CDC Study: Significantly Higher Lyme Disease Rates Among Older Adults Than Previously Reported

The AHA! Team — Mon, 23 Sep 2024 08:24:32 +0000

Dr. Sanchari Sinha Dutta, Ph.D. via News-Medical – The U.S. Centers for Disease Control and Prevention (CDC), in association with the University of Iowa, USA, has conducted an epidemiological study to determine the incidence rate of Lyme disease among older adults in the United States. The study is published in the CDC’s Emerging Infectious Diseases journal. Background Lyme disease, also known as Lyme borreliosis, is a vector-borne bacterial infection caused by a species of Borrelia bacteria that spreads to humans by the bite of infected black-legged ticks (Ixodes scapularis). The main symptoms are fever, headache, fatigue, and a specific type of skin rash called erythema migrans. While Lyme disease can present with a characteristic erythema migrans rash, it can also lead to severe complications if left untreated, including facial nerve paralysis, arthritis, and even heart rhythm irregularities. In the United States, Lyme disease most commonly occurs in the Northeast, mid-Atlantic, and upper-Midwest regions. Previous studies estimating the prevalence of the disease have used employer-sponsored insurance claims data to quantify the disease diagnoses. However, this type of data does not include information on individuals aged 65 years and above who exhibit higher susceptibility to Lyme disease than their younger peers. In this study, scientists have determined the incidence of Lyme disease among older adults in the United States using Medicare fee-for-service data that includes information on individuals aged 65 years and above. Study design The study analyzed Medicare fee-for-service data together with drug treatment data to identify Lyme disease diagnoses among individuals aged 65 years and above. The data collected during 2016 – 2019 was included in the analysis. The Medicare fee-for-service study population was compared with the 2019 US Census estimation data for individuals aged 65 years and above to ensure that the two groups were age-, sex-, race-, ethnicity- and region-matched. Lyme disease diagnoses identified in the Medicare fee-for-service data were compared with the confirmed and probable cases among individuals aged 65 years and above obtained through national surveillance. However, the study also notes certain limitations, such as slight differences between the Medicare fee-for-service population and the U.S. Census population regarding race, ethnicity, and sex. These differences, though small, were stable throughout the study period. Important observations The Medicare fee-for-service population included in the study was estimated to have a median of 17,872,466 person-years during the study period, as compared to the US Census population of 51,561,372 individuals aged 65 years and above. Person-years refer to the number of years for which persons contribute data. The proportion of individuals from neighboring high-incidence states was higher in the Medicare population than in the US Census population. Incidence of Lyme disease A total of 88,485 Lyme disease cases were identified in the Medicare population during the 2016-2019 study period. This corresponded to an average incidence of 123.5 diagnoses per 100,000 person-years. The total number of Lyme disease cases reported through public health surveillance during the same period was 34,183. This corresponded to an average incidence of 16.6 cases per 100,000 persons. Symptoms include fever, headache, fatigue, and a bullseye rash. Approximately 82% of Lyme disease cases were identified among individuals residing in high-incidence states. The median incidence of Lyme disease diagnoses was 346.9 per 100,000 person-years among residents of high-incidence states, 35.3 per 100,000 person-years among residents of states or jurisdictions neighboring high-incidence states, and 29.4 per 100,000 person-years among residents of low-incidence states. Public health surveillance data revealed that about 93% of Lyme disease cases were among residents of high-incidence states. The median incidence of these cases was 57.1 per 100,000 persons among residents of high-incidence states, 3.6 per 100,000 persons among residents of states or jurisdictions neighboring high-incidence states, and 0.6 per 100,000 persons among residents of low-incidence states. The majority of Lyme disease diagnoses occurred in the summer months. Among residents of low-incidence states, a large proportion of disease diagnoses occurred in winter months. According to Medicare and surveillance data, the majority of Lyme disease cases were identified among men. In high-incidence states, men had the highest incidence of Lyme disease for all age groups. In low-incidence states, women had a slightly higher incidence than men only in the 65–69-year age group and 75–79-year age group. Study significance The study identified more than 88,000 adults aged 65 years and above diagnosed and treated with Lyme disease during 2016 – 2019 in the United States. Most Lyme disease cases have been identified among residents of high-incidence states. The study reports a 7-fold higher incidence of Lyme disease diagnoses compared to that reported through public health surveillance. These findings are similar to the findings reported in previous claims analyses. The study also acknowledges the issue of overdiagnosis, which may partly explain the differences observed between the Medicare data and public health surveillance data. Overdiagnosis has been reported in other analyses and may contribute to the higher incidence rates observed in this older population. A variation in Lyme disease seasonality has been observed when Medicare fee-for-service data is compared with surveillance data. Some differences in gender-specific disease susceptibility have also been observed when this study is compared with previous claims analyses. Antibiotics like doxycycline are effective treatments. In previous claims analyses, male children have shown higher susceptibility to Lyme disease in both high- and low-incidence states. In contrast, male older adults have shown higher susceptibility in high-incidence states. Overall, the study findings add insight into Lyme disease patterns unique to this older population in the United States. Journal reference: Schwartz AM. 2024. Epidemiology of Lyme Disease Diagnoses among Older Adults, United States, 2016–2019. Emerging Infectious Diseases. https://wwwnc.cdc.gov/eid/article/30/9/24-0454_article To read the original article click here.

