Last week I was interviewed by KQED Forum host Dave Iverson on the physiological effects of Lyme disease, and on the controversy surrounding its diagnosis and treatment. Joining me was Pam Weintraub, author of the book, ``Cure Unknown: Inside the Lyme Epidemic.''
During this hour-long radio show, we were able to discuss these important points about Lyme disease:
-Lyme disease is often difficult to diagnose because of inaccurate testing, hard-to-measure neurological symptoms, and a complex clinical picture when a patient is infected with other tick-borne co-infections.
-There are over 100 strains of Lyme disease bacteria, and the standard tests don't detect all of them, resulting in the misdiagnosis of many Lyme sufferers.
-There is a growing body of scientific evidence that demonstrates that the Lyme disease bacteria can survive a four week course of antibiotics and go on to cause chronic Lyme disease.
Pam discussed one recent study that could explain why some patients relapse after a short course of antibiotics (published by UC Davis researcher Stephen Barthold). In this study, Dr. Barthold found that Lyme bacteria exposed to antibiotics often go into a dormant state inside tissue, then once antibiotics are halted, the organisms convert back into motile Lyme spirochetes.
She also summarized the flaws in the NEJM ``Klempner Study,'' which is often used by insurance companies to deny long-term antibiotic treatments to chronic Lyme patients.
Most important, this study was flawed in its selection of test subjects: Seventy-five percent of patients enrolled had failed treatment for early Lyme disease, so these very sick patients weren't representative of a typical response rate.
KQED Forum also featured a surprise caller, Eugene Shapiro, MD, a Yale pediatrician and one of the 14 authors of the contested IDSA Lyme diagnosis and treatment guidelines.
We were delighted that Dr. Shapiro had a chance to weigh in on the Lyme controversy, but we were disappointed that he failed to mention that he supplements his university salary by reviewing Lyme patient disabilities claims for Metropolitan Life. He has also testified against two Lyme-literate physicians who treat chronic Lyme patients with long-term antibiotics.
Both Pam and I emphasized the need for more Lyme disease research, and I heartily agreed when she said, ``We're going to have to turn our backs on the fight and look at the science to get down to the bottom of this.''
You can listen to an archive of this radio show on the KQED website. We also encourage you to weigh in on this issue by sending comments to [email protected].
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