As the question has been raised I herewith submit a letter to a reporter named Cliff LeBlanc which expresses my views on his reporting about the case of Dr. James Shortt. His reporting contained the usual errors about Lyme Disease. I do not purport to comment on the other aspects of the Dr. Shortt's case. I wrote LeBlanc a second letter in which I roundly castigated the CDC for its clear incompetence in the whole area of Lyme Disease.

When I find it I will submit to the membership the CDC report in which they state that in the early 1990's the number of actual cases of LD in endemic areas was six to twelve times the cases reported by the CDC. As of 2004 they openly admitted they did not know how much the current cases of LD were under-reported. They has thus openly admitted they do not know what they are talking about, yet they are clearly accepted by conventional medical practice and the medical state bureacracies as authoritative.

By their own statements they have admitted that their own methodology for recognition and diagnosis is totaly useless. As a result nobody has a clue as to what is actually going on. Further as a result of their pig-headed dogmatism, doctors are being bullied into refusing to even recognize the disease, much less diagnose or treat it.

So do you think it of is use for me to send a redrafting of these letters and information from the CDC to CBS? It seems to me that if one could interest them in the fact that this is a major national medical scandal one might pique their interest. Beside the clear case of massive medical abuse and medical malpractice going on in the area of lyme disease, I submit that the case of Dr. Shortt, however tragic and indeed very sad for the persons involved, is small potatoes indeed. Cheers. Thomas Parkman

November 16, 2004
Dear Mr. LeBlanc,
I have read with shock and dismay the reports of the two patients who died while under the care and treatment of Dr. James Shortt. I would not make any comment on any aspect of the situation as it has come out in the pages of your newspaper except for the fact that I myself suffer from late stage lyme disease or tertiary borreliosis, if you will. I feel that certain comments made in your article justify clarification.

Lyme disease is an horrendous illness. The suffering it causes can be enormous. It can attack the heart, brain, neurological system, connective tissue, joints, muscles and just about any other part of the body. A hideously painful illness, it can disable and even kill. It is a bizarre, Rube Goldberg kind of disease, something straight out of science fiction. A literary genius in his wildest imagination could hardly have concocted such a disease. It does not behave like other 'normal' or common bacterial infections. It is precisely for this reason that medical science has had such a hard time understanding, diagnosing and treating it. A leading medical authority on the disease has told me that we are decades away from a complete understanding of this disease.

I note that in your article you referred to the Center for Disease Control. As you must understand that agency does not treat disease. It monitors and tracks diseases. It has made clear that the criteria that it uses for those purposes are not to be used in the clinical diagnosis and treatment of disease. Yet that is precisely what many doctors are doing. The CDC has asserted that Lyme disease is a clinical diagnosis where serological tests can assist a physician in making a correct diagnosis. But these tests are often unreliable and should not be the sole basis of that diagnosis. Rather, a clinical diagnosis is based upon history, clinical symptoms, and response to therapy.

You stated that Dr. Short had made the false assertion that the patients cited in your article had Lyme disease. You stated that neither the patient nor his wife ever had any memory of a tick bite. I understand that Dr. Short sent samples of blood to be tested to an out of state laboratory. I would note that there are only a few laboratories in the country specializing in the testing of blood for tick borne diseases. All of these are located out of state.

The area in which these patients live, in northeast Richland County, has been an area where there have been a number of cases of lyme disease. The tick itself is so small that quite often people do not even know that they have been bitten. The classic sign of the disease, the bull's eye rash, appears in only 50% of the cases or less. Further the patient's wife, I understand, exhibited symptoms of severe fatigue, a common symptom of Lyme disease.

What most people, including those in the medical profession, do not understand is that there is a body of evidence that Lyme disease may be transmitted by any number of biting, blood sucking insects, not just deer ticks. I myself was probably infected by the bites of horse or deer flies. Further, as the epidemic expands there has been a great deal of discussion in the lyme community about the issue of sexual transmission of the disease. There are health care professionals who have treated married couples who are convinced that it indeed can be sexually transmitted. It is known that the spirochete that causes the disease can be transmitted from a mother to her unborn child or from a mother to her child in nursing that child.