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New Antibiotic Approach Proves Promising Against Lyme Bacterium

The AHA! Team — Fri, 31 May 2024 05:32:44 +0000

Duke Health – A technique that has demonstrated success against cancer tumors could also be lethal to bacteria and other pathogens DURHAM, N.C. – Using a technique that has shown promise in targeting cancer tumors, a Duke Health team has found a way to deploy a molecular warhead that can annihilate the bacterium that causes Lyme disease. Tested in cell cultures using the Borrelia burgdoferi bacterium, the approach holds the potential to target not only bacteria, but also fungi such as yeast and viruses. The findings appear in the journal Cell Chemical Biology. Duke Health team has found a way to deploy a molecular warhead that can annihilate the bacterium that causes Lyme disease “This transport mechanism gets internalized in the bacterium and brings in a molecule that causes what we’ve described as a berserker reaction – a programmed death response,” said lead author Timothy Haystead, Ph.D., professor in Duke’s Department of Pharmacology and Cancer Biology. “It wipes out the bacteria — sterilizes the culture with a single dose of light. And then when you look at what occurs with electron microscopy, you see the collapse of the chromosome.” Haystead and colleagues used a molecular facilitator called high-temperature protein G (HtpG), which is involved in protecting cells that are undergoing heat stress. This family of proteins has been the focus of drug development programs for possible cancer therapies. Studies of this protein as an antimicrobial have also been encouraging, but the Duke team’s work appears to be the first to tether an HtpG inhibitor to a drug that enhances sensitivity to light. The researchers found that the HtpG inhibitor, armed with the photosensitive drug, was rapidly absorbed into the cells of the Lyme bacteria. When hit with light, the bacteria’s cells went into disarray and ultimately collapsed, killing them. “Our findings point to a new, alternate antibiotic development strategy, whereby one can exploit a potentially vast number of previously unexplored druggable areas within bacteria to deliver cellular toxins,” Haystead said. In addition to Haystead, study authors include Dave L. Carlson, Mark Kowalewski, Khaldon Bodoor, Adam D. Lietzan, Philip Hughes, David Gooden, David L. Loiselle, David Alcorta, Zoey Dingman, Elizabeth A. Mueller, Irnov Irnov, Shannon Modla, Tim Chaya, Jeffrey Caplan, Monica Embers, Jennifer C. Miller, Christine Jacobs-Wagner, Matthew R. Redinbo, and Neil Spector (deceased). The study received funding support from the Steven and Alexander Cohen foundation and Bay Area Lyme Foundation. To read the original article click here.

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CDC Study: Significantly Higher Lyme Disease Rates Among Older Adults Than Previously Reported

New Antibiotic Approach Proves Promising Against Lyme Bacterium