Topic: ILADS letter toeditor demanding retraction of the IDSA
Greatcod
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Interesting, very interesting, and I had not seen it here before. Oct 06
October 25, 2006Sherwood Gorbach, M.D., EditorClinical Infectious DiseasesTufts University School of Medicine200 Harrison AvenueBoston, Massachusetts 02111Subject: Retraction of ``The clinical assessment, treatment, and prevention ofLyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical practiceguidelines by the Infectious Diseases Society of America.''
Dear Dr. Gorbach:
On behalf of the membership of the International Lyme and Associated Diseases Society(ILADS), I am submitting a formal request for retraction of the article, ``The clinical assessment, treatment, and prevention of Lyme disease, human granulocyticanaplasmosis, and babesiosis: Clinical practice guidelines by the Infectious DiseasesSociety of America'' (hereafter referred to as the ``Lyme guidelines article''), which has been published electronically in your journal (1).
ILADS is requesting retraction of the Lyme guidelines article because the authors of thearticle employed exclusionary data selection that substantially biased the resultingdiagnosis and treatment recommendations while ignoring opposing or dissenting viewsabout these recommendations.
As with research articles tainted by data selection, theLyme guidelines article threatens to harm patients and patient care due to the biasedmethodology used by the authors, and this threat can only be avoided by formal retraction of the article.The attached analysis of key points in the Lyme guidelines article demonstrates that theauthors of the article made statements that either reflected significant selection bias ofpublished data or ignored published evidence that conflicted with their opinions.
Nowhere is this more apparent than in Dr. Klempner's analysis of the three NIH-fundedLyme treatment studies, which elevates and relies on the findings of his own study whiledismissing the results of two other studies that conflict with his findings.
Other statements about the erythema migrans (EM) rash, Lyme testing methodology, antibiotictreatment of chronic Lyme disease, Lyme disease in pregnancy and Lyme disease inSouthern states all reflect a biased view of Lyme disease that is either unsubstantiated or refuted by available peer-reviewed published literature.It is disturbing that ten of the central recommendations in the guidelines are supported byevidence ranked E-III--that is, ``very strong'' recommendations based on the weakest level of evidence--opinion.
In light of the controversy surrounding Lyme diseasediagnosis and treatment and our evolving understanding of the disease, it is inappropriateto dictate medical care based on such weak evidence. The panel of authors was selectedto exclude divergent points of view from patients, from treating physicians in othermedical societies, and even from physicians within IDSA itself. The failure of the authors to disclose dissenting views presents a false sense of consensus on an issue that isin fact highly controversial, misinforming patients and physicians alike about available treatment options and denying the exercise of clinical discretion and individualizedmedical decision-making that is central to any complex illness.
Although the Lyme guidelines article boasts 405 references, many of the dissenting references are either glossed over or ignored in the text. In addition, as of the date ofpublication of the Lyme guidelines article there were 18,537 articles about tick-bornediseases listed on Medline, so the referenced articles represent only 2% of the availableliterature.
The remaining 98% of these articles often present opposing or conflictingviews of Lyme disease, and thus the data selection by the authors is even more striking.We are aware that retraction of medical publications is generally reserved for researcharticles that violate principles of scientific integrity (2).
Scientific integrity has beendefined as ``commitment to truthfulness, to personal accountability and to vigorousadherence to standards of professional conduct (eg, accuracy, fairness, collegiality,transparency)'' (3). Clinical guidelines from societies as powerful as IDSA are generallyaccepted as accurate, fair, collegial and transparent, and they rapidly become the standardof medical care in our country.
It is wholly inappropriate and dangerous for guidelines tobe formulated using exclusionary tactics, flagrant data selection, biased opinions andsweepingly ``strong'' recommendations based on the weakest category III evidence. Wefeel that the same principles of scientific integrity that apply to medical research shouldalso apply to practice guidelines.
In our opinion, the Lyme guidelines article does notreflect accuracy, fairness, collegiality or transparency and should be retracted.We propose the following: 1. Immediate retraction of the published Lyme guidelines article. 2. Formal notification of the CDC and other medical societies that the guidelines articlehas been retracted. 3. Formation of a widely diversified Lyme guidelines committee that bases itsrecommendations on the strength of the underlying evidence. 4. Reformulation of the Lyme guidelines article to reflect a more balanced view of tick-borne diseases, taking into account the existing evidence-based ILADS guidelines articlelisted by the National Guidelines Clearinghouse (4). 5. Submission of the reformulated guidelines article for outside peer review to a medicaljournal that is independent of IDSA.
