2009 Lyme Articles- 5
Stratton Holdings, Inc. Acquires LymeCLR(TM) and Company Assets
Marketwire -- 08/24/09 -- Stratton Holdings, Inc. acquires LymeCLR(TM), LymeCLR trademarks and manufacturing and distribution contracts with Universal Health Sciences, Inc. a Sedona, Arizona-based company.
LymeCLR(TM) is a full spectrum liquid antibiotic advanced immune system supplement for the purposes of increasing and promoting a healthy immune system in turn combating Lyme Disease in an all natural way. Currently customers have the options of purchasing a 21-day trial period for simply the cost of shipping, of purchasing two 16FL ounce bottles at the discounted cost of $89.97, or simply purchasing one 16FL ounce bottle at the cost of $49.97.
LymeCLR(TM) was created to meet the demand that lyme disease patients have for a prescription alternative. The treatment of Lyme disease is an extremely controversial subject, but the company strongly believes in the all natural route. Based on research done by Universal Health Sciences, Inc. results of LymeCLR(TM) are fantastic. Success stories can be found at www.lymeclr.com/testimonials.html.
Well, this is interesting: a product created to fill a market demand, not a clinical or formulary need. I have no idea what a “full spectrum liquid antibiotic advanced immune system supplement” is but I’m sure I can’t find such a thing in a hospital pharmacy. Still, its results are “fantastic” and the company apparently posted some patient testimonials to prove it.
Damn the scientific evidence; we have testimonials! Actually, the same day I came across this commercial nonsense, I read a piece in the London Times about Richard Dawkins’ new book. This line from the Times caught my eye: “Pseudoscientific beliefs [and personal testimony] can never be refuted, because their proponents do not recognise the concept of evidence.” That’s why this company is handing out testimonials instead of data.
LymeCLR is currently a web-based company that previously was headquartered in Arizona.
Arizona. A state with no endemic Lyme disease. Interesting. There must have been some financial or legal reason for having been there. Now it’s in cyberspace and maybe just an off-shore server away from the DoJ and the IRS.
[snip]
Safe Harbor Statement: The Private Securities Litigation Reform Act of 1995 provides a "safe harbor" for forward-looking statements. Certain of the statements contained herein, which are not historical facts, are forward-looking statements with respect to events, the occurrence of which involve risks and uncertainties. These forward-looking statements may be impacted, either positively or negatively, by various factors.
Wow. I have no idea what the above is intended to mean, but it’s got the viscous paw prints of lawyers all over it. Sounds like you can lie within the bounds of The Private Securities Litigation Reform Act of 1995. Or maybe Arizona. Or Cyberspace.
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Posted by Relative Risk at 10:33 0 comments Links to this post
Labels: Internet, Lyme disease, Quackery
Finally. I’ve been waiting to see this in print since I read the manuscript months ago. Too bad it didn’t get released in time for the recent IDSA re-review of its treatment guidelines for Lyme disease. I’m sure, however, the current members of the review panel will read it before the end of the year.
Actually, it might not be a bad idea to send copies (plus some of the earlier material) to member s of Congress who are thinking about a possible bill for more Lyme disease research. Maybe they can just redirect any future funds to the National Institute of Mental Health.
Am J Med 2009;122(9):843-850
Psychiatric Comorbidity and Other Psychological Factors in Patients with “Chronic Lyme Disease”
Afton L. Hassett, et al.
Background
There is no evidence of current or previous Borrelia burgdorferi infection in most patients evaluated at university-based Lyme disease referral centers. Instead, psychological factors likely exacerbate the persistent diffuse symptoms or “Chronic Multisymptom Illness” (CMI) incorrectly ascribed to an ongoing chronic infection with B. burgdorferi. The objective of this study was to assess the medical and psychiatric status of such patients and compare these findings to those from patients without CMI.
Methods
There were 240 consecutive patients who underwent medical evaluation and were screened for clinical disorders (eg, depression and anxiety) with diagnoses confirmed by structured clinical interviews at an academic Lyme disease referral center in New Jersey. Personality disorders, catastrophizing, and negative and positive affect also were evaluated, and all factors were compared between groups and with functional outcomes.
Results
Of our sample, 60.4% had symptoms that could not be explained by current Lyme disease or another medical condition other than CMI. After adjusting for age and sex, clinical disorders were more common in CMI than in the comparison group (P <.001, odds ratio 3.54, 95% confidence interval, 1.97-6.55), but personality disorders were not significantly more common. CMI patients had higher negative affect, lower positive affect, and a greater tendency to catastrophize pain (P <.001) than did the comparison group. Except for personality disorders, all psychological factors were related to worse functioning. Our explanatory model based on these factors was confirmed.
Conclusions
Psychiatric comorbidity and other psychological factors are prominent in the presentation and outcome of some patients who inaccurately ascribe longstanding symptoms to “chronic Lyme disease.”
Posted by Relative Risk at 01:31 0 comments Links to this post
Labels: diagnostics, Lyme disease, Psych
From the very entertaining and educational website on epidemiology and public health,Effect Measure, Revere writes,
Science Based Medicine is a site we highly recommend with experienced scientists and practitioners in charge. In other words, it's run by adults. But scientists often disagree about things. This is apparently a secret to non-scientists and many reporters who assume that when two scientists disagree, one is lying or wrong. But it's true nonetheless.
The SBM blog contains two recent entries worth noting. The first is, “Why We Need Science: “I saw it with my own eyes” Is Not Enough.” The second is about what can happen when people don’t read and understand the first article: “Connecticut Legislature Intrudes on Debate Over Chronic Lyme Disease.”
