Working Copy Symptoms Children List

Signs & Symptoms Associated With

Lyme Disease in Children

HOW NOT TO DO A STUDY!

Community of Health Sciences Study, Sweden- In this study we required not only a positive result on a routine ELISA, but also verification with a second ELISA before a case was included as Lyme disease.

Community of Health Sciences Study, Sweden- Patients with arthralgia, myalgia, and the fibromyalgia syndrome alone were excluded.

Community of Health Sciences Study, Sweden- Headache, fatigue, paresthesia, or mild neck stiffness alone was not accepted as evidence of neurologic involvement.

Community of Health Sciences Study, Sweden- Palpitations, bradycardia, bundle-branch block, and myocarditis as single symptoms were not accepted.

Community of Health Sciences Study, Sweden- Cases with negative Western blots were excluded.

Community of Health Sciences Study, Sweden- Twenty-seven of 85 patients had negative Western blot tests and were therefore classified as not having Lyme disease.

Community of Health Sciences Study, Sweden- A lumbar puncture was performed in 284 of 369 patients with neurologic symptoms.

Community of Health Sciences Study, Sweden- Patients with increased numbers of lymphocytes had no detectable antibodies to B. burgdorferi in cerebrospinal fluid or in serum and were therefore classified as not having Lyme disease.

Community of Health Sciences Study, Sweden- Results/Conclusions- Most of the patients had benign symptoms.

Turku University Central Hospital, Finland- Only patients with culture- or PCR-proven disease were enrolled in the study.

Turku University Central Hospital, Finland- Avoid patients with post-Lyme syndrome (1993).

Just plain old nasty

The committee recommends that insurance companies do not pay for laboratory assessments that are not indicated.

In addition, the committee asks laboratories not to recommend further serological assessments after a few weeks or months when interpreting serological results.

The belief that chronic Lyme disease exists is not supported by the evidence. It is a disservice to patients with unexplained symptoms to pastethat label on them and treat them with potentially harmful long-termantibiotics. They are suffering, and they deserve our compassion and the bestthat science-based medicine has to offer, not bogus treatments by charlatans orwell-meaning but misguided LLMDs. American Lyme Disease Foundation (ALDF)

German Committee for Infectious Diseases and Vaccinations- The committee recommends that insurance companies donot pay for laboratory assessments that are not indicated.This includes serological tests without well-founded clinical suspicion, tests for borrelial antigens or genomicsequences in ticks, and lymphocyte transformation assays.

The committee recommends that insurance companies do not pay for laboratory assessments that are not indicated.

In addition, the committee asks laboratories not to recommend further serological assessments after a few weeks or months when interpreting serological results.

Proof of spirochetes- children and/or adults

1985

Eyes- Blindness- Unilateral iritis followed by panophthalmitis- spirochetes found in specimens of vitreous debris obtained at surgery

Dangerous and Stupid

"Within endemic regions of the United States, selected states have higher Lyme rates, and within those states, there is significant variation by county. Our findings support a general approach of estimating clinical risk of disease at the point of care, accounting for recent spatial incidence.

This approach emphasizes applying epidemiologic context to the clinical decision making process rather than relying solely on history, physical exam, heuristics and preliminary diagnostic test results.9, 32, 33

Improved collaboration between public health departments and clinicians, the maturation of electronic health records, and advances in disease surveillance and automated reporting now increase the feasibility of delivering readily available and easily computed relevant public health information to clinicians at the point of care.3436

An important goal of national efforts to promote health information technology should be to foster electronic bidirectional communication of data and messaging between public health and clinical sites."

Integrating Spatial Epidemiology into a Decision Model for Evaluation of Facial Palsy in Children

Link- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644029/

Costs

The mean cost estimate of CLD per patient in the US, of $16,199 per annum in 2002 dollars [8], reflects the toll on human health and cost to society. The annual per-patient cost of CLD is substantially higher than the cost for other common chronic illnesses: $10,911 for fibromyalgia [21], $ 10,716 for rheumatoid arthritis [21], and $13,094 for lupus [22]. Eighty-eight percent of the cost ($14,327) of Lyme disease consisted of indirect medical cost, nonmedical cost, and productivity losses. Cutting medical cost would save, at most, only 12% or $1,872 per annum. In 2002, the annual economic cost of LD in the US, based on the 23,000 cases reported to the CDC that year, was estimated to be $203 million [8]. Considering that the actual number of LD cases is believed to be 10 times higher than the number of cases reported to the CDC, the actual annual cost could be $2 billion [23, 24]. Source Here

The total cost of NB-related healthcare was estimated to be euro500,000 for the entire study group (euro3300 per patient), and the cost of social benefits was estimated to be euro134,000 (euro2000 per patient). Source Here

Pregnancy & Lyme

Syphilis and lyme borreliosis have similar etiologic, clinical, and epidemiologic characteristics- therapy of pregnant women with syphilis and lyme borreliosis should follow the same strategy.

Add to list

Statements Proven False or Counterproductive

Patients with chronic pain, fatigue, or mental state disturbances should not be tested for Lyme borreliosis.

Just plain old nasty

My notes

The authors conducted a selective review of the literature, including various national and international guidelines.