Lyme Disease: Difficult Diagnosis Contributes to Problems

Second only to AIDS, Lyme disease is among the fastest-growing infectious diseases in the United States, yet it is widely under-reported. In fact, some estimates suggest the number of Lyme disease cases is up to 15 times higher than what is reported. This is an extraordinary figure, especially given the fact that the disease wasn’t widely known until an outbreak in Lyme, Connecticut, in 1975.

Why is Lyme Disease So Prevalent Yet So Underreported?

Because the tiny ticks, which spread the disease, inject a numbing agent, many people who are bitten don’t realize it. Also, although most of the attention is paid to the Northeast, cases have been reported in every state. Oftentimes, Lyme awareness and physician knowledge of the disease and competency in treating it are deficient in these other states.

There is also confusion surrounding the common carriers of Lyme disease. Although deer ticks are often associated with transmittal, lone star ticks, western black-legged ticks, and wood ticks (or dog ticks) can spread the disease as well. Treating physicians may not recognize these other carriers and fail to correctly diagnose and report the disease as a result.

Lyme Disease is Often Misdiagnosed

Often ignored and misunderstood, Lyme disease is a condition that is rarely diagnosed properly.

One reason for the difficulty in diagnosis is that conditions such as Fibromyalgia, Chronic Fatigue Syndrome, MS, ALS, Parkinson’s and Alzheimer’s, as well as more than some 350 different diseases, have symptoms similar to Lyme disease. Also, while the characteristic “bull’s eye” rash (erythema migrans) is associated with Lyme disease, the rash only appears in an estimated 50% of infected individuals, or it may appear in a different form. Further problems stem from the fact that most physicians do not know how to recognize or treat Lyme disease. Lyme disease has a complex pathogenesis and is a multisystem disease. Clinical presentation can be subtle and complex, and as a result, diagnosis is heavily based on history, symptoms, response to therapy, and other clinical information. Lastly, the ticks that transmit the bacteria that causes Lyme disease also carry other pathogens that can cause co-infection and will interfere with the clinical diagnosis of Lyme. Co-infections can adversely influence patients’ immune systems and alter the characteristics of the disease and the severity of the infection. As a result of all these factors, misdiagnosis often occurs, and patients receive improper treatment.

Further complications with diagnosis are caused by the lack of adequate testing for Lyme disease. Unfortunately, for people infected with Lyme disease, there is no standard test within the medical field that indicates a positive condition. And, while testing is available, it only focuses on markers for early stages of the disease. As well, current tests at most laboratories are based on only one strain of Borrelia burgdorferi (the bacteria that causes Lyme disease), despite the fact that there are more than 300 strains worldwide (100 in North America alone), such as Borrelia andersonii, Borrelia lonestari, and Borrelia miyamotoi. These other species of Borrelia are ignored mainly because the laboratories have difficulty isolating and identifying them. This difficulty contributes to researchers’ inability to study and understand the bacteria’s pathogenesis.

As a result of these testing limitations, patients have a high probability of receiving false negative test results. Furthermore, because most tests measure antibodies to Borrelia burgdorferi – not the organism itself – patients sometimes test positive even if the organism is no longer present.

The difficulty in diagnosing Lyme disease is made even more challenging when you consider that the possible number of symptoms total around 100.

To avoid long-term complications, proper treatment of the disease is necessary. When not treated correctly, Lyme disease can lead to a lifetime of debilitation.

Envita Medical Centers of America has been treating and studying Lyme disease for almost a decade. As part of our Disease Solutions Program®, we work with a number of specialized laboratories that exclusively test for Lyme disease and its co-infections. This specialized testing ensures that patients receive the most accurate diagnosis available. Our team of physicians also has extensive experience identifying and recognizing the clinical indicators of Lyme disease.

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