• MMWR Morb. Mortal. Wkly. Rep. · Oct 2014

    Notes from the field: update on Lyme carditis, groups at high risk, and frequency of associated sudden cardiac death--United States.

    • Joseph D Forrester, Jonathan Meiman, Jocelyn Mullins, Randall Nelson, Starr-Hope Ertel, Matt Cartter, Catherine M Brown, Virginia Lijewski, Elizabeth Schiffman, David Neitzel, Elizabeth R Daly, Abigail A Mathewson, Whitney Howe, Lindsay A Lowe, Natalie R Kratz, Shereen Semple, P Bryon Backenson, Jennifer L White, Phillip M Kurpiel, Russell Rockwell, Kirsten Waller, Diep Hoang Johnson, Christopher Steward, Brigid Batten, Dianna Blau, Marlene DeLeon-Carnes, Clifton Drew, Atis Muehlenbachs, Jana Ritter, Jeanine Sanders, Sherif R Zaki, Claudia Molins, Martin Schriefer, Anna Perea, Kiersten Kugeler, Christina Nelson, Alison Hinckley, Paul Mead, and Centers for Disease Control and Prevention (CDC).
    • MMWR Morb. Mortal. Wkly. Rep. 2014 Oct 31; 63 (43): 982-3.

    AbstractOn December 13, 2013, MMWR published a report describing three cases of sudden cardiac death associated with Lyme carditis. State public health departments and CDC conducted a follow-up investigation to determine 1) whether carditis was disproportionately common among certain demographic groups of patients diagnosed with Lyme disease, 2) the frequency of death among patients diagnosed with Lyme disease and Lyme carditis, and 3) whether any additional deaths potentially attributable to Lyme carditis could be identified. Lyme disease cases are reported to CDC through the Nationally Notifiable Disease Surveillance System; reporting of clinical features, including Lyme carditis, is optional. For surveillance purposes, Lyme carditis is defined as acute second-degree or third-degree atrioventricular conduction block accompanying a diagnosis of Lyme disease. During 2001-2010, a total of 256,373 Lyme disease case reports were submitted to CDC, of which 174,385 (68%) included clinical information. Among these, 1,876 (1.1%) were identified as cases of Lyme carditis. Median age of patients with Lyme carditis was 43 years (range = 1-99 years); 1,209 (65%) of the patients were male, which is disproportionately larger than the male proportion among patients with other clinical manifestations (p<0.001). Of cases with this information available, 69% were diagnosed during the months of June-August, and 42% patients had an accompanying erythema migrans, a characteristic rash. Relative to patients aged 55-59 years, carditis was more common among men aged 20-39 years, women aged 25-29 years, and persons aged ≥75 years.

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