The Lyme Disease Conundrum

tick

Lyme disease is back in the news. The Center for Disease Control (CDC) estimates 300,000 Americans are infected each year. This is ten times as many as the various reports have suggested in the past.

Lyme disease is an illness in which a spiral shaped bacteria – Borrelia burgdoferi is transmitted by the bite of the Blacklegged Tick. The basic test for Lyme disease (Enzyme-linked immunosorbent assay [ELISA]) is viewed as unreliable. There is a more reliable test called the Western Blot but its use is not automatic.

The signs and symptoms of acute Lyme disease are nonspecific and are often flu-like, including fever, chills, fatigue, body aches and/or headache. The most unique sign of Lyme disease is a red lesion at the site of the tick bite, surrounded by a clear area which in turn is surrounded by a red rash resulting in a bulls-eye pattern. Unfortunately this is not universally experienced, or may occur on the scalp or some other area that is not apparent.

The real controversy is in the discussion of chronic Lyme disease. The symptoms described by those who believe they are suffering from chronic Lyme disease include extensive fatigue, aching joints and/or headaches as well as vision problems, heat intolerance and adrenal insufficiency.

There are people in the medical and insurance industries who claim chronic Lyme does not exist. These include the Infectious Diseases Society of America and the American Academy of Neurology. Their position is essentially “We don’t know what it is, but it ain’t Lyme,” and refer to this medical condition as “Post-treatment Lyme Disease Syndrome.” I really have to wonder about medical professionals who don’t know what it is and are satisfied with that.

Are there opportunistic microbes like the parasite Babesia that take advantage of a patient’s compromised condition during acute Lyme, resulting in a long term disorder? Does the Lyme spirochete leave the bloodstream and settle in tissues where it is more difficult to find or medically treat? We don’t know and we need to find out.

So where does that bring us? Here’s the condensed version with additional facts inserted as appropriate.

We have a disease that was discovered in 1982. The primary test for this disease is not accurate. There is a more reliable test, but the medical establishment does not recommend its use when the first test is negative, but only when the first test is positive.

We now believe that we are understating the number of patients with acute Lyme by 90%.

Some who are infected have the condition have the condition relieved by prompt medical treatment including antibiotics. Others continue to describe pain and significant fatigue for years after treatment for acute Lyme disease. Medical science does not know what the chronic condition that follows is, or how to treat it.

Some practitioners have utilized long term antibiotics to treat chronic Lyme / Post-treatment Lyme Disease Syndrome, with the patients reporting relief of the symptoms. Other practitioners claim that the long term use of antibiotics is no more effective than placebos, and may be harmful. In my opinion, the research has not been comprehensive.

Incidentally, you can have your dog vaccinated to prevent Lyme disease, but not your children.

My recommendations?

1. Our understanding of disease is not absolute. There are things we don’t know.

2. Medicine has had to change its position on a number of issues. We no longer practice bloodletting and trepanning. Even in my lifetime, medical opinions have changed with regard to Multiple Sclerosis, Fibromyalgia, Agent Orange, and Gulf War Syndrome. We regret the lobotomies and involuntary sterilizations that once were common in dealing with the mentally ill.

3. Many medical conditions are handled by treating the symptoms rather than the disease. If a patient presents with sneezing and a runny nose during pollen season, practitioners prescribe Zyrtec (R), Flonase (R), Allegra (R), etc. without needing to know which flora or fauna is responsible.

4. We have the scientific tools available to investigate how to solve this question and alleviate patient suffering.

5. Should we reinstate human vaccination for Lyme?

Unfortunately, we will probably have to begin this research from scratch. Practitioners who have focused on the management of chronic Lyme disease / Post-treatment Lyme Disease Syndrome, have been driven from the field or tried to maintain a low profile to avoid criticism or censure by various professional societies and organizations.

In Virginia, there recently was legislation requiring doctors to tell Lyme patients that the ELISA test was not infallible and that the Western Blot test was available. It did not require any action on the part of the practitioner – only that the patient be informed. This was firmly opposed by the Medical Society of Virginia.

However, I have faith that practitioners and scientists out there will conduct the research that will lead to an effective method for alleviating these symptoms in patients.

Note: If you want to read a great book on how numerical and statistical data that seem to point incontrovertibly to a conclusion really doesn’t , read Proofiness, by Charles Seife.

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