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Assessing diagnostic coding practices among a sample of healthcare facilities in Lyme disease endemic areas: Maryland and New York – A Brief Report

Summary The value of using diagnostic codes in Lyme disease (LD) surveillance in highly endemic states has not been well studied. Surveys of healthcare facilities in Maryland (MD) and New York (NY) regarding coding practices were conducted to evaluate the feasibility of using diagnostic codes as a potential method for LD surveillance. Most respondents indicated that their practice utilized electronic medical records (53%) and processed medical/billing claims electronically (74%). Most facilities were able to search office visits associated with specific ICD‐9‐CM and CPT codes (74% and 73%, respectively); no discernible differences existed between the healthcare facilities in both states. These codes were most commonly assigned by the practitioner (82%), and approximately 70% of respondents indicated that these codes were later validated by administrative staff. These results provide evidence for the possibility of using diagnostic codes in LD surveillance. However, the utility of these codes as an alternative to traditional LD surveillance requires further evaluation.
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: SHORT COMMUNICATION Source Type: research

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Abstract Babesiosis is an emerging zoonotic disease caused primarily by Babesia microti, an intraerythocytic protozoan. Babesia microti, like the causal agents for Lyme disease and anaplasmosis, is endemic to the northeastern and upper midwestern United States where it is usually transmitted by the blacklegged tick, Ixodes scapularis. Although babesiosis is usually a mild to moderate illness, older or immunocompromised persons can develop a serious malaria-like illness that can be fatal without prompt treatment. The most common initial clinical signs and symptoms of babesiosis (fever, fatigue, chills, and diaphore...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
We examined whether pet ownership increased the risk for tick encounters and tickborne disease among residents of three Lyme disease‐endemic states as a nested cohort within a randomized controlled trial. Information about pet ownership, use of tick control for pets, property characteristics, tick encounters and human tickborne disease were captured through surveys, and associations were assessed using univariate and multivariable analyses. Pet‐owning households had 1.83 times the risk (95% CI = 1.53, 2.20) of finding ticks crawling on and 1.49 times the risk (95% CI = 1.20, 1.84) of finding ticks a...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusion: Our results highlight the potential for climate change to have an effect on future Lyme disease risk in Canada even if the Paris Agreement’s goal to keep global warming below 2°C is achieved, although mitigation reducing emissions from RCP8.5 levels to those of RCP6.0 or less would be expected to slow tick invasion after the 2030s. https://doi.org/10.1289/EHP57 Received: 02 March 2016 Revised: 26 August 2016 Accepted: 30 August 2016 Published: 31 May 2017 Address correspondence to H. Beltrami, Earth Science Department, Physical Sciences Center, PO Box 5000, 1 West St, Antigonish, NS B2G 1W5. Tel...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
Summary The spirochaete (Borrelia burgdorferi) associated with Lyme disease was detected in questing ticks and rodents during a period of 18 years, 1991–2009, at five locations on the Outer Banks of North Carolina. The black‐legged tick (Ixodes scapularis) was collected at varied intervals between 1991 and 2009 and examined for B. burgdorferi. The white‐footed mouse (Peromyscus leucopus), house mouse (Mus musculus) marsh rice rat (Oryzomys palustris), marsh rabbit (Sylvilagus palustris), eastern cottontail (Sylvilagus floridanus) and six‐lined racerunner (Cnemidophorus sexlineatus) were live‐trapped...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: Original Article Source Type: research
Summary Many disease surveillance programs, including the Massachusetts Department of Public Health and the Minnesota Department of Health, are challenged by marked increases in Lyme disease (LD) reports. The purpose of this study was to retrospectively analyse LD reports from 2005 through 2012 to determine whether key epidemiologic characteristics were statistically indistinguishable when an estimation procedure based on sampling was utilized. Estimates of the number of LD cases were produced by taking random 20% and 50% samples of laboratory‐only reports, multiplying by 5 or 2, respectively, and adding the number of pr...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: Original Article Source Type: research
Summary Lyme disease (LD) is the most common vector‐borne disease in Maryland and the United States. Surveillance for LD is valuable for understanding the burden of the disease, particularly to assess whether the disease is spreading and to appreciate who is affected. However, not all cases of LD in Maryland are reported, and surveillance practices vary across each of Maryland's 24 local health departments (LHDs). To better understand this variability and to systematically characterize the surveillance process, we surveyed Maryland's LHDs regarding LD surveillance. The Maryland Local Health Department Lyme Disease Survei...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: Original Article Source Type: research
Summary Lyme disease (LD), anaplasmosis, babesiosis and other tick‐borne diseases (TBDs) attributed to Ixodes ticks are thought to be widely underreported in the United States. To identify TBD cases diagnosed in 2009, but not reported to the Minnesota Department of Health (MDH), diagnostic and procedural billing codes suggestive of tick‐borne diseases were used to select medical charts for retrospective review in medical facilities serving residents of a highly endemic county in Minnesota. Of 444 illness events, 352 (79%) were not reported. Of these, 102 (29%) met confirmed or probable surveillance case criteria, inclu...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: Original Article Source Type: research
Summary Lyme disease (LD), anaplasmosis, babesiosis and other tick‐borne diseases (TBDs) attributed to Ixodes ticks are thought to be widely underreported in the United States. To identify TBD cases diagnosed in 2009, but not reported to the Minnesota Department of Health (MDH), diagnostic and procedural billing codes suggestive of tick‐borne diseases were used to select medical charts for retrospective review in medical facilities serving residents of a highly endemic county in Minnesota. Of 444 illness events, 352 (79%) were not reported. Of these, 102 (29%) met confirmed or probable surveillance case criteria, inclu...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: Original Article Source Type: research
Summary In the 14‐year period from 1993 to 2006, New York State (NYS) accounted for over one‐quarter (27.1%) of all confirmed Lyme disease (LD) cases in the United States. During that time period, a nine‐county area in south‐east NYS accounted for 90.6% of the reported LD cases in the state. Based on concerns related to diminishing resources at both the state and local level and the increasing burden of traditional LD surveillance, the NYS Department of Health (DOH) sought to develop an alternative to traditional surveillance that would reduce the investigative workload while maintaining the ability to track LD tre...
Source: Zoonoses and Public Health - Category: Infectious Diseases Authors: Tags: Original Article Source Type: research
Conclusions: These results emphasize the need for follow-up investigations to determine whether the identified spatial pattern is due to: clustering of misdiagnosed cases, clustering of patients with an out-of state travel history, or presence of a clustered unknown enzootic cycle of B. burgdorferi in Texas. This would enable an improved surveillance and reporting of LD in Texas.
Source: BMC Public Health - Category: Consumer Health News Authors: Source Type: research
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