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December 26, 2004

Dear Ms. Landers,

I came across your article on Lyme disease published in American Medical News on August 9, 2004...

It is important that the AMA give members accurate information. One notable error is the figure given for US Lyme disease cases at about 23,000. This figure is based on CDC surveillance cases with criteria so restrictive that perhaps only about 10% of proven Lyme disease cases can meet it. The CDC will tell you that the actual number of cases is in excess of 10 times the figure given for the number of cases that meet the surveillance criteria and reported. That is, well over 200,000 cases of Lyme disease per year.

The CDC figures also downplay the incidence of Lyme disease on the West Coast and other areas. Primarily because physicians do not consider it in differential diagnosis since many believe it is either "rare" or does not exist in their area. Relating the vastly understated surveillance case figure to your members reinforces these misperceptions. Also, strain variations will make serodiagnostic tests less accurate in areas other than the eastern seaboard where these tests were developed.

Lyme disease is a very serious bacterial infection. It can and does cause death from cardiac problems or other causes. It is normally not reported as a cause of death, per se. I have had serious cardiac complications from Lyme disease that nearly resulted in death. These occured before my diagnosis of Lyme disease. My death certificate would have never mentioned Lyme disease. The cardiac complications resolved with appropriate treatment for Lyme disease.

Lyme disease is expensive to diagnose, expensive to treat, and may be incurable (but treatable) in its late stages. It is frequently misdiagnosed as chronic fatigue syndrome, fibromyalgia, MS, ALS, Alzheimer's, cardiac problems and other conditions. Coinfections with other tickborne diseases are not uncommon and should be addressed in Lyme disease cases. Physicians should be alerted to this.

There are a number of expert sources of Lyme disease information available on the Internet. The CDC information tends to be incomplete and not up to date. The NIH has some worthwhile information. One site with a specialized perspective is...

There are also some excellent informative brochures issued by Pfizer, the Lyme Disease Foundation, and the State of California.

Perhaps you will entertain the idea of writing another article on Lyme disease for AMA members.

Best Holiday Wishes,

Miguel Perez-Lizano
Battle Ground, WA In Copyright since 2000