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Posted by Relative Risk at 11:31 0 comments Links to this post
Labels: Anti-science, Lyme disease, Politics
08-14-2009 PRESS RELEASE
August 13, 2009- Centreville, MD - As Maryland climbs to 5th highest in the nation for the number of Lyme disease cases, residents can be assured their elected Representatives in Washington, DC are taking steps to address the exploding Lyme and tick borne disease epidemic.
“We are fortunate and thankful that we have all of our Congressmen supporting and cosponsoring the Lyme disease bills again this year,” commented Lucy Barnes, Director of the Lyme Disease Education and Support Groups of Maryland.
Wow. Tincup has issued herself a press release; complete with quotes from….herself. I wonder if she read it to herself while standing in front of a mirror, which would have reflected back to her the entire membership of this imaginary support group.
But back to the press release, which starts off with an error or perhaps a lie. Maryland is sixth in the list of recently compiled numbers of confirmed cases of Lyme in 2008. Here’s the actual ranking: NY (5203), MA (3960), PA (3818), NJ (3214), CT (2738), and MD (1746). How hard is it to count to six?
“Our Congressmen are listening to people in their districts and across the country who are being negatively affected by Lyme and tick borne diseases.”
Sounds like hopeful PR, but then this press release turns into little more than an attack on one of those congressmen who apparently isn’t listening to Tincup and her imaginary legions.
In spite of a strong grass roots effort, it was kept “locked up” by Congressman Frank Pallone (NJ), the head of the Health Subcommittee.... Pallone, whose state is third highest in the nation with Lyme disease cases....
There’s that counting problem again, followed by more Pallone bashing and a quick swipe at the IDSA.
Pallone, repeating the IDSA’s fabricated mantra, “there is no such thing as chronic Lyme disease”, stated certain treatment protocols were “suggested, if not mandated” in the bill and he refused to bring the bill up, after promising he would do so.
“Congressman Pallone should not depend on a small medical society [IDSA] in Virginia that believes Lyme is cured after 3 weeks of antibiotics, especially a society found guilty of multiple wrong-doings and of having serious conflicts of interest with insurance companies”, stated Barnes.
I don’t remember any trial in which the IDSA was found guilty of anything. I don’t remember any conflicts of interest having an impact on the updating of pre-existing treatment guidelines either. But it must be true if Tincup wrote it and put the words, “Press Release,” at the top of the page.
So that’s the news from Lucy Tincup Barnes and the Lyme Disease Education and Support Groups of Maryland, which if not really in the state of Maryland can certainly be said to be in a state of mind.
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Posted by Relative Risk at 11:26 0 comments Links to this post
Labels: Lyme disease, Politics
AUGUST 17, 2009
It's All in the Timing for Lyme Disease Test
A nice little review of the two-tier test for Lyme infections, especially if you ignore the know-nothing quote from Ralph Stricker.
[snip]
The most common test involves two tests from the same sample. It typically costs about $25 to $70 and is often covered by insurance. Based on CDC guidelines, the blood is usually analyzed first with an antibody test called ELISA. If it is positive or unclear, then a confirmatory test called the Western blot is done.
Allen C. Steere, a Harvard University scientist who led the team that discovered Lyme disease in 1975, says the two-tier test is "quite accurate" as long as you use it properly—which means for the most part, not too soon after the suspected infection. In a study published last year, Dr. Steere and his colleagues found that of 76 patients exhibiting a bulls-eye-shaped rash characteristic of early Lyme disease, only a third tested positive for the disease. The bulls-eye rash typically appears within a week or two of infection, according to the CDC. But three to four weeks later, two-thirds of the group tested positive.
Given the tests' low sensitivity in the early stages of Lyme disease, physicians recommend treating with antibiotics when the patient develops the rash or other clear symptoms.
Still, individuals bitten by a tick in an area where Lyme disease is prevalent often think they should be tested immediately. Many people go to their doctors and say "I got bit by a tick. Test me!" says Wisconsin researcher Edward A. Belongia, director of the Epidemiology Research Center at the Marshfield Clinic Research Foundation. Dr. Belongia is author of a 2004 study that found only 20% of 356 Lyme tests the scientists reviewed were clearly appropriate, based on the patients' symptoms. Doctors say it is also wrong to get a test after being treated for the disease, since the antibodies can linger for years in your blood.
[snip]
The CDC Web site warns consumers to beware of labs offering nonstandard Lyme disease tests. The CDC encourages patients to "ask their physicians whether their testing was performed using validated methods."
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Posted by Relative Risk at 11:23 0 comments Links to this post
Labels: diagnostics, Lyme disease
The board of eight physicians and a veterinarian is charged with deciding if one society's guidelines should be revised.
By Susan J. Landers
AMNews, Posted Aug. 17, 2009.
Washington -- The debate over whether chronic Lyme disease exists and how it should be treated has become increasingly contentious in the past few years, even prompting antitrust charges by one state attorney general over treatment guidelines.
A day-long hearing was held July 30 as part of a voluntary agreement between the Infectious Diseases Society of America and the Connecticut attorney general for a review of the society's guidelines. Those guidelines characterize Lyme disease as an acute infection best treated with antibiotics for a few weeks at most.
In contrast, the International Lyme and Associated Diseases Society recommends long-term treatment with antibiotics for patients with what is called chronic Lyme disease, or post-Lyme disease syndrome, characterized by persistent and severe joint pain, fever and fatigue.
Scientists and physicians have to do a better job of reminding reporters that ILADS isn’t a real medical society, but rather a small collection of like-minded private practice physicians—many of whom have been censured by state medical boards, sued by their own patients, or barred from federal granting agencies—with little or no research experience or infectious disease training, and whose headquarters is a mail drop in Bethesda, Maryland. Their own treatment guidelines are a non-peer-reviewed, anecdote-based collection of self-justifications for expensive quackery.