Sincerely,Raphael Stricker, MDPresident, ILADS -------------------------------------------------------------------------------- Page 3 3References1. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS,Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS,Nadelman RB. The clinical assessment, treatment, and prevention of Lyme disease,human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by theInfectious Diseases Society of America. Clin Infect Dis. 2006 Nov 1;43(9):1089-134.Epub 2006 Oct 2.2. Warner TD, Roberts LW. Scientific integrity, fidelity and conflicts of interest inresearch. Curr Opin Psychiatry. 2004;17:381-5.3. Institute of Medicine National Research Council of the National Academies. Integrityin scientific research. Washington, DC: The National Academies Press, 2002.4. The ILADS Working Group. Evidence-based guidelines for the management of Lymedisease. Expert Rev Anti-Infect Ther 2004;2:S1-S13. -------------------------------------------------------------------------------- Page 4 4Lyme Disease Diagnosis and Treatment--Critique of IDSA 2006 GuidelinesInfectious Disease Society of America (IDSA) ClaimsFactPosition Overview:LYME DISEASE IS HARD TO CATCH, EASY TO CURE--Lyme disease is rare and occurs in limited locations--The disease is easy to diagnose--Lyme testing is reliable--Treatment rarely fails--Chronic Lyme disease does not existPosition Overview:LYME DISEASE AND COINFECTIONS RESULT IN A COMPLEX ILLNESS THAT REQUIRESCLINICAL JUDGEMENT TO DIAGNOSE AND TREAT--Lyme disease and other tick-borne coinfections are spreading--Tick-borne coinfections make treatment of Lyme disease more difficult--Lyme testing is unreliable--Borrelia burgdorferi is difficult to eradicate, and treatment failure is more common than we think--Prolonged antibiotic therapy appears to be useful and appropriate in persistent Lyme diseaseThe IDSA's ``one-size fits all'' approach to Lyme diagnosis and treatment will result in the misdiagnosis and denial of careof many thousands of patients a year, creating a public health burden as many of these patients become chronically ill anddisabled.THE LYME BULLSEYE RASH IS ALL IMPORTANT``The great majority of persons with B. burgdorferi infectionpresent with erythema migrans.'' [a bullseye `EM' rash]``Extracutaneous [non-rash] manifestations are less commonlyseen.''``The more indolent forms of neurologic Lyme disease are quiterare.''LYME IS FREQUENTLY A NEUROLOGICAL DISEASE, NOT A SKIN DISEASEOnly 35-68% of Lyme patients present with a bullseye `EM' rash, [1][2] but up to 40% develop neurologic involvement ofeither the peripheral or central nervous system.[3] The IDSA's overemphasis on the rash and denial of many commonneuropsychiatric symptoms will result in missed diagnoses and a future epidemic of late stage disease.---------------------------------------------------------------------------------------------------------------------------Many IDSA-cited studies are flawed because of selection bias for those subjects presenting with a bullseye `EM' rash. Theexclusion of Lyme disease patients with no rash leads to an artificially high estimate of the incidence of the rash amongpatients infected with B. burgdorferi. Furthermore, IDSA guidelines make no reference to the large body of Lyme-relatedpsychiatric literature, and there were no psychiatrists on the guidelines panel.TESTING IS RELIABLE AND MANDATORY``Clinical findings alone are not sufficient for diagnosis ofextracutaneous [non-rash] manifestations of Lyme disease...Diagnostic testing... is required for confirmation.''CLINICAL JUDGMENT IS ESSENTIAL, BECAUSE TESTS MAY MISS OVER HALF OF POSITIVE CASESDiagnosis should be based on clinical signs, symptoms, history, exposure risk, and course of illness. When laboratorytests are not a ``gold standard'' (at least 95% sensitive), clinical discretion is essential. In the case of Lyme disease, theFDA-approved kits are 36-70% sensitive.[7] Diagnosis should be based on clinical signs, symptoms, history, exposurerisk, and course of illness, with tests playing a supportive role. Since early treatment is essential for a favorable outcome,why is the IDSA supporting an overly restrictive diagnostic protocol that results in a high percentage of non-rash patientsbecoming chronically ill?---------------------------------------------------------------------------------------------------------------------------NIH: ``Until better tests are available, the diagnosis of Lyme disease must be based on characteristic clinical findings inwhich the results of laboratory tests play a supportive role.