The following was published in the The Lancet Infectious Diseases Feb 2005; 70-71,

http://infection.thelancet.com/

Lyme borreliosis: perspective of a scientist–patient

Thank you for publishing Lyme borreliosis: perspective of a scientist–patient by Ron Hamlen.(ref 1) At Lyme Disease Action, we feel that the points raised are serious. We are contacted both by people who have at least one positive laboratory test for Lyme and by people who have an array of symptoms suggestive of Lyme (or another borreliosis), but who prove negative by current testing procedures. It is too early to fully assess the health of many of those who, regardless of blood-test status, have obtained treatment; however, we are recording the beginnings of some treatment successes. Sadly, many other people contact us—even those from the Lyme-positive group—who are extremely ill and who have had little or no treatment. The prognosis for these people is less certain than if they had received timely treatment. We also note that one patient known to us has recently collected—over the space of just a few weeks—more than 40 case histories from people who find themselves in these circumstances. We wonder if this represents just the tip of the iceberg?

The question of diagnosis itself is proving problematic also, as Hamlen points out. The protean symptoms of this disease mimic many other conditions. I, personally, can add to observations upon this difficulty. In late 1985, I was thought to be suffering from one of the other conditions referred to— namely chronic fatigue syndrome. However, a few months later I was treated with a high-dose course of antibiotics against presumptive borreliosis. During this very prolonged treatment I recovered from chronic fatigue syndrome and I have been in a good state of health ever since.

We recall the publication of a critique entitled Frustrating survey of chronic fatigue,(ref 2) commenting on the report of the Royal Colleges on chronic fatigue syndrome. We believe the questions raised in this piece, and in Hamlen’s article, with particular reference to the potential confusion with other conditions—most notably chronic fatigue syndrome, but also the other conditions mentioned—are yet to be resolved satisfactorily.

Stephanie Woodcock

SW is Chairperson, Lyme Disease Action

1. Hamlen R. Lyme borreliosis: perspective of a scientist–patient. Lancet Infect Dis 2004; 4: 603–4.
2. The Lancet. Frustrating survey of chronic fatigue. Lancet 1996; 348: 971.