[snip]
Raphael Stricker, MD, past president of the ILADS, which advocates long-term use of antibiotics for patients with the chronic form of the disease, testified that he would like to see the IDSA guidelines rewritten.
I’m sure he would. He could probably use the money from all those foolish patient/fan/activists.
Dr. Stricker is hopeful that such a revision is possible. "The panel members seemed genuinely moved by the evidence, and I can only hope that will translate into something that is productive rather than something that is political," he said.
I think he means “something that is financial.” Activists and their enabling quacks have always claimed Lyme disease is a “political” disease, but it’s not: it’s a financial disease, in which a few practitioners, diagnostic labs, and home infusion companies hope to continue to make millions of dollars pumping expensive antibiotics (or more likely cheap saline) into gullible hypochondriacs.
[snip]
Phillip Baker, PhD, who served as program officer for the Lyme Disease Research Program at the National Institute of Allergy and Infectious Diseases, supported the IDSA guidelines.
"A major criticism raised by those who oppose the IDSA guidelines is that they fail to provide evidence to support legitimate opposing views, namely that extended antibiotic therapy is beneficial for the treatment of chronic Lyme disease," Dr. Baker said. "That is not a deliberate omission. The simple fact of the matter is that there is no published evidence -- derived from a well-designed placebo-controlled clinical trial -- to show that such therapy is both beneficial and safe."
Phil’s right of course. Scientists and clinicians are all from Missouri where the motto is, “Show us the evidence!” There’s nothing more compelling than hard data…except maybe cold, hard cash.
[snip]
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Posted by Relative Risk at 11:12 0 comments Links to this post
Labels: IDSA, ILADS, Lyme disease, Politics, Stricker
Newspaper- STAR DEMOCRAT, Easton, MD
Friday August 14, 2009
Md. lawmakers back federal Lyme bill
EASTON With U.S. Sen. Barbara Mikulski, D-Md., signing on to support a national Lyme Disease bill, all of Maryland's representatives are now on board. The legislation is aimed at helping to provide education about the disease, fund research for a better testing method and create an advisory committee. A similar bill introduced last session also had the support of all Maryland's lawmakers, but it did not make it to the floor for a vote.
"We've been trying for years to get a bill passed," said Lucy Barnes, director of the Lyme Disease Education and Support Groups of Maryland. "It's very unusual to have them all signed on to co-sponsor a bill."
Sounds like it’s time to update some letters to Maryland’s Congressional Reps and Senators. I know these congressional sign-ons are generally meaningless, especially now, in the midst of a financial crisis and a huge struggle over healthcare. Still, it’s best not to let these nuts have the last word.
Speaking of nuts, this local newspaper article reads like it was dictated by Lucy Barnes (aka, Tincup), a well-known LymeNut whose own online writings read like that of a 13-year-old hillbilly.
She still claims to be the director of what many other Lyme support people believe is a fictitious support group somewhere in Maryland (see www.lymeneteurope.org/forum postings about it).
She quit the one substantive advisory entity she was ever involved in (“Please accept my resignation from the Maryland Department of Health and Mental Hygiene's Lyme Disease Advisory Subcommittee.” "We're not quitting because we're mad," she added. "We're quitting because it's a brick wall in front of us.").
She’s not too gracious when politicians don’t behave the way she demands either (“Once again the legislators in Annapolis, MD tried to address the Lyme disease situation in Maryland without contacting Lyme patients or their doctors in advance to determine if their offer of help really was HELP rather than a potential nightmare. And once again... in spite of promises they made... they flip flopped their way right into making our lives MUCH worse.”)
Her juvenile online comments about scientists and academic physicians, and her online lectures about Lyme disease suggest she’s a horribly ignorant and ill-mannered 13-year-old hillbilly, or maybe just a liar. Is it possible to be both?
Anyway, I know some people on the Hill too. It shouldn’t be too hard to get them some real information and maybe a list of quotes from the highly quotable Tincup.
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Posted by Relative Risk at 11:09 0 comments Links to this post
Labels: Internet, Lyme disease, Politics
Media-Newswire.com - New Haven, Conn. — In post-colonial America, Lyme disease was isolated to a few islands along the Northeast coast and pockets of Wisconsin and Minnesota. But a new genetic analysis of the Lyme bacterium by Yale University researchers shows that the tick-borne disease roared back after the reforestation of this part of the country.
The findings, reported the week of August 10 in the Proceedings of the National Academy of Sciences, show Lyme spread from the Northeast to the Midwest thousands of years ago. Deforestation eliminated the deer that host Lyme-carrying ticks and the range of the disease was dramatically decreased.
“The current epidemic of Lyme disease is the result of infected ticks expanding their range independently from these isolated refuges,” said Durland Fish, professor of epidemiology at the Yale School of Public Health and senior author of the paper. “This expansion is likely to continue until the ticks, and the diseases they carry, return to their former range.”
Researchers collected samples of the Lyme bacterium Borrelia burgdorferi from black-legged ticks throughout its range in the eastern half of the country. Researchers analyzed mutations in the genome of the bacterium that allowed them to trace the evolutionary path it took in the U.S. They found ancestral variations in genetic sequences of bacterium that suggest it originated in the Northeast U.S. and then spread to the Midwest. Previous analysis of the bacterium suggests it first originated in Europe.
“An understanding of how and why Lyme disease is spreading has important public health applications,” Fish said.
[snip]
The study was funded by the National Institutes of Health, the Centers for Disease Control, the U.S. Department of Agriculture and the Mathers Foundation.
