Laboratory reporting of positive Lyme disease test results
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                                                  as of 27 December 1999

Note: To align the columns of numbers in the article below, ensure that 
your Mail/News reader is configured for "Fixed Width Font".

The following data source was used for the tables below:

CDC: Reported Cases of Lyme Disease, by State, 1989-1998
http://www.cdc.gov/ncidod/dvbid/Ldss2_aug99.htm

The 27 states that are known to require laboratories to report positive 
Lyme disease test results to state health authorities have a 2.6 times 
higher reported incidence of Lyme disease (85.723 cases per million 
population) for 1998 than the 13 states that do not require laboratories 
to report Lyme disease (32.916 cases per million population).

States known to require laboratory reporting of Lyme disease: 

                Total Lyme disease       1995
State           cases reported 1998      Population (M)
-----           --------------------     ----------
Alabama               24                    4.246
Colorado               0                    3.748                      
Connecticut [1]     3434                    3.271 
Delaware              77                    0.717 
Florida               71                   14.184
Georgia                5                    7.209
Indiana               39                    5.797
Kentucky              27                    3.857
Maryland             659                    5.039
Massachusetts        699                    6.071
Michigan              17                    9.538    
Minnesota            261                    4.615
Missouri              12                    5.319
Nebraska               4                    1.639
Nevada                 6                    1.533
New Hampshire         45                    1.148
New Jersey          1911                    7.950
New Mexico             4                    1.690
New York            4640                   18.191
North Dakota           0                    0.642
Ohio                  47                   11.134
South Dakota           0                    0.730
Tennessee             47                    5.247
Texas                 32                   18.801
Vermont               11                    0.585 
Wisconsin            657                    5.122
Wyoming                1                    0.479
-----------------------------------------------------
       totals     12,730                  148.502

            12,730/148.502 = 85.723 cases per million

States known NOT to require laboratory reporting of Lyme disease:

                Total Lyme disease       1995
State           cases reported 1998      Population (M)
-----           --------------------     ----------
Alaska                 1                    0.603
Arizona                1                    4.305
California           135                   31.565
Idaho                  7                    1.166
Illinois [2]          14                   11.790
Kansas                13                    2.564
Mississippi           17                    2.696
North Carolina        63                    7.202
Oregon                21                    3.149
Pennsylvania        2760                   12.060
South Carolina         8                    3.667
Utah                   0                    1.958
Virginia              73                    6.615
Washington             7                    5.448
-----------------------------------------------------
       totals      3,120                   94.788

            3,120/94.788 = 32.916 cases per million

Footnotes:

[1] Connecticut required laboratories to report Lyme disease results 
    as of January 1998.
[2] Illinois requires laboratories to report only positive cultures 
    for Lyme disease.

All states, except Hawaii, require physicians to report Lyme disease 
cases to state health authorities.  However, for various reasons and as 
studies have proven, many doctors do not report Lyme disease diagnoses.  
Maybe they fear retaliation by state authorities for reporting too many 
cases.  What's too many?  Enough cases to affect tourism in the state?  
Enough cases to show that state authorities do not have the disease 
"under control"?  Enough cases to substantially affect the profits of 
the HMOs and insurance companies and their lobbyists?  Enough cases to 
show that other doctors, the ones not reporting Lyme disease, are not 
doing their job.  In any event, anyone knowledgeable of the Lyme disease 
situation knows that current reported cases are merely the "tip of the 
iceberg."  

Of course, there are lots of other issues bearing on laboratory 
reporting of Lyme disease, such as standardized, accurate tests, 
reciprocal agreements by states to report cases contracted by out-of-
state visitors, and state follow up of laboratory reports - all costing 
money.

In any event, the above data suggests that a truer picture of the extent 
of Lyme disease would be presented if all laboratories in all states 
were required by all states to report their positive findings for Lyme 
disease.  

For more information on the reporting of Lyme disease including links to 
individual state laboratory reporting requirements, see:

Reporting of Lyme Disease
http://www.geocities.com/HotSprings/Oasis/6455/reporting-links.html

The above link includes:

   MEDLINE citations on reporting of Lyme disease
   Reported cases of Lyme disease - national
   Lyme disease reporting requirements and forms for individual states
   Articles and other information on reporting of Lyme disease

For more information on Lyme disease, see:

Lots Of Links On Lyme Disease
http://www.geocities.com/HotSprings/Oasis/6455/lyme-links.html

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Prepared by:
Art Doherty
Lompoc, California
doherty@utech.net