Subject: Comments on DHS Report: Investigation of suspected Lyme
disease in Malibu, Los Angeles County
Date: Thu, 24 Feb 2000 12:37:41 -0800
From: Art Doherty
To: LymeBarb@aol.com, pcm@pacific.net,
CFritz@dhs.ca.gov, Dvugia@dhs.ca.gov
24 February 2000
Comments on the recently released report by the California Department of
Health Services, January 18, 2000, subject: Investigation of suspected
Lyme disease in Malibu, Los Angeles County
Summary:
"Clinical data on participants did not objectively support a diagnosis
of Lyme disease in any of the participants."
The report itself refutes this statement in the "Results - Clinical
information" section where many symptoms of Lyme disease are noted for
the Malibu patients. What are the DHS/CDC "objective" symptoms needed
to support a clinical diagnosis of Lyme disease? If by "objective
clinical data" you mean positive serology, does the fact that
seronegative Lyme disease is not unusual under various conditions have
any impact on this conclusion? See:
Seronegative or False Negative Lyme disease - An Annotated Bibliography
http://www.geocities.com/HotSprings/Oasis/6455/seronegative-special.html
"The results of this study do not indicate that residents of the Malibu
area are at significantly increased risk of tick-transmitted infectious
disease, including Lyme disease".
This is a typical bureaucratic statement of little or no consequence -
it can't be proven wrong in the future! What does "significantly"
mean? "Increased" over what? Is there ANY increased risk of Lyme
disease in the Malibu area? What IS the risk for Lyme disease in the
Malibu area? Does the fact that the U.S. Army found a HIGH risk of
contracting Lyme disease at Vandenberg Air Force base (north of Malibu)
and a MODERATE risk (which would be a HIGH risk using today's U.S. Army
standards) at Camp Pendleton near San Diego (south of Malibu) have any
bearing on the risk of Lyme disease in Malibu? See:
U.S. Army Lyme Disease Risk Assessment, Camp Pendleton, 1992
http://www.utech.net/users/10766/003.txt
U.S. Army Lyme Disease Risk Assessment, Vandenberg Air Force Base, 1995
http://www.utech.net/users/10766/005.txt
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Results - Exposure/environmental questionnaire:
"One patient reported camping or hiking in naturally wooded area in the
12 months preceding onset of LD illness."
So what! This is a typical method of minimizing the Lyme disease
threat. As if the only type of activity where one could be bitten by a
Lyme disease infected tick is camping or hiking. I got my tick bite -
leading to my rash, leading to my Lyme disease symptoms, leading to my
positive test, leading to my antibiotics treatment, leading to my
probable cure - in my back yard, trimming trees. Not camping! Not
hiking!
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Discussion:
"Based on clinical information available in their medical records, most
of the patients did not have consistent objective symptoms typically
associated with LD. The most common clinical presentation was of
non-specific long-term myalgia and arthralgias; frank arthritis was rare
and when present was usually attributable to another cause (i.e.,
rheumatoid arthritis)."
"Did not have consistent objective symptoms typically associated with
LD"! What do you know about the symptoms of Lyme disease? All patient
symptoms mentioned in this report are symptoms of Lyme disease. Your
discussion implies that the presence of "frank arthritis" is required
for a diagnosis of Lyme disease. That's simply wrong. See:
Symptoms of Lyme Disease
http://www.geocities.com/HotSprings/Oasis/6455/lyme-links.html#symptoms
Also, did you know that Lyme disease was discovered in 1975 when a large
number of children who had been misdiagnosed with "juvenile rheumatoid
arthritis" were found to have a bacterial infection later called Lyme
disease. And, did you know that Lyme disease was "rediscovered" in
Santa Ynez, California in 1995, twenty years later, when a number of
children who had been misdisagnosed with "juvenile rheumatoid arthritis"
actually had Lyme disease.
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Recommendations:
While the present study revealed little evidence to support the
hypothesis that residents of the Malibu area are at elevated risk for
Lyme disease, ..."
"Elevated risk"? Is that like "significantly increased risk" as used in
the summary. See comments above for the summary.
"Even in a clinically compatible illness, physicians should not
automatically regard a "positive" serologic result as confirmation of
the diagnosis and need for treatment."
This is a preposterous statement! This could be interpreted to mean
that even if a patient has had a tick bite, and a rash, and Lyme disease
symptoms, and a positive test (notice the DHS/CDC says "positive",
meaning they do not have any faith in positive Lyme disease test
results!), the doctor should not be too quick to prescribe antibiotics!
Give me a break! What is a "clinically compatible illness"?
"Serologic and other tests for LD and other tick-borne diseases should
be requested only when these diseases are suspected based on clinical
symptomatology and not as part of a routine "tick panel"".
Do you really mean to say, as it appears, that, if a patient has been
bitten by a tick and later has some symptoms that might be associated
with a tick-borne disease, that that patient should not be tested for a
tick-borne disease? What's a "tick panel"? The term "tick panel" is
usually used by veterinarians when talking about testing dogs. Hey, if
they can do it for dogs, why not people? Oh, but the insurance is
different! And, state bureaucrats must protect the medical/insurance
industry. What about the people! Would you say the same things about
testing or treatment if it was you, your wife, or your son or daughter
who had been bitten by a tick?
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For more information on Lyme disease in California, see:
Lyme disease in California
http://www.geocities.com/HotSprings/Spa/6772/california-index.html
For more information on Lyme disease
Lots Of Links On Lyme Disease
http://www.geocities.com/HotSprings/Oasis/6455/lyme-links.html
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Art Doherty
Lompoc, California
doherty@utech.net
(
geocities.com/hotsprings/retreat) (
geocities.com/hotsprings)