News

Sixty seconds on . . . Lyme disease

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5976 (Published 09 December 2015) Cite this as: BMJ 2015;351:h5976

Fifty-nine seconds on . . . Lyme denialism

Fifty-nine seconds on . . . Lyme denialism
Raphael B. Stricker, MD
San Francisco

What is Lyme denialism?
Lyme denialism is the tendency to deny that Lyme disease is a significant problem. The recent news article by Nigel Hawkes in BMJ is a good example of this mistaken opinion (BMJ 2015;351:h5976).

Why is this opinion wrong?
The US Centers for Disease Control and Prevention (CDC) now says that more than 300,000 people are diagnosed with Lyme disease each year in the USA alone. Thus Lyme disease is six times more common than HIV/AIDS and 20 times more common than hepatitis C virus (HCV) infection. It is a major worldwide epidemic.

So how did this epidemic start?
Very much like HIV/AIDS, which became a problem because of celebrities like Rock Hudson and Magic Johnson plus some gay activists. Then it spread on the Internet and wiped out half of Africa. Now we have people like Yolanda Foster and Avril Lavigne spreading Lyme disease on the Internet.

That idea sounds ridiculous
Not to me. We can always blame celebrities, sick patients and the Internet for problems that we don't want to face, like Lyme disease.

Why doesn't the CDC do something?
The CDC is stuck in a 1990s mentality about Lyme disease, fueled by the Infectious Diseases Society of America (IDSA). These so-called "experts" claim that Lyme disease is a trivial illness that is "hard to catch and easy to cure", despite the mushrooming numbers of sick people with persistent disease who don't respond to short-course antibiotic treatment.

Can’t a test show that people are infected?
Unfortunately the commercial Lyme tests miss more than half of infected patients. Because these inaccurate tests are approved by the US Food and Drug Administration (FDA) and make lots of money, there is no financial incentive to make them better.

Can't we get better treatment?
Currently we are treating Lyme patients with 60-year-old antibiotics that don't work very well. And because of the "Lyme denialist" controversy, the pharmaceutical industry has steered clear of the disease. As a result, Lyme patients are being denied effective “designer drugs” like the ones that have revolutionized the treatment of HIV/AIDS and HCV infection.

What should we do?
Pay attention to the evidence that Lyme disease is a major epidemic. Get the CDC and IDSA to update their views on Lyme disease. Get pharmaceutical companies to invest in “designer drug” development for Lyme disease. Stop publishing misinformed Lyme denialist attacks on sick patients.

Why did you only devote 59 seconds to this topic?
We don't want to waste even one extra second on a trivial disease that is “hard to catch and easy to cure”.

Competing interests: No competing interests

16 December 2015
Raphael B. Stricker
MD
450 Sutter Street, Suite 1504, San Francisco, CA 94108, USA