Lyme Disease in Missouri
Updated 3-27-13
Lyme disease is a problem in Missouri, although many doctors don't know it. Patients often have
difficulty getting diagnosed and treated, which causes symptoms to progress and become
difficult to cure. Lyme disease has been reported in all 50 states and on 6 continents.
Infected ticks on migrating birds continue to take the disease to new areas. The St. Louis area is
at special risk, because it is on two major bird flyways.
In 1990, Missouri ranked 8th highest in the nation in reported cases of Lyme disease.
Cases of Lyme disease have been reported in Missouri every year since 1984. Missouri has
reported over 1,000 cases of Lyme disease to the CDC. Most Missouri cases aren't reported.
The CDC says Lyme disease is vastly under-reported.
A survey by IDEXX Reference Laboratories from 2001 to 2009 found 198 cases of Lyme
disease in dogs in 19 counties in Missouri, of which 29 cases were in St. Louis County (www.
dogsandticks.com). IDEXX says the actual number of cases is probably much higher.
Ticks in Missouri have been found to carry Borrelia burgdorferi (Bb) bacteria, the cause of Lyme
disease. (Edwin Masters, M.D., et al, Archives of Dermatology, Aug. 1998, vol. 134). Another
study, by the U.S. Army in 1992 at Fort Leonard Wood in Missouri, found that 40 of 112
Ixodes scapularis (“deer”) ticks taken from deer at the fort were positive for Bb bacteria.
Bb bacteria were found in lone star ticks (Amblyomma americanum) and American dog
ticks (Dermacentor variabilis) in southeastern Missouri and around St. Louis in a 1994
study by the Department of Biology at St. Louis University. (Dorothy Feir, C. Reppell, C.R.
Santanello, B.W. Li, C.S. Xie, Edwin Masters, R. Marconi, G. Weil, “Evidence supporting the
presence of Borrelia burgdorferi in Missouri,” Am J Trop Med Hyg. 1994 Oct;51(4);475-82).
Lone star ticks in Missouri also carry a strain of borrelia bacteria that is slightly different from
Borrelia burgdorferi. Dr. Masters found that the rash, signs, and symptoms of the disease are
the same as Lyme disease. This strain is called Masters' disease. The CDC calls the disease
STARI when transmitted by lone star ticks, although it is identical to Lyme and needs to be
treated as Lyme.
In a study of 672 patients in Missouri that met the CDC case definition of Lyme disease,
Missouri patients had a slightly higher incidence of the Lyme disease signs of encephalitis or
meningitis, second or third degree heart block, and Bell’s palsy than Lyme patients nationally,
and were more than twice as likely to have arthritis (64.7% versus 30.5%). Only 50.9% of the
Missouri Lyme patients had the erythema migrans (EM) rash. (Edwin Masters, MD; H.
Denny Donnell, MD, MPH; Michael Fobbs, B.A., “Missouri Lyme Disease: 1989 through 1992,”
Journal of Spirochetal and Tick-Borne Diseases, Vol.1, No. 1, 1994.)
There have been 10 support groups for patients with Lyme disease and/or Masters'
disease in Missouri: in Kansas City, Joplin, Butler, Columbia, St. Louis, Independence, Cape
Girardeau, Chillicothe, Jefferson City, and Springfield. The latter six have stopped having
meetings, primarily because the leaders and members are too ill to meet. The leader of one
group died at the age of 51. The Lyme Association of Greater Kansas City has been active
since 1993 and provides information to patients, schools, the general public, and medical
professionals throughout Missouri and Kansas.
For more information, contact:
Lyme Association of Greater Kansas City, Inc. P.O. Box 25853, Overland Park, KS 66225
(913)438-5963
Lymefight @aol.com
www. Lymefight.info
Study Found Lyme Disease More Severe in Missouri
By Kathy White, Corresponding Secretary
Lyme Association of Greater Kansas City, Inc.
In 1994 Dr. Edwin Masters of Cape Girardeau, MO reported a study of 672 Missouri cases that
met the CDC surveillance definition for Lyme disease. The Missouri patients had a significantly
higher incidence of arthritis than patients nationally. The study, “Missouri Lyme Disease: 1989
through 1992,” by Edwin J. Masters, M.D.; H. Denny Donnell, M.D., MPH; and Michael Fobbs,
B.A., was reported in the Journal of Spirochetal and Tick-Borne Diseases, Vol.1, No.1, 1994.
This study found that Lyme disease patients in Missouri were more than twice as likely to
develop arthritis than patients nationally, and Missouri patients had a slightly higher
incidence of Bell's palsy, encephalitis, meningitis, and 2nd or 3rd degree heart block:
Erythema migrans rash
Arthritis
Bell’s palsy
Encephalitis or meningitis
2nd or 3rd degree heart block
Radiculoneuropathy
Missouri
50.9%
64.7%
4.91%
1.49%
1.33%
4.46%
Nationally (excluding Missouri)
73.1%
30.5%
3.9%
.95%
.5%
No data
Only 50.9% of Missouri patients had the Lyme disease erythema migrans (EM) rash. This
rash is an expanding red spot. Most EM rashes do not develop the characteristic rings.
Therefore, only about half of diagnosed patients in Missouri get a large red spot, and even fewer
get a bull’s-eye rash. Since cases are often diagnosed based on the rash, the people that don’t
get the rash are less likely to get diagnosed. Therefore, the actual number of infected people
who get the classic rash is likely to be much fewer than 50% of patients. Dr. Charles Ray
Jones of New Haven, CT said that fewer than 10% of his patients had a bull’s-eye rash. (Dr.
Jones is a pediatrician who has treated over 11,000 children for Lyme disease. He has cured
75% of them by continuing treatment for at least 2 months after all signs and symptoms are
gone. Shorter treatment courses often cause a relapse.)
It is unknown whether the higher incidence of arthritis in Missouri is because the disease is
more severe in the state, or because the patients in Missouri may have been ill for a longer
period of time than the national sample, allowing the disease to progress and develop arthritis.
Many doctors are stilll unaware that Lyme disease is in Missouri and still fail to diagnose it,
which often causes symptoms to progress and become chronic. It's possible that arthritis is
more common in Lyme patients nationally than this study revealed, if many of the patients in the
study had been ill only a short time at the time they were studied.
Lyme-like illnesses in Missouri produce the exact same symptoms and require the same
treatment as Lyme, but they are largely being ignored. Patients in Missouri are continuing to
suffer for years from Lyme and Lyme-like diseases before getting diagnosed. Some have died
too young.