Bush Apparently Had Lyme Disease

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Bush Apparently Had Lyme Disease

President Was Treated for Rash in 2006

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By Brown

Washington Post Staff Writer

Thursday, August 9, 2007; A02

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President Bush was treated a year ago for what appears to have been Lyme

disease, the White House said yesterday in disclosing the results of his annual

physical exam.

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A report of the president's recent medical examination said his case had

" complete resolution " and was " without recurrence " since being treated last

August. The illness, an infection carried by deer ticks that is prevalent in the

Northeastern United States, had not been previously revealed.

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While untreated Lyme disease can cause arthritis, an abnormal heart rhythm and

problems with the nervous system, those complications usually can be prevented

by taking antibiotics at an early stage of the infection. The medical record did

not describe the details of the president's therapy.

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Up to 15 percent of people treated for Lyme disease later complain of symptoms

such as fatigue and muscle pain. Whether that is a consequence of the infection

is uncertain and a matter of controversy. Chronic pain and tiredness are

extremely common in adults; whether people who have had Lyme disease suffer from

those problems in higher numbers is unknown.

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" I wouldn't expect any problem at all for the president, " said Wormser,

chief of infectious diseases at New York Medical College and an expert on Lyme

disease. " He won't be impacted by this infection in the future. "

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Lyme disease, named after the town in Connecticut where the first cases were

identified in the 1970s, causes a rash that is often its sole manifestation.

Classically it is a large reddish oval with a lighter-colored center and is

often described as looking like a target.

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White House spokesman Stanzel said Bush found a rash on the front of his

lower left leg and alerted White House physicians.

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While the Lyme organism Borrelia burgdorferi can sometimes be isolated in the

skin or bloodstream -- and antibodies to it can also eventually be detected in

the blood -- laboratory testing is often not done. That is because a person with

a typical rash and a history of outdoor activity will be treated for the

disease, regardless of what the tests show.

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Without such tests, however, it is impossible to rule out a Lyme disease

look-alike called STARI as the cause of the president's illness last summer.

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STARI stands for " Southern tick-associated rash illness. " It also causes a

target-like rash and is associated with a tick bite, but the causative organism

has not been found.

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STARI is common in Texas. The lone star tick is the species that transmits it.

There are no documented cases of Lyme disease in the president's home state,

where he spent much of last August on vacation.

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" If he got it in Texas, it was undoubtedly STARI, " Wormser said.

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Stanzel said yesterday that he does not know when Bush's condition was

diagnosed. The interval between tick bite and rash appearance in Lyme disease

can be as long as 30 days. The president could have been infected with the Lyme

organism in the Washington area, with the rash appearing after he left.

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STARI seems to be a milder infection than Lyme disease. There is no specific

test for it. It is diagnosed primarily if a patient has a Lyme-like rash and a

tick bite, but no Lyme organisms or antibodies.

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People with STARI almost always take the same antibiotics that are prescribed

for Lyme disease. The rash goes away with treatment, as do the flu-like symptoms

that sometimes accompany it.

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Wormser said it is not known whether treatment of STARI is necessary. There

appear to be no long-term consequences of either treated or untreated infection,

he added.

http://www.washingtonpost.com/wp-dyn/content/article/2007/08/08/AR2007080802268.\

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http://www.washingtonpost.com/wp-dyn/content/article/2007/08/08/AR2007080802268.\

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