Lyme disease, transmitted by a bite from a tick infected by the Borrelia burgdorferi bacteria, had long been considered easy to treat, usually requiring a single doctor’s visit and a few weeks of antibiotics for most people.
But new research from the Johns Hopkins Bloomberg School of Public Health revealed
that a prolonged illness associated with the disease in some patients is more widespread and serious than previously understood.
With an estimated 240,000 to 440,000 new cases of the tick-borne illness diagnosed every year, the researchers found that Lyme disease costs the U.S. health care system between $712 million and $1.3 billion a year — or nearly $3,000 per patient on average.
Some doctors call those persistent symptoms post-treatment Lyme disease syndrome (PTLDS); others call it chronic Lyme disease. Still others attribute the complaints of fatigue, headaches and memory problems to the hum of daily life, the aches and pains that come with aging.
At the core of the controversy is whether PTLDS can be a severe and chronic condition that requires more than reassurance and symptomatic therapy. While a blood test can confirm Lyme disease, there is no definitive test for PTLDS and there are no approved or proven treatments. It’s a controversial topic in medicine, the researchers said.
“Our study looks at the actual costs of treating patients in the year following their Lyme diagnosis,” said study author Emily Adrion.
“Our data show that many people who have been diagnosed with Lyme disease are in fact going back to the doctor complaining of persistent symptoms, getting multiple tests and being treated. They cost the health care system about $1 billion a year and it is clear that we need effective, cost-effective and compassionate management of these patients to improve their outcomes even if we don’t know what to call the disease,” she said.
Lyme disease is named after the town in Connecticut where it was first recognized in 1975. Itnow hits its peak in June and July and is found all over the U.S. The tick causes a skin reaction that resembles a bulls-eye or spider bite. If left untreated, Lyme disease may lead to neurologic and rheumatic symptoms weeks or months later.
Treatment with the antibiotic doxycycline is associated with a more rapid resolution of early signs of infection and prevention of the majority of later symptoms, the researchers said.
Lead author John Aucott, MD, said it does no good to keep debating the existence of long-term problems related to Lyme disease while people are suffering a debilitating illness, and increase awareness of potential complications is crucial to avoid misdiagnosis and unnecessary medical testing.
“These patients are lost,” he says. “No one really knows what to do with them. It’s a challenge, but the first thing we need to do is recognize this is a problem. There is not a magic pill. These patients already got the magic pill and it didn’t work.”
“Health care costs, utilization and patterns of care following Lyme disease,” Emily Adrion, John Aucott, Klaus Lemke, Jonathan P. Weiner, PLOS ONE Feb. 4, 2015.