Federal law and a disconnect

Thanks again to one of my patients for enlightening me. President Bush signed Public Law 107-116 in 2002. The law states that laboratory testing for Lyme is very poor. It has led to misdiagnosis and delayed therapy. The law says that the CDC case surveillance definition is not to be used for diagnosis. The House of Representatives Committee notes the widespread misuse of the current Lyme disease case definition. The CDC does state that 'this surveillance case definition was developed for the national reporting of Lyme disease: it is NOT appropriate for clinical diagnosis,' the definition is reportedly misused as a standard of care for healthcare reimbursement, product (test) development, medical licensing hearings, and other legal cases. The CDC was encouraged to aggressively pursue and correct the misuse of this definition. To date, these recommendations have been ignored.

99% of practicing physicians misuse the surveillance case definition and are unaware of this law. Mill labs, like Labcorp and Quest provide only the 13 CDC bands. In fact they have thus far been unwilling to provide this missing 15 bands even though the assay contains these values.

It is hard to understand why this information has not been disseminated despite the passage of 5 years.

I hear the new documentary on Lyme disease is very good and plan on seeing it.