Why do some states zig while others zag?
Ever wonder what is going on with surveillance numbers? How come some states go up, up, up and others go down? If you look at Lyme surveillance in the US from 1990 to 2007 and just consider did cases go up or down, it can get pretty interesting. I don't know what to think when cases go down. Did all the ticks move out of dodge? Did the doctors quit diagnosing? Did people finally get the message and stay in doors with a book? Did the disease definition change? Is there a new department of health head? Did staffing go down? Did certain areas of the US just fall off the books because they were told there was no Lyme south of the Mason Dixie? I don't have answers. This is a list of those states that zigged when others were zagging. Tell me your thoughts.
State | Cases Reported 1990 | Cases Reported 2007 |
Arkansas | 22 | 1 |
California | 345 | 75 |
Georgia | 161 | 11 |
Michigan | 134 | 51 |
Missouri | 205 | 10 |
North Carolina | 87 | 53 |
Oklahoma | 13 | 1 |
Washington | 30 | 12 |
Yes, and especially Michigan and California where there are so many actual cases.
Diane J. Marie
This is not the total picture of all the zigs and zags, either, because California's unofficial tally for 2008 is 205.
I think in practically every state, the influences on the numbers are that they go UP because Lyme is always increasing. And they go DOWN because of failure to report. The failure to report may be because physicians and labs are not motivated or encouraged to report, or because the criteria and surveillance system is being manipulated in some way.
In our state, Connecticut, the largest zigs and zags are directly attributable to changes in the reporting system made by our state Department of Public Health.
One person in that department, Matthew Cartter, is responsible for much of this chicanery and, if he has his way, he will also influence the national criteria.
Under his reign, Connecticut's cases dropped from 4,631 in 2002, to 1,403 in 2003, sheerly due to changes in the reporting criteria. When a hue and cry ensued, they changed it back somewhat (but not completely).
Recent CT numbers were 2006 – 1,788, 2007 – 3,058 and 2008 – 3,896. So the numbers are climbing dramatically back up again. In response, Matthew Cartter is now reporting in two categories, "probable" and "confirmed." In this way, he can say that Lyme disease in CT has gone both UP and DOWN, in the same year! (More total cases, fewer confirmed cases.)
Hold onto your hat because he is a chair of a CDC committee and, if he can, he will get every state to report this way. I think some states may see through his scheme, though.
The white footed mouse and acorns. In high rain fall years there are more acorns and that means almost a 10 fold increase in white foot mice which are the first host to the deer tick and introduce Lyme into the insect’s body. Mice pass Lyme from mother to baby mouse. More mice – more Lyme. Deer and people are just secondary hosts. People are considered accidental hosts. Subsequently if you kill off the deer you just paint a bigger target on the back of the humans. The ticks are going to bite something. Trick is to kill the mice – you know just like they did back in the days of the Plague.