Unfortunately the serological test results for Lyme disease are inconsistent and unreliable. There are only a few laboratories in the country with established reputations that specialize in testing for this disease. The bacterium that causes Lyme disease, Borellia burgdorferi, is a genius at evading the human immune system. It is a spirochete, a corkscrew shaped organism from the same family of bacteria as Treponema pallidum, which causes syphilis and Treponema pertenue, which causes yaws. It can lie dormant for months and years until the 'coast is clear' and then return to its spirochete form and resume its attack on the body of its host.

It uses the immune reaction of the body in a kind of immunological judo to undermine the defense mechanism of its host. The pathogen is able to modulate the immune system to attack the host's body through inflammation, while at the same time suppressing the body's defense against the etiologic agent.

Under these conditions antibodies of the disease often may not be found in patients tested for the presence of B. burgdorferi. In fact those patients that have the highest bacterial load and are therefore the most seriously ill may be the very ones to show the least antibody response in testing.

Recent studies show that B. burgdorferi alters its appearance in the host's body once it encounters pressure from the immune system. Thus, it should come as no surprise that a patient mentioned in your article had a negative test result.

Thus to assert that Dr. Short made a false assertion that the patients cited in your article had Lyme disease is not supported by those facts reported in your article. Further there have been reports of certain herbal medications mentioned in your article, which Dr. Short used that people have found beneficial in treating this disease. Lyme disease is itself a difficult and complex subject which does not easily lend itself to clear-cut answers.

Sadly, the whole issue has become embroiled in politics. The understanding of established medical practice of this disease is at least ten to twenty years out of date. Many medical practitioners insist that there is no such thing as late stage lyme disease or that it is easily curable with a short treatment of antibiotics. These positions fly in the face of a large and growing body of evidence clearly to the contrary.

One hears repeatedly that there is little or no Lyme disease in South Carolina. Yet there are more and more reports of cases of this disease. In the year 2002 there was an increase of forty percent in the number of cases of this disease nationally. At that rate the number of cases is almost doubling every two years. From 1996 to 2000 the number of cases of Lyme disease reported from hospitals in South Carolina more than doubled. The CDC itself states that the cases it reports represent something in the range of ten percent of the actual cases. These facts in light of the growing body of anecdotal reports would indicate that there is a growing and increasingly serious problem here in South Carolina.

The medical profession here is in a state of denial. It has buried its head in the sand and refused to respond to the needs of a growing number of very sick people. Many people have to go out of state to get the treatment that they cannot get here. There are even reports of abusive situations. Thus people turn to doctors whom they hope can be of help to them. They turn to alternative forms of treatment because conventional medicine can or will do nothing for them. In a great many cases in late stage Lyme disease standard antibiotic therapies do not work.

The blunt truth is that we are at some point in an epidemic here in South Carolina. The members of the medical profession here have a moral obligation and professional duty to face the facts of the present situation and provide medical care to those suffering from this disease and to do so on the basis of science and human compassion. The people who are sick and are suffering so greatly from this terrible disease deserve nothing less.

Sincerely,

I knew you would have some idea of what to write. I agree anything we can do to make it look like a scandal would help our cause.

I wonder if any would be willing to submit interviews? What about Amy Tan? I sure wish we knew someone who was very famous (besides all of us LOL) who could help champion our cause. Do we have any actual pictures of people with late stage lymes we can send CBS? Of maybe we should just contact all the tv stations and see if anyone bites on doing a coverup scandal story? I know I sound like a wild woman but hey we need to get on this! I am willing to talk to anyone who will listen. However I need to study alot more about facts and I am not sure my brain can do that now.

Just some thoughts. Thanks alot Thomas for anwering.
LET'S GO GET EM!

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The following quote shows that things never seem to change:

Here is the link you were referring to for the underreporting of lyme six to twelve times. scroll down to where it is bolded.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5317a4.htm

Lyme Disease --- United States, 2001--2002

Lyme disease (LD) is caused by the spirochete Borrelia burgdorferi and is transmitted through the bite of Ixodes spp. ticks. CDC began LD surveillance in 1982, and the Council of State and Territorial Epidemiologists designated LD a nationally notifiable disease in 1991. This report summarizes the analysis of 40,792 cases of LD reported to CDC during 2001--2002. The results of that analysis indicate that annual LD incidence increased 40% during this period. The continued emergence of LD underscores the need for persons in areas where LD is endemic to reduce their risk for infection through integrated pest management, landscaping practices, repellent use, and prompt removal of ticks.

