Incidence and Impact of Lyme Disease on the Rise

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With roughly 20,000 new cases reported each year to the Centers for Disease Control and Prevention, Lyme disease is the most common vector-borne infection in the United States. As infections increase, the need for research becomes clear.

The rates of Lyme disease -- and the serious, often debilitating symptoms it can cause -- have been rising steadily across the U.S. and throughout the world. In fact, health experts from the Wildlife Conservation Society just released a report listing 12 pathogens, including the agents behind avian flu, Ebola, cholera, and Lyme disease, which are likely to invade new regions as a result of global climate change. Other experts are reporting that the ticks that carry the Lyme disease bacteria, Borrelia burgdorferi, once thought to be transmitted only by deer and mice, can also be spread by chipmunks and other small animals.

With roughly 20,000 new cases reported each year to the Centers for Disease Control and Prevention, Lyme disease is the most common vector-borne infection in the United States. Yet Lyme disease is hardly at the top of many researchers' rosters, says Dr. Harriet Kotsoris, neurologist and medical advisor to Time for Lyme, Inc., a research, education and advocacy group that along with the Lyme Disease Association recently endowed the first Lyme and Tick-Borne Diseases Research Center at Columbia University Medical Center in New York City dedicated to the study of chronic Lyme disease.

Why? For one thing, while everyone agrees that rates of Lyme infection continue to rise, there's no consensus on why they're rising. Since the early 90s, the annual number of reported cases has more than doubled. This reflects a growing problem which may only represent the tip of the iceberg. Both testing and surveillance methods are inefficient, which leaves thousands undiagnosed and therefore uncounted. To further complicate matters, many experts argue that Lyme disease is over-reported (others say it's under-reported), and most observers agree that there are significant differences in the way Lyme disease is diagnosed and tracked in various states in the U.S.

Another topic of debate is the disease itself -- more specifically, the way it can manifest itself in the months and years after the initial infection. Many experts argue that chronic or long-term Lyme can produce a long list of symptoms, including neurological and psychiatric problems, while others contend that the condition doesn't even exist. Just last year, the New England Journal of Medicine published an article disputing the existence of chronic Lyme -- and essentially ignoring more than 19,000 scientific studies on tick-borne illnesses in the process.

What's more, Lyme disease is only one of a whole host of diseases that are essentially competing for researchers' attention -- and dollars, says Dr. Kotsoris. "Lyme disease is just one of many serious diseases, and unfortunately, many of them get a lot more attention from the media -- the research facilities -- and the pharmaceutical companies -- than Lyme does."

In response, Time for Lyme has made substantial donations to several institutions and individuals, all of whom are conducting important research in a few different areas:

Better Antibiotics
Dr. Benjamin J. Luft, the Edmond Pellegrino Professor of Medicine at the State University of New York (SUNY), Stony Brook, is on a quest to find better antibiotic therapies for Lyme disease. We know that the Borrelia burgdorferi bacteria can remain viable in animals even after treatment with penicillin, tetracycline and macrolide antibiotics. Dr. Luft and his colleagues have discovered that the microbes possess something known as efflux pumps in their cell membranes, which help eliminate antibiotics and other toxins from the bacteria's body and thus help them survive. Research is underway to determine the mechanisms of resistance and whether two already approved antibiotics could block these efflux pumps and allow antibiotics to build up inside the bacteria, thus speeding their death.

Chronicling Chronic Lyme
Dr. John Aucott, Principal Investigator for the Lyme Disease Research Foundation of Maryland, is conducting a longitudinal study in collaboration with scientists at the Johns Hopkins School of Medicine. The clinical research team will examine the course of infection with the Lyme organism and the resulting illness from the initial rash to the chronic persistent stage. His objectives: to measure risk factors, symptom pattern and severity, and immune system response over time in patients with chronic Lyme symptoms.

Treating Persistent Symptoms
Dr. Armin Alaedini, Assistant Professor of Neuroscience at the Weill Medical College of Cornell University, is conducting research to determine the relevance and role of the body's immune system in chronic Lyme. To better understand how to help patients whose symptoms persist after antibiotic treatment, Dr. Alaedini is analyzing blood and spinal fluid for biomarkers that might correlate with various symptoms of the disease.

Research like this is not just important, says Dr. Kotsoris: It's absolutely essential. "We need to keep pushing for answers so that we can minimize and even eliminate these infections and their devastating effects," she says.

About Time for Lyme
Time for Lyme is an organization dedicated to eliminating the devastating effects of Lyme disease and other tick-borne illness. Our mission is to prevent the spread of disease, develop definitive diagnostic tools and effective treatments, and to ultimately find a cure for tick-borne illness by supporting research, education, and the acquisition and dissemination of information. In addition, we will continue to act as advocates for Lyme disease sufferers and their families through support of legislative reform on the federal, state and local levels. For more information on our organization, please visit http://www.timeforlyme.org.

April 18, 2009, Time for Lyme will present its bi-annual Gala event - The Dream, Creating a Lyme Free World, at the Hyatt Regency in Greenwich, CT. Proceeds from the Gala will go towards combating the devastating effects of Lyme and other tick borne illnesses. Call 203-969-1333 for more information and tickets.

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MELISSA CHEFEC
MCPR
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