[4]FDA: ``A patient with active Lyme disease may have a negative test result.''[5]The sensitivity and specificity of the currently used tests for Lyme disease are not adequate to meet the two-tier test -------------------------------------------------------------------------------- Page 5 5approach being recommended. Ideally, a screening test should have a high degree of sensitivity (95%).[6]ELISA: Sensitivities of 3 commercial ELISAs ranged from 36.8% to 70.5%[7]WESTERN BLOT: The sensitivities of the IgM and IgG immunoblot for detecting patients who were seropositive into thestudy period were 58.5 and 54.6% [8] Luger and Krause found up to a 56% false-negative rate. [9]IDSA-recommended tests are antibody tests, and only 70% of the documented Lyme patients in these 2 studies had asignificant antibody response.[10][11]CDC ``SURVEILLANCE CRITERIA'' SHOULD BE USEDFOR DIAGNOSIS``Serum samples should be tested using the 2-tier testingalgorithm recommended by the Centers for Disease Control andPrevention.''USING OVERLY STRICT CDC CRITERIA MISSES UP TO 75% OF POSITIVE CASESThe CDC explicitly states that this definition is intended for surveillance purposes only, and is "not intended to be used inclinical diagnosis." [12][13]---------------------------------------------------------------------------------------------------------------------------College of American Pathologists (CAP): ELISA assays for Lyme Disease do not have adequate sensitivity to be part ofthe two-tiered approach of the CDC/ASPHLD[6]Johns Hopkins 2-yr study (2005): The CDC 2-tiered testing procedure misses 75% of positive Lyme cases[14]NY Dept. of Health Letter (1996): CDC's 2-tiered testing procedure misses 81% of positive Lyme cases.[15]14-28 DAYS OF ANTIBIOTICS WILL CURE LYME``There is no convincing biological evidence for the existence ofsymptomatic chronic B. burgdorferi infection among patientsafter receipt of recommended treatment regimens for Lymedisease.''THIS SLOW-GROWING, EVASIVE SPIROCHETE OFTEN REQUIRES LONGER ANTIBIOTIC COURSESSubstantial treatment failures occur using standard protocols. Longer term treatment may be necessary. B. burgdorferimay persist in humans and animals for months or years despite a robust immune response and standard antibiotictreatment, particularly when treatment is delayed and dissemination is widespread. Numerous studies have demonstratedpersistence of infection despite antibiotic therapy.If the IDSA treatment limits are automatically adopted by insurance companies as they have been in the past, thousands ofchronically ill Lyme patients will be forced to pay for expensive, possibly life-saving treatments out of pocket, risking theloss of their life savings and their good health. Quality of care will be compromised because the most needy patients willbe denied care based on these IDSA ``one-size-fits-all'' guidelines.-------------------------------------------------------------------------------------------------------------------------------Treatment for 14-21 days results in a 26-50% failure rate. [16]Persistence of B burgdorferi despite antibiotic treatment demonstrated by post-treatment isolation of the bacteria. [17] -------------------------------------------------------------------------------- Page 6 6ANTIBIOTICS DON'T HELP CHRONIC LYME PATIENTS``Antibiotic therapy has not proven to be useful and is notrecommended for patients with chronic (≥6 months) subjectivesymptoms after recommended treatment regimens for Lymedisease.''``In many patients, posttreatment symptoms appear to be morerelated to the aches and pains of daily living rather than to eitherLyme disease or a tickborne coinfection.''MOST CHRONIC PATIENTS IMPROVE WITH TREATMENTClinical and research evidence shows that long-term antibiotics can significantly improve the quality of life for patientswith chronic Lyme disease. The potential harm in letting a persistent Lyme infection go untreated far outweighs thepotential side-effects of long-term antibiotic use. If long-term oral antibiotic therapy is considered safe enough for acnepatients, its use is certainly justified for chronic Lyme patients. Intravenous therapy is justified for serious, refractory casesor those with clear central nervous system involvement. Risks are minimized by skilled clinicians who take appropriateprecautions.-------------------------------------------------------------------------------------------------------------------------------Two NIH-funded double-blind studies support retreatment of those failing short-term approaches. Recently completed trial(not yet published) at Columbia University showed the efficacy of at least 10 weeks of IV treatment.