For surveillance purposes, a case of LD is defined as physician-diagnosed erythema migrans (EM) >5 cm in diameter or at least one objective manifestation of late LD (e.g., musculoskeletal, cardiovascular, or neurologic) with laboratory confirmation of B. burgdorferi infection using a two-tiered assay (1). National, state, and age-specific incidence was calculated by using U.S. Census Bureau data for 2001 and 2002; incidence by county was calculated by using U.S. Census data for 2000.

In 2001, a total of 17,029 cases of LD were reported to CDC by 43 states and the District of Columbia, yielding a national incidence of 6.0 cases per 100,000 population. In 2002, the number of reported cases increased 40% to 23,763 cases, yielding a national incidence of 8.2 cases per 100,000 population (Table, Figure 1). All states except Hawaii, Montana, and Oklahoma reported cases during 2002.

Twelve states reported an incidence of LD that was higher than the national average in both 2001 and 2002: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin. These 12 states account for 95% of cases reported nationally (Table, Figure 2).

During 2000--2001, LD case reports increased in 15 states, decreased in 26 states, and remained the same in nine states. During 2001--2002, LD case reports increased in 39 states, decreased in seven states, and remained the same in four states. Only one state, Arkansas, reported a decrease for both 2001 and 2002.

Counties reporting >15 cases accounted for >90% of all cases reported in both years. During 2001--2002, the number of counties reporting >15 cases increased from 123 to 151. In 2001, a total of 35 counties in seven states (Connecticut, Delaware, Massachusetts, New Jersey, New York, Pennsylvania, and Rhode Island) reported >100 cases. In 2002, a total of 53 counties in 10 states (i.e., the seven states from 2001 plus Maine, Minnesota, and New Hampshire) reported >100 cases. For both 2001 and 2002, the highest incidence of LD was reported from Columbia County, New York, with 1,026 and 1,583 cases per 100,000 population, respectively.

Combining data for both years, information on patient age and sex was available for 99% of patients. Patient ages ranged from <1 to 101 years and followed a bimodal distribution, with incidence peaks among children aged 5--14 years (9.9 cases per 100,000 population per year) and adults aged 50--59 years (9.2 cases per 100,000 population per year). Overall, 21,525 (53%) of 40,440 patients were male. Demographic features differed for states with above- and below-average incidence. Among 12 states with above-average incidence, the modal age of patients was 6 years; 54% were males. Among 38 states with below-average incidence, the modal age of patients was 44 years; 47% were males.

A total of 83% of reports for 2001 and 2002 had a date of illness onset provided. Patients were most likely to have illness in May (7%), June (28%), July (31%), or August (12%). Fewer than 7% were reported to have illness onset during December--March. Among 31,120 patients for whom at least one clinical finding was indicated, a history of EM was reported for 21,126 (68%) patients, arthritis for 10,126 (33%) patients, Bell's palsy for 2,510 (8%) patients, and radiculopathy for 1,009 (3%) patients. Meningitis, encephalitis, and heart block were reported in <1% of patients.

Reported by: State and District of Columbia health departments. RM Bacon, MS, PS Mead, MD, JL Kool, MD, AS Postema, MPH, Div of Vector-Borne Infectious Diseases, National Center for Infectious Diseases; JE Staples, MD, EIS Officer, CDC.
Editorial Note:

During 2002, a total of 23,763 LD cases were reported to CDC, more than in any previous year. Analysis of 2001 and 2002 data indicates that, as in previous years, most cases occur in northeastern, mid-Atlantic, and north central states, and the largest proportion of cases are reported among persons aged 5--14 years and 50--59 years. Factors potentially contributing to the increase in reported cases include growing populations of deer that support the Ixodes tick vector, increased residential development of wooded areas, tick dispersal to new areas, improved disease recognition in areas where LD is endemic, and enhanced reporting.

Surveillance for LD is subject to several limitations. Studies from the early 1990s suggested that LD cases were underreported by six to 12-fold in some areas where LD is endemic (2,3); the current degree of underreporting for national data is unknown. In addition, differences in the demographics of reported cases among states with above- and below-average incidence suggest variation in diagnostic and reporting practices among states. Clinicians are reminded that the LD case definition was developed for surveillance purposes and might not be appropriate for clinical management of individual patients (1).

