Lyme disease

Lyme borreliosis, the most common vector-borne disease in the northern hemisphere, is caused by bacteria belonging to the Borrelia burgdorferi complex. The disease is multisystemic, affecting mainly the skin, nervous system, heart and joints. In Europe, the vector of the disease is the tick Ixodes ricinus, whereas in the United States of America, two primary tick vectors exist, namely: I. scapularis in the north-eastern and mid-western regions and I. pacificus on the west coast. Several species of small and medium-sized mammals and ground-feeding birds serve as reservoirs for the bacteria in endemic areas. The prognosis for patients with Lyme borreliosis is excellent, particularly when diagnosed and treated early in the course of infection. Prevention of Lyme borreliosis can be achieved using two approaches, either prevention of infection by immunisation, or prevention of tick bites through avoidance, personal protection and tick control.     

Lyme disease

Lyme disease is being increasingly diagnosed in the UK. The clinical picture, laboratory diagnosis and treatment of the disease are described and aspects of the pathology and epidemiology are highlighted.     

Lyme disease and post-treatment Lyme disease syndrome: the neglected disease in our own backyard

Objectives

A survey was developed to assess experience and opinions about Lyme disease and post-treatment Lyme disease syndrome (PTLDS) among faculties in public health. No previous surveys of public health faculties have been found in the literature.

Study design

This is a cross sectional study of public health school faculty members designed to measure knowledge and experience with Lyme disease and PTLDS using an internet survey instrument.

Methods

Participants were recruited using all the publicly available e-mail addresses of faculty members in all the 50 accredited Schools of Public Health in the United States.

Results

A 15% response rate was seen for the survey. 50% of respondents were from Lyme endemic states. Less than 5% of faculty members consider themselves expert in Lyme or PTLDS. Many faculty members had known someone with Lyme disease or PTLDS, but few had been diagnosed themselves. Most believe that PTLDS can be severe and chronic, is not easy to treat, and does not resolve on its own, but were uncertain about its aetiology. Most respondents also felt that the incidence of Lyme disease will increase and that more education is needed.

Conclusions

The need for further understanding and communication presents an opportunity for public health research and education in Lyme disease and the sequelae of PTLDS.     

Lyme disease in the highlands

Serological results for Borrelia burgdorferi were examined for one year. The results suggest a 'pocket' of infection in one Highland general practice. In this practice, most of the patients had exposure to tick bites and rashes were frequent. There were difficulties in relating serological results to clinical features and management of some patients.     

莱姆病概述

莱姆病(Iyme disease)是一种由伯氏疏螺旋体(或莱姆病螺旋体)所引起，经硬蜱为主要传播介质的自然疫源性疾病。     

Dispelling the myth: Exploring associations between the HPV vaccine and inconsistent condom use among college students

Human papillomavirus (HPV) vaccination is safe and effective in preventing anogenital cancers and warts. However, myths have surrounded the HPV vaccine since its approval, including the possibility that HPV vaccinated young people are more likely to engage in risky sexual behaviors. The purpose of this study was to assess the association between HPV vaccination and engaging in inconsistent condom use in a sample of U.S. college students. A secondary data analysis of the National College Health Assessment-II (Fall 2013) was conducted in 2015. Risky sexual activity was operationalized as inconsistent condom use for oral, vaginal or anal sexual activity. Logistic regression models were stratified by sexual activity and gender, and controlled for socio-demographics and history of STIs. Inconsistent condom use was reported among females for vaginal (47%), oral (94%), and anal sex (75%); while males reported levels of inconsistency for vaginal (38%), oral (94%), and anal sex (58%). Sixty-nine percent of females reported receiving the HPV vaccine compared to 43% of males. Among females, there was no significant association between HPV vaccination and inconsistent condom use in any of the sexual activities. Among males, there was no significant association between HPV vaccination and inconsistent condom use in oral or vaginal sex. HPV-vaccinated males were less likely to report inconsistent condom use during anal sexual activity. This study contributes to the increasing evidence that HPV vaccination is not associated with risky sexual behavior. Dispelling this myth is important to facilitate uptake and completion of the HPV vaccine in the U.S.     

莱姆病概述及吉林省莱姆病调查研究进展

莱姆病（Lyme disease LD）是由伯氏疏螺旋体（Borrelia burgdorferi）经蜱（中国一些地方俗称草爬子）传播的自然疫源性疾病，是一种新发现的人兽共患病，在世界范围内于人和动物中广泛流行，且发病率呈现上升趋势。     

Dispelling the myth that 50 percent of U.S. schoolchildren have never had a cavity.

The erroneous claim that 50 percent of U.S. schoolchildren have never had a cavity has taken on the virtues of truth through frequent and widespread restatement. The 50-percent caries-free statement is an excessively optimistic misrepresentation by the media of the 1986-87 survey of oral health among schoolchildren by the National Institute of Dental Research because it only tells part of the story--it ignores dental disease in the primary dentition. This article documents that numerous public policy papers reflect failure to consider primary tooth caries data. Consequently, a significant disease burden has been overlooked. The article reviews the persistent underreporting of children''s caries experience in policy documents and the dental literature, and reviews additional epidemiologic studies of caries reported in U.S. dental literature since 1985. Dental caries remains the single most common disease of childhood that is not self-limiting or amenable to a course of antibiotics. The popular statement that half of U.S. schoolchildren have never experienced tooth decay fails profoundly to reflect the extremity and severity of this still highly prevalent condition of childhood. At a time of extreme pressure on the Medicaid Early and Periodic Screening, Diagnosis, and Treatment budget this uncritically held belief is leading to inappropriate policy and funding decisions that can put the health of children at risk.     

Lyme arthritis, Lyme carditis and other presentations potentially associated to Lyme disease

Lyme disease or Lyme borreliosis is the most common tick-transmitted disease in the Northern hemisphere and is caused by Borrelia burgdorferi spirochetes. Lyme disease commonly begins with a characteristic skin lesion, erythema migrans. Weeks or months later, the patients may have neurologic, joint, or cardiac abnormalities. Some patients may still present persistent deep fatigue and various unspecific symptoms after standard courses of antibiotic treatment for Lyme disease. This constellation of symptoms has been variously referred to as "chronic Lyme disease", or "post-Lyme disease syndrome". The first French National Consensus Conference on Lyme Disease was the reason to review all aspects of articular and cardiac manifestations of Lyme disease after a synthesis of recent literature. The involvement of Borrelia species in chronic Lyme disease and other pathologies is discussed.     

Economic impact of Lyme disease

To assess the economic impact of Lyme disease (LD), the most common vectorborne inflammatory disease in the United States, cost data were collected in 5 counties of the Maryland Eastern Shore from 1997 to 2000. Patients were divided into 5 diagnosis groups, clinically defined early-stage LD, clinically defined late-stage LD, suspected LD, tick bite, and other related complaints. From 1997 to 2000, the mean per patient direct medical cost of early-stage LD decreased from $1,609 to $464 (p<0.05), and the mean per patient direct medical cost of late-stage LD decreased from $4,240 to $1,380 (p<0.05). The expected median of all costs (direct medical cost, indirect medical cost, nonmedical cost, and productivity loss), aggregated across all diagnosis groups of patients, was approximately $281 per patient. These findings will help assess the economics of current and future prevention and control efforts.