Abstract
Non-specific symptoms in later stages of Lyme disease (LD) may mimic a variety of autoimmune, viral, or complex diseases. Patients lacking erythema migrans or who test negative under CDC guidelines, but suspect LD may search online symptoms in vein. As a result, patients with lingering and undiagnosed symptoms turn to alternative lab tests. This study addresses patient's perceived illness in relation to CDC surveillance data. Extending the literature beyond basic searches for symptoms or disease terms, this study examines spatiotemporal dynamics among symptom, disease, and unconventional lab test searches on Google Trends, in compared with CDC confirmed cases of LD. The search terms used for the Google Trends analysis between 2011 and 2015 include: (1) “lyme” and “lyme disease” for disease, (2) “tick bite,” “bone pain,” “stiff neck,” “circular rash,” and “brain fog” for symptoms, and (3) “IGENEX” for the alternative lab test. Spatial and temporal analyses illustrate noticeable similar patterns between the search frequency and the actual LD incidence. Beyond basic searches for symptoms or disease terms, we demonstrate the improved utility of Google Trends analysis in discovering spatial and temporal patterns of perceived LD and comparing with the reported LD cases. The public health and medical communities benefit from this research through improved knowledge of undiagnosed patients who are searching for alternative labs to explain lingering symptoms. This study validates the need for further research into Google Trends data and surveillance protocols of diseases characterized by non-specific symptoms, prompting patients to “self-diagnose.”
Highlights
Lyme Disease (LD), a tick-borne and multi-systemic infection caused by Borrelia burgdorferi sensu lato, is the most common vector borne illness in the United States, with an estimated 240,000–440,000 new cases each year [1, 2]
Clinical diagnoses of Lyme disease (LD) may be made in patients with erythema migrans (EM) [6], and rashes and fungal infections are known to be commonly mistaken for EM [2, 11]
The figures compare a longterm trend over the 5 years; the number of confirmed LD cases remained the same while the search trends for disease names has gradually increased over time
Summary
Lyme Disease (LD), a tick-borne and multi-systemic infection caused by Borrelia burgdorferi sensu lato, is the most common vector borne illness in the United States, with an estimated 240,000–440,000 new cases each year [1, 2]. Non-specific symptoms of LD may manifest in later stages due to a variety of autoimmune, viral, or complex diseases. Given the Google Trends for Lyme Disease incidence of LD and presence of non-specific symptoms on which to clinically diagnose, it is believed that at least 3 million LD lab tests are ordered in the U.S each year [4, 5]. CDC’s testing presents different levels of significance in accordance with symptom presentation, EM presence, or later-stage disease manifestation [12]. Patients with EM find themselves with a variety of symptoms that present clinically as LD but fail to positively meet two-tier serologic indicators [4].
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