Anything But Lyme Syndrome (ABLS)
Invalid Due To Lab Contamination
No such thing as "chronic Lyme disease"
QUOTE- "Similar symptoms are also common in persons in the general population who never had Lyme disease, regardless of whether they reside in a geographic area that is endemic for Lyme disease [3,5,7,8]. Not infrequently, such patients are labeled as having “chronic Lyme disease” and are treated with long-courses of antibiotic therapy [5]. In addition to never having had an objective clinical manifestation of Lyme disease, such patients typically are seronegative for antibodies to Borrelia burgdorferi sensu stricto by Centers for Disease Control and Prevention (CDC)-defined interpretative criteria and United States Food and Drug Administration-approved laboratory tests [3,5]."
QUOTE- "Those who believe that “chronic Lyme disease” is a real entity have made extensive efforts to try to document the existence of viable Lyme borrelia in these patients. Among the approaches used have been attempts to cultivate B. burgdorferi sensu stricto from the blood of these patients, despite the fact that such individuals have often already been treated extensively with antibiotics for Lyme disease and despite evidence from other studies that spirochetemia in patients with Lyme disease is usually detectable only at the very earliest stages of untreated infection [9]."
QUOTE- "The authors did state that none of the patients had received antibiotic therapy within the 4 weeks prior to collection of the blood samples. Investigators from the CDC analyzed genetic sequencing data of the isolates said to be recovered using this technique and found that most were not B. burgdorferi sensu stricto [17,18], making the results highly implausible, as infection with Lyme borrelia species other than sensu stricto has not been documented in North America, aside from a very small number of infections due to B. mayonii [19]. The findings of this study were most consistent with laboratory contamination [17,18]."
QUOTE- "The authors' laboratory had previously isolated and investigated numerous strains of B. burgdorferi sensu stricto, as well strains of B. bissettii-like spirochetes, from non-human sources [20-22], raising the question of whether the current findings could have been attributable to laboratory contamination."
QUOTE- "In conclusion, all of the reviewed reports that claimed to have had patients with positive blood cultures for Lyme borrelia, including two studies that employed novel techniques for which no clear rationale exists, are unconvincing [12-18]. The finding of positive blood cultures in patients with chronic non-specific symptoms, in seronegative patients from non-endemic areas for Lyme disease, or in patients previously treated with antibiotics for the illness that prompted performance of the blood culture (an illness referred to as Lyme disease by the study authors), are likely to be invalid. "
Link Here
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5657585/
A Critical Appraisal of “Chronic Lyme Disease”
QUOTE- "Chronic Lyme disease is the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections. Other examples that have now lost credibility are “chronic candida syndrome” and “chronic Epstein–Barr virus infection.”
The assumption that chronic, subjective symptoms are caused by persistent infection with B. burgdorferi is not supported by carefully conducted laboratory studies or by controlled treatment trials.
Chronic Lyme disease, which is equated with chronic B. burgdorferi infection, is a misnomer, and the use of prolonged, dangerous, and expensive antibiotic treatments for it is not warranted."
QUOTE- "The focus of this review, however, is not the objective manifestations of late Lyme disease but rather the imprecisely defined condition referred to as “chronic Lyme disease.”
This term is used by a small number of practitioners (often self-designated as “Lyme-literate physicians”) to describe patients whom they believe have persistent B. burgdorferi infection, a condition they suggest requires long-term antibiotic treatment and may even be incurable.
Although chronic Lyme disease clearly encompasses post–Lyme disease syndrome, it also includes a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection.
Chronic Lyme disease is used in North America and increasingly in Europe as a diagnosis for patients with persistent pain, neurocognitive symptoms, fatigue, or all of these symptoms, with or without clinical or serologic evidence of previous early or late Lyme disease.
How should clinicians handle the referral of symptomatic patients who are purported to have chronic Lyme disease? The scientific evidence against the concept of chronic Lyme disease should be discussed and the patient should be advised about the risks of unnecessary antibiotic therapy. The patient should be thoroughly evaluated for medical conditions that could explain the symptoms. If a diagnosis for which there is a specific treatment cannot be made, the goal should be to provide emotional support and management of pain, fatigue, or other symptoms as required.
Explaining that there is no medication, such as an antibiotic, to cure the condition is one of the most difficult aspects of caring for such patients. Nevertheless, failure to do so in clear and empathetic language leaves the patient susceptible to those who would offer unproven and potentially dangerous therapies. Additional advice to clinicians is included in the Supplementary Appendix, available with the full text of this article at www.nejm.org.
