http://relative-risk.blogspot.com/2011/ ... -book.html
An evidence-based book
Lyme Disease: An Evidence-Based Approach
John Jay Halperin (Editor)
From Chapter 17:
We live in interesting times. As a result of vigorous efforts by well-intentioned but misinformed patient advocates and by a small cadre of their physician supporters, Lyme disease – with fewer annual confirmed cases in the USA than varicella (Hall-Baker et al., 2010) – is repeatedly characterized as epidemic, controversial and difficult to diagnose or treat. Pseudo-documentary movies (Halperin, 2009) have been produced vilifying experts in the field and purporting to demonstrate a medical conspiracy – driven supposedly by unsupported and unsupportable allegations of conflicts of interest – to hide the suffering of the victims of this disorder.
The press, politicians and advocates repeatedly portray this as a subject of substantive and legitimate scientific controversy. Yet the scientific evidence is remarkably consistent, providing no real basis for controversy (Sigel, 2007; Weissmann, 2007; Baker, 2010). That fact notwithstanding, the states of Connecticut, Maryland, Minnesota, Massachusetts, New York, Pennsylvania, Rhode Island and others have passed or considered legislation or regulations to assure the provision of demonstrably ineffective prolonged antibiotic treatment (Klempner et al., 2001; Krupp et al., 2003; Fallon et al., 2008) for patients diagnosed with an undefined disorder termed ‘chronic Lyme disease’. In 2006, the Attorney General of the state of Connecticut opened an investigation of the Infectious Diseases Society of America (IDSA) for issuing evidence-based guidelines for the diagnosis and treatment of Lyme disease, on the legally questionable theory that this clinical guideline represented an anti-trust violation. Although this remarkable action yielded no finding of any anti-trust violation (but ultimately cost the IDSA over half a million dollars in legal and other costs (IDSA, October 2010, personal communication), it did result in a detailed review of the guidelines by an independent panel that endorsed all of the guidelines’ original recommendations (Lantos et al., 2010).
What, then, is the basis for this controversy?
Read the entire chapter here. http://www.aldf.com/thegreatcontroversy.shtml
Table of Contents
Part I: Biological Substrate
1. Ticks: the Vectors of Lyme Disease
2. Borrelia: Biology of the Organism
3. Borrelia: Interactions with the Host Immune System
4. Laboratory Diagnostic Testing for Borrelia burgdorferi Infection
5. Persistence…Infection after Antibiotic Treatment: What Can We Learn from Animal Models?
6. Global Epidemiology of Borrelia burgdorferi Infections
Part II: Clinical aspects
7. Antibiotic Therapy for Infection Caused by Borrelia burgdorferi Sensu Lato
8. Lyme Borreliosis in the UK and Ireland
9. Lyme Borreliosis: the European Perspective
10. Erythema Migrans
11. Cardiac Involvement
12. Rheumatological Involvement
13. Nervous System Involvement
14. Lyme Disease in Children
15. The Psychology of 'Post-Lyme Disease Syndrome' and 'Not Lyme'
16. Chronic Lyme Disease
17. Lyme Disease: the Great Controversy