Responses to IDSA/CDC
As Destructive to the
Public Health
As An F-5 Tornado
Lucy Barnes
What the "so-called experts" say just isn't so. Some examples...
When standard treatment (IDSA guidelines) is provided for Lyme patients there will be no resulting fibromyalgia like symptoms, no cyst forms/variants of Lyme, no lasting fatigue, no additional treatment needed and no deaths as a result of Lyme. FALSE
There are no false negative tests, no Bartonella in ticks, no chronic co-infections (Babesia, anaplasmosis, ehrlichiosis), no chance to be coinfected with Lyme and Bartonella at the same time, no Lyme/autism link possible, and… "patients treated for early Lyme disease develop protective immunity that is strain specific and lasts for at least 6 years.” FALSE
Lyme neuroborreliosis can resolve by itself without any treatment, a single dose of antibiotic is successful in preventing Lyme disease after a tick bite in an endemic area, and NINE year old medical treatment guidelines are acceptable. FALSE
All of the above conclusions (all false), mostly derived from tax-payer funded studies, are STILL being brought you to by Gary Wormser, Dattwyler, Nadleman, Nowakowski, Auwaerter, Paul Mead (CDC), Klempner, Baker, Shapiro, Halperin and/or Schwartz (listed as authors).
This war has got to stop!
Arthritis Rheumatol. 2014 Dec 2. doi: 10.1002/art.38972. [Epub ahead of print]
Long-Term Assessment of Fibromyalgia in Patients with Culture-Confirmed LymeDisease.
Wormser GP1, Weitzner E, McKenna D, Nadelman RB, Scavarda C, Farber S, Prakash P, Ash J, Nowakowski J.
1Divisions of Infectious Diseases, New York Medical College, Valhalla, NY, 10595.
Abstract
Background: Fibromyalgia occurs in 2% to 8% of the general population. One of the triggers may be Lymedisease. Methods: Patients with culture-confirmed Lyme disease who originally presented with erythema migrans have been evaluated annually in a prospective study to determine their long-term outcome. In 2011-2013, subjects were evaluated for fibromyalgia by interview and tender point examination. Results: 100 subjects were assessed, 52% of whom were male; the mean age was 64.9 years (median 64 years, range 42-86 years). The mean duration of follow-up was 15.4 years (median 16 years, range 11-20 years). At least twenty-four (24%) subjects had experienced a second episode of erythema migrans before the evaluation for fibromyalgia. One patient (1%, 95% C.I.: 0.025 to 5.4%) met criteria for fibromyalgia. The symptoms consistent with fibromyalgiabegan more than 19 years after Lyme disease was diagnosed. Conclusions: Fibromyalgia was observed in only 1% of 100 patients with culture-confirmed early Lyme disease, a frequency consistent with that found for the general population. This article is protected by copyright. All rights reserved.
Copyright © 2014 American College of Rheumatology.
Clin Infect Dis. 2014 Mar;58(5):663-71. doi: 10.1093/cid/cit810. Epub 2013 Dec 12.
A systematic review of Borrelia burgdorferi morphologic variants does not support a role in chronic Lyme disease.
Lantos PM1, Auwaerter PG, Wormser GP.
1Departments of Internal Medicine and Pediatrics, Duke University School of Medicine, Durham, North Carolina.
Abstract
BACKGROUND:
Much of the controversy that surrounds Lyme disease pertains to whether it produces prolonged, treatment-refractory infection, usually referred to as chronic Lyme disease. Some have proposed that round morphologic variants of Borrelia burgdorferi, known variably as "cyst forms" and "L-forms," are responsible for the pathogenesis of chronic Lyme disease. We have undertaken a systematic review of the literature to determine if there is a documented role of these variants in Lyme disease pathogenesis or in syndromes compatible with chronic Lyme disease.
METHODS:
Two systematic literature searches were performed to identify studies in which round morphologic variants of B. burgdorferi have been described in situ in human specimens.
RESULTS:
Our primary literature search identified 6 studies that reported round morphologic variants of B. burgdorferi in specimens obtained from 32 total patients. No study described these forms in patients who had purely subjective symptom complexes (eg, fatigue or pain). No study investigated a causal relationship between morphologic variants and clinical disease or evaluated treatment of morphologic variants in vivo. Of 29 additional studies that described the morphology of B. burgdorferi from patients with Lyme disease, the organism was invariably described as having spirochetal morphology.
