Newsgroups: sci.med
Subject: Re: Lyme (again) <sigh>
From: RGINZBERG@eagle.wesleyan.edu (Ruth Ginzberg)
Date: 28 Jan 93 12:26:31 EDT
Distribution: world
Organization: Philosophy Dept., Wesleyan University
X-News-Reader: VMS NEWS 1.20In-Reply-To: mcg2@ns1.cc.lehigh.edu's message of 27 Jan 93 16:33:02 GMTLines: 76

In <1993Jan27.163302.37858@ns1.cc.lehigh.edu> mcg2@ns1.cc.lehigh.edu writes:

> The Yale study is simply biased to the viewpoint of the Yale LD folks.  This
> is the way they protect their NIH grants (i.e. Don't panic the public).
> 
> If you want more complete information on LD, not just the crap that Yale
> releases on the AP wires, subscribe to the LymeNet newsletter.

Hi, Marc-

> (This is not a personal attact on the pervious posters - They just read the
> news reports they are given).

Ahem.  Well, that would be me, since I was the afore-mentioned "previous
poster".   :-)    I am sorry if I have committed a blunder in assessing the
reliability of sources.  In *my* field, Yale is considered to be a respected
research institution, so I didn't really bother to wonder whether Yale's
research findings in the field of LD research might be of suspect quality.  I
do believe I am a *tad* more careful in my assessment of sources of info than
just uncritically "reading the news reports I am given".  That IS an
insult to someone who teaches Critical Thinking. :-)  

I am certainly open to the possibility that Lyme Disease, CFS, (etc.) are
conditions which need advocacy groups in order to keep the research
focused in the right places. (E.g., as experience with AIDS and (my own 'pet
project':) 20th century obstetrics has shown.)  I am
also certainly open to the idea that "mainstream medical wisdom" may be wrong,
inaccurate, or incomplete. <I have published articles on this subject in
regular "print" media, not here on the Net.>

However, your assertions are not convincing to me.  They are, if I understand
correctly:
     1. Infection with Lyme Disease sometimes produces first-stage
     symptoms and sometimes does not.
     2. In either case, it may progress to disabling illness.
     3. Once past the first-stage (whether it then produced symptoms or
     not), it is no longer always detectable by blood test.
     4. However, it is still potentially dangerous to the host.
     5. If a person develops symptoms of late-stage Lyme Disease, even
     in the absence of laboratory confirmation of infection, or of any
     early-stage symptoms of Lyme Disease, the person should be presumed
     to have late-stage Lyme Disease, and treated aggressively for it.
     6. In order to avoid this drastic scenerio, you advocate treating
     all persons who might develop first-stage Lyme Disease,
     prophylactically if possible, to avoid developiong the more serious
     and possibly undetectable later stages of it at a later date.
Now, for one person, taken alone, living apart from the rest of the biosystem,
I agree that your strategy *may* make the most sense. But as a public health
strategy, on the whole, it would not make good public health policy to put
every resident of Connecticut and Nantucket Island on prophylactic amoxicilin
during the entire deer-tick season.  For one thing, I would dread to see the
number & type of SuperInfections (not only LD) that would develop antobiotic
resistance in such a population.  I think that w/in a few years you'd have
folks dying from SuperStrains of pneumonia & staph & strep infections (or
whatever -- I don't know the list of actual organisms that are now resistant or
sensitive to the particular antibiotics used to treat LD right now)
for whom NO successful antibiotic treatment was available.  So even if a few
cases of seriously disabling Lyme Disease DID turn out to be prevented that
way, you might have overall BIG TIME decline in public health, longevity, life
expectancy, quality of life, etc., because of the large-scale "side effects" of
such an approach.  (cf. problems of drug resistance in, e.g., STD's,
tuberculosis, some kinds of pneumonias, etc.)  I think you would need to
present an argument that your approach would be better GENERAL PUBLIC HEALTH
POLICY, OVERALL -- not just "better" for specific individuals who obtained this
treatment, provided, of course, that *NOT* everyone did the same thing.

> BTW, prophylactic LD treatment is cheap ... $15-$35.

Yes, but doctor-shopping to find a doc who will prescribe it is not ...
$80-$125 for "new patient; first visit".  My health insurance doesn't pay for
second opinions re. treatment of a tick bite.


------------------------
Ruth Ginzberg <rginzberg@eagle.wesleyan.edu>
Philosophy Department;Wesleyan University;USA
Newsgroups: sci.med