Resources for Medical Care Providers
Diagnosis and treatment of Lyme and other tick-borne diseases is often difficult due to the variable presentation of diseases. As these disease risks continue to grow, Coloradans are in need of more medical care providers experienced in recognition, diagnosis and treatment of these diseases in order to better help the growing number of patients afflicted by these illnesses.
The following reports highlight the diseases, the risks, and the need for increased research; and better diagnostic tools, treatment and education:
Federal-Health & Human Services-Tick-Borne Disease Working Group information for second report to Congress (due 2020) can be viewed here.
For most of these diseases, successful outcome depends on early diagnosis and adequate treatment. Some diseases can become chronic, debilitating or even fatal without proper recognition and initiation of treatment. The following resources are valuable tools for primary care physicians, emergency room doctors, nurses and specialists in learning how to recognize disease, evaluate, and properly treat their patients. Controversy surrounds the diagnostics, testing and treatment for Lyme disease making decision making between physicians and patients often contentious. The following resources provide information on the differing perspectives. Ultimately, medical decisions should be made by both fully informed patients and physicians as individual cases.
To report a case of tick-borne disease visit the Colorado Department of Public Health & Environment at here, or contact your local County Public Health Department.
Continuing Medical Education
Provides the only evidence based treatment guidelines for Lyme disease currently published by the National Guidelines Clearinghouse (NGC). They offer a Physician Training Program and a referral program for patients seeking a medical care provider experienced with Lyme and other tick-borne illness. Their goal is to foster excellence in care for Lyme and other tick-borne disease patients, addressing the challenges in effectively diagnosing and treating tick-borne diseases. Scholarships are available.
National leaders in Lyme research, education, prevention and patient support. LDA hosts an annual continuing medical education conference (CME) in partnership with Columbia University’s Lyme and Tick-borne Disease Research Center on Lyme and tick-borne diseases. Scholarships are available.
LivLyme Foundation hosts an annual continuing medical education conference (CME) in Colorado. CME accreditation is free with registration.
Provides accredited CME programs on Lyme and other tick-borne illnesses for physicians and other healthcare professionals. This project is spearheaded by Elizabeth Maloney, MD, Partnership for Tick-borne Diseases Education.
Diagnostic and Treatment Resources
The International Lyme and Associated Diseases Society (ILADS)
Provides the only evidence based treatment guidelines for Lyme disease currently published. They offer a Physician Training Program and a referral program for patients seeking a medical care provider experienced with Lyme and other tick-borne illness. Their goal is to foster excellence in care for Lyme and other tick-borne disease patients, addressing the challenges in effectively diagnosing and treating tick-borne diseases. Scholarships are available. www.ilads.org
Colombia University Medical Center’s Lyme and Tick-borne Diseases Research Center
Offers extensive information regarding Lyme and other tick-borne diseases as well as a second opinion evaluation program for Lyme www.columbia-lyme.org
Johns Hopkins University Lyme Disease Research Center
Provides patient consult and describes the importance of research in regard to the Lyme epidemic www.hopkinsrheumatology.org/specialty-clinics/lyme-disease-clinical-research-center/
Dr. Daniel Cameron, MD
As lead author of the 2014 ILADS evidence based treatment guidelines, he offers a thorough compilation of treatment resources, news, and updated information regarding Lyme and other tick-borne diseases as well as patient care www.danielcameronmd.com
Dr. Richard Horowitz, MD
As previous research has demonstrated, self-reported symptoms can be reliable predictors of health outcomes. Three studies evaluated The Horowitz Multiple Systemic Infectious Disease Syndrome (MSIDS) Questionnaire, a screening questionnaire that is both useful for providers and patients in diagnosing Lyme disease. Dr. Horowitz has also written two books to assist in physicians and patient care.
