The Maryland DHMH and CDC prepared the report below admitting in just one year there were 120% more cases (5,722) in Maryland than what was actually reported.
Had they been reported, Maryland would have been #1 in the USA for the highest number of reported cases.
H.J. Rutz1, S.B. Wee1, M.E. Brett2, A.B. Kay2, A.F. Hinckley2, K.A. Feldman1; 1Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA, 2Centers for Disease Control and Prevention, Fort Collins, CO, USA.
Background: Maryland ranks in the top ten states for reported Lyme disease (LD) cases; it is likely that LD in Maryland is underreported as a result of many surveillance factors.
Positive laboratory results are reported to the state’s 24 local health departments (LHDs) who investigate and classify LD cases as Confirmed, Probable, Suspect or “Not a Case” in the state surveillance database.
In 2009, 4,768 LD reports were in the state database; 2,029 (43%) were Confirmed or Probable. To better understand the burden of LD and LD surveillance and to explore alternative surveillance approaches, we conducted a survey of LHDs and sought additional billing codes and medical chart data for a sample of cases.
Methods: In July 2011, LHDs completed an online survey about LD surveillance, including number of reports not entered in the state database, staffing availability, and investigational approach. Healthcare Providers (HCPs) were requested to supply billing codes for a 10% random sample of reported LD cases (N=474) from 2009.
The predictive value of specific codes was evaluated. A medical chart review (N=149) was conducted on all sampled Suspect and select Not a Case reports for additional clinical and diagnostic data. The additional data was used, when available, to reclassify cases as Confirmed and to calculate a more accurate estimate of LD cases for the state.
Results: LHDs [local health departments] did not enter an additional 5,722 LD reports in the state database during 2009. Seven (29%) LHDs lost LD surveillance staff in the past 2 years; one lost all staff and does not currently investigate LD.
In 2008, 16 (75%) LHDs investigated each LD report while 5 (21%) investigated only if sufficient laboratory evidence of infection.
By 2011, 10 (42%) LHDs investigate LD reports only if sufficient evidence. LHD staff make 2 (range 1-4) attempts to contact HCPs to investigate reports.
LHDs expressed concerns about burden of LD surveillance with fewer resources and the utility of LD surveillance. The billing code assessment and medical chart review are ongoing.
Conclusions: In 2009, there were 120% more LD reports in Maryland than had been entered in the state database. Resources for LD surveillance vary by LHD, but have diminished overall. LHDs question the utility of LD surveillance and are eager for alternative approaches, such as querying billing databases.
Any state where you get bit and get Lyme is the worst state for Lyme Disease as far as I am concerned!
Posted by Keebler (Member # 12673) on :
- Any state that says "no lyme here" and has directed all their MDs to throw the positive Igenex tests in the trash can . . . nevermind not addressing the positive babesia & ehrlichia tests, nor the fainting and seizures.
"No lyme here" covers all the bases, apparently for a state code to not treat such patients at all - for anything. And then apparently stamp that in the patient chart for any doctor who will ever follow.
Any state where one is told to leave a doctor's office when they bring up the mere term.
Any state where, when in the ER for seizures they see in your chart that you "claimed to have lyme" the ER doctor, outside of the room and they think out of earshot, tells the attending ER resident that they will not treat this patient because "there is no treatment they would offer for lyme"
although that is not what the paramedics carted in you for . . . well, any state where then you are then told to get out of the ER "right now" for "trying to throw yourself off the table" when another seizure hits.
It's a terrible state of affairs that occurs in many of the states across the country.
They should do a survey of all the official "no lyme here" states. That would be a long list. -
Posted by Lymetoo (Member # 743) on :
quote:Originally posted by hiker53: Any state where you get bit and get Lyme is the worst state for Lyme Disease as far as I am concerned!
- Exactly!
Posted by randibear (Member # 11290) on :
texas says no lyme here...won't even treat
Posted by cbb (Member # 788) on :
The title should be: Worst States where the Most Cases of Lyme Disease Are Diagnosed (emphasis on Diagnosed).
I believe it's possible that some states in the South could be ranked right up there with New England states if doctors were aware of and followed the ILADS Guidelines.
I've said this before. When a doctor was checking the ringing in my ears, I asked about LD. He said: "We don't know the cause of 80% of cases of ringing in the ears and we don't waste our time studying an illness that we'll see only one bizarre case in a lifetime."
That was over 25 years ago, and things are about the same. I hope I live long enough to see Lyme patients diagnosed and treated properly.
In 2000, I had breast cancer. For me, the most difficult thing was realizing the difference in how cancer patients are treated in comparison to Lyme patients. People were falling all over themselves helping, giving comfort and support. That's the way it should be for Lyme patients, too.
Sorry for the rant, but I've had an issue with those statistics for a long time.
A college Professor who was a minister gave a great example about statistics: "In the last ten years, the number of ministers has remained the same. In that time, the consumption of alcohol has risen. Therefore, we can conclude that ministers are drinking more these days.
I rest my case.
Posted by Lymetoo (Member # 743) on :
We do have a few Dr's in Texas that are LLMD's. With the exception of one in NTX, none of them treat LD correctly and use very low doses of antibiotics, not enough to kill the bugs, Dr M in NTX is such a Dr NUT , just keeps you sick and coming back. Any new symptoms he calls herding and that's BS. Get thee out of state to w LLMD who does not put his medical license before your health. WTF! TSBME!