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Science Wednesday: Avoiding Lyme Disease: there’s an app for that!

2010 November 17

Each week we write about the science behind environmental protection. Previous Science Wednesdays.

By Aaron Ferster

Last weekend, I hopped the northbound train out of Washington, DC for New Haven, Connecticut, where I joined 500 or so other science writers to talk shop at the National Association of Science Writers annual conference. The conference was held jointly with the Forty-eighth Annual New Horizons in Science program, organized by the Council for the Advancement of Science Writing and hosted by Yale University and the Yale School of Medicine.

The two events are held consecutively, so that a couple of days of workshops and lectures on the craft of science writing are immediately followed by presentations by scientists eager to share their work with a receptive audience of science writers.

As you could imagine, a number of the presentations covered topics familiar to someone like me who’s “day job” is writing about EPA science and research. There were presentations on what scientists are finding in the aftermath of the Deep Water Horizon (BP) oil spill, case studies of the global climate change research, and even a presentation on green chemistry by former EPA environmental engineer Dr. Julie Zimmerman.

I even came across an example of EPA-related research completely unexpectedly. A feature story in the Fall, 2010 issue of the publication Yale Public Health highlights how Yale researchers helped to develop a Lyme disease “app” for iPhones and other popular Apple devices.

The app provides a map of infected tick density at a given location, providing a kind of user-friendly early warning system about Lyme disease risks. The program includes images of ticks people can use to identify different species—hopefully before picking them off their skin with a pair of tweezers.

Although EPA did not directly fund the development of the app, it has supported research integrating earth observation technologies, such as remote sensing, with field studies to model and map Lyme disease risk.

The development of the “app” is just the kind of research-based decision-making and information tool that EPA scientist Montira Pongsiri and her partners have been working to advance (and in Dr. Pongsiri’s case, blogging about) through EPA’s Biodiversity and Human Health Research Program.

About the Author: Aaron Ferster is an EPA science writer and the editor of “Science Wednesday.”

Editor’s Note: The opinions expressed in Greenversations are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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10 Responses leave one →
  1. armansyahardanis permalink
    November 17, 2010

    Urgency of live, survive and sustainable is sense of comfortable, both poor or rich conditions. The lost of Dinosaur is faster than the Tick, but the people tick still alive. We need Comfortable Ecosystem in our live, without seeing they are plants, animals, planets or people,too. Let’s we are called : “Togetherness” for The Things in this universes!!

  2. Liz Schmitz permalink
    November 18, 2010

    Unfortunately, as nifty as this app may sound, I’d be very careful about relying on it for numerous reasons. Could this do more harm than good, by creating a false sense of security?

    County-by-county tick flagging studies have never been performed across the Southeast (and in many other areas of the country) and tick prevalence and infection rates can vary greatly within only a few miles (even a few blocks!). Conclusive studies involving various tick vectors, hosts, and transmission haven’t been undertaken; and states across the country have NOT used the same, standardized, CDC reporting practices to document human Lyme disease cases, thereby completely invalidating Lyme disease statistics across the U.S. (What is counted as a Lyme case in the Northeast, isn’t even counted at all in many other areas.) The threat of Lyme disease to humans can in no way be ascertained by looking at state reported case numbers.

    Here in GA, our public health officials recently published that Lyme disease risk to humans still needs to be assessed.. over 20 years have passed since the CDC documented 715 Lyme disease cases here, and identified 27 Georgia counties with native human cases (and scientists have found the Lyme bacteria in thousands of tick and animal specimens from across the Southeast), yet they STILL haven’t assessed the risk to humans? Thousands of citizens report they are contracting Lyme and other tick-borne diseases in the South, but their cases are dismissed as, “false positives” without further investigation, and/or are never reported.

    Prevalence cannot be determined without a sensitive test. Some strains of Lyme borrelia are obviously not being detected by tests. In a Scottish study, when regional Bb strains were added to a Western blot, it increased its sensitivity. When Missouri’s Dr. Ed Masters tested his patients using the old ELISA which used whole cell sonicated borrelia, they were positive for Lyme. When they stopped using that in the tests, many of his patients no longer tested positive. How many Lyme cases are we missing due to poor testing and different regional strains and species?

