BMJ  2007;335:910-912 (3 November), doi:10.1136/bmj.39363.530961.AD

Feature

Lyme wars

BMJ, London WC1H 9JR

Patients with long term symptoms, lack of a scientific explanation, and insurance companies' reluctance to pay for treatment have created a perfect breeding ground for dissent, Alison Tonks reports

The first 150 words of the full text of this article appear below.

Lyme disease is a simple bacterial infection spread by ticks. There is a fairly characteristic rash, a well documented pattern of symptoms, and a safe effective treatment. But in the US, Lyme disease is at the centre of a long running and bitter controversy. It is no longer a disease but a legal and political battleground. At the core of the disagreement is the possibility that the Lyme bacterium could survive initial treatment, evade detection, and cause disabling symptoms for months or even years. A growing and vociferous patient lobby thinks it can. Mainstream medical opinion thinks it can't. Why does it matter? Because those who believe in chronic infection also believe in long term treatments, including repeated or prolonged courses of antibiotics that doctors are reluctant to prescribe and insurance companies are reluctant to pay for.

The trigger

The latest exchange of fire between the two sides was triggered by official . . . [Full text of this article]

The challenge

The politics

The disease

The ammunition

Centers for Disease Control and Prevention recommendations for diagnosis of Lyme disease¹⁴

Beginnings of a resolution

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