Oct 30: Experts debate existence of ‘chronic Lyme disease’

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Oct 30: Experts debate existence of ‘chronic Lyme disease’

Post by CaliforniaLyme » Tue 30 Oct 2007 15:16

What is intersting about this article is that a brand-new physician I have never heard of associated with a prominent
hosptial steps forward to say prolonged abx treatment is good*)!**)! WOW*)!*)!!
http://www.timesleader.com/living/20071 ... a_ART.html

Tuesday, October 30, 2007 7:03 A.M.
Experts debate existence of ‘chronic Lyme disease’

NEW YORK — In what is becoming one of the most heated debates in medicine, doctors, scientists and patients are lining up on two sides of a discourse about Lyme disease, an infectious condition whose incidence has risen sharply in recent years.

A prestigious group of physicians and scientists says there is no evidence that chronic Lyme disease exists, and that patients may be doing themselves more harm than good by undergoing prolonged antibiotic therapy.

The team wrote a report saying as much in the New England Journal of Medicine.

Their analysis is important to Pennsylvania because the state is second in the number of Lyme diagnoses. From 2002-2006, an average of 3,655 cases were reported each year. Cases are scattered throughout the Commonwealth, but the highest incidence is in the eastern parts of the state.

Scores of people who have been told by their physicians that they have chronic Lyme disease dismiss the report as biased and without merit.

Lyme disease is the most common of all vector-borne infections in the United States. Vectors include ticks, mosquitoes or fleas. In the case of Lyme disease, the vector is the Ixodes scapularis tick, or deer tick, which carries the bacterium Borrelia burgdorferi. Symptoms include fever, headache, fatigue, and sometimes a skin rash. Left untreated, infection can spread to the joints, heart and nervous system.

However, a team of doctors who doubt “chronic Lyme” is genuine say using the term itself is a misnomer. Moreover, they say, prolonged use of antibiotics is expensive and dangerous.

The doctors cite drug resistance as one consequence and the destruction of the body’s “good” bacteria as another.

Dr. Eugene Shapiro, lead author of the report and a professor of pediatrics and investigative medicine at Yale University, said more than 30 experts in infectious diseases participated in the research and support the new conclusions. Co-authors include those from the CDC, Harvard Medical School and New York Medical College, home of Dr. Gary Wormser, who led a task force last year on development of new diagnostic and treatment guidelines.

Wormser said when the new guidelines were announced that 95 percent of Lyme disease cases are cured within 10 to 28 days with use of oral antibiotics. Long-term antibiotic therapy, he said, has not proven effective, and may be dangerous. The new research picked up the mantle from there.

“People who say they have chronic Lyme have symptoms, such as fatigue and aches and pains. The epidemiology is very similar to chronic fatigue syndrome and fibromylagia,” Shapiro said Monday. “It’s also very similar to chronic Epstein-Barr infection, which people no longer believe in,” he said of an infectious disorder that was commonly diagnosed in the 1980s.

Rather than calling the condition chronic Lyme disease, Shapiro and colleagues advocate referring to symptoms that persist for six or more months as post-Lyme disease syndrome.

Eva Haughie of Manorville, N.Y., wonders how doctors could be so callous.

Haughie said tick-transmitted bacteria caused her to endure cognitive impairments similar to Alzheimer’s disease and weakened her ability to walk and talk. Long-term antibiotic therapy, she said, helped her regain her strength and memory. She said doctors have prescribed antibiotics on-and-off since 1988.

Dr. Len Horowitz, an attending physician at Lenox Hill Hospital in Manhattan, said prolonged antibiotic therapy may be warranted for patients with advanced symptoms. “In the later stages, patients may even need intravenous therapy because Lyme can progress from a simple infection to cardiac disease. The organism at this stage is more difficult to eradicate,” he said.

In Wilton, Conn., Dr. Steven Phillips, past president of the International Lyme and Associated Diseases Society, said he’s dismayed that Shapiro’s report appeared in such an influential journal. “It was biased and without merit,” he said.

But even though Phillips said chronic Lyme disease is real, he acknowledged that no one knows how many patients are affected. “Everybody defines chronic Lyme differently,” he said. “I define it as people who keep relapsing.”

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