Posted by Relative Risk at 11:21 0 comments Links to this post
Labels: Epidemiology, Lyme disease
Buzz Aldrin, sick of the conspiracy nuts who kept insisting his walk on the moon was faked, finally hauled off and punched one of these poor fools in the face. No doubt it was more effective—not to mention satisfying—than any reasoned argument could have been. Such people simply are beyond the reach of reason.
Likewise the Lyme conspiracy nuts who think a common bacterial infection is the work of some vast government-insurance plot.
Apparently, many of them are convinced the Infectious Diseases Society of America is “suppressing” information showing that “chronic Lyme disease” is actually a persistent infection, and not mere post-infection damage, inflammation, autoimmunity, etc. The activists seem to believe that a Lyme vaccine will activate their latent and persistent B. burgdorferi infections, thereby making it dangerous to use in Lyme-endemic areas. Further, their irrational thinking leads them to conclude that many people in the IDSA are involved in vaccine research and would lose a great deal of money if the possibility of persistent infection is made known. Consequently, they are suppressing any evidence of persistent infection. That’s why it’s not mentioned in the IDSA treatment guidelines for Lyme disease. Moreover, they are blocking the development of new diagnostic tests that might reveal persistent infection.
I’m not going to pick through this nonsense line by line; it would be like picking through week-old garbage with your bare hands. Suffice to say; the IDSA comes off sounding like that secret society Homer Simpson belonged to: the pervasive, persistent, all powerful Stone Cutters manipulating currencies, hiding Martians, electing presidents. Hell, if the IDSA can do pretty much the same things maybe I should just pay the annual dues and join. I wonder if they have cool (but secret) tattoos?
Buzz is probably too busy to stop by and punch out these nuts. Too bad, because the fluoride and other mind-control substances in the national water supplies don’t seem to be working very well.
Final thought: what if the IDSA really is working on vaccines? Maybe therapeutic vaccines?
Posted by Relative Risk at 11:14 0 comments Links to this post
Labels: Lyme disease, vaccines
For those interested in vector control, a series of papers have just been published inVector-Borne and Zoonotic Diseases. The paper by Fish and Childs (#7) describes and summarizes all of the studies.
1: Hoen AG, Rollend LG, Papero MA, Carroll JF, Daniels TJ, Mather TN, Schulze TL, Stafford KC 3rd, Fish D. Effects of tick control by acaricide self-treatment of
white-tailed deer on host-seeking tick infection prevalence and entomologic risk for Ixodes scapularis-borne pathogens. Vector Borne Zoonotic Dis. 2009
Aug;9(4):431-8.
2: Brei B, Brownstein JS, George JE, Pound JM, Miller JA, Daniels TJ, Falco RC,
Stafford KC 3rd, Schulze TL, Mather TN, Carroll JF, Fish D. Evaluation of the
United States Department Of Agriculture Northeast Area-wide Tick Control Project by meta-analysis. Vector Borne Zoonotic Dis. 2009 Aug;9(4):423-30.
3: Schulze TL, Jordan RA, Hung RW, Schulze CJ. Effectiveness of the 4-Poster
passive topical treatment device in the control of Ixodes scapularis and
Amblyomma americanum (Acari: Ixodidae) in New Jersey. Vector Borne Zoonotic Dis. 2009 Aug;9(4):389-400.
4: Daniels TJ, Falco RC, McHugh EE, Vellozzi J, Boccia T, Denicola AJ, Pound JM, Miller JA, George JE, Fish D. Acaricidal treatment of white-tailed deer to
control Ixodes scapularis (Acari: Ixodidae) in a New York Lyme disease-endemic community. Vector Borne Zoonotic Dis. 2009 Aug;9(4):381-7.
5: Stafford KC 3rd, Denicola AJ, Pound JM, Miller JA, George JE. Topical
treatment of white-tailed deer with an acaricide for the control of Ixodes
scapularis (Acari: Ixodidae) in a Connecticut Lyme borreliosis hyperendemic
Community. Vector Borne Zoonotic Dis. 2009 Aug;9(4):371-9.
6: Pound JM, Miller JA, George JE, Fish D. The United States Department Of
Agriculture Northeast Area-wide Tick Control Project: history and protocol.
Vector Borne Zoonotic Dis. 2009 Aug;9(4):365-70.
7: Fish D, Childs JE. Community-based prevention of Lyme disease and other
tick-borne diseases through topical application of acaricide to white-tailed
deer: background and rationale. Vector Borne Zoonotic Dis. 2009 Aug;9(4):357-64.
Posted by Relative Risk at 11:24 0 comments Links to this post
Labels: Epidemiology, Lyme disease
So Lorraine Johnson has published the secret history of the IDSA guidelines investigation. Unfortunately, it reads less like honest history and more like a self-serving pat on the back.
First off, she refers to the “historic” review of the guidelines. There’s nothing historic about this kind of action. Bush, Cheney and their underlings were suppressing and rewriting science throughout much of the 2001-2008 period. Just ask the Union for Concerned Scientists. The only thing new about this particular assault on evidence-based medicine and peer-reviewed science was that it was carried out by a Democratic state attorney general and some middle-aged ladies from California and New Jersey.
As for the history of the anti-trust efforts, well, lawyer Johnson may be a bad lawyer, but I doubt Richard Wolfram is. He must have known that had Lorraine and company filed an anti-trust suit on their own—and as far as I know any two-bit lawyer can—it would have been immediately tossed in the trash. Why? Because since 1996, the FTC and the Justice Department have concluded that treatment guidelines issued by medical societies don’t limit competition (F2d 397, 7th Cir 1989). That would have been the end of it. And a quiet end.