CONCLUSIONS:
In the context of the broader medical literature, it is not currently possible to ascribe a pathogenic role to morphologic variants of B. burgdorferi in either typical manifestations of Lyme disease or in other chronic disease states that are often labeled chronic Lyme disease. There is no clinical literature to justify specific treatment of B. burgdorferi morphologic variants.
KEYWORDS:
Borrelia; L-form; Lyme disease; cyst; spheroplast
PMID:
24336823
[PubMed - in process] PMCID:
PMC3922218 [Available on 2015-03-01]
Am J Med. 2015 Feb;128(2):181-4. doi: 10.1016/j.amjmed.2014.09.022. Epub 2014 Oct 15.
Long-term Assessment of Fatigue in Patients with Culture-confirmed Lyme Disease.
Wormser GP1, Weitzner E2, McKenna D2, Nadelman RB2, Scavarda C2, Nowakowski J2.
2Division of Infectious Diseases, New York Medical College, Valhalla.
Abstract
BACKGROUND:
Fatigue is a common symptom with numerous causes. Severe fatigue is thought to be an important manifestation of post-treatment Lyme disease syndrome. The frequency with which severe fatigueoccurs as a long-term sequela in prospectively followed patients with Lyme disease is unknown.
METHODS:
Patients with culture-confirmed Lyme disease who originally presented with erythema migrans have been evaluated annually in a prospective study to determine their long-term outcome. In 2011-2013, subjects were evaluated for fatigue using an 11-item Fatigue Severity Scale (FSS-11) that has been used in studies of post-treatment Lyme disease syndrome. An FSS-11 score of ≥4.0 is indicative of severe fatigue.
RESULTS:
A total of 100 subjects were assessed, 52% of whom were male; the mean age was 64.9 years (range, 42-86 years). The mean duration of follow-up was 15.4 years (range, 11-20 years). Nine subjects had severe fatigue but in none as a consequence of Lyme disease. Only 3 subjects were thought to possibly have persistent fatigue from Lyme disease. The FSS-11 value for these 3 individuals was less than 4, averaging 2.27, and none had functional impairment.
CONCLUSIONS:
Severe fatigue was found in 9 patients (9%) with culture-confirmed early Lyme disease at 11 to 20 years after presentation, but was due to causes other than Lyme disease. Fatigue of lesser severity was possibly due to Lyme disease, but was found in only 3% of 100 patients, and therefore is rarely a long-term complication of this infection.
Copyright © 2015 Elsevier Inc. All rights reserved.
Clin Infect Dis. 2011 Feb 1;52(3):364-7. doi: 10.1093/cid/ciq157. Epub 2010 Dec 28.
A review of death certificates listing Lyme disease as a cause of death in the United States.
Kugeler KJ1, Griffith KS, Gould LH, Kochanek K, Delorey MJ, Biggerstaff BJ, Mead PS.
Abstract
Lyme disease was listed as an underlying or multiple cause of death on 114 death records during 1999-2003. Upon review, only 1 record was consistent with clinical manifestations of Lyme disease. This analysis indicates that Lyme disease is rare as a cause of death in the United States.
Am J Med. 2014 Nov;127(11):1105-10. doi: 10.1016/j.amjmed.2014.05.036. Epub 2014 Jun 12.
Chronic coinfections in patients diagnosed with chronic lyme disease: a systematic review.
Lantos PM1, Wormser GP2.
1Division of Pediatric Infectious Diseases, Duke University School of Medicine, Durham, NC; Division of General Internal Medicine, Duke University School of Medicine, Durham, NC. Electronic address: Paul.lantos@duke.edu.
2Division of Infectious Diseases, New York Medical College, Valhalla.
Abstract
PURPOSE:
Often, the controversial diagnosis of chronic Lyme disease is given to patients with prolonged, medically unexplained physical symptoms. Many such patients also are treated for chronic coinfections with Babesia, Anaplasma, or Bartonella in the absence of typical presentations, objective clinical findings, or laboratory confirmation of active infection. We have undertaken a systematic review of the literature to evaluate several aspects of this practice.
METHODS:
Five systematic literature searches were performed using Boolean operators and the PubMed search engine.