[18] Krupp showedefficacy of retreatment in terms of fatigue.[19] Five uncontrolled studies support longer treatment approaches.[20-24]PREGNANT WOMEN SHOULDN'T WORRY ABOUTHAVING LYME DISEASE``There is little evidence that a congenital Lyme diseasesyndrome occurs.''PREGNANT WOMEN SHOULD BE FULLY INFORMED OF THE RISKS OF TICK-BORNE DISEASESLyme disease, as well as other tick-borne infections, can be transmitted from an infected mother to fetus through theplacenta during pregnancy, possibly resulting in complications or stillbirth.[25-26]-------------------------------------------------------------------------------------------------------------------------------``46 cases of adverse outcomes ...of gestational Lyme borreliosis were found, including miscarriage, stillbirth, perinataldeath, congenital anomalies, systemic illness, early-onset fulminant or mild sepsis and later-onset chronic progressiveinfection.''[27]Transmission to the fetus demonstrated in murine model.[28]B burgdorferi DNA has been detected in human breast milk.[29]THERE IS NO LYME DISEASE IN THE SOUTH``The panel is unaware of a proven case of B. burgdorferiinfection acquired indigenously in any state south of Marylandor Virginia.''THERE ARE NUMEROUS DOCUMENTED CASES OF INDIGENOUS LYME DISEASE IN THE SOUTHIndigenous Lyme disease has been documented by clinicians, military bases, and health departments across the southernstates. With early treatment being essential for a favorable outcome, it behooves southern physicians and epidemiologiststo remain open-minded about Lyme disease as a differential diagnosis, especially with the ease by which it can be acquiredwhile traveling out of state. If front-line physicians are told Lyme is rare, based on opinion only, it could result in misseddiagnoses and a future epidemic of late stage disease.-------------------------------------------------------------------------------------------------------------------------------From 1984-1989, 104 indigenous cases of Lyme disease were reported in North Carolina. [30-31]From 1997-2000, there were 44 cases of Lyme disease on Navy and Marine bases in North Carolina. [32]The U.S. Army conducts regular Lyme Disease Risk Assessments (LDRAs) at military installations and has determinedthat these southern states have been designated as HIGH RISK for Lyme (AR, CA); MODERATE RISK (NC, SC, CA,FL, KY) and SOME RISK (FL, GA, LA, MO, OK). [33]In 2005, the CDC reported 313 cases of Lyme disease in states south of Virginia.[34]NIH, National Institute of Health; CDC, Centers for Disease Control & Prevention; FDA, Food & Drug Administration; ELISA, enzyme-linked immunosorbent assay -------------------------------------------------------------------------------- Page 7 7References1.Stricker RB et al: Lyme disease without erythema migrans: cause for concern? Am J Med 2003; 115:72.2.Centers for Disease Control and Prevention (CDC). Lyme Disease - USA, 2001-2002. Morb Mortal Wkly Rep 2004;53(17):365-369.3.Fallon BA, Nields JA. Lyme disease: a neuropsychiatric illness. Am J Psychiatry 1994;151:1571-15834.National Institute of Allergies and Infectious Diseases (National Institute of Health). How Lyme Disease Is Diagnosed.1999. Available from:http://www.niaid.nih.gov/dmid/lyme/diagnosis.htm5.Food & Drug Administration. Lyme disease test kits: potential for misdiagnosis. FDA Medical Bulletin, 1999, Summer, Final Issue.http://www.fda.gov/medbull/summer99/Lyme.html6.Bakken LL, Callister SM, Wand PJ, Schell RF. Interlaboratory comparison of test results for detection of Lyme disease by 516 participants in the Wisconsin State Laboratory ofHygiene/College of American Pathologists Proficiency Testing Program. J Clin Microbiol 1997; 35(3):537-43.7.Marangoni A, Sparacino M, Cavrini F, Storni E, Mondardini V, Sambri V, Cevenini R. Comparative evaluation of three different ELISA methods for the diagnosis of early culture-confirmedLyme disease in Italy. J Med Microbiol 2005;54:361-3679.Engstrom SM, Shoop E, Johnson RC. Immunoblot interpretation criteria for serodiagnosis of early Lyme disease. J Clin Microbiol 1995;33(2):419-27.8.Luger SW, Krauss PJ. Serologic tests for Lyme disease: interlaboratory variability. Arch Intern Med 1990;150:761-763.10. Aguero-Rosenfeld ME, Nowakowski J, McKenna DF, Carbonaro CA, Wormser GP. Serodiagnosis in early Lyme disease. J Clin Microbiol 1993;31:3090-3095.11. Aguero-Rosenfeld ME, Nowakowski J, McKenna DF, Carbonaro CA, Wormser GP. Evolution of the serologic response