Dr. Robert Bransfield
Complied List of articles citing chronic infection associated with tick-borne disease www.ilads.org/ilads_news/2015/list-of-700-articles-citing-chronic-infection-associated-with-tick-borne-disease-compiled-by-dr-robert-bransfield/
Ying Zhang, MD, PhD
Dr. Zhang is a Professor at Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. His group recently identified a range of FDA-approved drugs and drug combinations that have excellent activity against Borrelia burgdorferi persisters. These findings have generated considerable interest and opened up new opportunities for more effective treatment of persistent Lyme disease. In collaboration with colleagues, his group is interested to evaluate the promising drug candidates with high activity against Borrelia persisters and drug combinations in animal models and also in patients for more effective treatment of persistent Lyme disease. www.jhsph.edu/faculty/directory/profile/786/ying-zhang
Bartonellosis, One Health Perspectives for an Emerging Infectious Disease academic.oup.com/ilarjournal/article/55/1/46/846503/Bartonellosis-One-Health-Perspectives-for-an
Bartonella brochure: www.galaxydx.com/web/pdfs/Bartonella_brochure_general.pdf
National leaders in Lyme providing advocacy, education and research. They publish The Lyme Times (now electronically), an excellent resource for patients, parents, physicians, and educators, and have initiated the patient powered research database, MyLymeData. They provide a simple symptom checklist if you suspect Lyme disease. www.lymedisease.org
Centers for Disease Control and Prevention (CDC)
Provides the Tick-borne Diseases of the United States: A Reference Manual for Health Care Providers to aid in diagnosis and treatment of tick-borne diseases.
Centers for Disease Control and Prevention (CDC)
The CDC’s page on ‘Post-Treatment Lyme Disease Syndrome’ www.cdc.gov/lyme/postLDS
Ticks and Tick-borne Diseases
Use of a tick-borne disease manual increases accuracy of tick identification among primary care providers in Lyme disease endemic areas. 2016. Amber D. Butler, Meredith L. Carlson, Christina A. Nelson www.sciencedirect.com/science/article/pii/S1877959X16302357
For information regarding ticks, diseases, prevention and identification. Visit University of Rhode Island TickEncounter Resource Center
New England Journal of Medicine
A recent article indicated that Borrelia miyamotoi, a form of bacteria that is genetically related to the Lyme-causing species Borrelia burgdorferi, may cause relapsing fever and other Lyme-like symptoms. It has been detected in all tick species that also carry Lyme disease.
Tick-Borne Diseases Worldwide
Diseases worldwide are also emerging. Visit the CDC for information on Tick-Borne Diseases Abroad.
Patient Laboratory Testing
IGeneX Inc. laboratory is a CLIA-certified high complexity testing lab with expertise in testing for tick-borne diseases for over 25 years.
Galaxy Diagnostics laboratory that has specialized in testing for Bartonella and other Tick-Borne Diseases. They currently test for the highest number of strains of Bartonella in the country. Edward Breitschwerdt, DVM, Chief Scientific Officer, is an internationally recognized leader in the area of Bartonella research, diagnosis, and treatment. B. Robert Mozayeni, MD, Chief Medical Officer, under an ongoing research collaboration with Dr. Breitschwerdt, maintains an observational clinical evaluation of the significance of Bartonella infection in a cohort of several hundred human patients with otherwise unexplained chronic conditions as well as maintaining his private practice.
Medical Diagnostic Laboratories, L.L.C. (MDL) serves mainly as a reference laboratory for molecular diagnostic based testing to laboratories, hospitals and physicians worldwide. CLIA certified.
Stonybrook School of Medicine– Lyme Disease Laboratory
Coppe Laboratories is a CLIA-certified diagnostic reference laboratory that provides specialty testing with a focus on infectious agents involved in acute and chronic illness. Testing for Powassan Virus has recently begun at this lab
Division of Vector-Borne Diseases Laboratory– Centers for Disease Control and Prevention
Mayo Clinic Medical Laboratories– Tick-Borne Disease Testing
Dr. Anne Corson
Provides a talk on pediatric Lyme disease and co-infections. Visit www.lymepa.org/CorsonPediatricLymeTalk.pdf
A source of valuable information regarding children impacted by Pediatric Acute-Onset Neuropsychiatric Syndrome, an autoimmune illness triggered by Lyme disease, strep, pneumonia, Coxsackie virus and more. Visit www.panslife.com
Sandy Berenbaum, LCSW, BCD, Lyme-Literate Psychotherapist
“Lyme disease can be a debilitating illness having a profound effect on interpersonal relationships and a patient’s ability to function at home, in school, and in the workplace. Making matters worse, most chronic Lyme patients suffer from delayed or inaccurate diagnoses prior to finding a doctor who will treat their illness effectively. Some patients have spent months or even years trying different treatments that don’t work, since their diagnosis was, in fact, wrong. Patients often feel isolated and trapped when those around them do not understand the complexity of their illness and what they are experiencing.” Sandy provides resources for parents, educators and children dealing with these complexities of Lyme in the family and the schools. www.lymefamilies.com