RESULTS:
The literature searches did not demonstrate convincing evidence of: 1) chronic anaplasmosis infection; 2) treatment-responsive symptomatic chronic babesiosis in immunocompetent persons in the absence of fever, laboratory abnormalities, and detectable parasitemia; 3) either geographically widespread or treatment-responsive symptomatic chronic infection with Babesia duncani in the absence of fever, laboratory abnormalities, and detectable parasitemia; 4) tick-borne transmission of Bartonella species; or 5) simultaneous Lyme disease and Bartonella infection.
CONCLUSIONS:
The medical literature does not support the diagnosis of chronic, atypical tick-borne coinfections in patients with chronic, nonspecific illnesses.
Copyright © 2014 Elsevier Inc. All rights reserved.
Am J Med. 2013 Aug;126(8):665-9. doi: 10.1016/j.amjmed.2013.02.014. Epub 2013 Jun 10.
Treatment trials for post-Lyme disease symptoms revisited.
Klempner MS1, Baker PJ, Shapiro ED, Marques A, Dattwyler RJ, Halperin JJ, Wormser GP.
Abstract
The authors of 4 National Institutes of Health-sponsored antibiotic treatment trials of patients with persistent unexplained symptoms despite previous antibiotic treatment of Lyme disease determined that retreatment provides little if any benefit and carries significant risk. Two groups recently provided an independent reassessment of these trials and concluded that prolonged courses of antibiotics are likely to be helpful. We have carefully considered the points raised by these groups, along with our own critical review of the treatment trials. On the basis of this analysis, the conclusion that there is a meaningful clinical benefit to be gained from retreatment of such patients with parenteral antibiotic therapy cannot be justified.
Copyright © 2013 Elsevier Inc. All rights reserved.
KEYWORDS:
Borrelia burgdorferi; Clinical trials; Lyme disease; Post-Lyme disease syndrome
Comment in
Potential benefits of retreatment highlight the need for additional Lyme disease research. [Am J Med. 2014]
Ongoing discussion about the US clinical Lyme trials. [Am J Med. 2014]
The reply. [Am J Med. 2014]
Semin Neurol. 1997 Mar;17(1):45-52.
Treatment and prevention of Lyme disease, with emphasis on antimicrobial therapy for neuroborreliosis and vaccination.
1Division of Infectious Diseases, New York Medical College, Valhalla, USA.
Abstract
Antibiotic therapy is recommended for all forms of neuroborreliosis. Although stage 2 neuroborreliosis will usually resolve without any treatment, antibiotic therapy has been associated with faster resolution of symptoms and may prevent additional non-neurologic disease manifestations. Ceftriaxone is the most convenient parenteral agent for stage 2 and 3 neuroborreliosis because of its once-daily dosage. Available data indicate that a 2-4-week treatment course is adequate for most patients. Patients with isolated seventh nerve palsy may be treated with an oral agent (for example, doxycycline). Recombinant outer surface protein A of Borrelia burgdorferi is a highly protective immunogen for prevention of Lyme disease in experimental animals. Humoral immunity is sufficient for protection. A recombinant OspA vaccine has been licensed for prevention of Lyme disease in dogs. Licensure of an OspA vaccine for humans will depend on a critical analysis of the results of recently completed efficacy studies.
PMID:
9166959 [PubMed - indexed for MEDLINE]
Infect Immun. 2014 Apr;82(4):1408-13. doi: 10.1128/IAI.01451-13. Epub 2014 Jan 13.
Evidence for strain-specific immunity in patients treated for early lyme disease.
Khatchikian CE1, Nadelman RB, Nowakowski J, Schwartz I, Wormser GP, Brisson D.
Abstract
Lyme disease, caused by Borrelia burgdorferi, is the most commonly reported vector-borne disease in the United States. Many patients treated for early Lyme disease incur another infection in subsequent years, suggesting that previous exposure to B. burgdorferi may not elicit a protective immune response. However, identical strains are almost never detected from patients who have been infected multiple times, suggesting that B. burgdorferi exposure may elicit strain-specific immunity. Probabilistic and simulation models assuming biologically realistic data derived from patients in the northeastern United States suggest that patients treated for early Lyme disease develop protective immunity that is strain specific and lasts for at least 6 years.
PMID:
24421042
Last Updated- February 2019
Lucy Barnes