    Additionally, Lyme disease is certainly not the only tick-borne pathogen our citizens should be concerned about. There are many other very serious diseases that ticks can transmit, and some of these are “emerging” (by that, of course, we mean probably not just now moving into an area, but are only now being discovered).

    No matter how cool-looking a computerized program, the public and medical providers should never be lulled into thinking they are safe after a tick bite, simply because it’s not a certain type of tick or due to their locale. Sometimes there is very limited and flawed data (and in some areas, next to NO data). We must be careful to err on the side of caution in order to protect public health when true prevalence hasn’t been established and so many other factors remain unknown. Many tick-borne diseases require prompt recognition and treatment or ongoing problems and permanent damage may occur.

  3. Jonathan Todd permalink
    November 18, 2010

    Though I understand the above commenter’s concern about a false sense of security, I ultimately believe that having information like this readily available to individuals who otherwise would be without any information is a positive thing. I am certainly no expert in Lyme disease or tick-borne illnesses of any kind but it seems to me that having some information on the location and existence of disease carrying ticks would be better than having no information at all.

    On a more general point, I think that presenting scientific data in a way that is more accessible to the general public, an Iphone app for example, allows individuals to have access to knowledge with which, in all likelihood, they would not otherwise come in to contact. Rather than viewing the dissemination of information as danger because it is incomplete, I think we should encourage the spread knowledge whenever possible and just make it clear that such information is incomplete.

  4. Liz Schmitz permalink
    November 18, 2010

    I strongly disagree, Jonathan; how can providing very flawed, unreliable data and assumptions that may lull people and medical providers into thinking a disease is not found in their area, when it IS, be helpful? If some company created an I Phone App that told you that statistics indicate that eating french fries and smoking cigarettes is good for you, would you still believe that some data is better than none? Sometimes a little data can do great harm. The public doesn’t go to the trouble to research gaps and flaws in information provided to them, usually until it’s far too late. We must not allow citizens to dismiss tick bites when so much of the science is unknown or questionable.

    Having not seen it completely, I’m not sure whether the makers of this app are letting people know that the science is “incomplete” (as you stated). But if the following is any indication, there is great cause for alarm. In the article’s referenced video, Dr. Durland Fish makes this irresponsible statement, that is incorrect. Lyme disease cases have been documented from every state. Prevalence has not been determined in most states, as there is no sensititve test detecting all strains and species. Numerous scientists and medical professionals disagree with Dr. Fish’s assertion:

    “…because Lyme disease doesn’t occur everywhere in the country, it only occurs in certain locations where infected ticks are abundant. In more than half the country, there’s absolutely no risk of Lyme disease. So, people can immediately determine whether or not there’s ticks where they presently are, or even where they intend to travel…. it will immediately tell them whether or not there are ticks in that particular area that can cause Lyme disease.”

    Dangerous statements like these, continuously made by a handful of doctors and researchers in this country, can greatly contribute to Lyme disease cases going unrecognized and undiagnosed (and being dismissed) in so-called, “non-endemic” areas. When this serious disease is not treated early, patients’ lives are often ruined because, without early treatment, they develop permanent damage and often chronic illness.

    We constantly hear reports from patients from areas considered “non endemic” who contract Lyme disease but are dismissed and told they do not have it. Many are denied treatment. They are told their test results are false positives, and many believe this until it’s far too late – they lose their ability to work, their homes, families, etc. – all because a handful of people in this country keep saying you cannot contract Lyme disease here or there.

    It’s time for this country to wake up. Lyme disease has been found on every continent except Antarctica. It’s well-documented in humans in South America. To believe it is contained in a tiny pocket in the northeastern United States, and then miraculously jumps over the rest of the entire continent and lands in Mexico, is completely irrational. (Google photos of ticks and birds.) To continue to say that Lyme tests are good in the Northeast, but produce false positives everywhere else; to continue to dismiss cases of tick bites, rashes, symptoms, and positive tests in non endemic areas – these things are senseless, yet they are what patients tell us happen to them all the time.

    Many citizens and medical providers don’t know better because they are unfamiliar with what is scientifically known or unknown and with the huge, controversial Lyme disease debate among researchers and medical practitioners. (I encourage everyone to read Cure Unknown: Inside the Lyme Epidemic and watch Under Our Skin, soon to be released via movie rental stores.) Statements like Dr. Fish’s, and apps based on flawed or unknown data, may have a tremendous affect on people’s very lives, and permanently.

