Treatment Guidelines

IDSA/CBO guidelines:
According to the IDSA/CBO guidelines Lyme is a disease that is relatively easy to identify and treat. A treatment of from 2 to 4 weeks of antibiotics is sufficient. If persistent or recurrent symptoms, they should be attributed to the “post Lyme syndrome” if it is said that you cannot still have Lyme.

Post-Lyme syndrome is a term for a “cured” Lyme infection where there may be six months of symptoms present such as pain and fatigue, which is said that they will eventually disappear if it is said that Lyme disease cannot still be active.

IDSA is an American PRIVATE organization that wrote the current guidelines. The members have different interests, and earn from this disease through vaccines and ties to the pharmaceutical industry and insurance companies.

Why the IDSA / CBO guidelines are not being changed:
Of the 14 authors of the first edition of the guidelines:  6 of them or their universities have patents on Lyme and co-infections, four received funding from Lyme and co-infection test kit manufacturers, four were paid by insurance companies to the Lyme guidelines to prescribe policies and to consult in Lyme lawsuits, and 9 received money from the Lyme disease vaccine manufacturers. Some of them even had multiple interests. (Documentary: Under our skin)

The CDC Health in America does not intervene because the director of the CDC  is a member of the IDSA.

The IDSA guidelines are deleted from the American NGC  and the ILADS guidelines are yet the only currently recognized in the National Guidelines Clearinghouse. https://www.guideline.gov/search?q=lyme%20disease The Netherlands still cling to this outdated guidelines.

ILADS guidelines:
Besides the IDSA / CBO guidelines, there are also the guidelines ILADS (International Lyme and Associated Diseases Society) An organization where all famous and important doctors and scientists are affiliated with. They train doctors worldwide and conduct research and provide many patients with a chance of having their life back.

According to the ILADS guidelines Lyme disease is a persistent, often difficult to diagnose and treat. A treatment is needed for at least six weeks of antibiotics with high dose (immediately after the bite). Persistent or recurrent symptoms may indicate an active infection and lasting reason for a longer treatment of months to sometimes years.

According ILADS Lyme disease is a multisystem disease, these bacteria can cause any symptoms. ILADS not only does prolonged antibiotic but also provides natural support resources. Everything has fallen must be strengthened, everything is affected must be restored, sometimes there are gene defects. Everywhere should be looked at.

Unfortunately, this treatment is not reimbursed because it holds regular in the Netherlands at the IDSA / CBO guidelines two weeks antibiotics which patients remain ill. The bacterium is slain during cell division, this only takes place around 4 weeks, hence the ILADS guidelines prescribed immediately after the bite 6 weeks of antibiotics.

A good replacement of the IDSA / CBO guideline is the guideline for the diagnosis and treatment of Lyme disease which is arranged by ILADS. http://www.ilads.org/lyme/treatment-guideline.php

Science:

There is no scientific study proving that the Borrelia bacterium that causes Lyme disease has been eradicated after month recommended antibiotics. There are at least 293 peer-reviewed studies showing that the Borrelia bacterium persists after this short course. Source: http://www.lymebelgiebelgiqueprotest.be/menu/publicaties/293-peer-reviewed-studies/

List of 700 peer-reviewed articles about scientific persistent Borrelia and co-infections: http://www.ilads.org/ilads_news/wp-content/uploads/2015/09/EvidenceofPersistence-V2.pdf

In 1993, 1 in 4 nymphs were already infected.

Lyme disease is the fastest growing infectious disease in the world and is currently the most commonly reported infectious disease in the US. Source: http://www.cdc.gov/lyme/stats/

The World Health Organization describes Lyme disease as “emerging diseases” in addition to AIDS, Ebola, SARS, Hepatitis C. This emerging diseases are a major cause of suffering and death and impose a huge financial burden to society report the World Health Organization. Source: http://www.who.int/trade/glossary/story022/en/

IDSA/CBO directives from the American NGC (for recognized guidelines) shall be deleted and the ILADS guidelines are the only currently listed in the National Guidelines Clearinghouse. Source: https://www.change.org/p/president-obama-and-congress-a-call-to-legalize-lyme-disease/u/13489608?tk=OSia1oTS-gKgUSj_zL2xaOfh2fWq_8xgk-k4EA0cmXo&utm_source=petition_update&utm_medium=email

A doctor who still claims that “Lyme does not exist”, you can give the ICD-10 code: https://www.zorg-en-gezondheid.be/Cijfers/Over-deze-cijfers/Gebruikte-codes/ It is officially disease classified in ICD-10 (see Annex, governed 351: under heading of A65-A69) Other Diseases by Spirochetes: A69.2: Lyme disease. “International Statistical Classification of Diseases and Related Health Problems – 10th Revision.” See also: Flemish Infectious Diseases Bulletin (1999).

