Testing For Lymes DiseaseThere's definitive evidence of the over diagnosis of Lyme disease in pets. And long-term antibiotic use can result in its own medical problems, said Mr. Weld, citing an investigation by the federal Centers for Disease Control and Prevention of 15 teen-agers who had been given long-term antibiotic treatment for Lyme disease. About half of them had to have gallbladders removed because of damage caused by the antibiotics, he said, even though it was later determined that only one of the teen-agers actually had Lyme disease. Dr. Richard Ellison, associate director of the Division of Infectious Diseases at UMass Memorial Health Care in Worcester, said he has had patients referred to him with symptoms that indicate Lyme disease, but has not found evidence of that disease. Some of them have fibromyalgia, which is a poorly characterized disorder as well. There is no test for the bacteria that causes Lyme disease. Instead, doctors mostly look for the antibodies produced by the patient's body that fight the Lyme bacteria. Two tests, the enzyme-linked immunosorbent assay, or ELISA test, and the Western Immunoblot test are used together to find those antibodies when the physician thinks there is a high probability the patient has Lyme disease. Dr. Ellison says “there is a problem doing the test because of the nature of the Lyme bacteria. It's hard to get a correct result; even in the best laboratories, it is difficult to do.” And some medical authorities argue that not everyone develops antibodies to the disease, which would make the test useless for some people. Dr. Nancy Y-N Liu, associate professor of clinical medicine at the University of Massachusetts Medical School, prefers the polymerase chain reaction or PCR test for those suspected of having Lyme disease because it searches not for antibodies, but for the DNA or proteins of the Lyme bacteria. Dr. Ellison thinks that test, which has been rapidly improving over the last ten years, may be helpful in the future for Lyme disease. Right now, however, the test performance can be impacted by proteins in the blood that have nothing to do with Lyme disease. If there were an accurate test, Dr. Ellison said, and then the controversy over whether an individual had Lyme disease or another problem would be quickly resolved. That's also the belief of the Hartford-based Lyme Disease Foundation Inc., a national scientific nonprofit group that includes the discoverer of the Lyme bacteria, Dr. Willy Burgdorfer. “There a great deal to be learned about Lyme disease,” said Karen Vanderhoof-Forschner, chairman of the foundation's board of directors. “There are significant gaps in our understanding of the Lyme bacterium. There are no tests to prove who is bacteria-free, no test that can show who no longer has Lyme disease.” While the foundation, she said, takes no position on what is the correct treatment for Lyme disease, we do believe that people who respond to antibiotic therapy should be able to get antibiotic therapy. Right now, science doesn't have the answer as to who is infected and who isn't and until we have a perfect test, people should be entitled to receive the kind of medical care they do deserve.She called for open and forthright discussions of the different theories about Lyme disease and its treatment. This discussion, she claims, has been stifled by academic physicians and researchers favored by government agencies. |