Physicians and laypeople who believe in the existence of chronic Lyme disease have formed societies, created charitable foundations, started numerous support groups (even in locations in which B. burgdorferi infection is not endemic), and developed their own management guidelines.
Scientists who challenge the notion of chronic Lyme disease have been criticized severely."
T h e New England Journal of Medicine- October 4, 2007
A Critical Appraisal of “Chronic Lyme Disease”
Henry M. Feder, Jr., M.D., Barbara J.B. Johnson, Ph.D., Susan O’Connell, M.D., Eugene D. Shapiro, M.D., Allen C. Steere, M.D., Gary P. Wormser, M.D., and the Ad Hoc International Lyme Disease Group*
Link Here https://www.researchgate.net/publication/5931063_A_Critical_Appraisal_of_Chronic_Lyme_Disease
2014- Borrelia burgdorferi (Lyme Disease)
QUOTE- "There is substantial evidence that there is no such entity as chronic Lyme disease. Indeed, there is not even a case definition for chronic Lyme disease.
There are many websites that contain misinformation about Lyme disease that only enhance the already inflated and inaccurate fears about the consequences of Lyme disease of many parents and patients.
Many patients labeled as having chronic Lyme disease actually have medically unexplained symptoms. Such patients are best treated symptomatically rather than with prolonged courses of antimicrobial therapy, which have been associated with serious adverse effects and little or no benefit.
It is important to acknowledge that the patient has symptoms even if they are not due to Lyme disease. Forming a therapeutic alliance with the patient and instituting a program of exercise and other strategies designed to help the patient cope with the symptoms often is the most productive approach."
QUOTE- "Although the annual number of cases of Lyme disease have been reported to be as high as 300,000, information about the true incidence of the disease is complicated by reliance on passive reporting of cases and the high frequency of misdiagnosis and false-positive serologic test results. "
QUOTE- "Several studies designed to assess the potential link between Lyme disease during pregnancy and congenital infection with B burgdorferi found no documented B burgdorferiinfections of the fetus or infant.
Additional studies found no difference in birth outcomes between seropositive and seronegative pregnant women. Likewise, a survey of pediatric neurologists in endemic areas found no evidence of any credible cases of congenital Lyme disease. Transmission of Lyme disease via breastfeeding has also not been documented."
QUOTE- "Antibody tests for Lyme disease should not be used as screening tests. Unfortunately, because many laypersons (as well as physicians) have the erroneous belief that chronic, nonspecific symptoms alone (eg, fatigue or arthralgia) may be manifestations of Lyme disease, patients with only nonspecific symptoms are frequently tested for Lyme disease.
Lyme disease will be the cause of the nonspecific symptoms in few such patients, if any. However, because the specificity of even the best antibody tests for Lyme disease is nowhere near 100%, many of the test results in patients without specific signs of Lyme disease will be falsely positive (Table 2).
Nevertheless, an erroneous diagnosis of Lyme disease frequently is made, and such patients often are treated with antimicrobials unnecessarily.
Even though a symptomatic patient has a positive serologic test result for antibodies to B burgdorferi, it is possible that Lyme disease may not be the cause of that patient's symptoms."
Link Here
https://pedsinreview.aappublications.org/content/35/12/500
2013- Lyme Disease
QUOTE- "Persistent symptoms after therapy are most often due to misdiagnosis rather than treatment failure. Although Lyme disease is a public health concern, extensive publicity has resulted in a degree of anxiety about Lyme disease that is out of proportion to the actual morbidity that it causes."
QUOTE- "Small numbers of case reports, most of which involved women with unrecognized and untreated Lyme disease during their pregnancies, suggested B. burgdorferi may be transmitted across the placenta and that congenital Lyme disease was associated with poor outcomes [15].
Although spirochetes compatible with B. burgdorferi were seen in pathologic specimens, B. burgdorferi was never isolated in culture from any of these cases.
Several subsequent studies, designed to assess the potential link between Lyme disease during pregnancy and congenital infection with B. burgdorferi, found no documented B. burgdorferiinfections of either the fetus or the infant [16]. Additional studies found no difference in birth outcomes comparing seropositive and seronegative pregnant women [17,18]. Likewise, a survey of neurologists in endemic areas found no evidence of any credible cases of congenital Lyme disease [19].
Transmission of Lyme disease via breast-feeding has also not been documented."