to Borrelia burgdorferi in treated patients with culture-confirmederythema migrans. J Clin Microbiol 1996;34:1-9.12. Lyme Disease (Borrelia burgdorferi): 1996 Case Definition. CDC Case Definitions for Infectious Conditions under Public Health Surveillance.13. CDC Testimony before the Connecticut Department of Health and Attorney General'sOffice. CDC'sLyme Prevention and Control Activities. http://www.hhs.gov/asl/testify/t040129.html14. Coulter P, Lema C, Flayhart D, Linhardt AS, Aucott JN, Auwaerter PG, Dumler JS. Two-Year Evaluation of Borrelia burgdorferi Culture and Supplemental Tests for Definitive Diagnosis ofLyme Disease. J Clin. Microbiol 2005;43:5080-508415. Letter from B. DeBuono of NY Dept. of Health to C. Fritz of CDC. April 15, 1996.16. Wahlberg P, Granlund H, Nyman D, Panelius J, Seppala I. Treatment of late Lyme borreliosis. J Infect 1994;29(3):255-61.17. Oksi J, Marjamaki M, Nikoskelainen J, Viljanen M. Borrelia burgdorferi detected by culture and PCR in clinical relapse of disseminated Lyme borreliosis. Ann Med 1999; 31(3): 225-32.18. Fallon BA. Laboratory findings in chronic Lyme disease and results of the controlled treatment study. Lyme & Other Tick-Borne Diseases:Technology Leading the Way Conference; 2004October 22, 2004; Rye Town, NY.19. Krupp LB, Hyman LG, Grimson R, Coyle PK, Melville P, Ahnn S,Dattwyler R, Chandler B. Study and treatment of post Lyme disease (STOP-LD): a randomized double masked clinicaltrial. Neurology 2003; 60(12):1923-30.20. Donta ST. Macrolide therapy of chronic Lyme Disease. Med Sci Monit 2003;9(11):136-42. PMID 14586290. -------------------------------------------------------------------------------- Page 8 821. Donta ST. Tetracycline therapy for chronic Lyme disease. Clin Infect Dis 1997;25(Suppl 1):S52-6. PMID 9233665.22. Wahlberg P, Granlund H, Nyman D, Panelius J, Seppala I. Treatment of late Lyme borreliosis. J Infect 1994;29(3):255-61. PMID 7884218.23. Oksi J, Nikoskelainen J, Viljanen MK. Comparison of oral cefixime and intravenous ceftriaxone followed by oral amoxicillin in disseminated Lyme borreliosis. Eur J Clin Microbiol InfectDis 1998;17 (10):715-9. PMID 9865985.24. Fallon BA, Tager F, Fein L, Liegner K, Keilp J, Weiss N, Liebowitz M. Repeated antibiotic treatment in chronic Lyme disease. J Spirochet Tick-Borne Dis 1999;6(3):94-102.25. MacDonald AB. Gestational Lyme borreliosis. Implications for the fetus. Rheum Dis Clin North Am 1989;15(4):657-77.26. Schlesinger PA, Duray PH, Burke BA, Steere AC, Stillman MT. Maternal-fetal transmission of the Lyme disease spirochete, Borrelia burgdorferi. Ann Intern Med 1985;103 (1): 67-8.27. Gardner T. Lyme disease. In: Remington JS and Klein JO, editor(s). Infectious diseases of the fetus and newborn infant. Philadelphia: Saunders; 1995. p. 447-528.28. Silver RM, Yang L, Daynes RA, Branch DW, Salafia CM, Weis JJ. Fetal outcome in murine Lyme disease. Infect Immun 1995;63(1):66-72.29. Schmidt BL, Aberer E, Stockenhuber C, Klade H, Breier F, Luger A. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lymeborreliosis. Diagn Microbiol Infect Dis 1995; 21(3):121-8.30. Levine JF, Apperson CS, Spiegel RA, Nicholson WL, Staes CJ. Indigenous cases of Lyme disease diagnosed in North Carolina. South Med J 1991;84(1):27-31.31. Pegram PS, Sessler CN, London WL. Lyme disease in North Carolina. South Med J 1983;76(6):740-2.32. McGinnis J, Bohnker BK, Malakooti M, Mann M, Sack DM. Lyme disease reporting for Navy and Marine Corps (1997-2000). Mil Med. 2003;168(12):1011-4.33. U.S. Army Lyme Disease Assessment Reports 1983-1996. http://members.utech.net/users/10766/lyme.htm34. CDC. Summary of notifiable diseases, United States, 2005. Morb Mortal Wkly Rep 2005;53(53) -------------------------------------------------------------------------------- Page 9 cc: Julie L. Gerberding, MD, MPH, Director, CDCMichael O. Leavitt, Secretary, U.S. Department of Health and Human ServicesElias A. Zerhouni, MD, Director, NIHAnthony S. Fauci, MD, Director, NIAIDAndrew C. von Eschenbach, MD, Director, FDAJesse L. Goodman, MD, Director, CBERJay E. Berkelhamer, MD, FAAP, President, American Academy of PediatricsMary K. Crow, MD, President, American College of RheumatologyLynne M. Kirk, MD, FACP, President, American College of PhysiciansLarry S. Fields, MD, FAAFP, President, American Academy of Family PhysiciansMartin J. Blaser, MD, FIDSA, President, Infectious Diseases Society of America
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CaliforniaLyme
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Doc S is the best. He saved my life.
