Rich addresses Lyme Disease Physicians Forum

Medical zoologist Stephen Rich of the Microbiology Department was an invited speaker on May 16 at the annual Lyme Disease Physicians Forum sponsored by the Barnstable County Cooperative Extension and the Cape Cod Lyme Disease Task Force.

 

About 100 physicians from the Cape and Islands heard leading clinical researcher and physician Benjamin Luft of Stony Brook University speak on diagnosis and treatment; Catherine Brown, the state’s public health veterinarian, speak on incidence and Rich speak about passive surveillance for newly emerging tick-borne diseases.

 

Rich says, “I highlighted the work being done at UMass Amherst, in particular our Laboratory of Medical Zoology testing service that now tests thousands of ticks for dozens of pathogens and provides individual results to subscribers as well as aggregated data to the general public.

 

He gave an overview of the Laboratory of Medical Zoology’s passive surveillance in Massachusetts, where Lyme is found in ticks throughout the Commonwealth. “We’re seeing evidence of two new diseases, both potentially fatal, transmitted by these same ticks,” he points out. “Anaplasma phagocytophilum and Babesia microti aren’t yet household names as Lyme is, but we find evidence that these are increasing in frequency in ticks and state public health officials see a similar pattern in reports of human cases of those diseases.”

 

Rich adds, “So far, the greater proliferation of these new diseases is on the Cape and Islands, as Lyme was a few decades ago. It was widely agreed at the forum that testing disease in ticks adds a whole new dimension to the epidemiological understanding of tick-borne diseases. Human case reports give an ‘after the fact’ picture of who got sick, while our passive surveillance of ticks can help assess risk of exposure.”  

 

During a panel discussion, Brown, Luft and Rich, with two Cape physicians fielded questions from physicians on the front line of Lyme disease, which now has more new cases reported each year than HIV, the medical zoologist notes. 

 

Brown reported on the incidence of human Lyme disease cases in the state, noting that it is now high across the Commonwealth, which is a contrast to the situation decades ago when Lyme was concentrated on the Cape and Islands. Luft discussed attempts he and his colleagues are making to improve human diagnostic procedures, emphasizing the importance of not treating all Lyme as equal. There are 22 different varieties of the bacteria and perhaps only five cause disease. Rich reported that the UMass Amherst tick testing lab now offers tests to discern the different types.

 

“Panel discussions are always very spirited at this meeting,” he adds. “Physicians are eager to report their clinical cases of patients with complicated diagnoses and/or lack of response to treatment, which can be controversial. Events such as this one are important to keep dialogue open between clinicians, scientists and public health officials. The moderator ended by noting that he learns much from the forum but he also leaves with new questions.  From my viewpoint as a scientist/educator, that’s a good thing.  We want people to be asking well-informed questions.”