 2015
Jefferson M. Jones, MD, MPH, EIS officer, Office of Public Health Scientific Services, Binational Dengue Outbreak Along the United States-Mexico Border — Yuma County, Arizona and Sonora, Mexico, 2014
Ian D. Plumb, MD, EIS officer, Office of Infectious Diseases, Endocarditis from Bartonella quintana in Anchorage, 2012–2014
Heather Venkat, DVM, MPH, EIS officer, Office of Public Health Scientific Services, Evaluation of a Query for Identifying West Nile Virus Symptoms Using Arizona’s BioSense Platform Data —2015
Jessica A. Nadeau, PhD, MPH, EIS officer, Office of Public Health Scientific Services, Risk Factors for Disseminated Lyme Disease — United States, 2005–2013
Natalie A. Kwit, DVM, MPH, EIS officer, National Center for Emerging and Zoonotic Infectious Diseases, Risk Factors for Disseminated Lyme Disease — United States, 2005–2013
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