QUOTE- "Antibody tests for Lyme disease should not be used as screening tests [50,51]. Unfortunately, because many lay persons (as well as physicians) have the erroneous belief that chronic, nonspecific symptoms alone (e.g., fatigue or arthralgia) may be manifestations of Lyme disease, patients with only nonspecific symptoms are frequently tested for Lyme disease. Lyme disease will be the cause of the nonspecific symptoms in very few such patients, if any. However, because the specificity of even the best antibody tests for Lyme disease is nowhere near 100%, some of the test results in patients without specific signs or symptoms of Lyme disease will be falsely positive (Table 2) [50,51]. Nevertheless, an erroneous diagnosis of Lyme disease frequently is made and such patients often are treated unnecessarily with antimicrobials [52]."
QUOTE- "Clinicians should realize that even though a symptomatic patient has a positive serologic test result for antibodies to B. burgdorferi, it is possible that Lyme disease may not be the cause of that patient’s symptoms."
QUOTE- "Physicians should not routinely order antibody tests for Lyme disease either for patients who have not been in endemic areas or for patients with only nonspecific symptoms."
QUOTE- "The long-term prognosis for individuals who are treated with appropriate antimicrobial therapy for Lyme disease, regardless of the stage of the disease, is excellent. The most common reason for a lack of response to appropriate antimicrobial therapy for Lyme disease is misdiagnosis (i.e., the patient actually does not have Lyme disease).
Nonspecific symptoms (such as fatigue, arthralgia or myalgia) may persist for several weeks even in successfully treated patients with early Lyme disease; their presence should not be regarded as an indication for additional treatment with antimicrobials.
These symptoms usually respond to non-steroidal anti-inflammatory agents. Within a few months of completing the initial course of antimicrobial therapy, these vague, nonspecific symptoms will usually resolve without additional antimicrobial therapy.
For those unusual patients who have persistent symptoms more than six months after the completion of antimicrobial therapy, an attempt should be made to determine if these symptoms are the result of a post-infectious phenomena or of another illness."
QUOTE- "Consequently, routine use of antimicrobial agents to prevent Lyme disease in persons who are bitten by a deer tick, even in highly endemic areas, is not generally recommended because the overall risk of Lyme disease is low (1-3%), only doxycycline (which is not recommended for children < 8 years of age) has been shown to be effective and treatment for Lyme disease, if it does develop, is very effective [62]."
Link Here
2017- False and Misleading Information About Lyme Disease
QUOTE- "Many patients with symptoms attributed to chronic Lyme disease likely come from these groups that share similar symptoms and personal experiences.3 Although there are multiple definitions of chronic Lyme disease,3 we are using the term to refer to patients with persistent, unexplained subjective symptoms, with no documented history of Lyme disease and without credible laboratory evidence – past or present – of infection with Borrelia burgdorferi, the bacterium that causes Lyme disease."
QUOTE- "Health care providers who diagnose chronic Lyme disease question the reliability of 2-tier antibody-based tests for Lyme disease approved by the Food and Drug Administration (FDA)"
QUOTE- "It is highly implausible that either patients with chronic Lyme disease or patients who had Lyme disease and have posttreatment symptoms, who are seronegative, who have no objective findings, and who have already been treated extensively with antibiotics would have cultivable B. burgdorferi in their blood. Nevertheless, fake research has been used to support this notion."
QUOTE- "Fake blood cultures are not the only false tests that have been used to support a misdiagnosis of Lyme disease."
QUOTE- "False and misleading information about Lyme disease is not restricted to fake diagnoses, fake diagnostic tests, or fake laboratory research."
QUOTE- "Unfortunately, the news media sensationalizes controversial aspects of patients' stories that they consider “newsworthy” under the guise of increasing “Lyme awareness.”
Media-sponsored public discussions often use a format based on “false equivalency” in which emotional arguments and unproven opinions are given the same weight as the results of rigorous, evidence-based scientific research; obviously, it is incumbent upon all participants in such discussions to provide sufficient evidence to support the statements and claims they make."
QUOTE- "Politicians are attempting to displace mainstream physicians as diagnosticians in the complex world of Lyme disease by passing legislation that encourages the use of unproven treatments and that requires health insurance companies to pay for unsafe remedies with no documented benefit and well-documented adverse effects.
This makes it difficult for medical review boards to safeguard public health by disciplining those who put patients at risk. It also increases the cost of health care without tangible benefits.
The real shame in all of this is that the time, attention, and resources that are being misdirected could be better spent on research that is designed to address, to understand, and to try to remedy the problems that these patients have. By so doing, we might begin to improve the lives of those who are genuinely and indisputably suffering – just not from Lyme disease."
Link Here
https://www.amjmed.com/article/S0002-9343(17)30138-9/fulltext