US politicians propose legislation to tackle the growing problem of Lyme disease across the country.
Last week, in an effort to address the growing number of Lyme disease cases in the state of New Jersey and across the United States , U.S. Representative. Chris Smith (R-N.J.) announced that he had introduced legislation, with backing from both political parties, to authorize $100 million of extra funding over 5 years, aimed at dramatically expanding Lyme disease research and education.
Rep. Smith's proposed bill, known as the 'Lyme and Tick-Borne Disease Prevention, Education, and Research Act of 2007', would, as the name suggests, tackle the increasing problem of Lyme disease from every angle. Details of the bill reveal that it would improve laboratory tests used to diagnose Lyme disease, as well as enhancing the public health surveillance systems and improving public education campaigns to reduce new cases of Lyme disease. The bill would also would create an advisory committee on Lyme and other tick-borne diseases.
Lyme disease is an infectious disease caused by a spirochete (spiral shaped bacterium) known as Borrelia burgdorferi (Bb). The disease is most often spread by ticks, but can also be transmitted by other insects such as fleas, mosquito's, and mites. Although the infection is usually caught by way of tick bites, it has been suggested that infected insects might not actually have to bite a person to infect them. Worryingly, there is also evidence that Lyme disease can be spread by a number of other non-insect methods including from person to person through sex, or from mother to baby in the womb. Researchers at the University of Wisconsin have found dairy cattle and other animals can acquire the disease and pass it on to humans through the food chain.
Cases of Lyme disease have increased rapidly in recent years. Figures for 2005 (the most recent available) reveal that 22,000 new cases were reported across the US in that year. Due to poor awareness and diagnosis however, it is estimated that only 10% of cases are reported, so the actual numbers are likely to be over 200,000. To cloud the numbers still further, it's known that of those infected with Borrelia burgdorferi, only a small proportion show any signs of illness. A study conducted in Switzerland in 1998, found that only 12.5% of those infected with spirochete had any clinical symptoms. Borrelia burgdorferi can lay dormant for years, but those infected could develop symptoms at any time, leading to the possibility of an explosion of cases in the future.
In the state of New Jersey in 2005 there were 3372 reported cases of Lyme disease, the 3rd highest of all the states. Again though, the actual number of cases is likely to be up to 10 times as many. Indeed, in a press release Rep. Smith says that the Centers for Disease Control (CDC) admits that with better diagnosis and reporting procedures, their own figures for cases in New Jersey would be around the 30,000 mark for 2005.
When proposing his new Lyme disease bill, Smith said "The number of reported Lyme disease cases in New Jersey has skyrocketed in recent years. Our state currently ranks third in the nation in the number of reported cases, trailing only our regional neighbors, New York and Pennsylvania. We must increase our investment in understanding and combating Lyme disease before these numbers reach epidemic proportions."
Commenting on the gulf between reported cases and estimates of actual numbers, Smith said "Improving testing and surveillance should lead us to a more accurate reflection of the extent of the outbreak in our state and across the nation."
Initial Lyme disease symptoms are quite easy to spot. They include those directly associated with tick bites such as a tell tale rash known as erythema migrans, often referred to as a "bulls-eye" rash due to it being a large, round spot, often with a pale area in the centre. Other more general symptoms include those usually associated with infectious diseases, such as fatigue, aching joints and muscles, fever, and headaches.
To be successfully treated the infection must be caught early, which makes the proposed improvements in testing, awareness, and diagnosis, very important. If Lyme disease becomes chronic it can cause a whole host of debilitating symptoms which can leave sufferers unable to work and having to claim disability benefits. Chronic Lyme disease can cause symptoms in every system of the body and for this reason it is often referred to as the "great imitator". Many doctors with a high degree of awareness about Lyme disease believe that many unexplained chronic illnesses could actually be undiagnosed Lyme disease. The Sierra Integrative Medicine Clinic in Reno, Nevada, states that "Authorities estimate that up to 90% of the (US) population could be carrying the Lyme spirochete and that Lyme is a factor in over 50% of chronic illnesses."
Lyme disease is suspected of being to blame, at least in part, for many cases of unexplained chronic illnesses such as chronic fatigue syndrome (CFS), fibromyalgia (FMS), and Gulf War syndrome (GWS). The American Lyme Disease Alliance (ALDA), found that most patients diagnosed with chronic fatigue syndrome were actually suffering from Lyme disease. From 31 volunteers diagnosed with chronic fatigue syndrome, the study found that 28 were actually suffering from Lyme disease. With recent surveys indicating that around 5% of the population in developed nations are suffering from these unexplained illnesses, improved testing and awareness of the role of Lyme disease could help relieve the suffering of those affected, and reduce the burden on governments paying disability benefits.
Rep. Smith has been a long-time advocate of Lyme disease research and prevention funding, having previously introduced legislation aimed at increasing Lyme disease research and awareness . Last July, he organized a Lyme disease summit, bringing together the national director of the Centers for Disease Control (CDC) Julie Gerberding, other lawmakers, doctors and activists to discuss ways that the needs of patients and doctors could be met.
"As the numbers show, the Lyme disease outbreak is only going to get worse the longer we wait to address it. I will continue to vigorously work with my colleagues in Congress to secure passage of this important bill to enhance our ability to treat this debilitating disease and begin to reverse the trend of record Lyme disease cases," said Smith.
Smith's bill is the only one to address Lyme disease at a national level and be submitted to Congress, but efforts are also being made elsewhere to tackle the disease. In Connecticut, Reps. Jason Bartlett (D-Bethel, Danbury, Redding) and William Tong (D-Stamford, New Canaan), Attorney General Richard Blumenthal, and members of the Lyme disease community announced new legislative proposals last month to increase Lyme disease awareness and prevention in the state.
The Connecticut proposals mirror those of Smith's bill in calling for improved education, reporting, and awareness. They also call for the reinstatement of The Department of Public Health's policy of having all laboratories report positive Lyme tests, which was discontinued in January 2003.