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Understanding the Increase in Reported Lyme Disease Cases in 2022

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Ayanna Amadi
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Understanding the Increase in Reported Lyme Disease Cases in 2022

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Understanding the Reported Increase in Lyme Disease Cases

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In 2022, the U.S. saw a significant increase in reported Lyme disease cases, with a rise of nearly 70%, reaching over 62,000 reported cases. This increase, however, is largely attributed to a change in reporting requirements rather than a major surge in new infections. This has been confirmed by the Centers for Disease Control and Prevention (CDC), who noted that the numbers for 2023 will be released later this year.

Lyme disease is the most common tick-borne infection in the U.S., significantly affecting the Northeast, Midwest, and mid-Atlantic states. It is estimated to affect about 476,000 Americans annually. However, it's important to note that only a fraction of these cases are officially reported.

Changes in Reporting and Surveillance Methods

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The sudden increase in reported Lyme disease cases in 2022 is largely due to changes in the surveillance methods. The revised case definition now allows for reporting of cases from high-incidence jurisdictions based on laboratory evidence alone, eliminating the need for additional clinical information. This change in reporting requirements, which now only demands a positive lab test for reporting cases, has inevitably contributed to the increase in reported cases.

According to the CDC, there was a relative change in incidence increasing with patient age, and the reported Lyme disease cases were 1.7 times the annual U.S. average during 2017-2019. A total of 62,551 Lyme disease cases were reported to the CDC in 2022, representing an overall 68.5% increase from the annual average of 37,118 cases reported during 2017-2019.

Understanding Lyme Disease

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Lyme disease is caused by the bacterium Borrelia burgdorferi, transmitted through the bites of black-legged ticks, mainly found in certain states. The infection is treated with antibiotics, but if left untreated, it can spread to the joints, heart, and nervous system. The existing diagnostic tests do not detect the disease in the first weeks after infection, which makes it challenging to capture the full burden of Lyme disease.

The previous surveillance system required public health departments to verify with every physician who ordered a test to see if the clinical picture supported a diagnosis of a current Lyme infection. The new surveillance approach was developed to manage the high volume of suspect cases that needed to be investigated and to meet the diverse needs of states in terms of Lyme surveillance.

Implications of the Reporting Change

Despite the significant increase in reported Lyme disease cases in 2022, the CDC emphasized that there is no cause for alarm as this upsurge is due to changes in how cases were reported. With the new reporting requirements, cases that would not have been counted previously are now included in the count. Still, researchers caution that cases of Lyme disease are likely under-reported, especially among mild cases and outside of the regions where the disease is most common.

The COVID-19 pandemic also influenced the reporting of Lyme disease cases, with a drop in reporting in 2020 and 2021. There is also evidence suggesting a potential southward expansion of the disease, highlighting the need for increased awareness and diagnostic capabilities. Therefore, while there is no major surge in new Lyme disease infections, the change in reporting requirements underscores the importance of continuous surveillance and improved diagnostic methods in managing Lyme disease.

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