 |
|
Long-term Outcomes of Persons With Lyme Disease
Elyse G. Seltzer, MD;
Michael A. Gerber, MD;
Matthew L. Cartter, MD;
Kimberly Freudigman, PhD;
Eugene D. Shapiro, MD
JAMA. 2000;283:609-616.
Context Few data exist about the long-term outcomes of patients with Lyme disease.
Objective To assess the long-term outcomes of patients with Lyme disease.
Design Two-part project including a community-based longitudinal cohort study and a matched cohort study.
Setting and Participants Six hundred seventy-eight patients identified from a random sample of all reports of Connecticut residents with suspected Lyme disease submitted to the Connecticut Department of Public Health from 1984-1991 were evaluated in the longitudinal study; for a random subsample of 212 patients from the larger study, 212 age-matched controls without Lyme disease also were enrolled.
Main Outcome Measures Self-reports or parents' reports of symptoms and ability to perform certain daily activities since diagnosis of Lyme disease; scores on the 36-Item Short-Form Health Survey and the Center for Epidemiologic Studies-Depression scale, for adults, by case-definition status and between patients and controls.
Results Of the 678 patients, 51.6% were female, 34.4% were children, and 64.3% met the national surveillance case definition for Lyme disease. Most patients (85.6%) were treated with antimicrobial agents. Interviews were conducted a median of 51 months after diagnosis (range, 15-135 months). An increased frequency of symptoms (eg, pain, fatigue) or of difficulty with daily activities (eg, performing housework, exercising) was reported by 69% of the patients, although few (19%) of these problems were attributed to Lyme disease. Whenever there was a statistically significant difference in the frequencies of either increased symptoms or increased difficulties with typical activities between those who did or did not meet the surveillance case definition, in all instances the greater frequency of problems was in the group that did not meet the case definition. The frequencies of reports of both increased symptoms and increased difficulties with typical activities among patients who had been diagnosed as having Lyme disease were similar to those among age-matched controls without Lyme disease.
Conclusions In this cohort, although many patients reported increases in symptoms and/or increased difficulties with typical daily activities between 1 and 11 years after diagnosis of Lyme disease, the frequencies of these reports were similar to the frequencies of such reports among age-matched controls without Lyme disease.
Author Affiliations: Departments of Medicine (Dr Seltzer), Pediatrics (Drs Seltzer, Freudigman, and Shapiro), and Epidemiology and Public Health, and the Children's Clinical Research Center (Dr Shapiro), Yale University School of Medicine, New Haven, Conn; Department of Pediatrics, University of Connecticut School of Medicine, Farmington (Dr Gerber); and the Connecticut Department of Public Health, Hartford (Dr Cartter). Dr Seltzer is now with SmithKline Beecham Pharmaceuticals.
RELATED LETTER
Long-term Outcomes of Lyme Disease
Sam T. Donta, Virginia T. Sherr, Elyse G. Seltzer, Eugene D. Shapiro, and Michael A. Gerber
JAMA. 2000;283(23):3068.
EXTRACT
| FULL TEXT
RELATED ARTICLES
Long-term Outcomes and Management of Patients With Lyme Disease
Pierce Gardner
JAMA. 2000;283(5):658-659.
EXTRACT
| FULL TEXT
February 2, 2000
JAMA. 2000;283(5):681-682.
EXTRACT
| FULL TEXT
Dangers of Lyme Disease
JAMA. 2000;283(5):698.
PDF
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Halperin et al.
Neurology 2007;69:91-102.
ABSTRACT
| FULL TEXT
Does This Patient Have Erythema Migrans?
Tibbles and Edlow
JAMA 2007;297:2617-2627.
ABSTRACT
| FULL TEXT
Author's response to comments by Sigal and Hassett, Phillips et al., and Shapiro et al.
Cairns
Int J Epidemiol 2005;34:1440-1443.
FULL TEXT
Post-Lyme borreliosis syndrome: a meta-analysis of reported symptoms
Cairns and Godwin
Int J Epidemiol 2005;34:1340-1345.
ABSTRACT
| FULL TEXT
Response to meta-analysis of Lyme borreliosis symptoms
Shapiro et al.
Int J Epidemiol 2005;34:1437-1439.
FULL TEXT
Antibiotic treatment of Lyme borreliosis: what is the evidence?
Dinser et al.
Ann Rheum Dis 2005;64:519-523.
ABSTRACT
| FULL TEXT
Long-Term Neuropsychologic and Health Outcomes of Children With Facial Nerve Palsy Attributable to Lyme Disease
Vazquez et al.
Pediatrics 2003;112:e93-97.
ABSTRACT
| FULL TEXT
A 58-Year-Old Man With a Diagnosis of Chronic Lyme Disease
Steere
JAMA 2002;288:1002-1010.
FULL TEXT
Recognition and Treatment of Erythema Migrans: Are We Off Target?
Nadelman and Wormser
ANN INTERN MED 2002;136:477-479.
FULL TEXT
Misconceptions about Lyme Disease: Confusions Hiding behind Ill-Chosen Terminology
Sigal
ANN INTERN MED 2002;136:413-419.
FULL TEXT
Single-Dose Doxycycline for the Prevention of Lyme Disease
Pontrelli et al.
NEJM 2001;345:1348-1350.
FULL TEXT
Lyme Disease
Steere
NEJM 2001;345:115-125.
FULL TEXT
Doxycycline for Tick Bites -- Not for Everyone
Shapiro
NEJM 2001;345:133-134.
FULL TEXT
Long-term Outcomes of Lyme Disease
Donta et al.
JAMA 2000;283:3068-3068.
FULL TEXT
Excellent Prognosis in Lyme Disease
JWatch Neurology 2000;2000:17-17.
FULL TEXT
Benign Long-Term Outcomes for Lyme Disease Patients
JWatch Infect. Diseases 2000;2000:2-2.
FULL TEXT
Chronic Refractory Lyme Disease Is Rare
JWatch Psychiatry 2000;2000:18-18.
FULL TEXT
Chronic Refractory Lyme Disease Is Rare
JWatch General 2000;2000:2-2.
FULL TEXT
Long-term Outcomes and Management of Patients With Lyme Disease
Gardner
JAMA 2000;283:658-659.
FULL TEXT
|
