Lyme Disease And Armed Services Briefing Paper

According to the Armed Forces Health Surveillance Center report i, confirmed cases of Lyme disease in the services were diagnosed at more than 120 locations worldwide. Medical facilities at the following locations accounted for nearly one-half of the total: West Point, NY; Heidelberg, GE; Walter Reed Army Medical Center, Washington; Camp Lejeune, NC; Vilseck, GE; Landstuhl Regional Medical Center, GE; Naval Health Clinic New England (branch clinics in Newport, RI; Groton, CT; Portsmouth, NH; Brunswick, ME; Saratoga Springs, NY); National Naval Medical Center, Bethesda, MD; Fort Knox, KY; Andrews Air Force Base, MD; Fort Meade, MD; and McGuire Air Force Base, NJ. 2008 had nearly 3 times more confirmed cases than 2004.

Air Force aeromedical concerns may require flyers to receive a waiver to fly if they have Lyme disease. “The symptoms during primary Lyme disease, included arthralgias, fatigue, headache, neck pain and possible fever are obviously not optimal in the flying environment. As with all infectious diseases, if recognized and treated early with full resolution of symptoms, return to flight status is appropriate. However, if untreated, then aeromedical concerns of this disease are its debilitating effects in regards to the neurologic, cardiovascular, and arthritides that may result. Neurocognitive impairment, cardiac arrhythmias and arthritic pain are all manifestations that could impact the safety of the individual and mission.” ii

At a blood products advisory committee meeting on Babesia in the blood supply, Dr. Jesse Goodman, M.D., Director of FDA’s Center for Biologics, made the observation, “I will say I just finished a month of clinical attending at the Naval hospital in the summer, and I was actually fairly shocked by the number of cases of disseminated Lyme disease that we are seeing. So I think that the notion that we have control over tick-borne disease…we don’t really have a good hand on how many cases of primary infection[Lyme disease] there are.” iii

US Army Centers for Health Promotion & Preventive Medicine (CHPPM) report states that ticks are among the most important of all arthropod vectors of disease. There are over 850 recognized species worldwide. Ticks rank second only to mosquitoes in the number of life-threatening and debilitating diseases they transmit to humans. In the United States, ticks are responsible for more human disease than any other arthropod group. Tick-borne diseases represent potentially serious health threats to troops, their family members, DoD civilian employees, and other residents at military installations in many parts of the world.iv

The Lyme Disease Association, a national non profit, presented testimony to the Defense Health Board on a Lyme disease agenda item “LDA has spoken about Lyme disease on several bases and presented a 2002 educational briefing for military officials at a DC meeting arranged by then House Veteran’s Committee Chair, Congressman Christopher Smith (NJ). LDA provided noted clinicians who educated military officials from all branches of the armed services about chronic Lyme disease and the problems faced by Lyme disease patients…. Military doctors indicated they faced the same set of “political” problems in treating their Lyme disease patients…LDA has been invited twice to US Army Centers for Health Promotion & Preventive Medicine (CHPPM), Aberdeen Proving Grounds, where…CHPPM has shared its extensive work on identifying tick-borne disease organisms in various ticks found on military installations nationwide. CHPPM discussed its mapping of military installations for risks of Lyme disease and its plan to beam that information to satellites which then will convey it to handheld devices, alerting troops to the presence of ticks. CHPPM shared development of technology which enables it to test ticks in the field for any known disease agent, so that troops can be treated immediately if bitten by infected ticks. CHPPM has been both a speaker and exhibitor at LDA’s annual scientific conference for physicians on tick-borne diseases−conferences jointly sponsored with New York’s Columbia University. The LDA’s 9th annual scientific conference in San Francisco Oct. 17, 2008, has a speaker from the Armed Forces Institute of Pathology who will discuss the pathology of Lyme carditis….[Lyme can also produce palpitations, heart block, and valve prolapse.]” v

i Medical Surveillance Monthly Report Armed Forces Health Surveillance Center July 2009 Lyme disease among U.S. military members, active and reserve component, 2001-2008_
ii Air Force Aeromedical Corporate Board Meeting Minutes September 2005 WAIVER GUIDE Updated: Jul 07 By: Lt Col Stephen Hingson (RAM 08) and Dr Karen Fox
iii Food and Drug Administration Workshop 2008
iv US Army Centers for Health Promotion and Preventive Medicine (CHPPM) to Congress in 1999 DoD Research and Surveillance Activities Regarding Lyme Disease and Other Tick-Borne Diseases,
v Lyme Disease Association, Inc. testimony, Defense Health Board Meeting, Sept 4-5, 2008 Falls Church, VA


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