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LD Backgrounder- Dollars and Sense

The Bottom Line: …is the bottom line. No one in the business of diagnosing or treating Lyme patients is going broke. Lyme disease is a growth industry built on misinformation, marketing, propaganda and a certain degree of hysteria.

The cost of Lyme disease is $60 million annually--estimated for early, acute disease only. Reliable estimates of total cost are not available (1). One Lyme activist organization claims that the annual cost is $1 billion, and more recently, that "actuarial studies have shown that Lyme disease has cost the United States about $18 billion" (2).

Contrast such claims with annual national figures for:

Food-borne infections.....................$5-6 billion
Sexually transmitted diseases........$5 billion
Influenza..........................................$5 billion (direct medical costs)
AIDS................................................$3 billion
Antibiotic resistant infections.........$4 billion in treatment, and increasing (3)

In 1994 the average cost of 4 weeks of i.v. antibiotics (ceftriaxone 2g/day) was $5,528 (4). This is why home infusion is a $4 billion-a-year business (5). Again, some advocacy groups have produced their own selected survey estimates of $60,000 for the average the cost of treating late- stage disease (6).

A recent study of Lyme disease tests and costs among 232 patients noted that the "total direct charges for diagnosing and managing tick bites was $47,595 for the 232 patients. The average direct charge per patient was $205.... Most patients with tick bites are undergoing costly serologic testing of no benefit, and the majority are receiving prophylactic antibiotic therapy, an intervention of unproven benefit" (7).

"The reason that many patients have misguided demands for inappropriate treatments is partly due to heavy advertising by certain infusion companies and vigorous advocacy by organized LD groups. In the public's eyes, the spreading of misinformation is legitimized by the large amount of money spent" (8).

  1. CDC: Lyme Facts.
  2. Lyme Disease Foundation, March 6, 1998 fund-raising letter.
  3. 1995 White House CISET Report on Emerging Infectious Diseases.
  4. Eckman MH et al. NEJM, 1997;337:357-363.
  5. US News & World Reports, May 9, 1994.
  6. 1991 estimate from "Exciting news from the Lyme Disease Foundation," 1998.
  7. Fix AD et al. JAMA, 1998;279:206-10.
  8. Nahass RG, Herman DJ, Hirsh EJ. Arch Intern Med. 1997;157:697.


LD Backgrounder- By the Numbers

The Bottom Line: As a source of significant morbidity and mortality Lyme disease is pretty far down the list.

Infectious diseases are the world's leading cause of premature death. The World Health Organization (WHO) estimates that 17 million deaths in 1995 were due to infectious diseases, including about 9 million deaths among young children (1).

Here are some of the notifiable diseases tracked by CDC during 1996:

Chlamydia 498,884 cases
Gonorrhea 325,883 cases
Syphilis 52,976 cases
Salmonella 45,471 cases
Hepatitis A 31,032 cases
Tuberculosis 21,337 cases
Lyme disease 16,455 cases
Hepatitis B 10,637 cases
Pertussis 7,796 cases

Infectious Disease Deaths in 1996 (WHO):

Respiratory Infections 3.0 million
Diarrheal Diseases 2.5 million
Malaria 2.7 million
AIDS 1.5 million
Lyme disease 10-15 total direct deaths

It is often stated that Lyme disease is the most common vector-borne disease in the U.S. That should be of some comfort considering other vector-borne diseases include malaria, bubonic plague, dengue, Yellow Fever, and a variety of fatal encephalitis viruses.

"Most people…have a less than 5 in 1,000 chance of contracting a case of Lyme disease" (2).

  1. WHO.
  2. Meltzer M. CDC Summary.


LD Backgrounder- Lyme-Like Illnesses

The Bottom-line: Ticks are nasty little blood-suckers. In addition to the Lyme agent, Borrelia burgdorferi, they carry a variety of other bacteria, rickettsia, parasites, viruses, fungi, and occasional toxins. They apparently carry other species of pathogenic, "Lyme-like" borrelia.

Bites from the hard tick Amblyomma americanum are associated with a Lyme disease-like illness in the southern United States. Uncultivable spirochetes were present in approximately 2% of the ticks. Analysis showed that the spirochete was a Borrelia species distinct from previously characterized members of this genus, including B. burgdorferi (1).

Borrelia burgdorferi, the causative agent of Lyme disease, has never been isolated from a patient thought to have acquired Lyme disease in any southeastern state. Fourteen cases of an erythema migrans (EM)-like rash illness that occurred during 2 summers in central North Carolina were investigated. This investigation suggests the existence of a new tick-associated rash illness. We suspect that the disease agent is carried by A. americanum ticks. In the southern United States, EM-like rash illness should no longer be considered definitive evidence of early Lyme disease (2).

Lyme disease and tick-borne relapsing fever are worldwide systemic borrelioses caused by several Borrelia species transmitted by hard ticks (Ixodidae) and soft ticks (Argasidae), respectively. We have discovered a new borrelia pathogen that is closely related to the other tick-borne agents of relapsing fever in Europe and Africa, and which causes a relapsing systemic disease with serological similarities to Lyme borreliosis (3).

  1. Barbour AG, Maupin GO, Teltow GJ, Carter CJ, Piesman J. J Infect Dis 1996 Feb;173(2):403-9.
  2. Kirkland KB, Klimko TB, Meriwether RA, Schriefer M, Levin M, Levine J, Mac Kenzie WR, Dennis DT. Arch Intern Med 1997 Dec 8-22;157(22):2635-41.
  3. Anda P, Sanchez-Yebra W, del Mar Vitutia M, Perez Pastrana E, Rodriguez I, Miller NS, Backenson PB, Benach JL. Lancet 1996 Jul 20;348(9021):162-5.


LD Backgrounder- Quackery and Advocacy

See the Internet Quackwatch report.