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Wednesday, June 4, 2008
What does the CDC say about Lyme disease?
This is an important question. The Center for Disease Control is located in Atlanta Georgia. It is branch of the United States Government under the U.S. Department of Health and Human Services. Its mission relates to the detection and prevention of diseases which affect Americans. I have found the information on the web site to be unhelpful. The statement given by Dr. Paul Mead, a medical epidemiologist of the Division of Vector-Borne Infectious Diseases within the CDC is much more instructive. His printed statement was provided under oath at a hearing of the Connecticut Department of Public Health and the Attorney General's Office. He states that Lyme disease is the most prevalent vector borne infectious disease in the United States. He states that: "If not diagnosed and treated in its early stages, Lyme disease can result in serious complications." He states: "There is no question that Lyme disease is an important public health concern in Connecticut; the question is how to prevent it. It is towards this question that CDC cooperative agreements are focused." The CDC's primary interest is prevention, not diagnosis or treatment. He makes it clear that the CDC has developed a national case surveillance definition. He says: "Surveillance case definitions are created for the purpose of standardization, not patient care." He distinguishes this from a clinical diagnosis which is made for the purposes of patient care. He states: "CDC has stated repeatedly that the surveillance case definition is not a substitute for sound clinical judgement. Given other compelling evidence, a physician may choose to treat a patient for Lyme disease when their condition does not meet the case definition." He concludes his statement with: "CDC will continue to work with its partners to develop and implement community-wide strategies to prevent Lyme disease, including educational efforts, tick control efforts and the development of improved diagnostic methods." It is clear that the CDC is focused on prevention and that it freely admits that current diagnostic standards are lacking. Yet most physicians will only diagnose Lyme disease when it is positive by CDC criteria. This is exactly what the CDC is telling physicians not to do. Returning to the two tier lab test, the CDC last visited this issue in 1994! The inaccuracy of the ELISA has not been redressed. And the short comings of the Western Blot has not been addressed. Labs continue to report only 13 bands, which were chosen for surveillance criteria instead of providing physicians with all the data, 28 bands. We know that critical bands are not being reported, including the 31kd and 34kd bands. What's up with that?