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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David95928
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What was the printed sources for this? Thanks.
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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Vermont_Lymie
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Thanks for posting
Dr. S is my hero Posts: 2557 | From home | Registered: Aug 2006
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canbravelyme
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Doc S is saving my life.
9 weeks ago, I could barely leave my room, my light sensitivity was so bad, and I was having many simple seizure type events, as well as quite complex partial ones that were disabling every 2 days (with vomiting / diarrhea).
9 weeks of treatment: I am sitting in front of my computer for longer periods, and without the screen reversed to white on black for longer periods as well. My seizure-like / seizure events have decreased to 50% in terms of their frequency and severity.
I can get out of the house.
I can walk a few blocks. I can walk a few more if I rest inbetween.
I had been disabled for 3 1/2 years.
I am disgusted with IDSA. Shame on them. And the CDC. And the Canadian Goverment for supporting them.
Shame on them, and those others who are involved in suppressing the truth of this, and creating an underclass of unnecessary disability.
-------------------- For medical advice related to Lyme disease, please see an ILADS physician. Posts: 1494 | From Getting there... | Registered: Aug 2006
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I have seen this letter.First it probably wont happen.The ILAIDS doesn't have any ground to stand on. First ILAIDS doctors,at least 90 percent of them use Igenex. Igenex,finds BB,in people that other labs cant. BUT, when Igenex was sent samples from a IDSA study,IGENEX,cound NOT,identify lyme in any of the samples. And one doctor ask me why Igenex needs a questionaire with there test,asking if you ever been bitten by a tick.Which now that i think about it,is kinda crazy. Was it fixed,who knows.Igenex has done nothing to prove to the CDC,or the IDSA,that they can find lyme that nobody else can. If the lyme community gets this problem fixed, there wont be so much,contriversy about lyme disease. IF they did,the CDC would have a standardized test to put on there diagnostic page. And maybe alot of lyme wouldnt be missed. OR,is it possible that ticks are carrying unknown infections,that antibiotics help. Look at the big picture,if you go to almost any doctor,they know about IGENEX. Show them your test, i had one doctor throw mine in the garbage can.So the IDSA,has these doctors brain washed. So i say are problem starts there,we need doctors to believe in there testing. Until then only lyme doctors will use that lab. The IDSA will win the battle becuase,they will keep useing other labs. There will be no lyme disease and no,lyme doctors. We can scream at the IDSA,to quit writing these papers,OR,we as paying customers who all had positives on an Igenex test,can ask them to prove how they get so many postives others dont. I know,they add bands,well then be that the case the other labs need to add them. But with the testing system as today,there isnt much lyme. Igenex really needs to help us.They need to prove to IDSA doctors there test isnt bogus,because that is what the problem has been from the begining of time.If they can find lyme,it shouldn't be hard to show the country. I myself feel it needs to be a clinical diagnosis,with blood test to back it up. I dont think they even know what all ticks carry. I believe alot of lyme needs long term antibiotics.Meaning years. Just a opinion from a lymie who has been through the wringer like the most.
Posts: 510 | From NEVERLAND.USA | Registered: Jul 2005
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Greatcod
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This was published by the Journal of Clinical Infectious Diseases. I googled Steere Bulleye on Google Scholar, and this was the first listing.
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