Pathogens & People: Lyme disease: The good, the bad and the silly
By EDWARD, McSWEEGAN, For The Capital
Published August 03, 2008
Summer is here with its annual flurry of news reports about Lyme disease and tick bites.
This year's news is a lot like a newspaper; there's good news, bad news, comics and movie reviews.
First, the good news.
Scientists at the Centers for Disease Control and Prevention developed a slow-release antibiotic formulation that should protect against Lyme disease and a related tick-borne infection called anaplasmosis.
Instead of swallowing antibiotics such as doxycycline or amoxicillin for two to four weeks, a single injection of slow-release doxycycline hyclate should provide effective protection or therapy for 19 days.
A slow-release skin patch also may be possible and would eliminate the discomfort of a needle.
Now the bad news.
The slow-release antibiotic isn't ready for human use yet.
That's unfortunate because there's more bad news about Lyme disease.
In Maryland last year, reported Lyme cases doubled to 2,576.
Counties with increased cases included Anne Arundel, Baltimore, Harford, Howard and Prince George's.
The increase may be due to better diagnosing and reporting.
It also may be due to more actual cases because of developments encroaching on woodlands populated by deer and other tick-carrying creatures.
Other states are seeing similar increases.
Worse, a more virulent strain of the Lyme bacterium may be spreading through parts of the United States.
According to Ben Luft and colleagues at Stony Brook, Long Island, this strain - called OspC Type A - appears to be the most common in the U.S. today, and may be partly responsible for both the increase in cases and the seriousness of some of those cases.
Durland Fish at Yale University suggests changes in climate, tick feeding behavior and the presence of this virulent clone may lead to more severe infections in the Northeast.
It's a little good news and a lot of bad news about an infection that can be prevented, or cured, but which continues to generate great public angst.
So on to the comics.
Earlier this year, M.M. Drymon, a self-described historian, published the book, "Disguised as the Devil: How Lyme Disease Created Witches and Changed History" (Kindle, $24.95).
The author believes Salem's witches were identified not by the devil's mark but by the Lyme disease skin rash, and their behavior was not supernatural but rather symptomatic of neurological infection.
There's a lot wrong with this theory, but it reminded me of Macbeth's witches concocting potions of "eye of newt and toe of frogge, wool of bat and tongue of dogge."
Similarly, some modern-day Lyme enthusiasts like to gather online to hawk the benefits of equally exotic potions such as teasel root extract, colloidal silver and rectal refloridization.
Adding to the humor was Connecticut Attorney General Richard Blumenthal who - at the behest of two Lyme groups - started an investigation of the Infectious Diseases Society of America and its treatment recommendations for Lyme disease.
(The IDSA takes a dim view of quackery.)
In May, Mr. Blumenthal gave up his attempt to overturn evidence-based medicine, but implied the treatment recommendations were tainted by financial conflicts.
He offered no evidence of such conflicts, leaving IDSA President Donald Poretz to wonder how the authors of the recommendations could gain financially by discouraging long treatments, expensive drugs and patented diagnostics.
IDSA's guidelines remain in effect.
Mr. Blumenthal's actions caught the attention of Congressman Frank Pallone, D-NJ. Mr. Pallone had a $100 million Lyme disease research bill (HR 741) originally drafted by activists, but then decided to hold it up.
In May, he announced, "At a time when significant disagreements exist on treatment, I am hopeful that the (IDSA) panel's final recommendations will give us guidance on how best to proceed."
Angry activists quickly descended on his office waving signs that read, "Pallone hates sick people" and "Time to make him pay."
If the activists had not created so much controversy there might have been $100 million for Lyme research next year.
Taking solace at the movies, activists cheered a Lyme disease docudrama, which the journal Lancet Infectious Diseases described as manipulative, partisan and prone to conspiracy theory.
One of the DVD's physician stars is currently under investigation by the Connecticut licensing board.
So the controversies and antics continue.
And that's not helpful to the public.
Paul Auwaerter, director of infectious diseases at Johns Hopkins, recently told Baltimore magazine, "I train infectious disease fellows; fellows don't want to see Lyme patients.
They don't want to enter this controversial area because it seems like it's just a recipe for headaches."
With fewer interested doctors, it's also a recipe for more serious disease.
For some straightforward information about Lyme disease, see Maryland's educational Web site at www.marylandtickoff.org.
Dr. Edward McSweegan has a Ph.D. in microbiology and lives in Crofton.
He works on and writes about infectious disease issues.
-------------------- My Lyme dx:11/05. My Mom's Lyme dx:5/16. ISO ASAP-Lyme Literate Dr & Neurologist-Prefer IL, IN, KY, MO, OH, TN. Can travel farther. Finances limited. Prefer Drs take Medicare or Payments. Need great list to find best fit. Tyvm. Posts: 701 | From Owensboro, KY | Registered: Sep 2005
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