Children with Lyme Disease & Autism from New Jersey and Connecticut

Developmental Delay and Lyme Disease
in Children: An epidemiologic study
Participants: Children with Lyme Disease & Autism from New Jersey and
Connecticut

Goals:To understand more about the association between LD and developmental
delay and developmental regression

Status of study :Underway. As this is a population-based study, we are not
recruiting individual patients.

Principal Investigator :Brian A. Fallon, MD

Design of the Study : This study is supported by the Wilton Lyme Disease
Task Force. Based on the hypothesis that the prevalence of autism may be
increased in Lyme endemic areas, the prevalence statistics for autism in the
school districts of known hyperendemic areas in New Jersey and Connecticut
will be compared to the prevalence statistics for autism in the school
districts of areas without much Lyme Disease. The hyperendemic and
non-endemic areas will be identified by categorizing rates of Lyme disease
(in each area) into quantiles. Once the data has been collected and
prevalence rates have been calculated for both autism and Lyme disease, an
expected rate of autism will be calculated based on areas that have a low
prevalence of Lyme Disease. From this rate, an expected number of cases will
be determined (based on population size) and a calculation of the observed
number of autism cases minus the expected number of autism cases will be
made. From this calculation, graphical comparisons will be made to determine
if observed values of autism more dramatically deviate from expected values
in areas that have high rates of Lyme Disease. Prevalence rates will then be
mapped in overlays to determine if Lyme hyperendemic areas overlap with high
rates of autism. Arcview, a Geographic Information System (GIS) of which
Columbia University is already in possession, will be used for all mapping
purposes.

Contact :This is an epidemiologic study. No contact by subjects is needed at
this time.

Screening Questionnaire :This is an epidemiologic study. No contact by
subjects is needed at this time.

Frequently asked questions

Why is this study needed? Lyme disease has been associated with a broad
array of neuropsychiatric disorders. Undoubtedly, the most common are
headaches and stiff neck in early neurologic Lyme Disease and mild to
moderate cognitive problems in later neurologic Lyme Disease. This latter
syndrome has been termed encephalopathy. Lyme Disease may also cause
considerable irritability, particularly in the acute phase of the illness,
as well as less common symptoms such as paranoia, obsessive compulsive
behaviors, or mania. Autism is classically considered to be a
neurodevelopmental disorder, the cause of which is unknown. In our work with
children who have developed Lyme disease, we have encountered a few children
who had developed autistic-like disorders which were eventually also
diagnosed as having Lyme Disease due to other concomitant symptoms; when the
child received intensive antibiotic therapy, the autistic syndromes
dramatically improved and, in some cases, resolved. We hypothesize: a) that
a small subpopulation of children with autism in Lyme endemic areas may have
an antibiotic responsive disorder due to a spirochete-induced autistic
syndrome; and b) that areas with very high rates of Lyme Disease would show
higher than expected rates of autism. The latter hypothesis will be tested
using geographic mapping.

What are some questions to ask if a child presents with new onset autistic
behaviors?

Certainly if a child was well until age 4 and then develops significant
abnormalities in social interaction, language, or imaginative play, this
would not be typical of autism which is a disorder that shows signs and
symptoms prior to age 3. Autistic behaviors that emerge after age 3 would be
diagnosed as either Asperger.s or possibly childhood disintegrative
disorder. Childhood disintegrative disorder in particular may be associated
with various general medical conditions, such as Addison-Schilder.s disease
or subacute sclerosing panencephalitis. Medical conditions need to be ruled
out in children who develop these disorders after age 3. Lyme Disease should
be suspected if the child has been exposed to a Lyme Endemic area, if the
child has been bitten by ticks or experienced unusual round rashes, or if
the child has had a bad bout of flu-like symptoms, or the child has been
complaining of joint pains, headaches, or fatigue. In the child younger than
age 3, the diagnosis of a Lyme-induced autistic syndrome would be harder to
make, as the age of abnormal behaviors would be consistent with the typical
onset for non-Lyme autistic-like disorders. The work-up should include blood
tests and a spinal tap to look for evidence of increased intracranial
pressure, elevated protein or white cells, and/or elevated levels of
antibodies to borrelia burgdorferi.

How often would Lyme Disease cause an autistic-like disorder?

This is probably a rare occurrence.

If Lyme Disease has induced an autistic-spectrum disorder, is it reversible?
Based on our knowledge of Lyme Disease, we would expect that appropriately
intensive intravenous antibiotic therapy would result in a marked
improvement in the autistic-spectrum behaviors. We do not know how long such
a treatment should last, but our experience with other patients suggests
that, if six weeks of therapy do not result in significant change, a longer
course of therapy may be warranted and ultimately effective.