In Belgium they recognize Lyme disease as an occupational disease and provide a benefit for patients for the rest of his or her life: http://www.beroepsziekten.nl/beroepsziekten/Lyme People here talk about suffering and death.

2009: The National Reference Centre in Oberschleißheim Borre Lien has recognized for years that 10% of all Lyme disease cases cannot be cured and remain chronically ill. The medical professional association Deutsche borreliosis-Gesellschafte assumes that in Germany more than a million people are affected by chronic Lyme disease, which many do not know even which they suffer and receive no treatment. These figures are in many other Member States comparable high. Source: http://www.europarl.europa.eu/sides/getDoc.do?type=WQ&reference=E-2009-4142&language=NL

A scientific institute of the government in the US has recognized the ILADS guidelines as scientific. Orphanet EU has included the ILADS guidelines. Source: http://www.lymebelgiebelgiqueprotest.be/2015/02/18/wetten-europese-unie/

RIVM admits that Lyme tests are not reliable. Source: https://www.facebook.com/ziektevanlyme/posts/1092771880787449

The RIVM recognizes that long-term problems may arise and writes: “It is still unknown why some people keep having persistent symptoms after Lyme disease and others do not. Because of the high burden of disease for patients with persistent symptoms, it is important to better understand the causes. ”
Source: http://www.rivm.nl/Documenten_en_publicaties/Algemeen_Actueel/Nieuwsberichten/2015/Groot_verlies_van_gezonde_levensjaren_door_langdurige_klachten_na_Lyme?sp=Y3RsMT1uZXdzbWVzc2FnZTtxdWVyeT0oMTU2NzY1KTtJTkxJQlJBUlk9dHJ1ZTtTSVRFTEFOR1VBR0U9bmw7c2VhcmNoYmFzZT0wO3NlYXJjaHJhbmdlPTUwO3NlYXJjaGV4cHJlc3Npb249KGN0bDEpIEFORCBJTkxJQlJBUlkgQU5EIFNJVEVMQU5HVUFHRTtzb3J0ZmllbGQ9cHVibGlzaGRhdGU7c29ydHJldmVyc2VkPXRydWU7&query=&pagenr=1&result=rivmp%3A281407

IDSA is a private institution whose guidance has found the Attorney General of Connecticut serious defects in the form of concealed financial interests and ignoring evidence for the existence of a chronic form of Lyme disease (2008). http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284

International Classification of Diseases (ICD)
On http://apps.who.int/classifications/icd10/browse/2015/en is the current classification of the WHO disease. Lyme has also there own codes.

A69.2 Lyme disease – erythema (chronicum) migrans by Borrelia burgdorferi
A69.2 + G01 * Meningitis
A69.2 + G63.0 * Polyneuropathy
A69.2 + M01.2 * Lyme arthritis
L90.4 Acrodermatitis chronica atrophicans

The chronic form has no code, therefore it is sometimes taken the following code for borreliosis:

A28.8 Other specified zoonotic bacterial diseases, not elsewhere classified

European Union
In 2008, the EU decided to store information on rare diseases in the Orphanet database.
http://ec.europa.eu/health/ph_threats/non_com/docs/rare_com_en.pdf

Dissemination of knowledge and information on rare diseases

One key element for improving diagnosis and care in the field of rare diseases is to provide and disseminate accurate information in a format adapted to the needs of professionals and of affected persons. The establishment of an EU dynamic inventory of rare diseases will contribute to tackle some of the main causes of neglecting the issue of rare diseases including the ignorance of which diseases are rare. The Commission will ensure that this information continues to be available at European level, building in particular on the Orphanet database, supported through Community programmes.

