1990 CSTE POSITION STATEMENT 1  COMMITTEE: Surveillance TITLE: National Surveillance of Lyme Disease and Resources for Lyme Disease and Epidemiology ISSUE: The number of Lyme disease cases reported to state health departments has increased dramatically in recent years, and health departments have had to devote considerable resources to its surveillance. Efforts to achieve reliable surveillance have been hindered by the lack of a workable case definition. In November 1989, a consultants committee of CSTE members and Lyme disease experts was convened in Atlanta. This group developed a national case definition and produced clinical definitions. This will improve the specificity of national surveillance and the comparability of data between the states. POSITION TO BE ADOPTED: CSTE recommends that Lyme disease be made a nationally notifiable disease and that states adopt the CDC case definition for Lyme disease. CSTE also recommends that CDC make surveillance for Lyme disease a high priority, with emphasis on overcoming technical deficiencies in currently available Lyme disease serological tests and in upgrading proficiency of laboratories performing these tests. CSTE recommends that CDC increase funds to state and territorial health departments to strengthen surveillance activities, to better define the geographic limits of infection, to determine risk factors responsible for transmission in highly endemic foci, and to develop strategies of prevention and control. CSTE recommends that CDC support efforts by states to carry out Lyme disease-related public health education activities. BACKGROUND/JUSTIFICATION: Lyme disease is the most frequently reported vector-borne disease in the United States. In the period 1982-1988, 13,825 cases were reported to the CDC, with a fivefold increase in 1987 as compared with 1982, and a doubling of reported cases between 1987 and 1988. All but 5 states had reported cases by the end of 1988. Epidemiologists have a critical role to play in the national response to Lyme disease. Surveillance is essential to define the scope, the population at risk, and to identify prevention strategies. It is also needed to evaluate the impact of prevention measures. CSTE recognized the efforts of CDC to improve the surveillance and laboratory diagnosis of Lyme disease. CONSULTATION WITH OTHER ORGANIZATIONS: Agency for Response: CDC (EPO) Agency for Information: ASTHO CONTACT: Matthew Cartter, M.D. Connecticut State Department of Health 117 Washington Street Hartford, CT 06106 203-566-5058