blimeyitslymie
08-24-2007, 09:41 AM
IDSA
Infectious Disease Society of America
August 7, 2007
The Honorable Jon S. Corzine Chairman
Health and Human Services Committee
National Governors Association
444 North Capitol Street, NW, Suite 267
Washington, DC 20001
(Letter also sent to the National Conference of State Legislatures)
Dear Governor Corzine:
I write on behalf of the Infectious Diseases Society of America
(IDSA) to bring to the National Governors Association' s (NGA)
attention problematic Lyme disease legislation that has been
introduced in several states. In making the NGA aware of these
legislative efforts, many of which are well-intentioned but
therapeutically dangerous, our primary concern is to ensure the best
quality in patient care and to protect the public's health and
safety. To this end, we believe it is critically important that you
be fully apprised of the widespread consensus within the medical and
scientific community about the appropriate treatment of Lyme disease,
as well as the medical community's concerns about unproven,
potentially harmful treatments for so called "chronic" Lyme disease
that are advocated by a small group of physicians.
IDSA represents more than 8,000 physicians and scientists and is
widely recognized as the pre-eminent authority on infectious diseases
(ID) in the United States. The Society's members focus on the
epidemiology, diagnosis, investigation, prevention, and treatment of
infectious diseases in the U.S. and abroad. Our members care for
patients of all ages with serious infections, including Lyme disease.
In 2006, IDSA published revised practice guidelines for the clinical
assessment, treatment, and prevention of Lyme disease. The
development of guidelines requires the review of scientific and
medical literature. IDSA's guidelines were developed by a 14-member
panel of infectious diseases clinicians and researchers, including
physicians with many years of clinical experience treating patients
with Lyme disease. Nearly 400 references of papers and studies are
cited in the IDSA guidelines and many, many more were reviewed that
did not meet rigorous scientific standards.
As you may know, Lyme disease is a tick-transmitted infection that
can cause non-specific symptoms such as muscle and joint pain,
fevers, chills, and fatigue. Some patients may continue to experience
these symptoms even after a course of antibiotic therapy has killed
the Lyme disease bacterium. A small group of physicians have
diagnosed such patients as having "chronic" Lyme disease and advocate
treating them with repeated or prolonged courses of oral or
intravenous
Page Two – Chairman Corzine
antibiotics. Such diagnoses and treatments are not supported by the
IDSA's practice guidelines, nor are they supported by new Lyme
disease guidelines published by the American Academy of Neurology,
nor by the vast majority of experts in the field.
Of greatest concern are some states' misguided attempts to legislate
the prolonged use of antibiotic therapy for Lyme disease. There are
no convincing published scientific data that support the existence of
chronic Lyme disease. Carefully designed and conducted studies of
Lyme disease treatments have failed to demonstrate benefit from
prolonged antibiotic therapy. Rather, these studies have demonstrated
that there is no difference in the measured improvement between
patients receiving placebo and patients treated with long term
antibiotics.
Furthermore, long-term antibiotic therapy may be dangerous, leading
to potentially fatal infections in the bloodstream as a result of
intravenous treatment. Also, although the bacteria that causes Lyme
disease does not acquire resistance to antibiotics, long-term
antibiotic exposure can lead to drug-resistance among other
microorganisms, creating "superbugs" that cannot be treated with
currently available drugs. In summary, far from improving the
patient's quality of life, prolonged antibiotic therapy may actually
increase the patient's suffering.
While IDSA opposes enactment of legislation that sanctions the use of
prolonged antibiotic therapy, we support efforts to hold public
hearings on Lyme disease as well as the establishment of legislative
commissions to study all aspects of Lyme disease. Such hearings or
commissions could play an important role in educating both state
legislatures and the general public about the controversy surrounding
treatment for Lyme disease. In order to ensure that these educational
efforts are science-based, IDSA strongly urges the inclusion of board-
certified ID physicians who represent a balanced perspective on Lyme
disease.
For more information on Lyme disease and the recommendations by the
vast majority of experts in the field, please visit websites for IDSA
(www.idsociety. org), the Centers for Disease Control and Prevention
(www.cdc.gov) , the National Institute of Allergy and Infectious
Diseases (www.niaid.gov) , the American Academy of Neurology
(www.aan.com) , or the American College of Physicians
(www.acponline. org).
I hope you will contact Mark Leasure at IDSA if you have questions or
would like the names of board-certified ID physicians who may be
willing to provide further guidance on appropriate treatments for
Lyme disease. Mr. Leasure may be reached at (703) 299-0200 or via e-
mail at mleasure@idsociety. org.
Best Regards,
Henry Masur, MD, FIDSA
IDSA President
cc:
Matt Salo, HHS Committee Director, NGA
Kathleen Nolan, Health Division Director, NGA Center for Best
Practices
Page Three – Chairman Corzine
Enclosures:
IDSA's Practice Guidelines for the Treatment of Lyme Disease
IDSA's Press Release on Practice Guidelines for the Treatment of Lyme
Disease, October 2, 2006
David Whelan. "Lyme Inc. Ticks aren't the only parasites living off
patients in borreliosis- prone areas." Forbes, March 12, 2007.
Jason Feifer. "Combat Zone. There's No Neutral Ground in War Of
Information About Lyme Disease." Washington Post, May 15, 2007; HE01.