But if they could find some government official or attorney general to launch an “investigation,” well, that would create news, buzz, public confusion, media interest, etc. And they had one: Richard Blumenthal—not a guy with “vision and Intestinal fortitude” as Lorraine suggests, but rather a megalomaniac and TV-camera addict who already had an unhealthy obsession with Lyme disease. He already had spent public money on his obsession so what was a little more CT taxpayer money to “investigate” a VA-based medical society in support of the delusions of a few people from CA and NJ?
No, I don’t think the real purpose of the “suit” or “investigation” or whatever you want to call it was to bring the IDSA into court—that was clearly impossible. Rather it was to generate noise. Make a big public demonstration. Embarrass the IDSA. Maybe embarrass some of the authors of the guidelines. Keep “chronic” Lyme disease in the news. Keep the public and the press confused. Undermine the credibility of the IDSA while boosting the credibility of ILADS and the other activists groups. And maybe if they made enough noise some congressmen would hear and start writing legislation or holding hearings.
No, this was never a legal strategy. It was a PR strategy. And to some degree, I think it worked. Lorraine confesses as much when she writes, “…we have grown enormously as a community….”
They must have raked in a lot of money too. Lawyers—even bad ones—aren’t cheap, and Lorraine notes that the “legal costs were borne by CALDA, Time for Lyme and the national Lyme Disease Association.” I hope they’ll post on their websites how much donor money they spent on this one-ring circus.
Finally, Lorraine suggests the activists uncovered “previously suppressed information” about chronic Lyme disease. Well, it couldn’t have been too suppressed if they managed to find 1300 pages of peer-reviewed literature. How hard is it to go to the library or log onto PubMed? Much of this “suppressed” information has been regurgitated by ILADS and CALDA before, and much of it has nothing to do with human disease or treatment of human infections. I’m familiar with the Lyme and borreliosis literature too, and most of it has nothing to do with human beings. Lorraine, et al. could have dumped 13,000 pages in the panel’s laps and it would not have made any difference. Irrelevant is irrelevant, no matter how much of it there is.
There’s some irony here. Well, actually, a lot of irony. The activists like Lorraine regularly accuse IDSA of ignoring vast amounts of relevant literature, but then they do exactly the same thing. I’ve never once heard an activist acknowledge the likely role of psychiatric co-morbidity in many cases of chronic Lyme disease, or the all too common phenomenon of “medically unexplained syndromes” or the secondary pharmacological properties of many antibiotics or the large number of people who contract Lyme, get treated and go on about their lives, or the 10% of people who contract Lyme, never know it, and go on about their lives.
But this bias is not unique to Lyme activists. It’s fairly standard behavior among the anti-vaccine groups too. And the homeopaths, and other alternative medicine, and alternative science groups.
In the end, they’re all like the Pope Urban VIII who refused to look through Galileo’s telescope because he didn’t want belief threatened by reality. Instead, he tried a couple of legal maneuvers on Galileo. It didn’t work….but people are still talking about it.
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Posted by Relative Risk at 11:18 0 comments Links to this post
Labels: Blumenthal, IDSA, Lyme disease
posted 08-06-2009 on LymeNut by Kris Newby, one of the producers of the propaganda film on Lyme disease. She writes, “The Infectious Diseases Society of America (IDSA) just requested from Open Eye Pictures copies of UNDER OUR SKIN to be be given to each of the nine Lyme guidelines review panelists. We’re happy and humbled that the film is proving its potential to affect policy and people's lives.”
Happy and humbled? Please. What rot. I can’t imagine how this crude, celluloid propaganda has affected anyone’s life, except perhaps to make more sensible viewers wonder: “Is this damned thing ever going to end?” and “Why’s this healthy, normal, articulate park ranger in so much of a movie about an allegedly deadly infection?” and “How much time has Dr. MacDonald spent alone in his basement?” and “Maybe these patients and their quack doctors deserve each other?”
No, I’m sure the requested copies for the panel members are intended to drive home the point that many of these patient/activists are nuts—as if that wasn’t evident from some the presentations and documentation sent to the review panel—and these LLMDs and ILADS guys are charlatans and quacks, and are a general threat to the health and wealth of their patients.
I’m sure the film will have an effect on panel members, but it’s not likely to be the effect Newby hopes for.
Posted by Relative Risk at 11:39 0 comments Links to this post
Labels: Film, Lyme disease, Politics
Check out the Lyme disease Resource Center at Medscape for recent updates on cases management and the (endless) controversies generated by activists.
Ten Clinical Pearls for the Diagnosis and Management of Lyme Disease
Paul Auwaerter on Infectious Diseases
July 27, 2009
Lyme Disease: Issues and Controversies
Paul Auwaerter on Infectious Diseases
July 27, 2009
Ticks and Tick-Borne Diseases: Slideshow
July 2009
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Posted by Relative Risk at 11:37 0 comments Links to this post
Labels: Lyme disease
Lies told often enough often come to be believe--just ask any Republican--so it’s worth taking the time to knock them down. That said, here’s yet another refutation to Blumenthal’s oft-repeated lies about the IDSA treatment guidelines for Lyme disease.
Blumenthal Off Base Criticizing Lyme Guidelines
8/3/2009
By Anne Gershon
We could not disagree more with the inaccurate statements made by
Connecticut Attorney General Richard Blumenthal in his opinion piece
on our Lyme disease guidelines (”Conflicts of interest in treatment
guidelines,” July 19).
The physicians and scientists who wrote the Infectious Disease Society
of America's (ISDA) guidelines thoroughly reviewed all the medical
evidence and took great care to address the claims made by the small
minority of physicians who advocate long-term antibiotic use. Their
conclusion, based on several peer-reviewed studies, was that long-term
antibiotics are unnecessary and potentially harmful.
The notion that the authors had financial conflicts of interest is
absurd to anyone who has read the guidelines, which recommend generic
tests and a short course of generic drugs. If the authors were seeking
to profit financially, it would have made more sense for them to
recommend a lengthy course of treatment and a broader definition of
the disease.