In February 2002, the only Food and Drug Administration--approved LD vaccine for humans was withdrawn from the market, reportedly because of poor sales. However, several other effective preventive measures remain available to persons living in areas where LD is endemic (4). Personal protective measures, such as repellent use and routine tick checks, are key components of primary prevention (Box). Removing infected ticks within 48 hours of attachment can reduce the likelihood of transmission (5), and prompt antimicrobial prophylaxis of tick bites, although controversial, might be beneficial under certain circumstances (6). Exposure to ticks in peridomestic and recreational areas can be reduced 50%--90% through simple landscaping practices, such as removing brush and leaf litter or creating a buffer zone of wood chips or gravel between forest and lawn or recreational areas (4,7) (Figure 3). Correctly timed applications of pesticides to yards once or twice a year can decrease the number of nymphal ticks 68%--100% (8,9). In addition to these interventions, several novel approaches to LD prevention are under investigation or will soon be available. These include bait boxes and "four-poster" devices that deliver acaricides to rodents and deer without harming them, and the use of biologic agents, such as fungi that kill Ixodes ticks (4,10).
References

1. CDC. Case definitions for infectious conditions under public health surveillance. MMWR 1997;46(No. RR-10):20--1.
2. Meek JI, Roberts CL, Smith EV Jr, Cartter ML. Underreporting of Lyme disease by Connecticut physicians, 1992. J Public Health Manage Pract 1996;2:61--5.
3. Coyle BS, Strickland GT, Liang YY, Pena C, McCarter R, Israel E. The public health impact of Lyme disease in Maryland. J Infect Dis 1996;173:1260--2.
4. Hayes EB, Piesman J. How can we prevent Lyme disease? N Engl J Med 2003;348:2424--30.
5. Sood SK, Salzman MB, Johnson BJ, et al. Duration of tick attachment as a predictor of the risk of Lyme disease in an area in which Lyme disease is endemic. J Infect Dis 1997;175:996--9.
6. Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med 2001;345:79--84.
7. Schulze TL, Jordan RA, Hung RW. Suppression of subadult Ixodes scapularis (Acari: Ixodidae) following removal of leaf litter. J Med Entomol 1995;32:730--3.
8. Stafford KC. Effectiveness of carbaryl applications for the control of Ixodes dammini (Acari: Ixodidae) nymphs in an endemic residential area. J Med Entomol 1991;28:32--6.
9. Schulze TL, Jordan RA, Hung RW, Taylor RC, Markowski D, Chomsky MS. Efficacy of granular deltamethrin against Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) nymphs. J Med Entomol 2001;38:344--6.
10. Pound JM, Miller JA, George JE, Lemeilleur CA. The `4-poster' passive topical treatment device to apply acaricide for controlling ticks (Acari: Ixodidae) feeding on white-tailed deer. J Med Entomol 2000;37:588--94.

CBS screwed up again, no question. And I am a hard core Democrat who would have walked through hell (oh yea I am doing that) to get rid of our current president. Things are obviously falling apart at CBS and with this report, we can see why. Hidiously done, pathetically researched.

I used to be a reporter and writer for 20 years, nose for news and all of that. Early this fall, I saw an interview with Primetime Live (ABC) folks that reported they were going back to their "investigative roots." More exposes etc, etc.

I am sick and herxing on mino and the rest of it and you write so well. Why not send your letter to Primetime Live, possibly follow up with calls etc. Give them a chance to do a full well-rounded report on this disease which is sweeping the nation as we know and is so miserably undereported.

From an old reporter's point of view, this is one hell of a story for a network that would take it on. Obstacles as I see it could be corporate sponsors such as insurance companies, AMA, etc or the Plum island deal which, (like JFK's assasination) we may never know the answer.

Anyway think about it. We here at lymenet could offer tremendous testimony alone.

Lymelady

I think we need to send all of our info to all the stations. Don't forget Fox! I will help anyway I can.

The CDC link is great since it states so clear the problem.

Pictures say a thousand words so does anyone have any pictures to send with this article to the TV stations?

Thomas, let us know how we can help if you are willing to send these and you can certainly add my name to the letter! How about all of us on lymenet adding our names??? That should show some of the #'s with this.
Blessings on you Thomas! And all of you!
Mule

It's amazing how many people are so ignorant about lyme.

The Today Show did a story on Brooke from CT who had lyme and the reproter (can't recall her name), stated lyme is the number one infectous disease.

Wake up news media and do your homework!