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October 12, 2007|Volume 36, Number 6


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Chronic Lyme disease does not
exist, researchers report

There is no evidence that “chronic Lyme disease” exists and even if it does, the risks of prolonged antibiotic treatment outweigh any benefits, according to a review article by researchers at Yale and other institutions in the Oct. 4 New England Journal of Medicine.

Lyme disease is the most common tick-borne infection in the Northern hemisphere. The disease is caused by bacteria, Borrelia burgdorferi (B. burgdorferi), and typically manifests as a rash, while later — less common — symptoms may include meningitis, facial nerve palsy and arthritis. All of these conditions typically respond well to conventional antibiotic treatment, but a minority of patients subsequently complain of fatigue, musculoskeletal pain, and difficulty with concentration or short-term memory. These symptoms are usually mild and self-limited and are referred to as “post-Lyme disease symptoms.” If they last longer than six months, the symptoms are called “post-Lyme disease syndrome.”

The review article, written by Dr. Eugene D. Shapiro of Yale and colleagues from other institutions, focused on what the authors refer to as the “imprecisely defined” condition “chronic Lyme disease.” The authors note that this term is used by a small number of physicians to describe patients they claim have persistent B. burgdorferi infection, a condition that they say requires long-term antibiotic treatment and may be incurable.

“Although ‘chronic Lyme disease’ clearly encompasses post-Lyme disease syndrome, it also includes a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection,” says Shapiro, who is professor of pediatrics, epidemiology and public and investigative medicine at Yale School of Medicine.

The article advises clinicians to tell their patients that there is no scientific evidence of “chronic Lyme disease” and to inform patients of the risks of unnecessary antibiotic therapy. The authors say that patients should also be thoroughly evaluated for medical conditions that could explain the symptoms.

“Explaining that there is no medication, such as an antibiotic, to cure the condition is one of the most difficult aspects of caring for such patients,” says Shapiro. “Failure to do so leaves the patient susceptible to those who would offer unproven and potentially dangerous therapies.”

Shapiro and his colleagues maintain that “chronic Lyme disease” is a misnomer, and the use of prolonged, dangerous and expensive antibiotic treatments is not warranted.

Other authors on the study included Dr. Henry M. Feder Jr., Barbara J.B. Johnson, Dr. Susan O’Connell, Dr. Allen C. Steere, Dr. Gary P. Wormser, and the Ad Hoc International Lyme Disease Group.

— By Karen Peart


T H I SW E E K ' SS T O R I E S

New facility is place where ‘future of medicine’ can unfold

Facility balances researchers’ needs with environmentally friendly features

Alumnus’ gift supports ‘critical’ work at F&ES

Yale affiliates to exhibit photographs, games and paintings at art festival

Yale’s United Way fundraising goal set at $1.2 million


SCHOOL OF MEDICINE NEWS

Museum honorees to ponder ‘The Future of Life on Earth’

‘The Greening of Yale and Beyond’ is topic of symposium

Symposium to examine the intersection of faith and politics

‘21st Century Democracy’ is the theme of Law School reunions

IN MEMORIAM

Exhibit examines post-war effort to halt the spread of communism . . .

Campus Notes


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