Ironically, Mr. Blumenthal and those who criticize IDSA guidelines
would increase profits for pharmaceutical companies and revenues for
physicians who treat Lyme disease. Mr. Blumenthal's investigation of
IDSA ended without filing any legal complaint, and the agreement (not
a settlement) that he signed stipulated that IDSA guidelines remain in
place. The agreement called for a special review, which is currently
under way.
IDSA's signing the agreement was not, as he alleges, an admission of
guilt, but an effort to end a fruitless investigation that was costing
our organization (and presumably Connecticut taxpayers) thousands of
dollars. We hope the review will put to rest the tired old allegations
and put the focus where it belongs: making sure that people with Lyme
disease get treatment that is safe, effective, and supported by sound
medical evidence.
Editor's note: The writer, a physician, is president of the Infectious
Diseases Society of America.
Posted by Relative Risk at 11:33 0 comments Links to this post
Labels: Blumenthal, Lyme disease, Politics
Blumenthal pleased? Well, that was the whole point: Blum's megalomanical need to appear in the news on an hourly basis, and his obsession with Lyme disease. It's clear from his comments below that he still doesn't understand that "fairness" and other points of view are simply irrelevant to science. The only thing that matters is what can be consistently and independently demonstrated.
Blumenthal pleased with D.C. Lyme hearing
By Lisa
Chamoff
Hartford Courant
Posted: 07/30/2009
Connecticut's attorney general said he felt a hearing in Washington, D.C., on Thursday on Lyme disease treatment guidelines that he helped bring about was "unprecedented" and set a standard for transparency and fairness in crafting medical recommendations.
"It certainly aired diametrically different and sometimes conflicting views and highlighted the stark divide between various sides in the debate," said Attorney General Richard Blumenthal in a phone interview Thursday evening.
[snip]
While Blumenthal didn't attend the invitation-only hearings -- which included testimony from 18 presenters representing varying viewpoints on Lyme disease diagnosis and treatment -- an attorney from his staff was present, and Blumenthal viewed the proceedings through a live Webcast.
"There undoubtedly are individuals or groups who feel either one viewpoint or presenter should have been given more emphasis or time, but that kind of criticism is also healthy no matter who the critics are, because it means that they're watching or scrutinizing the process," Blumenthal said.
But again, an opinionated process is irrelevant to peer-reviewed science and evidence-based medicine.
Lyme advocates hope the IDSA changes its guidelines to allow more liberal
treatment. Doctors who don't believe chronic Lyme disease exists say there simply is no scientific basis to allow it.
The new IDSA panel will now review whether the existing guidelines should be maintained, modified or entirely rewritten, and expects to complete its review by the end of the year.
"The panelists seemed to be listening very intently, asking probing and
perceptive questions, which augers well for the outcome," Blumenthal said.
[snip]
If by outcome Blumenthal means the guidelines are going to be changed by a politician and his fans, then he’s just as delusional as the chronic Lyme activists. I’m sure much of the strange, irrelevant, and anecdotal information submitted to the review panel by the public will only encourage them to retain the existing guidelines intact. Certainly, Carol Baker’s statement doesn’t suggest that anything the panel heard was going to warrant much attention.
Posted by Relative Risk at 09:34 0 comments Links to this post
Labels: Blumenthal, IDSA, LDA, Lyme disease
CALDA, LDA and TFL Press Release on IDSA Hearing
CALDA, the national Lyme Disease Association and Time for Lyme have issued a joint press release regarding the IDSA Lyme review hearing, which is schedule for July 30th in Washington D.C. The release highlights the growing opposition to the IDSA guidelines, the importance of acknowledging the full spectrum of science in Lyme disease, and the importance of permitting clinical judgment and treatment options for patients. Concerns are also raised about the current process, which attorney Lorraine Johnson points out is not impartial because IDSA controls the process and has selected both the panel members and those who may present before the panel. Of critical importance is that fact that no physicians who treat chronic yme disease were selected to sit on the panel. The testimony will be aired live over the internet on July 30th.
Five sentences, six lies. At least the date is true. You’d think Karl Rove helped draft the above paragraph.
First, there is no “growing opposition.” It’s the same several dozen people saying the same things over and over and over, yet failing and failing and failing to provide any evidence for those statements.
Second, the “spectrum of science” is well-known to every scientist who has read or helped to create the body of 30 years of research literature.
Third, no one has outlawed “clinical judgment” (even bad judgment).
Fourth, patients have plenty of options, including finding another doctor.
Fifth, the IDSA doesn’t control the process; the moderator, jointly selected by the IDSA and the weasel attorney, Richard Blumenthal controls the July 30 review.
Sixth, no so-called LLMDs were selected because they have financial conflicts of interest--Something the activists and the LLMDs regularly accuse IDSA physicians and other scientists of having, and having let influence the writing of the IDSA’s treatment guidelines for Lyme disease. Kind of ironic, yes?
The actual press release is just a dense-pack of oft-told lies. I’m not going to pick through it again: having previously discussed much of the Lyme Movement’s junk thought.
In her book, The Age of American Unreason, Susan Jacoby notes the “defining characteristics of junk thought…are anti-rationalism and contempt for countervailing facts and expert opinions.” I suppose that’s why activists like Lorraine Johnson wanted patient and LLMD beliefs presented and represented, and ultimately allowed to affect the conduct and outcome of peer-reviewed science and evidence-based medicine.
Jacoby writes, “Junk thought should not be confused with stupidity or sheer ignorance, because it is often employed by highly intelligent people to mislead and confuse a public deficient in its grasp of logic, the scientific method, and the basic arithmetic required to see through the pretensions of poorly designed studies.”