Lymehelp wrote:
> Developmental Delay and Lyme Disease
> in Children: An epidemiologic study
> Participants: Children with Lyme Disease & Autism from New Jersey and
> Connecticut
>
> Goals:To understand more about the association between LD and developmental
> delay and developmental regression
>
> Status of study :Underway. As this is a population-based study, we are not
> recruiting individual patients.
>
> Principal Investigator :Brian A. Fallon, MD
>
> Design of the Study : This study is supported by the Wilton Lyme Disease
> Task Force. Based on the hypothesis that the prevalence of autism may be
> increased in Lyme endemic areas, the prevalence statistics for autism in the
> school districts of known hyperendemic areas in New Jersey and Connecticut
> will be compared to the prevalence statistics for autism in the school
> districts of areas without much Lyme Disease. The hyperendemic and
> non-endemic areas will be identified by categorizing rates of Lyme disease
> (in each area) into quantiles. Once the data has been collected and
> prevalence rates have been calculated for both autism and Lyme disease, an
> expected rate of autism will be calculated based on areas that have a low
> prevalence of Lyme Disease. From this rate, an expected number of cases will
> be determined (based on population size) and a calculation of the observed
> number of autism cases minus the expected number of autism cases will be
> made. From this calculation, graphical comparisons will be made to determine
> if observed values of autism more dramatically deviate from expected values
> in areas that have high rates of Lyme Disease. Prevalence rates will then be
> mapped in overlays to determine if Lyme hyperendemic areas overlap with high
> rates of autism. Arcview, a Geographic Information System (GIS) of which
> Columbia University is already in possession, will be used for all mapping
> purposes.
>
> Contact :This is an epidemiologic study. No contact by subjects is needed at
> this time.
>
> Screening Questionnaire :This is an epidemiologic study. No contact by
> subjects is needed at this time.
>
> Frequently asked questions
>
> Why is this study needed? Lyme disease has been associated with a broad
> array of neuropsychiatric disorders. Undoubtedly, the most common are
> headaches and stiff neck in early neurologic Lyme Disease and mild to
> moderate cognitive problems in later neurologic Lyme Disease. This latter
> syndrome has been termed encephalopathy. Lyme Disease may also cause
> considerable irritability, particularly in the acute phase of the illness,
> as well as less common symptoms such as paranoia, obsessive compulsive
> behaviors, or mania. Autism is classically considered to be a
> neurodevelopmental disorder, the cause of which is unknown. In our work with
> children who have developed Lyme disease, we have encountered a few children
> who had developed autistic-like disorders which were eventually also
> diagnosed as having Lyme Disease due to other concomitant symptoms; when the
> child received intensive antibiotic therapy, the autistic syndromes
> dramatically improved and, in some cases, resolved. We hypothesize: a) that
> a small subpopulation of children with autism in Lyme endemic areas may have
> an antibiotic responsive disorder due to a spirochete-induced autistic
> syndrome; and b) that areas with very high rates of Lyme Disease would show
> higher than expected rates of autism. The latter hypothesis will be tested
> using geographic mapping.
>
> What are some questions to ask if a child presents with new onset autistic
> behaviors?
>
> Certainly if a child was well until age 4 and then develops significant
> abnormalities in social interaction, language, or imaginative play, this
> would not be typical of autism which is a disorder that shows signs and
> symptoms prior to age 3. Autistic behaviors that emerge after age 3 would be
> diagnosed as either Asperger.s or possibly childhood disintegrative
> disorder. Childhood disintegrative disorder in particular may be associated
> with various general medical conditions, such as Addison-Schilder.s disease
> or subacute sclerosing panencephalitis. Medical conditions need to be ruled
> out in children who develop these disorders after age 3. Lyme Disease should
> be suspected if the child has been exposed to a Lyme Endemic area, if the
> child has been bitten by ticks or experienced unusual round rashes, or if
> the child has had a bad bout of flu-like symptoms, or the child has been
> complaining of joint pains, headaches, or fatigue. In the child younger than
> age 3, the diagnosis of a Lyme-induced autistic syndrome would be harder to
> make, as the age of abnormal behaviors would be consistent with the typical
> onset for non-Lyme autistic-like disorders. The work-up should include blood
> tests and a spinal tap to look for evidence of increased intracranial
> pressure, elevated protein or white cells, and/or elevated levels of
> antibodies to borrelia burgdorferi.
>
> How often would Lyme Disease cause an autistic-like disorder?
>
> This is probably a rare occurrence.
>
> If Lyme Disease has induced an autistic-spectrum disorder, is it reversible?
> Based on our knowledge of Lyme Disease, we would expect that appropriately
> intensive intravenous antibiotic therapy would result in a marked
> improvement in the autistic-spectrum behaviors. We do not know how long such
> a treatment should last, but our experience with other patients suggests
> that, if six weeks of therapy do not result in significant change, a longer
> course of therapy may be warranted and ultimately effective.


Can you post a link next time you copy and paste someones Else's work?

You need to post the link, that is the terms of service rules. You
can't use a copyrighted article without crediting the authors.

Just a heads up


Chuck P Adams
Newsgroup leader

The persons name is in the article.