Student Lyme Documentary

 

Wonderful 26 minute documentary put out by student filmmakers from SUNY Broome Community College in New York exploring the impact of Lyme disease in their local area.

A few comments:  they state that 70-80% of those bitten by a tick will get a bullseye rash, but according to ILADS (International Lyme and Associated Diseases Society), that number is less than 50%.  Hardly anyone I talk to (and I talk to many) has seen a tick or a rash.  In fact, I would go as far to say seeing a bullseye rash is the exception, not the norm.

Also, I felt they were extremely generous in their wording of many items such as testing for instance.  They said they weren’t foolproof.  Now that’s an understatement: https://www.lymedisease.org/lyme-basics/lyme-disease/diagnosis/

Did You Know?

52% of patients with chronic Lyme disease are negative by ELISA but positive by Western blot (Donta 2002).  Between 20-30% of patients with confirmed Lyme disease are seronegative (Aguero-Rosenfeld 1996, 1993; Donta 1997).  The College of American Pathologists (CAP) found that ELISA tests to not have adequate sensitivity to be used for screening purposes (Bakken 1997). LLMDs consider the specificity of the particular bands that test positive for a patient.  The NIAID views the Western blot as the best method for detecting Borrelia antibodies.  Although the CDC requires 5 of 10 bands to IgC surveillance purposes, 2 of 5 bands have specificity of 93-96% and a sensitivity of 100% (Engstrom 1995).

Two-Tier Testing
The most common diagnostic tests for Lyme disease are indirect ones. They measure the patient’s antibody response to the infection, not the infection itself. The two most-used antibody tests are the enzyme-linked immunosorbent assay (ELISA) and the Western blot. The CDC recommends that doctors first order an ELISA to screen for the disease and then confirm the disease with a Western blot.

During the first four-to-six weeks of Lyme infection, these tests are unreliable because most people have not yet developed the antibody response that the test measures. Even later in the illness, the two-tiered testing is highly insensitive

missing roughly half of those who have Lyme disease.

Screen-Shot-2014-08-25-at-5.08.30-PM

Chart from Lymedisease.org

HIV/AIDS is diagnosed with tests that are both highly sensitive and highly specific. They are accurate more than 99% of the time.  How well would  AIDS patients accept testing that was accurate less than half the time?

I felt they were also generous in their dialogue about whether Lyme Disease is chronic or not.  

http://norvect.no/230-peer-reviewed-studies-show-evidence-of-persistent-lyme-disease/  According to NorVect, a Nordic non-profit organization, there are 230 studies stating borrelia persists.  I can’t believe this is still being debated.

And lastly, there is Sapi’s recent work showing borrelia biofilms exist, further demonstrating the challenge in eradication.    http://consumer.healthday.com/diseases-and-conditions-information-37/lyme-disease-news-454/lyme-disease-agent-that-eludes-antibiotics-found-study-708316.html

The CDC remains strangely quiet.  Meanwhile an African proverb comes to mind:

“The ax forgets; the tree remembers.”

We may be cognitively impaired, but we are far from stupid!