Lancet – Lyme disease testing

The March edition of Lancet Infectious diseases published the LDA comment.

Dear Editor

By objective criteria it is a moot point whether any diagnostic test on an individual patient is positive or negative when the tests are unreliable. In this position other forms of assessment of whether a patient has Lyme borreliosis or not are brought into play.
Unfortunately, much of the other information available to assist in diagnosis relies on subjective assessment as to whether the patient was at risk or not. Subjective evidence however, could turn out to be unreliable if unknown factors are in play.

The crux of the argument centres on the
interpretation of laboratory tests; should they be regarded with suspicion as presenting too many false positives, or alternatively, are many of these cases true positives? If the former holds true, then perhaps many patients could be receiving unnecessary treatment with antibiotics, which for some
may present a certain degree of risk. If the latter holds true, many patients are going untreated and left to progress into an illness not unlike syphilis in its later effects.

From the point of view of the patients, and those yet to find themselves with the disease, the latter is a far
worse outcome. Who can blame anyone who insists on presumptive treatment when they are suffering typical symptoms? More humane acknowledgement of the awful predicament that patients find themselves in would be appropriate from those bodies whose duty it is to guard public health.


Stephanie Woodcock
Lyme Disease Action
Registered Charity 1100448

This was released in response to the article “Controversy brewing over Lyme disease testing.”

October 2005 Lancet Infectious Diseases. 2005;5:605 Nelson R Text

Click here to see other responses to this Lancet article.