Lyme Disease Puzzling Texans

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Lyme Disease Puzzling Texans

August 20, 2002

FORT WORTH (The Fort Worth Star-Telegram) -- Many Texans diagnosed with Lyme

disease tell the same story. They say they never felt the tick bite that

triggered their tailspin into flulike symptoms and misdiagnoses. Many faced

decades of illnesses and got sicker and sicker, and some eventually became

crippled. A few say they came close to death before finding physicians who

recognized the disease.

" I just wish they would listen to us, " said Hudson, a 35-year-old

businesswoman who lives in Haltom City. She was diagnosed with arthritis,

lupus and multiple sclerosis before learning she had Lyme disease.

Whether Lyme disease is prevalent in Texas has caused a dispute in the

medical community. The lack of a consensus and the confusion of Lyme disease

with a similar and relatively new ailment will be discussed during the ninth

International Conference on Lyme Borreliosis and Other Tick-Borne Diseases,

which started Sunday in New York.

Some researchers say Lyme disease may be confused with Southern

Tick-Associated Rash Illness, or STARI, a mysterious malady in Texas and

other states south of land. It causes the same type of rash and reacts

well to antibiotics, as Lyme does. Unlike Lyme disease, STARI is thought to

be benign, though there is little research on it.

Diagnosis of either disease is a crapshoot because of a lack of accurate

tests, said on, head of the University of North Texas Health

Science Center Lyme Disease Laboratory in Fort Worth. The two diseases

confuse laboratories, leading to false test readings and misdiagnoses, he

said.

on is leading research that could produce a more accurate test for

both. He will present his theories during the conference.

Lyme disease, often called " the great imitator, " is hard to diagnose for

several reasons.

When patients arrive at a physician's office, they often seem to be

suffering from several diseases at once. Symptoms can be severe at the

onset, involving every system and organ, then disappear quickly. Or the

disease can lie dormant for years.

Some physicians maintain that one-fourth to one-third of the people

diagnosed with chronic fatigue syndrome and fibromyalgia, a disease that

causes severe muscle and soft-tissue pain, are suffering from Lyme disease,

said Hamid Moayad, a Bedford neurologist and Lyme-disease specialist.

An initial bull's-eye rash, clear in the center with a red band, is supposed

to be a sure sign of the disease. But only 50 percent of patients remember

having had a rash, a tick bite or flulike symptoms.

In the Northeast, where most cases of Lyme disease are reported, the

bacteria that cause the ailment are spread primarily by the deer tick.

North Texas doctors are told that the tick does not exist here " so they

don't look for Lyme disease in their patients, " Moayad said.

As a result, Moayad said, up to nine Lyme cases go unreported for every case

that comes to the attention of state health authorities.

The similarities between Lyme disease and STARI - thought to be spread by

the Lone Star tick, common in Texas - also cast doubt on the prevalence of

Lyme disease.

" For a long time, this illness was thought to be regular Lyme disease, " said

Wormser, chief of the infectious-disease division at New York Medical

College. " It took a long time to realize that it was not the same. "

The Texas Department of Health estimates that 2,039 possible cases of Lyme

disease were reported in the state from 1990 to 1999, but only 655 met the

definition of Lyme disease set by the federal Centers for Disease Control

and Prevention. The CDC criteria include providing confirmation by two

laboratory tests or a specimen of the bacterium.

STARI doesn't have to be reported to health authorities, so there are no

accurate numbers on how common it is, said Ned , a medical

epidemiologist with the CDC.

" I imagine that some cases of STARI get reported as Lyme, " he said.

One of the most sensitive tests for either disease is DNA-based. But a

problem with it is that it continues to show that bacteria are present long

after they are gone. So doctors may not recognize other tick-borne illnesses

transmitted through the same bite, on said.

" If they can find a new test, that's the key, " said Rawlings, the

state's chief epidemiologist. " If they can find a test, then everything else

will fall in line. "

on believes that an RNA-based test would be more accurate and would

help distinguish between the diseases.

The RNA that matches the microbes that cause Lyme or STARI will be produced

only as long as the microbes live, on said. When the RNA is gone,

the Lyme or STARI microbes that make people sick are below detectable

levels.

The new test may also detect other diseases, on said.

" We know we have a potential problem here, and we need to get a handle on it

before it gets out of hand, " he said.

Until an accurate test is developed, misdiagnoses may continue.

Pat McCartan, 50, of North Richland Hills used to be a financial analyst

before she was diagnosed with Lyme disease. Now she cannot remember numbers

she saw a minute ago. During the 27 years that McCartan has been ill, she

said, she has had 12 diagnoses.

" My friends just thought I was a hypochondriac, " McCartan said. " I went to

pain management, and the doctors there said I would just have to learn to

deal with the pain. After a while, you become very distrustful of doctors. "

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