On http://www.orpha.net/orphacom/cahiers/docs/GB/List_of_rare_diseases_in_alphabetical_order.pdf
There are 2 references to Lyme disease:

91546 Lyme borreliosis
91546 Lyme disease

Orphanet describes the further disease in the “Encyclopedic Orphanet Grand Public” under the heading “Maladie Lyme” (see Annex 3) including the following quotes:

https://www.orpha.net/data/patho/Pub/fr/Lyme-FRfrPub12159.pdf
*Orphanet is de portaalsite waarop informatie kan worden geraadpleegd over zeldzame ziekten en weesgeneesmiddelen.

Orphanet is the information portal which can be accessed on rare diseases and orphan drugs.

Orphanet is led by a European consortium of 40 countries, coordinated by the French team. The national teams are responsible for collecting information about specialized hospitals, medical laboratories, ongoing research and patient organizations in their country. All Orphanet teams must provide the same quality charter.

Law voted in Canada (Bill C-442) in late 2014
Available at http://www.parl.gc.ca/HousePublications/Publication.aspx?Language=E&Mode=1&DocId=6836507&Col=1&File=24

“Whereas recent research further demonstrates the persistence of Borrelia spirochetes after antibiotic treatment that follows the guidelines used in Canada (Embers et al., 2012) and indicates that current serology does not adequately describe the diversity of Borrelia bacteria existing in Canada and that the general understanding of, and practices for dealing with, Lyme disease are no longer sufficient or in line with emerging evidence of how the disease operates (Ogden et al., 2011);

Whereas the current guidelines in Canada are based on those in the United States and are so restrictive as to severely limit the diagnosis of acute Lyme disease and deny the existence of continuing infection, thus abandoning sick people with a treatable illness;

And whereas the 2010 report prepared for the Provincial Health Services Authority of British Columbia entitled Chronic Lyme Disease in British Columbia, A Review of Strategic and Policy Issues concluded that current diagnostic testing for Lyme disease is inadequate and advocated placing the highest priority on the development of reliable diagnostic testing for the disease and on educating physicians so they can recognize the symptoms of Lyme disease and treat patients in a manner that is medically appropriate, including treatment with antibiotics as justified”

Voted law in the U.S.  (H. R. 4701) 2014 final
Available at https://www.congress.gov/bill/113th-congress/house-bill/4701/text

“Not later than 3 years after the date of enactment of this section, and every 5 years thereafter, the Secretary shall submit to the Congress a strategic plan, informed by the most recent summary under section 399OO-1(b)(1), for the conduct and support of Lyme disease and tick-borne disease research, including

(1) proposed budgetary requirements;

(2) a plan for improving outcomes of Lyme disease and    other tick-borne diseases, including progress related to chronic or persistent symptoms and chronic or persistent infection and co infections;

(3) a plan for improving diagnosis, treatment, and prevention;

(4) appropriate benchmarks to measure progress on achieving the improvements described in paragraphs (2) and (3);

(5) a plan to disseminate each summary under section 399OO-1(b)(1) and other relevant information developed by the

Working Group to the public, including health care providers, public health departments, and other relevant medical roups.”.

The state of Vermont US act H.123
http://www.leg.state.vt.us/docs/2014/Acts/ACT134.pdf

A small bit:
“Long-term antibiotic therapy” means the administration of oral, intramuscular, or intravenous antibiotics singly or in combination, for such periods of time as decided by the attending physician.

“Lyme disease” means the clinical diagnosis of a patient by a physician licensed under 26 V.S.A. chapter 23 of the presence of signs or symptoms compatible with acute infection with Borrelia burgdorferi; late stage, persistent, or chronic infection with Borrelia burgdorferi; complications related to coinfections; or with such other strains of Borrelia that are identified or recognized by the Centers for Disease Control and Prevention (CDC) as a cause of disease. “Lyme disease” shall also mean either an infection that meets the surveillance criteria set forth by the CDC or a clinical diagnosis of Lyme disease that does not meet the surveillance criteria but presents other acute and chronic signs or symptoms of Lyme disease as determined by a physician. The clinical diagnosis shall be based on knowledge obtained through medical history and physical examination alone or in conjunction with testing that provides supportive data for the clinical diagnosis.

