georgia
2014-09-23 22:54:44 UTC
Lyme Disease: A Public Health Crisis
By Steven E. Phillips, M.D.
The Harvard Post
Friday, June 9, 2006
A Florida State quarterback is found half-naked and disoriented in
downtown Tallahassee. Pop singer Daryl Hall cancels part of his
national concert tour. Author Amy Tan is writing a new book about it.
The picture is clear: Lyme disease has hit the front burner.
Lyme disease is a major public health problem and growing crisis.
It's the most prevalent bug-borne illness. According to the Centers for
Disease Control and Prevention new cases are reported in about 20,000
people yearly and this number represents a 10-fold underestimate.
Lyme disease is caused by a complex bacterial agent carried and
spread by ticks. The Lyme bacteria have the ability to evade immune
destruction, entrench themselves deep within tissues and migrate
throughout the body with impunity causing a multi-system illness that
can be baffling to many physicians.
The result is that one tiny tick bite can cause innumerable
symptoms running the gamut from muscle and joint pain to heart disease
to neurological and even psychiatric illness. Lyme patients may be
misdiagnosed as having other serious diseases such as lupus, multiple
sclerosis, rheumatoid arthritis and psychiatric disorders. The
take-home message is Lyme disease may be hard to diagnose and
difficult, if not impossible, to fully eradicate, if not caught early.
There are several reasons for this.
First, there is no single reliable diagnostic laboratory test. The
common two-tiered blood test cannot be solely relied upon for
diagnosis. The initial ELISA screening test can give up to 50 percent
false negative results, and just as disheartening, many laboratories
interpret the second Western Blot test by highly restrictive CDC
criteria that miss many cases. Better tests are described in the
medical literature, but haven't seen the light of day. So some patients
seek more sophisticated testing by approved reference laboratories -
labs within a single state that get samples from around the country -
but which often don't take their insurance companies and frequently pay
for their tests out-of-pocket. Furthermore, a person with "Lyme
disease" may be co-infected with other organisms and "co-infections"
often require different antibiotic therapy compared to Lyme.
Second, there is no universally accepted treatment. During chronic
infection the organism burrows deep into tissues that some antibiotics
can reach only marginally. This is but one of many reasons why a
two-to-four week treatment cannot eliminate chronic infection. The
consensus opinion of the International Lyme and Associated Diseases
Society is that an individualized treatment approach is necessary based
on clinical judgment. ILADS is a multi-specialty medical society
composed of virtually all sub-specialists who treat Lyme disease,
including infectious disease specialists, neurologists,
rheumatologists, psychiatrists, endocrinologists and internal medicine
physicians. The society has published diagnostic and treatment
guidelines in peer reviewed infectious disease medical literature,
which stand in stark contrast to the guidelines of some infectious
disease specialists who reject voluminous medical data documenting
persistent infection and co-infection.
ILADS believes it is essential for patients with Lyme symptoms to
be tested for multiple tick-borne disorders. They encourage the
education of all medical personnel about the array of Lyme symptoms and
its related infections in order to increase the number of health care
providers who can recognize and treat these illnesses.
Dr. Steven E. Phillips is a practicing physician from Wilton and
is president of the International Lyme and Associated Diseases Society
(ILADS)
By Steven E. Phillips, M.D.
The Harvard Post
Friday, June 9, 2006
A Florida State quarterback is found half-naked and disoriented in
downtown Tallahassee. Pop singer Daryl Hall cancels part of his
national concert tour. Author Amy Tan is writing a new book about it.
The picture is clear: Lyme disease has hit the front burner.
Lyme disease is a major public health problem and growing crisis.
It's the most prevalent bug-borne illness. According to the Centers for
Disease Control and Prevention new cases are reported in about 20,000
people yearly and this number represents a 10-fold underestimate.
Lyme disease is caused by a complex bacterial agent carried and
spread by ticks. The Lyme bacteria have the ability to evade immune
destruction, entrench themselves deep within tissues and migrate
throughout the body with impunity causing a multi-system illness that
can be baffling to many physicians.
The result is that one tiny tick bite can cause innumerable
symptoms running the gamut from muscle and joint pain to heart disease
to neurological and even psychiatric illness. Lyme patients may be
misdiagnosed as having other serious diseases such as lupus, multiple
sclerosis, rheumatoid arthritis and psychiatric disorders. The
take-home message is Lyme disease may be hard to diagnose and
difficult, if not impossible, to fully eradicate, if not caught early.
There are several reasons for this.
First, there is no single reliable diagnostic laboratory test. The
common two-tiered blood test cannot be solely relied upon for
diagnosis. The initial ELISA screening test can give up to 50 percent
false negative results, and just as disheartening, many laboratories
interpret the second Western Blot test by highly restrictive CDC
criteria that miss many cases. Better tests are described in the
medical literature, but haven't seen the light of day. So some patients
seek more sophisticated testing by approved reference laboratories -
labs within a single state that get samples from around the country -
but which often don't take their insurance companies and frequently pay
for their tests out-of-pocket. Furthermore, a person with "Lyme
disease" may be co-infected with other organisms and "co-infections"
often require different antibiotic therapy compared to Lyme.
Second, there is no universally accepted treatment. During chronic
infection the organism burrows deep into tissues that some antibiotics
can reach only marginally. This is but one of many reasons why a
two-to-four week treatment cannot eliminate chronic infection. The
consensus opinion of the International Lyme and Associated Diseases
Society is that an individualized treatment approach is necessary based
on clinical judgment. ILADS is a multi-specialty medical society
composed of virtually all sub-specialists who treat Lyme disease,
including infectious disease specialists, neurologists,
rheumatologists, psychiatrists, endocrinologists and internal medicine
physicians. The society has published diagnostic and treatment
guidelines in peer reviewed infectious disease medical literature,
which stand in stark contrast to the guidelines of some infectious
disease specialists who reject voluminous medical data documenting
persistent infection and co-infection.
ILADS believes it is essential for patients with Lyme symptoms to
be tested for multiple tick-borne disorders. They encourage the
education of all medical personnel about the array of Lyme symptoms and
its related infections in order to increase the number of health care
providers who can recognize and treat these illnesses.
Dr. Steven E. Phillips is a practicing physician from Wilton and
is president of the International Lyme and Associated Diseases Society
(ILADS)