Sunday, July 10, 2011

5 Google Trends On Lyme Disease

I have been having fun with this specialized search tool on Google called Trends, and also an advanced trend tool, Insights. You might want to give them a try here:

http://www.google.com/trends
http://www.google.com/insights

In particular, I've been looking up "Lyme disease" and "Borrelia burgdorferi" and breaking down the search into different data sets by region.

Check this out...

Between 2005 and 2010,  of all worldwide Google searches related to Lyme disease, these were the top keyword searches made:

Notice that most people worldwide have been interested in knowing about Lyme disease symptoms, ticks, and treatment - with tests weighing in at #9.  Some unfortunate people do not know how to spell  "Lyme disease" properly.

Now, take a look at this... Here is a list of the top ten worldwide keyword searches related to Lyme disease which are on the increase between 2005-2010:




There is, oddly, a 90% increase in people looking up lupus symptoms associated with Lyme disease, and 90% increase from people trying to find out if Lyme disease is contagious. Why is that?

"Lyme disease doctors" went up by 90%. Symptoms in some combination of spelling falls to #4 and #5 - but notice that there is a 70-90% increase in searches for these terms during the past 5 years.

Does this reflect an increase in overall awareness of Lyme disease - or does this reflect an increase in the number of people who think they have or already do have Lyme disease?

Here, chronic Lyme disease is gaining by 50% . In the previous five years, this reflects growing exposure to the idea of chronic Lyme disease - but through which channels is not tracked here.

In terms of which countries have been running searches on "Lyme disease", who do you think ranks in the top ten?

You might find some of this predictable, and some of this interesting:

Visually, the above chart looks like this on a world map:

(If you use Google Insights, you can get an animated gif showing how the search for Lyme disease has changed around the world between 2005-2010... Try it by using Trends special tool, Insights, here: http://www.google.com/insights/search/#q=Lyme%20disease&cmpt=q)

The top five ranking countries which look up "Lyme disease" make sense to me. Australia would have surprised me in the past, but now it is not a surprising entity since Karl McManus' death and the growing awareness of Lyme disease in both patients coming back to Australia from overseas and an increasing number of patients who claim to have been infected within Australia itself.

But the Philippines, South Africa, New Zealand, India, and Singapore are somewhat surprising to me. New Zealand probably the least surprising of this group - but none of these are countries one readily associates with Lyme disease. Other types of tickborne infections - yes. Lyme? Not so much. 

How many documented cases of Lyme disease are found in these countries? What is the reason for searches on "Lyme disease" from these locations? Are they from expats and travelers who are wondering if they caught Lyme disease elsewhere or caught it within those countries listed? Are they academic searches? 

Let's look at "Lyme disease" as a keyword search in the United States...


Is any of this surprising, that the historically most endemic states  and cities would have the highest number of searches? No.

But check this out - now, what about "Borrelia burgdorferi" as a search? Who is looking these keywords up the most?

When it comes to the good ol' USA, these are the top states and cities:


Now,  I suspect I hear everyone from Connecticut and outside it letting out a huge, "Well, duh!" in response to this ranking. 

Ranked states from #2-#6 are also not a surprise. But #7, Louisiana, comes as somewhat as a surprise to me - especially as it is ranked above Michigan and New Jersey.

Has there been a marked increase in Lyme disease cases in Louisiana, or increased awareness about it for some reason?

Note, also, that the last three cities listed are not in areas which many medical professionals think of as hotbeds of Lyme disease activity, though the recent IOM summary report on tickborne illnesses noted an increase in infection number and diversity in the south and the CDC has stated for some time that Northern California has a growing number of Lyme disease cases (and in some counties, it is highly endemic). Oregon, being part of the Pacific Northwest CDC surveillance corridor, should be considered more often as an area where Lyme disease is endemic.

What happens if we look at how the entire world searches for "Borrelia burgdorferi"?


Czech Republic and Netherlands are not surprising to me at all. They do a lot of Lyme disease research, plus there are a lot of cases there.  None of those countries come as a surprise to me at all.

The cities list is somewhat different here, though. When we look at "Borrelia burgdorferi" as a global data set and not just the United States, it's clear American cities still have the highest number of searches collectively for "Borrelia burgdorferi" even though the United States ranks #3. 

Why don't more European cities rank higher?  Is it an issue of population density of American cities versus European ones? Not sure of what I'm seeing here.

And finally, to acknowledge US neighbors to the north, here is who in Canada is looking up  "Lyme disease":


If there is anyone from Canada reading this blog, what do you think of these rankings? Do you have research and surveillance information that would correlate to these areas being ranked in order of endemic Lyme disease? 

I just thought I'd share this tool with everyone, and I encourage you to use it for your own observation of trends. It does leave me with questions. Interesting.

