The economic burden of Lyme disease could be nearly $1 billion annually, according to a new study by researchers from the Yale School of Public Health, the U.S. Centers for Disease Control and Prevention (CDC), and health officials from four states heavily impacted by the disease.The report, the CDC’s most comprehensive evaluation of the economic impact of Lyme disease to date, looked at the total cost of diagnosed Lyme disease cases between September 2014 and January 2016 and followed reported cases in four states where the tickborne disease is prevalent: Connecticut, Maryland, Minnesota, and New York.\n“Lyme disease represents a substantial economic burden to individuals and U.S. society,” said Sara Niesobecki, one of the study’s co-authors and an investigator with the Connecticut Emerging Infections Program (EIP) at the Yale School of Public Health. “The aggregate cost of diagnosed Lyme disease could be close to $1 billion annually but this does not include suspected, undiagnosed, or nonacute cases.”\nThe researchers acknowledge that further evaluation is warranted to determine the total economic burden attributable to Lyme disease in the U.S.Niesobecki is coordinator of the TickNET Program at the Yale School of Public Health, one of four TickNET sites nationally that assisted the CDC in developing protocols and collecting data for the study. TickNET is a collaborative public health effort that was established by the CDC in 2007 to help coordinate surveillance, research, education, and prevention of tickborne diseases.\nIn estimating the economic burden of Lyme disease, the researchers collected data for direct medical costs, nonmedical costs, and losses in productivity from patients clinically diagnosed with Lyme disease. They also collected billing code information from the patients’ health care providers to assess societal costs (i.e., all costs, no matter who pays them, whether the patient, health care system, third party payer/insurance, or government) and patient costs (i.e., “out-of-pocket” costs). They determined that the average out-of-pocket patient cost was approximately $1,200 per illness and the average societal cost was about $2,000 per patient.\n“Most patients had low costs, but some experienced very high costs related to Lyme disease,” Niesobecki said. “Patients with later stages of disease had double the costs of those with early disease.”\nPatients with later stages of disease had double the costs of those with early disease.Sara Niesobecki, investigator, Connecticut Emerging Infections ProgramUsing these data and additional information on the estimated number of Lyme disease cases diagnosed in the United States, the researchers estimated that the annual total cost of diagnosed Lyme disease could be $345 million to $968 million (in 2016 U.S. dollars).Patients with later stages of disease had double the costs of those with early disease“These findings emphasize the importance of effective prevention of Lyme disease and early and accurate diagnosis in order to reduce illness and the associated costs to the patient and society,” said Niesobecki. “They can also be used in cost-effectiveness analyses of current and future Lyme disease prevention methods, such as a vaccine.”\nLyme disease is the most common vector-borne disease in the United States, and approximately 476,000 cases of Lyme disease are diagnosed and treated each year nationally. Lyme disease is caused by the bacterium Borrelia burgdorferi and rarely, B. mayonii, which is transmitted to people through the bite of an infected blacklegged tick. Early symptoms can include rash and flu-like symptoms. If untreated, later signs and symptoms can include facial palsy, arthritis, nerve pain, and heart palpitations or an irregular heartbeat.\nThe Connecticut Emerging Infections Program is funded through a cooperative agreement with CDC and is a partnership between the Connecticut Department of Public Health and Yale School of Public Health. There are 10 Emerging Infections Program sites in the country and four of those sites — Connecticut, Minnesota, Maryland, and New York — participate in TickNET.\nThe study estimating the economic burden of Lyme disease was published May 11 in Emerging Infectious Diseases. Information from a media advisory issued by the CDC was included in this article.