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Medical Revisionists Threaten Effective Lyme Treatment
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DR. RAPHAEL B. STRICKER

July 31, 2006

A small group of scientists is turning the world of Lyme disease on its
head. They deny the existence of chronic Lyme disease.

They insist there is no "credible scientific evidence" for persistent
infection after a short course of antibiotic treatment because the
corkscrew-shaped bacteria that causes Lyme disease, Borrelia burgdorferi,
cannot survive this treatment.

Fearing "over-diagnosis," they publish guidelines endorsing an
insensitive testing program that misses half the patients with the tick-borne
illness.

Fearing "over-treatment," they recommend antibiotic therapy barely
adequate for acute infection and wholly inadequate for chronic Lyme
disease.

Soon they will publish the latest version of an already restrictive set
of guidelines that will further pressure the Centers for Disease
Control and Prevention and academic institutions to ignore chronic Lyme
disease. The guidelines will encourage insurance companies to embrace
up-front cost savings inherent in shorter treatment and deny payment for
longer treatment, even if the Lyme patient is still sick but showing signs
of improvement.

Although the Lyme denialists claim support from mainstream medical
groups, the reality is that the handful of them have managed to dictate
policy to larger health care organizations through a closed process that
rejects dissenting views. Unaware of this one-sided process, the rest of
the medical industry blindly follows their lead while patients suffer.

Lyme disease is the most common tick-borne illness in the world. Named
after the town where it was discovered in 1975, the disease is
transmitted by the bite of an infected tick. Research has demonstrated that the
Lyme bacteria is one of the most invasive and elusive pathogens known
to man. After causing a telltale "bulls-eye" rash, the bacteria screws
its way into multiple organs and tissues to produce often-debilitating
muscle, joint, nerve, brain and heart ailments.

Although New England remains the epicenter of the disease, with up to
20 percent of new cases reported in Connecticut alone, Lyme disease and
associated infections are popping up in new locations around the globe.
Where you live doesn't accurately reflect your risk of catching Lyme
disease because people travel on planes, trains and automobiles, while
ticks travel on deer, birds and household pets. As a result, the risk of
acquiring the disease is increasing unpredictably.

We know treatment is effective when instituted early, but fewer than
half the people with Lyme disease even remember getting a tick bite or
seeing a rash. The resulting infection may spread and become chronic
before the victim has a chance to seek treatment.

Research over the past two decades suggests the key to eliminating
chronic Lyme disease is prolonged antibiotic therapy. Lyme-treating
physicians recognize this fact and studies support it.

The Lyme denialists refuse to accept this point of view.

Imagine if "AIDS denialists" had won out in the early 1990s. Doctors
would have refused to prescribe antiviral medications and insurance
companies would have refused to pay for them. How many millions of patients
would have gone undiagnosed and untreated?

Sound scary? Welcome to the world of Lyme disease run by Lyme
denialists.

Today many Lyme patients are going undiagnosed and untreated because of
the Lyme denialist agenda. Although Lyme disease is usually not fatal,
the disability associated with a chronic case is equivalent to
congestive heart failure.

Health care providers, government agencies and Lyme patients must
confront the Lyme denialists and fight for better recognition and treatment
of Lyme disease.

Raphael B. Stricker, MD, of California is president of the
International Lyme & Associated Diseases Society.
Copyright 2006, Hartford Courant