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- Page navigation anchor for RE: Combatting Lyme disease myths and the “chronic Lyme industry”RE: Combatting Lyme disease myths and the “chronic Lyme industry”
Dr. Stephen Phillips is past President of ILADS [International and Associated Disease Society] and has treated over 100 physicians for persistent Lyme. So it would be fair to say that some physicians are voting with their feet. An opinion piece by Dr. Phillips from January 27, 2020 has just been printed in which he reviews the complexities involved and the great divide between two camps. The courts have ruled that doctors need not follow the majority opinion if they follow those of a reputable minority. The courts view both the ILADS 2014 guidelines and the 2006 IDSA guidelines as being equally valid. These two groups are diametrically opposed.
Lyme disease patients fight for their lives while researchers squabble, Phillips S, Focus –Opinions & Features, Lymedisease.org 20-01-27: https://www.lymedisease.org/lyme-dr-steven-phillips/
Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group, Shor S, Green C, Szantyr B, Phillips S, Liegner K, Burascanno J, Bransfield R, Maloney EL, Antibiotics 8 [4] 269; 19-12-16: https://doi.org/10.3390/antibiotics8040269 https://www.mdpi.com/2079-6382/8/4/269/htm
Competing Interests: Canadian Lyme Disease Foundation Board member - Page navigation anchor for RE: Combatting Lyme disease myths and the "chronic Lyme industry"RE: Combatting Lyme disease myths and the "chronic Lyme industry"
Re: Combatting Lyme disease myths and the “chronic Lyme industry”
Those increasing number of concerned Canadians who have been bitten by a tick are right in seeking immediate help. Those lucky enough to get the much overemphasized rash, recall a tick bite, seek and receive prompt attention generally do quite well but there is only a brief window of opportunity for treatment before the planktonic Borrelia bacteria burrow into the tissue and this shape-shifting stealth pathogen deploys its many defensive strategies such as producing antibiotic tolerant cells, settling out in immune protected places like our brain, inside cells or form biofilm that is 1,000 times more resistant to antibiotic treatment. Biofilm or plaque is chronic/ persistent disease by definition. [1]
Lyme and tick-borne diseases are now the commonest vector-borne diseases we have in Canada. There is vast under-reporting and we are likely missing 90% of the cases. [2] Serologic testing is terrible and should be scrapped as this has what has gotten us into all this trouble. Delayed treatment for Lyme can lead to severe disease and fatal outcome. [3]
There is a refusal to recognize that untreated/ undertreated Lyme evolves into an entirely different multi-staged, multi-system, life-altering, life-threatening disease misclassified in 1994 as a minor nuisance disease when the insurance industry red-flagged it as being too expensive to treat. [4] It belongs in the same health risk category as...
Show MoreCompeting Interests: Canadian Lyme Disease Foundation [www.CanLyme.org] - Page navigation anchor for RE: Combatting Lyme disease myths and the 'chronic Lyme industry'RE: Combatting Lyme disease myths and the 'chronic Lyme industry'
LymeNB reacts to CMAJ news article: Combatting Lyme disease myths and the ‘chronic Lyme industry’ by Wendy Glauser, Toronto. September 17, 2019
LymeNB was horrified to read the CMAJ news article published on September 17 that spoke about how the patient-facing toolkit being developed by the Centre for Effective Practice (CEP) in partnership with the Association of Medical Microbiology and Infectious Disease (AMMI) in Canada would serve to combat, as the title suggested, Lyme disease myths and the ‘chronic Lyme industry’. How disrespectful for the patient community!
This article seems to be more about bashing patients in general and, in particular, those suffering from late-stage Lyme disease rather than promoting better understanding of Lyme disease for improved management of early-stage disease (CEP presentation at Public Health Agency of Canada’s multidisciplinary roundtable in May 2019). Chronic Lyme is not a WHO ICD-11 disease classification and we prefer and promote the use of the term Disseminated Lyme Borreliosis (DLB) to refer to diagnoses of patients with long-standing untreated, undertreated, or undiagnosed Lyme infection. Disseminated Lyme Borreliosis and Early Lyme Borreliosis worlds apart in terms of diagnosis and treatment. They cannot be considered as one and the same. To our knowledge the CEP-led project does not address late-stage disease (Disseminated Lyme) but as stated above early-stage disease (Early Lyme).
We question the et...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE:If it could only be so simple.RE:If it could only be so simple.
Picture a two year old child running through the beautiful fields and forests of Connecticut. Then picture two weeks down the line the child presents with a febrile illness in the middle of July. The parents are informed by the pediatrician that the child has a "summer flu". The parents were not warned sufficiently by the Connecticut Department of Public Health back in 1994 to adhere to personal protection measures so no tick check was performed. The little child goes on to develop rashes that would come and go, crying spells that would last for hours, limping, inability to interact with peers. As the child grows up and starts complaining of headaches, neck pain, joint pain along with frequent infections etc. the mother is diagnosed with Lyme and tick-borne diseases. The mother is immediately aware that her child has been suffering along side her. Who would have thought and infectious tick-borne disease or disease? Both have Lyme disease, babesiosis and bartonellosis. This is what is happening everyday in the United States and Canada. It is not as simple as the author portrays. People are not simple minded enough that they want to make an industry of Lyme disease, they are sick, very sick. So are their children and their communities. I invite the author to come out in the field. The field of homes and neighborhoods in Connecticut. It would be a real eye opener. The physicians who do not want to acknowledge these diseases due to the fact of investigatio...
Show MoreCompeting Interests: None declared. - Page navigation anchor for To start or not to start Lyme disease prophylaxisTo start or not to start Lyme disease prophylaxis
I see that this CMAJ article is mainly advocating against over-treating unconfirmed Lyme’s disease. However, I would also like to bring up the counterargument, in which clinicians hesitate to start Lyme disease prophylaxis that lead to adverse consequences to patients, such as arthritis and cranial nerve palsies. In the infectious disease consultation service at Ottawa, we receive calls from periphery institution clinicians who require help for their symptomatic patients who are tested positive for Lyme serology. We notice quite a number of the inquiring clinicians are unaware of the Lyme Diseases prophylaxis and treatment guidelines published jointly by the Ottawa Public Health and four local hospitals: http://www.ottawapublichealth.ca/en/professionals-and-partners/resources...
Although hindsight is 20/20, some of the disseminated Lyme disease cases are preventable if prophylaxis or treatment is started more promptly. I understand the difficulty to make a clinical diagnosis of Lyme disease since serology could be falsely negative in the first 4 weeks of infection. Therefore, I would like to raise awareness of this Ottawa Public Health Lyme Disease Algorithm, which may help both clinicians and patients to make a well-informed decision.
Competing Interests: I have been paid for working as a resident physician, but not writing this letter.