Lyme
Disease: A Public Health Crisis Ignored
More accurate
tests for Lyme Disease are described in the medical literature,
but such tests aren't approved for wide public use.
by Steven
E Phillips, MD
TheDay.com
Hartford, CT
30 October 2005
This article
also appeared in the following publications, under these titles:
Lyme
disease: a public-health crisis
The
Harvard Post on Townonline.com
9 June 2006
A public-health
crisis ignored
The Lowell Sun
Lowell, MA
23 December 2005
Lyme
disease is health crisis being ignored
The New Bedford Standard-Times
New Bedford, MA
16 December 2005
Lyme
Disease: a health crisis ignored
The Cape Cod Times
Cape Cod, MA
12 December 2005
Phillips:
Unite in Fight Against Lyme Disease
The Cape Codder
Cape Cod, MA
2 December 2005
Lyme
Disease: Not Amusing Anymore
The Hartford Courant
Hartford, CT
November 2005
Lyme
Disease: Public Health Infectious Ticking Time Bomb
The Worcester Telegram & Gazette
Worcester, MA
21 November 2005
Manning
the Front Lines of Lyme Treatment
The Vineyard Gazette
Martha's Vineyard, MA
18 November 2005
Lyme
Disease: a Public Health Crisis Ignored
The Ipswich Chronicle
Ipswich, MA
3 November 2005
A Florida
State quarterback is found half-naked and disoriented in downtown
Tallahassee. Pop singer Daryl Hall cancels part of his national
concert tour. Author Amy Tan is writing a new book about it.
The picture
is clear: Lyme disease has hit the front burner.
Lyme disease
is a major public health problem and growing crisis. It’s
the most prevalent bug-borne illness. According to the Centers
for Disease Control and Prevention new cases are reported in
about 20,000 people yearly and this number represents a 10-fold
underestimate.
Lyme disease
is caused by a complex bacterial agent carried and spread by
ticks. The Lyme bacteria have the ability to evade immune destruction,
entrench themselves deep within tissues and migrate throughout
the body with impunity causing a multi-system illness that can
be baffling to many physicians.
The result
is that one tiny tick bite can cause innumerable symptoms running
the gamut from muscle and joint pain to heart disease to neurological
and even psychiatric illness. Lyme patients may be misdiagnosed
as having other serious diseases such as lupus, multiple sclerosis,
rheumatoid arthritis and psychiatric disorders. The take-home
message is Lyme disease may be hard to diagnose and difficult,
if not impossible, to fully eradicate if not caught early.
Why is
that?
- First,
there is no single reliable diagnostic laboratory test. The
common two-tiered blood test cannot be solely relied upon
for diagnosis. The initial ELISA screening test can give up
to 50 percent false negative results, and just as disheartening,
many laboratories interpret the second Western Blot test by
highly restrictive CDC criteria that miss many cases.
Better
tests are described in the medical literature, but haven’t
seen the light of day. So some patients seek more sophisticated
testing by approved reference laboratories — labs within
a single state that get samples from around the country
— but which often don't take their insurance companies
and frequently pay for their tests out-of-pocket.
Furthermore,
a person with “Lyme disease” may be co-infected
with other organisms and “co-infections” often
require different antibiotic therapy compared to Lyme.
- Second,
there is no universally accepted treatment. During chronic
infection the organism burrows deep into tissues that some
antibiotics can reach only marginally. This is but one of
many reasons why a two-to-four week treatment cannot eliminate
chronic infection.
The
consensus opinion of the International Lyme and Associated
Diseases Society is that an individualized treatment approach
is necessary based on clinical judgment.
ILADS
is a multi-specialty medical society comprised of virtually
all sub-specialists who treat Lyme disease, including infectious
disease specialists, neurologists, rheumatologists, psychiatrists,
endocrinologists and internal medicine physicians. We've
published diagnostic and treatment guidelines in peer reviewed
infectious disease medical literature, which stand in stark
contrast to the guidelines of some infectious disease specialists
who reject voluminous medical data documenting persistent
infection and co-infection.
What should
be done?
We, the
clinical doctors who man the frontlines of treatment, extend
an olive branch to our colleagues with divergent opinions to
work together to develop practical diagnostic and treatment
protocols.
We believe
it is essential for patients with Lyme symptoms to be tested
for multiple tick-borne disorders. We know better tests exist
and recommend the entire medical community push for them.
We encourage
the education of all medical personnel about the array of Lyme
symptoms and its related infections in order to increase the
number of health care providers who can recognize and treat
these illnesses.
In the
early days of the AIDS epidemic activists screamed for attention
to get medical care. We hope Lyme patients are not forced to
follow the same path, but we will not be content until Lyme
disease is yesterday’s news.
Dr. Steven
E. Phillips is a practicing physician from Wilton and is president
of the International Lyme and Associated Diseases Society (ILADS),
the only professional medical organization in the world devoted
exclusively to tick-borne illnesses. This piece represents the
views of ILADS.
Disclaimer:
The goal of this ILADS Discussion Group is to provide informational
exchange among/between member physicians and other member health
care professionals regarding their interests in tick-borne disease.
Information presented is intended only for educational exchange
based on personal medical experience and opinions. If you are
a Lyme patient, as well, please ask your own doctor to explain
in what manner this information may or may not apply to you.
It is not intended as medical advice for anyone.
— The Co-moderators
