Wednesday 26 September 2012

HAS THE HEALTH PROTECTION AGENCY ONCE AGAIN FAILED US?

The Health Protection Agency publishes the figures for Lyme Borreliosis in England and Wales in 2011.here 

In 2011, 959 cases of laboratory-confirmed Lyme borreliosis (LB) were identified in residents of England and Wales, an incidence rate of 1.73/100,000 total population. This compares with 905 cases and an incidence rate of 1.64/100,000 in 2010. Excluding the 197 (21%) people known to have acquired their infection abroad during 2011, 762 are believed to have acquired their infection in the UK an incidence rate of 1.38/100,000 total population.

(To those not familiar with Lyme Disease certain sources believe the true figures of cases are likely to be about 10x the number of serological cases year on year.)

One point that interested me was this 'Almost  half (n=463) reported presentations compatible with recent infection,' therefore the other half must be cases found beyond the early stages of disease- perhaps disseminated Chronic Lyme Disease!

Did the HPA recommended treatment of a couple of weeks antibiotics cure all, actually do that? or maybe that is the reason so many patients are joining Eurolyme looking for answers to why their NHS short treatment didn't work.

This NHS doctor has something to say about her initial failed treatment but recovery on longer treatment here 

This BBC interview In 2007 with researcher Dr Klaus Kurtenbach ( sadly now deceased) has some very interesting points here


"In France they have diagnosed 10 times as many cases as here", says Dr Klaus Kurtenbach, one of the scientists at Bath University.
"Yet we've found the same number of ticks here carrying the disease."
Scientists in forest
Scientists studying ticks in the West Country's open spaces
Dr Kurtenbach and his colleagues believe British doctors are failing to spot the symptoms of the disease.
They say hundreds of people are suffering with headaches and even mild paralysis, who could be treated.
For Inside Out West, Dr Kurtenbach went out to woods near Bath to gather ticks.
Even in February, he found a large number of the bugs.
"Many people think it's only a problem in summer, and only in major forests", he says.
"But we are finding them now, and in greater numbers than ever."
It's clear that the public needs to be more aware of the growing health risk.





France (over 10 times the incidence as the UK's)
"In France, the incidence has varied considerably from one region to another
and it is estimated between12,000 and about 15,000 the number of new cases per
year. "
(Compare this with about 2,500 per year over the whole of the UK including
Scotland)

"The eastern and central regions are most affected, with an incidence of up to
more than 200 cases/100,000 population in Alsace." link here 


Germany (148 times the UK rate)
"An incident diagnosis of LB was coded in 14,799 and 16,684 individuals for the
years 2007 and 2008, respectively, resulting in an incidence of 261/100,000
cases annually in the DAK cohort. Although the extrapolation of these numbers
may lead to an overestimation due to clinical misdiagnosis and/or miscoding, our
findings translate into 213,912 annual incident cases on a population-wide
scale, which suggests more LB cases in Germany than projected previously in the
available literature dealing with this topic." 

Taken from 
Clinical and Developmental Immunology
Volume 2012 (2012), Article ID 595427, 13 pages
doi:10.1155/2012/595427
Research Article: Evaluating Frequency, Diagnostic Quality, and Cost of Lyme
Borreliosis Testing in Germany: A Retrospective Model Analysis
Link here 

Netherlands (20 times as many cases reported compared with England and Wales)
Our nearest neighbour, the Netherlands, has 43 per 110,000 (slightly different
use of 110,000 instead of 100,000 there but I don't know why, that's at

least 20 times the rate supposedly in England and Wales.) Link here 

Belgium (45 times the rate reported in England and Wales)
Europe Journal of Clinical Microbiology and Infectious Diseases
2012, DOI: 10.1007/s10096-012-1580-3
"The overall Belgian incidence rates in the SGP practice in 2008–2009 were 18.65
(95% CI 17.29–20.08) per 10,000 persons for tick bites and 9.02 (95% CI
8.08–10.03) for erythema migrans."

This means 90.2 actual infections per 100,000. Link here 


Norway (about 40 times the UK incidence)
Depending on the region, up to 84 per 100,000. They have really detailed maps of
the worst areas on the west coast, and south coast, which is where everyone
lives) Link here  



Thanks to Denise Longman for sharing her research into these figures from our neighbouring countries.

3 comments:

  1. This is exactly why it's so important that doctors and their patients work together- I wrote my book specifically to help avoid misdiagnosis and stop the pain as soon as possible.

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    Replies
    1. Thanks for your comment Dr Petraglia I had read some of your posts on line recently. It does seem that so much of medicine at the doctors surgery is one type of pain killer or anti depressant or steroid I so wish that first locum doctor who I saw with bites bulls eye rashes had known enough to consider Lyme Disease as a differential diagnosis, it would have spared me 4 years of chronic arthritis and muscle weakness. However I consider myself fortunate to have had a very understanding doctor who has treated me on long term antibiotics and I have made a good recovery. How many so crippled with arthritis make such an amazing recovery and how many more have had their diagnosis missed just like me? And have spent years on pain killers, steroids and anti - depressants and could have recovered on a different treatment.

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  2. From Lymenet Europe
    The political situation in the UK is far more extreme,
    with the HPA (Health Protective Agency) actually FORBIDDING
    UK physicians from attending International symposia on Lyme borreliosis
    in Year 2011.

    For many years ( until retirement in year 2011) Dr Susan OConnell MD was in
    the position of complete control of all lyme Borreliosis testing, which under her
    custodianship, was coincidentally centralized at her personal hospital--
    Southampton Hospital. Following her retirement, the HPA (central UK Health authority)
    elected to relocate the centralization of UK national Lyme disease testing to
    the Porton Down facility ( which is mandated by Parliament to oversee
    Biodefense and Biowarfare Activities fo the UK).
    Under the custodianship of Susan OConnell MD, the United Kingdom has the lowest
    number of annual new Lyme borreliosis cases in the entire European Community.

    Physicians who are general practitioners in the British NHS have signs posted in their
    waiting rooms which direct patients who believe that they might have signs and symptoms of Lyme borreliosis to "go elsewhere".

    It is simple to understand why the UK has the lowest annual number of new Lyme Borreliosis cases of any country in Europe.

    By way of contrast, Germany (including both East and West Germany) reported about 250,000 new cases of Lyme borreliosis for calendar year 2011. Estimates of the actual (unreported cases) number of LB annual cases for years 2011 to 2012 are projected by to be 750,000 new cases per annum. Some German physician observers feel that 750,000 cases estimate is in fact only 50% of the actual Lyme Borreliosis new case load per annum.

    These statistics are received from physicians who practice Infectious Disease Medicine
    in Germany.
    http://www.lymeneteurope.org/forum/viewtopic.php?f=6&t=4204&sid=557e7848b2acc0ab7f79d5411c6a7618&start=70

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