Wednesday 23 December 2015

LYME DISEASE- BRITISH MEDICAL JOURNAL- TIME FOR A NEW APPROACH

Lyme disease: time for a new approach?

BMJ 2015351 doi: http://dx.doi.org/10.1136/bmj.h6520 (Published 03 December 2015)Cite this as: BMJ 2015;351:h6520

Many more questions than answers
Lyme disease is the most common vector borne disease in North America and Europe, with 300 000 new cases in the United States1 and an estimated 100 000 new cases in Europe each year.2 These numbers are likely to be underestimates because case reporting is inconsistent3 and many infections go undiagnosed.4 Climate change may have contributed to a rapid increase in tick borne diseases, with migratory birds disseminating infected ticks.5
Our common understanding of Lyme disease is that a tick bite is followed by the development of a classic rash pattern (erythema migrans). When treated early with a relatively short course of antibiotics, most patients have good outcomes.6 But the standard two tier testing for Lyme disease is inaccurate in the early----

  1. Liesbeth Borgermans, professor
  2. Christian Perronne, professor
  3. Ran Balicer, professor 
  4. Ozren Polasek, professor 
  5. Valerie Obsomer, ecological and environmental risk expert

  6. http://www.bmj.com/content/351/bmj.h6520  


  7. Unfortunately this is not open access but the heading and brief introduction says it all we need a new and open approach.


  8. Sometimes it is the responses which are as enlightening as the initial publications these can be read
  9.  

  10.  http://www.bmj.com/content/351/bmj.h6520/rapid-responses


    From doctors who treat many patients and doctors who struggle to get family members treated and one that interested me from Dr Dryden -
 Consultant in infection and microbiology 
Hampshire Hospitals NHS Foundation Trust & RIPL, PHE, Porton Royal Hampshire County Hospital, Winchester, SP11 6NU 
  1.  'Much research is needed on this group, as outlined in the editorial, but most urgently there needs to be research on diagnosis to establish whether persisting infection is present in some of the patients with persisting chronic symptoms. This will allow the development of more appropriate treatments for this group. It will also save the anguish and confusion that many patients experience when forced to spend money on tests which have not been clinically validated.' 

  2. Do I sense a slight change in Dr Dryden's views? 


  3. What a pity Dr Dryden has recently closed his private clinic for treating Lyme patients which with the help of his doctor colleague was at last making in roads into helping a handful of the many patients, who had been dismissed by their NHS doctors with no medical help for their illness following tick bites.


  4. Time PHE got their act together and opened specialty clinics to learn the best ways to treat these patients.


  5. PHE empty promises could if put into practice save NHS valuable resources for this patient group as well as help alleviate suffering of many thousands of patients.



  6. Prof Perronne has given his views many times at various conferences, published papers and press articles 

Lyme and associated tick-borne diseases: global challenges in the context of a public health threat

Christian Perronne Infectious Diseases Unit, Hôpitaux Universitaires Paris-Ile de France-Ouest, Assistance Publique – Hôpitaux de Paris, University of Versailles – Saint Quentin en Yvelines, Garches, France
  1. http://journal.frontiersin.org/article/10.3389/fcimb.2014.00074/full

Lyme disease antiscience.
Perronne C.
Lancet Infect Dis. 2012 May;12(5):361-2; author reply 362-3. doi: 10.1016/S1473-3099(12)70053-1. No abstract available.
Efficacy of a long-term antibiotic treatment in patients with a chronic Tick Associated Poly-organic Syndrome (TAPOS).
Clarissou J, Song A, Bernede C, Guillemot D, Dinh A, Ader F, Perronne C, Salomon J.
Med Mal Infect. 2009 Feb;39(2):108-15. doi: 10.1016/j.medmal.2008.11.012. Epub 2009 Jan 4.

And a Newspaper article Lyme Disease- you may never be rid of it. 

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