Tuesday 24 November 2015

MISLEADING LYME DISEASE FIGURES PHE 2015

Public Health England published the latest figures for 

Common animal-associated infections quarterly reports: 2015
https://www.gov.uk/government/publications/common-animal-associated-infections-quarterly-reports-2015


Lyme borreliosis (Borrelia burgdorferi) Total cases of positive serology in the first 3 quarters of 2015 = 606

 of these 429 were considered to be Acute infections.
Lyme disease (data from the Rare and Imported Pathogens Laboratory, Porton) 
'During the third quarter of 2015, a total of 421 cases of laboratory confirmed Lyme disease were reported, compared with 300 during the third quarter of 2014. Of these cases, 340 were acute (including 30 neuroborreliosis) and 81 were past infections. Of the acute cases, 182 were male (aged 2- 90 years, median 46) and 151 were female (aged 1- 93 years, median 51). Gender was unrecorded for seven cases and age was unrecorded for one case.' 

'Thirty-four (10%) of the acute cases reported foreign travel. The majority of cases had travelled in Europe (n=24), eight had travelled in the Americas, one had been to the Middle East, and one to the Far East. One hundred and fifty-six acute cases reported an insect bite, of whom 145 specified a tick bite. Sixty-eight cases reported erythema migrans as a presenting symptom.'

These figures leave far more questions than answers. -

PHE refer to cases that were not considered to be acute cases as past infection - that is quite misleading because there is no test used by NHS that can say the infection was a past infection. The normal rules of antibody responses do not always apply with Lyme disease - the immune system shows an undulatory immune response in early disease and has not been researched in late disease, although cases are documented of further IgM spikes in later disease as is found in Relapsing fever Borreliosis.

340 acute cases of which 68 reported erythema migrans ie 20% suggest that maybe rather less than the 60% often quoted of people develop a erythema rash
 - but as Lyme Disease Action say in recent tweets
'NB this only lab reports. Aim to reduce this to zero - those with EM should be treated without blood test.'
 '% of acute cases sent for a blood test when they have EM ideally = zero. EM Should be treated w'out test.'
'See lymediseaseaction.org.uk/wp-content/upl under "What needs to be done No, 1" Hope it explains.'

Why are doctors sending blood to be tested when patients have presented with an EM rash? - NHS guidance says to treat, testing is not required and is unlikely to be positive in the first few weeks when treatment is necessary to try to prevent further sequale.

Anecdatol reports suggest that many doctors are not prepared to consider treatment unless they have a positive test result and others have been reported to withdraw treatment even with an EM rash because the test result comes back negative, completely contrary to the NHS guidance.

Estimates of actual Lyme Disease cases are considered by CDC and a previous head of Lyme reference unit in Scotland to be 10x that of serological positive cases
 http://lookingatlyme.blogspot.co.uk/2011/03/lyme-disease-cases-soar-in-tayside-but.html

How blind our governments are to the Economic costs of this disease - http://lookingatlyme.blogspot.co.uk/2015/02/economic-costs-of-lyme-disease-lessons.html 

I posted about the figures in 2011 with information on figures in other European countries to compare how low reported cases in UK are by comparison -why?
http://lookingatlyme.blogspot.co.uk/2012/09/has-health-protection-agency-once-again.html


also earlier figures http://lookingatlyme.blogspot.co.uk/2012/03/lyme-disease-increases-again-in-uk.html

and http://lookingatlyme.blogspot.co.uk/2011/12/concern-over-increasing-lyme-disease-in.html 


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