I don’t know how or where Lorraine Johnson (JD, MBA) and her gaggle of quack MD’s got their respective degrees, but I’ll give them the benefit of doubt and allow that they are smarter than the average “chronic” Lyme sufferer. (Bearing in mind that ‘W’ went to Yale and the Harvard B School.) Having said that, I have to conclude they are regularly and consistently misleading and confusing the public about a common bacterial infection.
The only question is, why?
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Posted by Relative Risk at 01:51 0 comments Links to this post
Labels: IDSA, LDA, Lyme disease
The controversy over Lyme Disease -- whether a chronic form of the disease exists, and whether long-course antiobiotics should be prescribed for those suffering from what they believe are its lingering symptoms -- goes live on the Internet.
…the Infectious Diseases Society of America, which wrote the treatment guidelines for Lyme, will hold a day-long hearing that will be Webcast live through its web site. The hearing is being held in accordance with a settlement of an anti-trust case brought against IDSA by the Connecticut attorney general, who alleged that the treatment guidelines were not drafted fairly and that several members of the drafting panel had conflicts of interests they did not disclose.
Dr. Paul Auwaeter, head of the Division of Infectious Diseases at Johns Hopkins and a member of IDSA, says the suit was politically motivated, that sound medical science has found no evidence of chronic Lyme and that long-term antiobiotic use can be harmful to patients.
Auwaerter, a recent guest on my Midday show, said he doesn't expect any new medical findings to come of the hearing, and he doesn't believe the hearings are even necessary. The IDSA, he said, reluctantly settled with the Connecticut AG, agreed to a new panel and the July 30 hearing to avoid a lengthy and costly legal battle.
There are many Americans who believe they have chronic health problems related to the Lyme Disease they got from a tick bit. They believe that so-called "Lyme-literate" doctors should be allowed to prescribe antibiotics to alleviate their suffering. A recent polemical film, Under Our Skin, suggested that Lyme Disease is responsible for all sorts of conditions that mainstream medicine has ignored and that the disease may even be sexually transmitted.
Since commenting on that film, I've received dozens of e-mails and posted comments [read, hate mail] from people who claim to have the chronic Lyme disease that mainstream medicine says does not exist.
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Posted by Relative Risk at 10:54 0 comments Links to this post
Labels: Film, Internet, Lyme disease, Politics
July 27, 2009, NYT
Is the tick problem getting worse, or does it just seem that way at this time every year?
Fighting back involves a lot of individual strategies: tucking pant legs in socks, using bug spray (while hating it), obsessively doing full-body checks at the end of a summer day and building deer fences. Yet the public as a whole has been ineffective in dealing with the plague of black-legged (deer) ticks, which spread Lyme disease, a problem linked to, among other things, the overpopulation of deer, which the ticks feed on. What is important to know about ticks and their environment, and what steps might be taken to control them?
Thomas Mather, professor of public health entomology
Felicia Keesing biology professor
Richard S. Ostfeld, Cary Institute of Ecosystem Studies
William L. Krinsky, entomologist
Daniel E. Sonenshine, Old Dominion University
Yes, There Are More Ticks
Thomas Mather is a professor of public health entomology at the University of Rhode Island. He directs the Tick Encounter Resource Center, a leading source on tick-bite protection and disease prevention.
Ticks definitely are a bigger problem than 25 years ago. In the northeastern U.S., black-legged (deer) ticks have spread well beyond former coastal haunts; in the southeast, Lone Star ticks are seemingly everywhere. The only good news is that dog ticks are far less common in domestic environments, probably due to wider-spread use of pet spot-on products.
Deer are the most important reproductive hosts for deer ticks.
The observed tick increase relates directly to deer populations, which are exploding in suburban and even semi-urban areas. Deer are the most important reproductive hosts for deer and Lone Star ticks. In Rhode Island, each deer produces about 450,000 larval deer ticks every year. Add a few deer and it’s no wonder that tick populations skyrocket. While the level of deer reduction needed is logistically and politically challenging, one potential solution we are working on is an anti-tick vaccine — to make humans or deer inhospitable tick hosts.
As disease-carrying ticks become more common in the domestic environment, tick bite protection and disease prevention becomes a critical everyday need (at least during spring and summer). Effective everyday tick-bite protection strategies do exist but few people use them regularly.
Until effective broad-spectrum vaccines are found, social marketing may prove most effective at encouraging anti-tick actions. For example, changing the way people dress in summer — wearing clothing with permethrin tick repellent built in — can make protection easy, but this strategy is still not mainstream. Maybe just a few of the thousands of celebrities living within 25 miles of the Route 95 corridor from Washington to Maine could step forward and help out.
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Posted by Relative Risk at 10:44 0 comments Links to this post
Labels: Emerging Infections, Epidemiology, Lyme disease
From the Chronic Lyme disease activist community:
There’s good news for the Lyme community in a House Appropriations bill that just emerged from committee. Although the economic downturn has forced many programs covered by the bill to be reduced or even cut out entirely, the measure actually increases the Lyme disease budget of the Centers for Disease Control. The CDC’s Lyme budget had been dropping in recent years. But the committee’s 2010 appropriations bill calls for an increase of $3.66 million, bringing the CDC’s total Lyme budget to almost $9 million.
Well, that’s a far cry from the $100M/5 year bill the activists have been wanting for years. Sounds like the Lyme and Tick-Borne Disease Prevention, Education, and Research Act of 2007 (H.R. 741/S. 1708) is dead again.
According to a July 20 press release from Frank Wolf’s (R-VA) office the “House Appropriations Committee increased the CDC’s budget for Lyme disease by more than $3.6 million to $8,938,000 as part of the fiscal year 2010 Labor-Health and Human Services-Education spending bill approved last week.”