5 comments:

  1. Cute tools. :)

    A bit about Oregon:

    ****Oregon, being part of the Pacific Northwest CDC surveillance corridor, should be considered more often as an area where Lyme disease is endemic.****

    I agree. But because of legislation passed in OR regarding Lyme disease (meaning "there is no Lyme disease in OR) doctors in that state are told it's their DUTY to report ("rat on") other doctor's. The word 'DUTY' is in the legislation. Look it up.

    http://www.leg.state.or.us/ors/676.html

    "676.150 Duty to report prohibited or unprofessional conduct"

    (d) “Unprofessional conduct” means conduct unbecoming a licensee or detrimental to the best interests of the public, including conduct contrary to recognized standards of ethics of the licensee’s profession or conduct that endangers the health, safety or welfare of a patient or client.

    (2) Unless state or federal laws relating to confidentiality or the protection of health information prohibit disclosure, a licensee who has reasonable cause to believe that another licensee has engaged in prohibited or unprofessional conduct shall report the conduct to the board responsible for the licensee who is believed to have engaged in the conduct. The reporting licensee shall report the conduct without undue delay, but in no event later than 10 working days after the reporting licensee learns of the conduct.

    ReplyDelete
  2. cave76,

    How does this legislation specifically target Lyme disease treatment as being unprofessional conduct?

    The above code states that unprofessional conduct is that which is conduct contrary to recognized standards of ethics of the profession or conduct that endangers the patient.

    There's nothing there which states conduct contrary to recognized standards of care and treatment guidelines - or anything about Lyme disease in particular.

    So how does one legally apply this legislation to doctors who treat Lyme disease? Acute Lyme disease? Late stage Lyme disease? Persisting symptoms?

    How does one even go about stating such treatment is misconduct - or know that another doctor is engaging in said unprofessional conduct - whatever it is?

    ReplyDelete
  3. ****including conduct contrary to recognized standards of ethics of the licensee’s profession or conduct that endangers the health, safety or welfare of a patient or client.****

    Standard of conduct----Over-use of antibiotics, according to the IDSA and Dr. David Gilbert (in OR) endangers the health of a patient.

    "detrimental to the best interests of the public" ------ over--use of antibiotics contributes to antibiotic resistance, which is detrimental to the public.

    ****So how does one legally apply this legislation to doctors who treat Lyme disease? Acute Lyme disease? Late stage Lyme disease? Persisting symptoms?****

    Treating acute Lyme (with a bulls-eye rash) is probably not a problem in Oregpm UNLESS the ELISA test comes back negative. Then that rash is ring worm, contact dermatitis or some such. If it comes back positive then the patient will receive 10-30 days of doxycycline, maybe.
    Hopefully the patient went in with tick attached and bulls-eye around it. (grin)

    There is no treating for other stages for Lyme in OR. Now, there are some ND's in OR that will treat------however I'm not sure how long they'd treat for either. They're all out of pocket for most people.

    Persisting symptoms are 'something else'. Probably cured by an antidepressant.

    ****How does one even go about stating such treatment is misconduct ****

    It's easy in OR especially if any doctor who goes against that legislation will be reported by other doctors (nay, it's their DUTY to do so, and if doctors don't 'report' they're found wanting also.) Everyone in OR in the medical field is holding their breath, hoping no one says the "L" word.

    More later, maybe

    ReplyDelete
  4. CO:

    You wrote:

    "If there is anyone from Canada reading this blog, what do you think of these rankings? Do you have research and surveillance information that would correlate to these areas being ranked in order of endemic Lyme disease?"

    I will take a closer look in the near future (tomorrow is another day of medical appointments for me) and then comment from a Canadian perspective. Unfortunately, I deleted the information I had compiled about reported rates of Lyme disease, as well as surveillance efforts, so I'll have to redo that research (which took me a while to do). Retracing my own tracks is more difficult than it might seem, however I do want this information at my fingertips and was planning to do this anyway.

    I want to thank you for including information about Canada because there are now quite a number of us who read your blog with great interest and gratitude.

    Rita A
    Toronto

    p.s. I tend to use "borrelia" versus "Lyme disease" when trying to find information from Europe and/or scientific studies. "Tick-borne" or "vector-borne" sometimes works better for surveillance studies/articles (but not always). Some of the most interesting stuff I come across is purely by happenstance rather than any great research skills on my part.

    Rita A
    Toronto

    ReplyDelete
  5. A petition is being circulated to get President Obama to nullify the outrageous IDSA
    guidelines whic have severely harmed many thousands of people. We need as many signatures
    as possible as quickly as possible. Information
    about this petition and how to get your signature added is available at: http://lymediseaseresource.com/wordpress
    Now click on: Jenna's Lyme blog
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    and not correct this grave injustice.

    ReplyDelete

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