By Robert Preidt HealthScout Reporter

SUNDAY, Jan. 21 (HealthScout) -- A renewed caution against using antibiotics for sore throats may have revived a potentially fatal disease that had almost vanished, British researchers say. Lemierre's disease, fairly common in the early 20th century, was essentially eradicated with the introduction of antibiotics. But a recent surge in the disease has been discovered by Wynne Jones and Terry Riordan, consultant medical microbiologists with the Public Health Laboratory Service in southwestern England.

"We haven't seen it, and suddenly we saw three cases within a few months," says Jones, who's based in Taunton.

So she and Riordan collected six years of records from eight public health laboratories in southwestern England and found 11 other cases of Lemierre's disease. All were successfully treated.

The disease, caused by the bacterium Fusobacterium necrophorum, affects young, healthy adults. The first symptom is a sore throat, but the bacteria later travel into the blood, infecting the lungs, liver and joints. It can be fatal if not treated with antibiotics.

While they say they have no proof, Jones and Riordan suspect the reemergence of Lemierre's may be linked to the trend of not prescribing antibiotics for sore throats.

Most sore throats are caused by viruses, which are immune to antibiotics. And doctors know that the use of antibiotics in those cases only encourages the bacteria's resistance to the antibiotics.

"In the old days, they were quite liberal in treating sore throats with antibiotics, and that's likely why Lemierre's disappeared," Jones says. "And now, because of antibiotic resistance, people are being far more cautious with prescribing antibiotics."

"Certainly, in this country, there is heavy pressure on doctors, particularly those in general practice, not to use antibiotics for treating sore throats," says Riordan, who's based in Exeter.

"The message from our work and other bits and pieces is … a very small proportion of patients who present with sore throats do have conditions which, if untreated with antibiotics, can be very life threatening," he says.

Riordan says Lemierre's is not a wide-spread threat.

"It's unquestionably a small thing. It's never going to have a huge public health impact. It would be quite wrong to give that impression, but it is worth raising awareness about this," he says.

The increase in Lemierre's is not an argument against the campaign to reduce antibiotic use because the advantages far outweigh the risks, the researchers say.

"Overall, there is benefit in restricting the use of antibiotics, but there is that small potential for an occasional patient to have an adverse effect from delayed therapy," Riordan says.

Both researchers suggest doctors consider antibiotics for people who have sore throats that don't get better after several days, or for those who have other symptoms, including fever and swollen lymph nodes.

They say Lemierre's can be a challenge for doctors and other health professionals because it's no longer mentioned in the major medical textbooks and is an almost forgotten disease.

"A number of microbiologists were unaware of the condition until we mentioned it to them. They'd never seen a case of it, never heard of it," Riordan says.

"We're just starting to raise the profile so we don't overlook this condition," Jones says.