The Lyme Disease Controversy
Excerpted from ReadingEagle.com ( Posted: 05/15/2012)
The federal Centers for Disease Control has clinical criteria for Lyme disease that are narrowly defined in order to ensure accuracy when tracking the disease.
These criteria are mainly useful for the early stages of Lyme when patients present with more obvious symptoms, such as a rash in the shape of a bull’s-eye and arthritis-like problems.
The CDC criteria are not very helpful for clinicians attempting to detect late-stage neurologic Lyme.
For example, the most common manifestation of late neurologic Lyme is cognitive dysfunction, often referred to as encephalopathy.
A patient who presents with new onset encephalopathy and a positive blood test for Lyme would not be considered by the CDC to be a case of Lyme disease.
Although the CDC recognizes that Lyme encephalopathy exists, encephalopathy is not part of the “surveillance case definition.”
Hence, physicians who rely on the narrow surveillance case criteria of the CDC for clinical diagnosis will fail to diagnose some patients who have Lyme disease.
In these cases, the patient’s treatment will either not occur or be delayed.
Such delay in treatment could result in an acute, treatable illness becoming a chronic, less-treatable one.