Lyme Disease in Texas

Lyme disease is the most common vector-borne disease in the U.S. Since the year 2000, the number of reported cases in Texas has ranged between 50 and 100, with probable cases (those which do not meet the strict CDC reporting criteria) at twice that number. For the past two years, TXLDA has received between 600 and 900 requests annually from patients seeking medical care for Lyme disease symptoms. Many diagnosed cases are not reflected in official statistics due to restrictive reporting criteria. Lyme is largely unrecognized in Texas so it is often misdiagnosed by doctors who are not familiar with its clinical presentation. Currently, there are thousands of Texans who must go out of state to seek treatment for Lyme Disease.

The causative agent of Lyme disease, Borrelia burgdorferi, was first identified in Texas in 1984. Lyme disease is now known to be endemic to Texas. A study published in Parasites & Vectors in 2014 found the causative agent of Lyme disease in 45% of Ixodes scapularis (black-legged deer ticks) collected. This tick was found to be widely occurring in East Texas and into Northern parts of Mexico in a continuous region along the Gulf Coast. Read more

Dr. Kerry L. Clark of the University of North Florida has found the DNA of different strains of Borrelia burgdorferi (sensu lato), Borrelia andersonii, and Borrelia americana associated with Lyme-disease like signs and symptoms in patients in the South. His study suggests that human cases of Lyme disease in the southern USA may be more common than previously recognized and may also be caused by more than one species of B. burgdorferi sensu lato. Other research, published in Geospacial Health in 2014, has found a significant discrepancy between the location of Lyme cases reported in Texas and the suitable habitat for Ixodes scapularis ticks, suggesting that other vectors of Lyme disease may be possible. Further study is needed on transmission by other species of ticks and other vectors. Patients with Lyme disease reside in each of the 11 public health regions in Texas. Texans are at risk of Lyme disease both from native sources and those brought in by migrating birds and animals, as well as from travel to other endemic areas. Visitors to any undeveloped countryside are at considerable risk of being bitten by ticks that carry the Lyme disease bacteria. Ticks may also be picked up in high grass, on golf courses, school playgrounds, greenbelts, farms, ranches, and in private yards. Anyone who engages in outdoor pursuits may be exposed to Lyme disease and should take proper precautions. Additionally, pets can bring ticks into the home, placing household members at risk.

Tick-borne illnesses can be extremely debilitating and even deadly. Failure to diagnose and treat aggressively leads to disability, which can be comparable in intensity and effect to that caused by congestive heart failure.

There are six reportable tick-borne illnesses in Texas: babesiosis, ehrlichiosis (including anaplas- mosis), Lyme disease, Rocky Mountain spotted fever, tularemia, and tick-borne relapsing fever. Additionally, a Lyme-like illness known as STARI (Southern Tick-Associated Rash Illness), transmit- ted by the Lone Star Tick, is reportable as Lyme disease. Failure to report these diseases is a Class B misdemeanor under the Texas Health and Safety Code, Section 81.049, but this provision is rarely, if ever, enforced. Texas is a passive surveillance state, and it is likely that there is considerable under-reporting of tick-borne illnesses. The U.S. Center for Disease Control and Prevention (CDC) estimates that only ten percent of Lyme disease cases in the U.S. are reported.

Greater public awareness is needed for prevention, and physician education based on current research is needed for proper diagnosis and treatment. Contrary to the assertions of many physicians, Lyme disease is not a rare illness that is easy to avoid, difficult to acquire, and simple to diagnose; nor is it easily treated and cured. The longer the time elapsed between a tick bite causing infection and the diagnosis and treatment of Lyme disease, the more likely the illness will be serious and long lasting, and the cost of treatment very high.

Tick-borne illnesses can be extremely debilitating and even deadly. Failure to diagnose and treat aggressively leads to disability, which can be comparable in intensity and effect to that caused by congestive heart failure. Early detection and treatment is critical, and aggressive treatment is needed at every stage.

Many doctors in Texas believe that Lyme disease is not endemic to the state, and patients are often told that there is no Lyme disease in Texas. As a result, many patients must go out of state for diagnosis and treatment.

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