Lyme disease in a British referral clinic

Cottle, Lucy; Mekonnen, Eyasu; Beadsworth, Mike; Miller, Alastair; Beeching, Nicholas J.

doi:10.1093/qjmed/hcs003

Cited by 24 publications

(16 citation statements)

References 24 publications

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“…Other potential hazards of taking antibiotics unnecessarily include their toxicity, potential hypersensitivity reactions and even anaphylaxis (allergy), and predisposition to infection with Clostridium difficile and antibiotic‐resistant bacteria 42 …”

Section: What Are the Problems For Patients The Australian Communitymentioning

confidence: 99%

Does Lyme disease exist in Australia?

Collignon

Lum

Robson

2016

Medical Journal of Australia

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There is no convincing evidence that classic Lyme disease occurs in Australia, nor is there evidence that the causative agent, Borrelia burgdorferi, is found in Australian animals or ticks. Lyme disease, however, can be acquired overseas but diagnosed in Australia; most people presenting with laboratory-confirmed Lyme disease in Australia were infected in Europe. Despite the lack of evidence that Lyme disease can be acquired in Australia, growing numbers of patients, their supporters, and some politicians demand diagnoses and treatment according to the protocols of the "chronic Lyme disease" school of thought. Antibiotic therapy for chronic "Lyme disease-like illness" can cause harm to both the individual (eg, cannula-related intravenous sepsis) and the broader community (increased antimicrobial resistance rates). Until there is strong evidence from well performed clinical studies that bacteria present in Australia cause a chronic debilitating illness that responds to prolonged antibiotics, treating patients with "Lyme disease-like illness" with prolonged antibiotic therapy is unjustified, and is likely to do much more harm than good.

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Section: What Are the Problems For Patients The Australian Communitymentioning

confidence: 99%

Does Lyme disease exist in Australia?

Collignon

Lum

Robson

2016

Medical Journal of Australia

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“…The relative proportion of patients presenting to either setting is currently unknown, as is the patient pathway between primary, secondary and tertiary care. Within England and Wales, studies that describe patients in a hospital setting have been either limited to one hospital [10, 11], specialist referral centres [12–14], or one clinical presentation [15].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998–2015)

et al. 2019

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Background Lyme disease is a tick-borne disease of increasing global importance. There is scant information on Lyme disease patient demographics in England and Wales, and how they interact with the National Health Service (NHS). Our aims were to explore the demographic characteristics of Lyme disease patients within the Hospital Episode Statistics (HES) and Patient Episode Database for Wales (PEDW), and to describe patient pathways. Methods Data from 1st January 1998 to 31st December 2015 was retrieved from the two administrative hospital datasets (HES and PEDW), based on patients coded with Lyme disease. Information was collected on demographic characteristics, home address and case management. Incidence rates were calculated, and demographics compared to the national population. Results Within HES and PEDW, 2361 patients were coded with Lyme disease. There was a significant increase ( p < 0.01) in incidence from 0.08 cases/100,000 in 1998, to 0.53 cases/100,000 in 2015. There was a bimodal age distribution, patients were predominantly female, white and from areas of low deprivation. New cases peaked annually in August, with higher incidence rates in southern central and western England. Within hospital admission data ( n = 2066), most cases were either referred from primary care (28.8%, n = 596) or admitted via accident and emergency (A&E) (29.5%, n = 610). This population entering secondary care through A&E suggest a poor understanding of the recommended care pathways for symptoms related to Lyme disease by the general population. Conclusions These data can be used to inform future investigations into Lyme disease burden, and patient management within the NHS. They provide demographic information for clinicians to target public health messaging or interventions.

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“…Lyme disease might become misdiagnosed as fibromyalgia [ 95 ], chronic fatigue syndrome [ 96 , 97 ], amyotrophic lateral sclerosis [ 80 ], autism spectrum disorder [ 98 ], Parkinson's disease, rheumatoid arthritis [ 99 ], multiple chemical sensitivity, Guillain-Barre syndrome (GBS) [ 80 ], and dementia [ 100 ], as well as other numerous neurological [ 101 , 102 ] and psychiatric disorders [ 88 , 103 ]. Caution is however warranted as misdiagnosis of CLD may result in unnecessary antibiotic courses [ 104 ].…”

Section: Resultsmentioning

confidence: 99%

Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

Borgermans

Goderis

Vandevoorde

et al. 2014

International Journal of Family Medicine

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Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.

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Lyme disease in a British referral clinic

Cited by 24 publications

References 24 publications

Does Lyme disease exist in Australia?

Does Lyme disease exist in Australia?

Characteristics and patient pathways of Lyme disease patients: a retrospective analysis of hospital episode data in England and Wales (1998–2015)

Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

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