ILADS vs IDSA ~ The Lyme Wars
How is it possible that the opinions of 2% of the medical community is dominating the beliefs and practices of the mass majority of practicing physicians? POWER!!!
Those few individuals with the power to influence our governing and academic bodies are using and abusing their positions to promote and propagate their personal views and opinions regardless of the SCIENCE to the contrary. To review a comparision document between the two opposing organizations' guidelines:
Below is the current debate being waged between the opposing sides:
The political battle over Lyme disease features two polarized medical camps: the dominant camp adheres to the philosophy that the disease is ‘hard to catch and easy to cure’, and that chronic infection with Borrelia burgdorferi, the spirochetal agent of Lyme disease, is extremely rare or nonexistent. The opposing camp views Lyme disease as an underreported and growing menace that often fails to respond to standard antibiotic therapy, resulting in a chronic debilitating infection that requires prolonged antibiotic treatment. This difference of opinion has resulted in frequent denial of treatment for patients with chronic Lyme disease and prosecution of healthcare providers who treat these patients, and over the past decade the ‘Lyme Wars’ have become progressively more acrimonious.
...What sustains this controversy? It is important to recognize that the science of Lyme disease suffers from two major problems. First, there is no test currently available that proves the eradication of B. burgdorferi from the human body. Conversely, there is growing evidence for long-term persistence of the Lyme disease spirochete in animal models and humans, despite supposedly adequate treatment for the disease with 2 to 4 weeks of antibiotics.
Authors: Raphael B Stricker, Andrew Lautin and Joseph J Burrascano
Published: Expert Rev. Anti Infect. Ther., April 2005, Vol.3, No.2, Pgs 155-165
Source: www.future-drugs.com or
The Two Standards of Care
Lyme Disease: Two Standards of Care
By Lorraine Johnson, JD, MBA Executive Director, CALDA
Updated February, 2005
Opinion within the medical community is deeply divided regarding the best approach for treating Lyme disease, particularly persistent Lyme disease that is not cured by short-term protocols. This split has resulted in two standards of care. Both viewpoints are reflected in peer-reviewed, evidence-based guidelines. Some physicians treat patients for 30 days only and assume that remaining symptoms reflect a self-perpetuating autoimmune response. Other physicians assume that the persistent symptoms reflect on-going infection and gauge the duration of treatment by the patient's individual clinical response. These physicians believe that there is insufficient evidence at this point to adopt standardized treatment protocols.
Guidelines: Comparision of Facts vs Opinions
Recently IDSA (Infectious Disease Society of America) released their revised guidelines on Lyme Disease which was electronically published in the medical journal Clinical Infectious Diseases. IDSA has long held the position that Lyme Disease is easily diagnosed and must present the classic bullseye rash, is easily treatable and can basically be cured with less than a month’s worth of antibiotics, and that Chronic Lyme does not exist nor has the disease spread to the southern states. And why shouldn’t they have such beliefs… after all their board of directors consist of government employees and academics at major medical universities rather than actual doctors dealing with the diseases face-to-face with the patients. IDSA’s 2006-2007 Board of Directors includes:
Henry Masur, MD, FIDSA, President (employed by National Institutes of Health, Bethesda, MD)
Anne Gershon, MD, FIDSA, Vice President (employed by Columbia University College of Physicians, New York, NY)
Barbara E. Murray, MD, FIDSA, Secretary-Treasurer (employed by University of Texas Medical School, Houston, TX)
James M. Hughes, MD, FIDSA (employed by Emory University, Atlanta, GA)
Martin J. Blaser, MD, FIDSA, Past President (employed by New York University School of Medicine, New York, NY)
In response, ILADS (International Lyme and Associated Diseases Society) issued a formal request of RETRACTION in their October 25, 2006 letter to the Editor of Clinical Infectious Diseases regarding the journal's publication of IDSA's recently revised guidelines...
...The attached analysis of key points in the Lyme guidelines article demonstrates that the authors of the article made statements that either reflected significant selection bias of published data or ignored published evidence that conflicted with their opinions.
Nowhere is this more apparent than in Dr. Klempner’s analysis of the three NIH-funded Lyme treatment studies, which elevates and relies on the findings of his own study while dismissing the results of two other studies that conflict with his findings.
... Although the Lyme guidelines article boasts 405 references, many of the dissenting references are either glossed over or ignored in the text. In addition, as of the date of publication of the Lyme guidelines article there were 18,537 articles about tick-borne diseases listed on Medline, so the referenced articles represent only 2% of the available literature. The remaining 98% of these articles often present opposing or conflicting views of Lyme disease, and thus the data selection by the authors is even more striking.
ILADS' nine page letter lays out the errors of IDSA's position and conclusions with sound science and factual information.