Tuesday, June 10, 2008
I am being treated for Lyme disease. Should I have my kids tested?
No. Not unless they show signs of the illness. Even if people have blood test which show exposure to Borrelia, it does not mean they have Lyme disease. Many patients are exposed but never show signs or symptoms of the disease. Patients who are not symptomatic should not be treated. Therefore, they should never be tested. This only generates information which is confusing, anxiety provoking and potentially harmful. Why consider exposing your child to the risk of antibiotic therapy when they are not ill? Since the child does not have acute symptoms we can never know when the exposure occurred. Since the endpoint of treatment is resolution of symptoms, even if we were to treatment we wouldn't have anything to shoot for. We do not know what percent of exposed individuals will ever develop the disease in their life times. And we don't have a magic formula for a number of days with a particular drug which will guarantee that Lyme will never develop. Clearly there are many patients who experience a full relapse of Lyme symptoms after long periods of antibiotic therapy. No one who is not ill should be tested based on the current state of the art.