Contagion® Launches First Peer Exchange on Lyme Disease
CRANBURY, N.J.--Contagion®, the nation’s leading digital and print publication that provides practitioners and specialists working in the infectious disease field with disease-specific information, unveiled its first Peer Exchange, a lively conversation between medical experts that provides opinions and perspectives on issues faced by the infectious disease community.
This 13-part Peer Exchange was facilitated by Peter L. Salgo, M.D., professor of medicine and anesthesiology at Columbia University; who was joined by Samuel Shor, M.D., FACP, president of the International Lyme and Associated Diseases Society, associate clinical professor, George Washington University Health Care Sciences, Reston, Virginia; Robert C. Bransfield, M.D., DLFAPA, in private practice in psychiatry in Red Bank, New Jersey, and associate professor of psychiatry, Rutgers New Jersey Medical School; Leonard Sigal, M.D., former Chief of the Division of Rheumatology and Clinical Professor, Rutgers Robert Wood Johnson Medical School, and Founder of Gateway Immunosciences, LLC, Stockbridge, Massachusetts; and Patricia Smith, president of the Lyme Disease Association, Inc., Jackson, New Jersey. The group discussed the geographic expansion of Lyme disease, difficulties in diagnosing it, and the controversial topic of chronic Lyme disease.
Remarking on the widespread expansion of Lyme disease, Smith shared that, “the current studies seem to indicate that Lyme disease is found in almost 50 percent of continental United States counties now, and that’s an increase of 45 percent since 1998.” Although most of the country may assume that Lyme disease is a problem contained in the Northeast and Midwest, Smith asserts that the disease is found in 43 states; however, there is not enough money available to the states to perform the rigorous type of environmental surveillance needed to truly determine where the ticks are located.
Adding to the difficulties in determining the true extent of the disease, geographically, are the complications in determining the key criteria for evaluating the multisystemic manifestations of the disease and making a diagnosis. “The majority of people with bona fide Lyme disease don’t remember a tick bite, so it’s a challenge in that respect,” said Dr. Shor. “Without treatment, it will resolve on its own. The problem with that is that it can then result in more chronic manifestations that are well-recognized.” It is these chronic manifestations that result in lingering, and sometimes debilitating symptoms for many previously infected individuals, sparking them to believe that they are in fact dealing with a chronic Lyme disease infection. And, it is the term, “chronic Lyme disease” that sparked much heated debate among the panelists.
When speaking on whether or not an individual is actually chronically infected, Dr. Bransfield asserted that, “it’s more the immune provocation symptoms, whatever we call them, that are associated with the manifestations of the disease. And if the immune system is being provoked, something is provoking it. Now, it might be infection, it might be something else.” To which Dr. Sigal responded, “[Previous studies] demonstrated quite clearly that when you take mice and treat them with antibiotics, there’s no live organism left, and yet there’s debris that persists—Borrelia burgdorferi-derived debris—which is going to be a proinflammatory nidus.” It is potentially this debris, or the inflammation resulting from the infection, some of the panelists argued, that is leading to the lingering symptoms many individuals experience after a Lyme disease diagnosis. And, although the treatment for an acute infection remains relatively straightforward, the practice of some physicians to put patients on long-term courses of antibiotics to treat the “chronic” form of the disease led the panelists to debate the additional effects these regimens can have. They also explored the impact a lack of consensus on the existence of chronic Lyme disease has on patients, providers, and the health care system.
Find out if the panelists were able to come to a consensus about the existence of chronic Lyme disease, as well as new and emerging tests for disease detection, and treatment modalities by watching the full Peer Exchange®, available on the Contagion® website: www.contagionlive.com/peer-exchange.
Contagion® is a fully integrated news resource covering all areas of infectious disease. Through our website, quarterly journal, email newsletters, social media outlets and Outbreak Monitor, we provide practitioners and specialists with disease-specific information designed to improve patient outcomes and assist with the identification, diagnosis, treatment and prevention of infectious diseases. Our mission is to assure that the health care community and public have the knowledge to make more informed choices and have a positive impact on patient outcomes.