“The bill also urges the NIH to intensify its research on tick-borne diseases and encourages the agency to ‘support research that may lead to the development or more sensitive and accurate diagnostic tests for Lyme disease.’ In addition, the bill calls for the NIH and the National Institute of Allergy and Infectious Diseases (NIAID) to sponsor a scientific conference on Lyme and other tick-borne diseases. The report language accompanying the bill said ‘the committee believes that the conference should represent the broad spectrum of scientific views on Lyme disease and should provide a forum for public participation and input for public participation and input from individuals with Lyme disease.’”
There’s two qualifiers in there: “urges” and “scientific”. The committee bill--which the House could easily toss into a trash can this year--merely “urges” the NIH to do something. Moreover, it says a “scientific” conference should represent the broad spectrum of “scientific” views, not the wacky opinions of charlatans and naïve patients.
I’m sure CDC will welcome the funds to do some research on diagnostics and some epi on non-burgdorferi species of Borrelia, and other tick-borne pathogens. And it’s been a while since Bethesda has had a Lyme conference. That shouldn’t be too hard to pull off. Keep the planning below the radar, find a small conference room on the fenced, guarded and difficult to access campus, do the science discussion up front and let everyone head back to National and Union Station before the conference degenerates into daytime television.
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Posted by Relative Risk at 15:25 0 comments Links to this post
Labels: Lyme disease, Politics
…and a reminder that, with a few exceptions, the one should not be confused with the other.
Clin. Micro. Rev., July 2009, p. 387–395 Vol. 22, No. 3
Antibiotic Treatment of Animals Infected with Borrelia burgdorferi
Gary P. Wormser and Ira Schwartz
Division of Infectious Diseases, Departments of Medicine and Microbiology and Immunology, New York Medical College
Post-Lyme disease syndrome is sometimes referred to as “chronic Lyme disease,” but this term is poorly defined and is often used to refer to chronic symptoms that are unrelated to Borrelia burgdorferi infection. Although post-Lyme disease syndrome is a topic of considerable interest and controversy, it is important to point out that the principal evidence in support of the existence of this syndrome is derived from older retrospective studies in which the diagnosis and treatment of Lyme disease would not meet current standards.
No prospective treatment study of patients with Lyme disease has been published to prove or disprove that the frequency of such nonspecific symptoms at 6 or 12 months after antibiotic treatment actually exceeds that of the same types of symptoms in individuals without Lyme disease. There is also no convincing evidence that post-Lyme disease syndrome will resolve following additional courses of antibiotic therapy.
Most patients with Lyme arthritis respond well to a 4-week course of oral antibiotic therapy, and PCR testing cannot be carried out after therapy because affected joints are no longer swollen. However, a small subgroup of patients have persistent synovitis for months or even several years after treatment for >2 months with oral antibiotics or for >1 month with intravenous antibiotics, or usually after both types of therapy, a condition which is referred to as antibiotic-refractory Lyme arthritis.
Antibody responses to B. burgdorferi antigens decline similarly in patients with antibiotic-responsive or antibiotic-refractory arthritis, suggesting that spirochetal killing occurs in both groups. Because joint inflammation persists for months after antibiotic treatment, it provides an opportunity to assess the duration of PCR positivity after antibiotic therapy. Of 34 patients with antibiotic-refractory arthritis for whom joint fluid was available after antibiotic therapy, only 2 (6%) had a positive PCR result after 4 to 5 months, and just 1 still had a weakly positive result at 6 months. No one had a positive result after the 6-month time point. Thus, B. burgdorferi DNA may rarely persist in the joints of patients with Lyme arthritis for several months after recommended treatment with oral and/or intravenous antibiotics, but it eventually disappears.
Could the phenomenon of PCR positivity for B. burgdorferi DNA in the absence of culture positivity after antibiotic therapy provide an explanation for post-Lyme disease syndrome, as suggested by Hodzic et al.?
This seems highly unlikely. Clearly the B. burgdorferi cells remaining in animals after antibiotic treatment are biologically different from those in untreated animals. Most importantly, their presence does not elicit a local inflammatory response in mice or dogs, even when the animals are immunocompromised. In addition, the decline in antibody response to B. burgdorferi in animals after treatment suggests a reduction in the overall immunologic response to the spirochete. Since there is no convincing evidence that B. burgdorferi is capable of elaborating a systemic toxin, it is difficult to imagine how residual spirochetes in the absence of a detectable local or generalized immunologic or inflammatory response by the host could lead to chronic subjective symptoms.
…a number of recent studies in which B. burgdorferi-infected animals were treated with antibiotic therapy have demonstrated the presence of PCR positivity in the absence of culture positivity. A serious methodological concern with most of these studies is the failure to consider adequately the pharmacokinetic-pharmacodynamic properties of the antibiotic in choosing the dosage regimen used.
In mice that have been treated with antibiotic therapy, residual spirochetes can be taken up by ticks during a blood meal, at least for the first several months after treatment, and can be transmitted to SCID mice. The biological nature of these spirochetes is unclear.
Evidence indicates that they are nonpathogenic. Whether the lack of pathogenicity is simply related to low numbers of residual spirochetes or is due to a more fundamental genotypic or phenotypic alteration is unknown. It is also unknown whether the lack of pathogenicity is irreversible. Since in the mouse studies the number of spirochetes is declining over time, a reasonable conjecture is that they are in the process of dying. There is no scientific evidence to support the hypothesis that such spirochetes, should they exist in humans, are the cause of post-Lyme disease syndrome.
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Posted by Relative Risk at 01:17 0 comments Links to this post
Labels: Lyme disease