Baltimore Sun (MD) Letters to the Editor Originally published December 14, 2006
Clinical evidence of chronic infections
As the letter "Lyme guidelines scientifically sound" (Dec. 9) shows, the infectious disease community unfortunately is largely hiding behind the scientific literature's "evidence base" and ignoring the clinical evidence about chronic Lyme disease patients that is all too evident to other physicians.
Only a few decades ago, the infectious disease community scoffed at the notion of infectious agents causing chronic illnesses.
But we now have incontrovertible proof that infectious agents are associated with chronic diseases. For instance, H. pylori bacteria infection causes ulcers; C. trachomatis causes inflammatory arthritis; and the Epstein-Barr virus can cause cancer.
Chronic Lyme disease patients are ill-served by the squabbling and territorial in-fighting that is only hindering productive inquiry into this debilitating condition.
Instead, the infectious disease community should take this moment to bring intelligent minds together to find effective treatments that can prevent or ameliorate the consequences of such chronic diseases.
Sheila West Baltimore The writer is a professor of opthalmology and epidemiology at the Johns Hopkins University.
Baltimore Sun (MD) Letters to the Editor Originally published December 9, 2006
A culture in denial over Lyme infections
Thanks for the editorial on Lyme disease and the Infectious Disease Society of America's guidelines ("Missing the mark," Nov. 30).
I have a son whose bipolar symptoms are very much related to Lyme disease and associated infections. Even though I wrote a book on the subject, and he has tested positive repeatedly not only for Lyme but for associated infections, he persists in the belief that he doesn't have Lyme disease.
Until there is a change in the culture, my son and thousands like him will either remain ignorant about the care they need or refuse to accept it.
Thanks again for a timely and right-on editorial.
Dave Moyer Penn Valley, Calif. The writer is a member of the International Lyme and Associated Disease Society. ```````````````````````````````````````````````````````````````````
Lyme guidelines scientifically sound
There is nothing more heartbreaking to conscientious doctors than to read the charge, as made in The Sun's editorial "Missing the mark" (Nov. 30), that they are not meeting the needs of their patients.
But to the 8,000 members of the Infectious Disease Society of America (IDSA), the controversy about Lyme disease and the IDSA guidelines raised by a handful of doctors has done a grave disservice to patients.
First, some facts:
* The IDSA guidelines are based on established national criteria for evidence-based medicine. This means the panel of Lyme disease experts who developed the guidelines did so by reviewing all valid, peer-reviewed scientific literature on the subject.
* Contrary to the statement in the editorial that the IDSA guidelines claim no antibiotics should be prescribed "beyond initial preventive doses," the guidelines do recommend treatment for up to 28 days with antibiotics for those who have clinical signs confirming the disease. The guidelines also include recommendations for retreatment if objective signs of the disease are established and symptoms persist.
* The guidelines clearly acknowledge that their recommendations do not and should not take the place of the judgment of individual physicians. We know that every person, every patient is different and that each doctor must do what he or she thinks is best for the individual.
* Those who have been diagnosed with so-called "chronic Lyme disease" (i.e., who did not recover after the initial course or courses of antibiotics that cure the disease in the great majority of patients) often have generalized symptoms that may be caused by many diseases other than Lyme. To automatically assume they continue to suffer from Lyme disease, without considering other options, is simply not good medicine.
Also, a small percentage of people do have persistent symptoms such as fatigue and musculoskeletal aches after Lyme disease. But there is no evidence that continued treatment with antibiotics leads to substantial improvement.
Medicine is always evolving, which is why we review the literature at regular intervals and update our guidelines.
When we do, we are obligated to base our guidelines on the best information available.
As new information becomes available, we will respond accordingly.
For the time being, however, our guidelines are based on the best scientific evidence that is available.
Dr. Donald Poretz Alexandria Va. Dr. Paul G. Auwaerter Baltimore The writers are, respectively, the president-elect of the Infectious Diseases Society of America and the clinical director of the Division of Infectious Diseases for the Johns Hopkins School of Medicine.
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We have lots to take hope from and help from such health care professionals as from the doctor whose letter is quoted below is one of them.
-------------------- "Help Or Be Helpless" Please visit "Activism" board daily. See the threads regarding the IDSA Guidelines crisis and the threads about Dr. Charles Ray Jones and decide how best to help today! Posts: 1265 | From does not list | Registered: Jun 2004
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From hubby's recent visit to an ID duck and his hospital stay at a "teaching hospital" in Pittsburgh the IDSA has what I consider a really underhanded tactic to deny diagnosis and treatment --
said that based on treatment history and physical exam there was no need for hubby to even be tested for tickborne diseases. I guess you could say they are taking no chances that someone with "chronic Lyme" might actually be found to have a persistant infection.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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