Jamie Talan. "A Rift Over Lyme Disease. Experts are split over
diagnosis and treatment of the tick-borne illness." Newsday, May 22,
2007
Infectious Disease Society of America
August 7, 2007
The Honorable Jon S. Corzine Chairman
Health and Human Services Committee
National Governors Association
444 North Capitol Street, NW, Suite 267
Washington, DC 20001
(Letter also sent to the National Conference of State Legislatures)
Dear Governor Corzine:
I write on behalf of the Infectious Diseases Society of America
(IDSA) to bring to the National Governors Association' s (NGA)
attention problematic Lyme disease legislation that has been
introduced in several states. In making the NGA aware of these
legislative efforts, many of which are well-intentioned but
therapeutically dangerous, our primary concern is to ensure the best
quality in patient care and to protect the public's health and
safety. To this end, we believe it is critically important that you
be fully apprised of the widespread consensus within the medical and
scientific community about the appropriate treatment of Lyme disease,
as well as the medical community's concerns about unproven,
potentially harmful treatments for so called "chronic" Lyme disease
that are advocated by a small group of physicians.
IDSA represents more than 8,000 physicians and scientists and is
widely recognized as the pre-eminent authority on infectious diseases
(ID) in the United States. The Society's members focus on the
epidemiology, diagnosis, investigation, prevention, and treatment of
infectious diseases in the U.S. and abroad. Our members care for
patients of all ages with serious infections, including Lyme disease.
In 2006, IDSA published revised practice guidelines for the clinical
assessment, treatment, and prevention of Lyme disease. The
development of guidelines requires the review of scientific and
medical literature. IDSA's guidelines were developed by a 14-member
panel of infectious diseases clinicians and researchers, including
physicians with many years of clinical experience treating patients
with Lyme disease. Nearly 400 references of papers and studies are
cited in the IDSA guidelines and many, many more were reviewed that
did not meet rigorous scientific standards.
As you may know, Lyme disease is a tick-transmitted infection that
can cause non-specific symptoms such as muscle and joint pain,
fevers, chills, and fatigue. Some patients may continue to experience
these symptoms even after a course of antibiotic therapy has killed
the Lyme disease bacterium. A small group of physicians have
diagnosed such patients as having "chronic" Lyme disease and advocate
treating them with repeated or prolonged courses of oral or
intravenous
Page Two – Chairman Corzine
antibiotics. Such diagnoses and treatments are not supported by the
IDSA's practice guidelines, nor are they supported by new Lyme
disease guidelines published by the American Academy of Neurology,
nor by the vast majority of experts in the field.
Of greatest concern are some states' misguided attempts to legislate
the prolonged use of antibiotic therapy for Lyme disease. There are
no convincing published scientific data that support the existence of
chronic Lyme disease. Carefully designed and conducted studies of
Lyme disease treatments have failed to demonstrate benefit from
prolonged antibiotic therapy. Rather, these studies have demonstrated
that there is no difference in the measured improvement between
patients receiving placebo and patients treated with long term
antibiotics.
Furthermore, long-term antibiotic therapy may be dangerous, leading
to potentially fatal infections in the bloodstream as a result of
intravenous treatment. Also, although the bacteria that causes Lyme
disease does not acquire resistance to antibiotics, long-term
antibiotic exposure can lead to drug-resistance among other
microorganisms, creating "superbugs" that cannot be treated with
currently available drugs. In summary, far from improving the
patient's quality of life, prolonged antibiotic therapy may actually
increase the patient's suffering.
While IDSA opposes enactment of legislation that sanctions the use of
prolonged antibiotic therapy, we support efforts to hold public
hearings on Lyme disease as well as the establishment of legislative
commissions to study all aspects of Lyme disease. Such hearings or
commissions could play an important role in educating both state
legislatures and the general public about the controversy surrounding
treatment for Lyme disease. In order to ensure that these educational
efforts are science-based, IDSA strongly urges the inclusion of board-
certified ID physicians who represent a balanced perspective on Lyme
disease.
For more information on Lyme disease and the recommendations by the
vast majority of experts in the field, please visit websites for IDSA
(www.idsociety. org), the Centers for Disease Control and Prevention
(www.cdc.gov) , the National Institute of Allergy and Infectious
Diseases (www.niaid.gov) , the American Academy of Neurology
(www.aan.com) , or the American College of Physicians
(www.acponline. org).
I hope you will contact Mark Leasure at IDSA if you have questions or
would like the names of board-certified ID physicians who may be
willing to provide further guidance on appropriate treatments for
Lyme disease. Mr. Leasure may be reached at (703) 299-0200 or via e-
mail at mleasure@idsociety. org.
Best Regards,
Henry Masur, MD, FIDSA
IDSA President
cc:
Matt Salo, HHS Committee Director, NGA
Kathleen Nolan, Health Division Director, NGA Center for Best
Practices
Page Three – Chairman Corzine
Enclosures:
IDSA's Practice Guidelines for the Treatment of Lyme Disease
IDSA's Press Release on Practice Guidelines for the Treatment of Lyme
Disease, October 2, 2006
David Whelan. "Lyme Inc. Ticks aren't the only parasites living off
patients in borreliosis- prone areas." Forbes, March 12, 2007.
Jason Feifer. "Combat Zone. There's No Neutral Ground in War Of
Information About Lyme Disease." Washington Post, May 15, 2007; HE01.
Jamie Talan. "A Rift Over Lyme Disease. Experts are split over
diagnosis and treatment of the tick-borne illness." Newsday, May 22,
2007