In January 2022, the U.S. Council of State and Territorial Epidemiologists (CSTE) published a revision to its 2017 Lyme disease case definition. (See the changes here.) This definition will soon be integrated into the physician reporting form that is used by the Centers for Disease Control (CDC) to classify, count, and track Lyme disease cases consistently across the country.
The annual Lyme disease case count is an important metric for allocating government research dollars and staff resources. With about 476,000 new cases a year and growing, the CDC’s previous case definition and reporting requirement was already burdensome to physicians and local health departments. (In 2016, Massachusetts opted out of CDC reporting because of this.) Unfortunately, the 2022 revision may only make this worse.
The two biggest changes to the definition are the inclusion of Borrelia mayonii, a newly discovered Borrelia burgdorferi family member, in the Lyme case count, and the option for physicians to use a cheaper, simpler test in the second part of the two-tiered testing protocol. Despite a few positive changes to the 2022 revision, the new definition doesn’t fix some of the fundamental flaws of the old definition, and this could lead to the undercounting and misdiagnosis of truly ill Lyme patients.
2017 Lyme Disease Definition
2022 Lyme Disease Definition
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