Endemic Confusion

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Misconceptions about what it means for Lyme to be considered endemic

in a particular area are roadblocks to effective diagnosis and

treatment in much of the country. Lyme can be found in virtually any

state but it is endemic in only a few. A disease is endemic in an area

when the number of instances of the disease is relatively stable. When

the number of instances becomes unstable and increases over time the

disease is no longer endemic but epidemic. Epidemic diseases sometimes

settle back down to an endemic state but more often, they burn out

like a fire.

Southwestern Connecticut and eastern Long Island are among the places

that have steady rates of Lyme. They are therefore endemic areas. When

a disease appears sporadically in a region it is neither endemic nor

epidemic. Thus, in much of the rest of the country Lyme exists in

significant numbers but not enough to be endemic.

A good analogy might be that in an endemic state the number of cases

of a disease are like a steady flowing stream but when it's

overflowing its banks it is an epidemic. Lyme is a mere trickle in

most places, not enough to be a steady stream, but it is certainly

enough to get a significant number people wet.

In Nevada there are only few cases reported every year. It doesn't

seem to exist here in a steady state, just a few cases here and there.

It's here but it isn't endemic. The trickle here only occasionally

touches a few people. Unfortunately, my wife was one of the few to get

splashed.

When doctors roll their eyes and scoff at the possibility that someone

might have Lyme because they happen to live in a non-endemic area,

they commit what philosopher's call a fallacy of ambiguity. More

specifically, it is an equivocation of two different senses of the

term `endemic'. In medical jargon, the term is statistical and refers

simply to the state where the number of cases reported stays constant.

In its everyday use, the term means that something can only be found

in that particular area. So, when we say something is endemic to an

area in the ordinary sense, we mean that it can't be found anywhere

else. When we say that something is endemic and we are using it as

medical jargon, we are giving a bit of statistical information and not

saying one way or another whether it can be found elsewhere.

Doctors often refuse to diagnosis or even test because it isn't

endemic (in the medical sense) to that area. If they understand the

meaning of `endemic' in the medical sense then they should acknowledge

the possibility of Lyme even in non-endemic areas. If they believe

that Lyme could only be found in endemic areas that would mean that

Lyme couldn't exist anywhere because it simply isn't endemic anywhere

in the non-medical sense. That would mean that it can only be found in

one place and we know that's not true. The bottom line is that Lyme

can exist just about anywhere, even in non-endemic areas. Doctors

might sometimes remind themselves of this.

(with permission from www.lymeenigma.proboards104.com)