BASKING RIDGE, N.J., November 10, 2002 -- Concerned by the number of Lyme disease cases that are undiagnosed or misdiagnosed, the International Lyme and Associated Diseases Society (ILADS) today presented new guidelines for the detection and treatment of this illness. The board of ILADS, a group of more than 100 experts specializing in the study of Lyme, approved the guidelines for release during its annual meeting in Basking Ridge, N.J., on November 9 and November 10.

Spearheaded by Daniel Cameron, M.D., MPH, and Joseph Burrascano, M.D., the new guidelines:

Broaden the diagnostic criteria for Lyme, and emphasize more aggressive antibiotic therapy to prevent recurrence and long-term disability.

The Centers for Disease Control and Prevention (CDC) conservatively estimates there are 19,000 new cases of Lyme disease in the United States each year. ILADS physicians believe the number of new infections may be more than 200,000. “That’s five times the rate of new AIDS infections,” says Dr. Burrascano, an internist in East Hampton, N.Y. and a pioneer in the treatment of chronic Lyme disease.

Since Lyme was first recognized in Connecticut in1977, tens of thousands of victims have been misdiagnosed with fibromyalgia, chronic fatigue, multiple sclerosis and even ALS (Lou Gehrig’s disease). By the time they are properly assessed, Lyme disease is in the chronic stage and much more difficult to treat. Lyme complications range from seizures to suicide and from retinitis to rare cases of sudden cardiac death.

“Lyme has been around for a quarter of a century and as many as five million Americans may have it and not be aware of it,” says Dr. Cameron, an internist and epidemiologist in Mt. Kisco, N.Y., who treats 800 cases of Lyme per year.

“The problem is that most physicians don’t know how to recognize it and many of their sources, including the CDC, have outdated treatment guidelines,” he adds.

For example:

The CDC advises doctors to look for a red bull’s eye rash caused by an infected tick. Yet ILADS experts say less than half of Lyme patients develop a rash. And less than half ever recall getting a tick bite.

Physicians should be looking for a wider range of complaints, according to ILADS experts. These include fever, joint pain or arthritis, facial palsy, headaches, dizziness, sudden weight change, fatigue, mood swings, memory loss, depression, and disorientation.

Most doctors rely on the ELISA test for Lyme that has a low accuracy rate. Yet ILADS recommends a panel of tests to assess Lyme antigens and antibodies, as well as Lyme DNA.

ILADS also calls for more aggressive treatment of Lyme disease, in both early and late-stages. It notes that:

The Infectious Diseases Society of America currently recommends a two- to three-week course of oral antibiotics for early Lyme. ILADS says this is not enough. Because these bacteria are so intransigent and can get into the white cells, ILADS recommends six to eight weeks of oral antibiotic therapy for Early Lyme.

Chronic Lyme sufferers may need to take antibiotics even longer, says Dr. Burrascano, and they may also need to take them intravenously.

“If properly diagnosed and treated, the symptoms of Lyme disease can be reversed,” says Andrea Gaito, M.D., ILADS president and a rheumatologist in Basking Ridge, N.J.

“The new guidelines are a crucial step in combating this disease,” says Dr. Gaito.

“ILADS physicians are the ones most familiar with its clinical manifestations and responsiveness to treatment. Together we manage over 50,000 cases of Lyme a year.”



About ILADS:

Founded in 1999, The International Lyme and Associated Diseases Society is an interdisciplinary group of physicians and researchers dedicated to improving the diagnosis and treatment of Lyme disease. Members include neurologists, rheumatologists, internists, family practitioners, pediatricians, immunologists, ophthalmologists, dentists, board certified Infectious disease specialists, and psychiatrists.

For more information about the diagnosis and treatment of Lyme disease, go to www.ilads.org.
International Lyme and Associated Diseases Society
PO Box 341461
Bethesda, Maryland 20827–1461

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