    This program might be a good one, if it clearly describes what is known and unknown about Lyme disease. Ignoring the existence of divergent scientific viewpoints, controversies, and the outcries of patients doesn’t help anyone. Again, maybe sometimes one could argue that a little data is better than none. In this case, it appears far more dangerous to have a little information, than none at all. Seeing a neighbor nearly die last year from unrecognized ehrlichiosis after a tick bite convinced me: Citizens should ALWAYS take EVERY tick bite seriously.

  5. Joan permalink
    November 19, 2010

    This Lyme “app” contains too much misinformation . A waste of a persons time and money. For the BEST Lyme info

  6. Patricia Ricks permalink
    November 19, 2010

    I, too, find this a dangerous and misleading ap. Many Texas doctors believe there is no Lyme disease in TX, when the Texas State Dept of Health Services has been warning doctors that it is in Texas for at least 20 years, and we have thousands of TX patients with Lyme disease and/or other vector-borne diseases. The department has found Bb (as opposed to Lonestari) in ticks that have been taken off Texans and submitted for DNA testing. Even had they not, the other diseases transmitted by ticks present significant health risks and should not be discounted. This kind of misinformation contributes to patients’ frustrations in seeking adequate healthcare and prolongs diagnosis, leading to much more serious cases, when if caught early, Lyme can be treated successfully with a shorter course of antibiotics.

    Patricia Ricks
    Secretary, Board of Directors
    Texas Lyme Disease Association

  7. Esteban Minero permalink
    November 20, 2010

    An iPhone app that told people that they were not at risk for cancer because they did not live near a cluster would be unthinkable. Yet, this Lyme Disease app is directly analogous to such a hypothetical abomination. Lyme Disease is geographically widespread and can be transmitted via tick species that certain local and federal public health agencies refuse to acknowledge. The American Lyme Disease Foundation, which supported the development of the app, is a special interest group which promotes disinformation so that insurance companies can deny paying claims for more costly therapies for late stage or chronic Lyme Disease. If the ALDF supports it, you can be assured that it is against the public interest.

  8. miles permalink
    November 24, 2010

    I know the LDRD has thought of doing this.

    The idea is that an app can actually be updated in real time as information is available. But which data do you use? Lyme data is controversial depending on your wolrdview – traditional, modern, post modern.

    The problem with an app is that it is not going to fit nice and tiddy in with every ones worldview by which they use to formulate an opinion about the intricacies of Lyme through.

    It is easier to just assume that nature comes with ticks and be cautious no matter where you are!

  9. Chicago Web Design permalink
    November 29, 2010

    Thank you so much for providing this information. It would really help us.

  10. web design companies permalink
    March 25, 2011

    “This is the first health application for smartphones that could have an immediate impact on a major disease” said Durland Fish, a Yale professor of epidemiology who oversaw the development of the application. Users of the app should be able to avoid being bitten if they know that ticks are around, and if they are bitten, they can tell if it is the right kind and right stage that can cause Lyme disease. They will know when to seek medical advice so that the disease can either be prevented or treated in its very early stages. “You can only get Lyme disease is certain areas, only by certain ticks, and only after a tick has remained attached for a certain amount of time” said Fish. “Information provided by this app should help many people prevent Lyme disease.”

    Is it just me…or does this seem just completely off-the-wall, weird? Just goofiness?

    I’m not sure that “scary” is the word here, but I would have to agree with, at least, the caution, expressed in the following comment posted at the site:

    Wow, that is just scary.
    First, with tick populations spreading, the information about tick presence is very likely to be out of date or just plain wrong, giving many people a false sense of security.

    Yeah,that has always been a concern of mine. How accurate are field studies of tick populations and how accurate are the surveys of the percentage carrying Bb?

    For instance, in my area, I have followed the progression…and in some areas we have gone from no or little risk to “moderate” risk very quickly.

    In Lake County, Illinois, immediately north of Chicago, (as I noted elsewhere here) a recent study showed 37% of the ticks to be “packing” Bb. That area is shown on ALDF maps as a “moderate” risk site.

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