Britain’s leading medical publication, the British Medical Journal (BMJ), called for more research and a complete re-examination of all the evidence on Lyme Disease in its December 12th edition (page 8).
The widely respected medical journal pointed out that the medical community has recently been “forced out of its comfort zone on Lyme disease” by the increasing evidence of the complexity of this multi-systemic disease.
Cases seriously under-reported
The article, by doctors and professors from teaching hospitals and universities in France, Belgium, Israel and the UK, opened by stating that 100,000 new cases of Lyme disease are reported each year in Europe, and 300,000 in the US.
“These numbers are likely to be underestimates because case reporting is inconsistent and many infections go undiagnosed,” the authors commented.
Testing is inaccurate
Cases which are diagnosed and treated early often have positive outcomes, the article stated, but then went on to report:
“But the standard two tier testing for Lyme disease is inaccurate in the early stages, and many patients and doctors fail to recognise the rash. Patients who present with the later stages of the disease can also be easily dismissed because the two tier testing lacks sensitivity and cannot distinguish between current and past infection.”
Two-tier testing involves initially testing patients with an ELISA blood test. If this is negative, the patient is considered not to have Lyme disease. If the result is positive or equivocal, they are then tested with a Western blot blood test. If that test is also positive, they are officially diagnosed with Lyme disease but if it is negative, they are often told they simply have antibodies from a past infection. (clarify whether it’s because ELISA is positive that patients are told they have a past infection or whether it’s because they have some positive bands on a Western blot but not enough to be considered an overall positive).
A lack of available resources for patient care
The article, whose authors include Professor Liesbeth Borgermans, Professor Christian Perronne, Professor Ran Balicer, Professor Ozren Polacek and Valerie Obsomer, also highlighted problems with follow-on medical care:
“Most patients will present to family physicians, who often have few subsequent resources when the initial treatment proves unsuccessful.”
Much harder to cure than previously thought
One of the popular myths about Lyme disease is that it is ‘hard to catch and easy to cure’. This complacent stance is no longer tenable in light of the weighty and growing evidence suggesting the contrary.
“Recent evidence shedding light on how spirochaetes of the borrelia genus evade host immune defences and survive antibiotic challenge threaten current beliefs about the persistence of infection, one of the largest points of contention in the medical community.”
Heads cannot stay buried in the sand
The article concludes by comparing some of the current attitudes towards Lyme disease with the resistance to change within the medical establishment following the discovery of the true bacterial cause of stomach ulcers.
“Previous examples in medical history, such as the delayed recognition of the role of helicobacter pylori in gastric disease, have shown the consequences of ignoring findings that contradict our current beliefs about a disease.”
An agenda for future research
Caudwell LymeCo wholeheartedly supports the agenda for new research proposed in the BMJ:
“TICK BOX: RESEARCH AGENDA
• Range of clinical presentations, including between sexes
• Diagnostic criteria and tools
• Treatments and their efficacy
• Transmission modes and vectors
• Role of coinfections
• Uncertainty over clinical definition of chronic Lyme disease and whether detection of active infection is essential
• Whether and for how long the pathogen can persist
• Role of psychoneuroimmunology, host-pathogen interactions, and autoimmunity to residual or persisting antigens
• Role of toxins or other bacterial products in symptoms and signs
• Contribution of environmental factors”