The state of Massachusetts in the U.S. law H.4142
https://malegislature.gov/Bills/188/House/H4142/History

“Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides medical expense coverage shall provide coverage for diagnostic testing and long-term antibiotic treatment of chronic Lyme disease when determined to be medically necessary and ordered by a physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results and response to treatment. Treatment otherwise eligible for benefits pursuant to this section shall not be denied solely because such treatment may be characterized as unproven, experimental, or investigational in nature.”

New York state in the U.S. law S7854-2013
https://malegislature.gov/Bills/BillHtml/136869?generalCourtId=11

“Section one of the bill amends Section 230 of the public health law by adding a new subdivision 9-b to ensure that neither the board for professional medical conduct nor the office of professional medical conduct shall identify, charge, or cause a report made to the director of such office to be investigated based solely upon the recommendation or provision of a treatment modality by a licensee that is not universally accepted by the medical profession, including but not limited to, varying modalities used in the treatment of Lyme disease and other tick-borne diseases.”

The state of Maine in the U.S. law 416-597
http://www.mainelegislature.org/legis/bills/getPDF.asp?paper=HP0416&item=1&snum=126&PID=

3. Publicly accessible website.  The Maine Center for Disease Control and Prevention shall maintain a publicly accessible website to provide public awareness and education on Lyme disease and other tick-borne illnesses. The website must provide information on the prevention, diagnosis and different alternatives for treatment of Lyme disease and other tick-borne illnesses for use by health care providers and the public, including, but not limited to, links to resources made available and recommended by the United States Department of Health and Human Services and an international nonprofit multidisciplinary medical society.

Sec. 2. Maine Center for Disease Control and Prevention; alternatives for the treatment of Lyme disease. The Department of Health and Human Services, Maine Center for Disease Control and Prevention shall include on the publicly accessible website established pursuant to the Maine Revised Statutes, Title 22, section 1645, subsection 3 information, including links to websites, about treatment guidelines recommended by the Infectious Diseases Society of America and the International Lyme and Associated Diseases Society. The center shall work with health care professionals to inform patients about different alternatives for the treatment of Lyme disease.

SUMMARY
This bill directs the Maine Center for Disease Control and Prevention to include on its publicly accessible website information about different alternatives for the treatment of Lyme disease. The bill also requires the center to include information about treatment guidelines recommended by the Infectious Diseases Society of America, which represents physicians, scientists and other health care professionals who specialize in infectious diseases, and the International Lyme and Associated Diseases Society, an international nonprofit multidisciplinary medical society. The bill directs the center to work with health care professionals to inform patients about different alternatives for the treatment of Lyme disease.

Bill of France 2291
http://www.assemblee-nationale.fr/14/propositions/pion2291.asp

Chronic lyme you can’t just deny
(Article from De Standaard 01/23/15)

THOUSAND FACES, BUT WHY NOT FICTITIOUS
When it comes to chronic lyme, we quickly get involved in a trench debate where each defends his unwavering positions. According LIESBETH BORGER MANS the debate should be conducted based on scientific evidence.

LIESBETH BORGERMANS
Who? Teacher chronic care at the Department of General Practice (VUB). Writes in her own name.
What? Chronic Lyme disease is a system of great complexity. Simple answers do not exist.

The World Health Organization (WHO) estimates that every year in Europe at least 100,000 new cases of Lyme disease. In addition, they recognize that the real number probably ten times as large.

Occupational disease by foresters, Belgium
Below are some excerpts from the infectious disease bulletin No. 26, 1999/2 (12)

“Chronic forms remain difficult to treat and require a prolonged administration of antibiotics. One of the reasons is the existence of dormant forms of spirochetes which are only slightly sensitive to the action of antibiotics. ”

“Due to its severity and extension, it is a worrying illness and she deserves the full attention of all doctors and, more generally, of all health professionals who come into direct contact with patients. In Belgium, we may speak of an endemic infection. The incidence of new cases in proportion to the number of inhabitants rises from the center of our country to the wooded areas of the south-east. She is a threat to everyone who walks in the woods. In France, it was already recognized as an occupational disease of farmers in 1988. Her make severe articular and neurological complications it can be difficult to diagnose. This disease is almost always curable in the initial stages. But the setting of an antibiotic therapy in an early stage of the disease is strongly recommended. The penicillins or cephalosporins which are suitable for oral administration (amoxycillin and cefuroxime), macrolides and tetracyclines are effective treatments for the cutaneous forms of Lyme disease. The parenteral administration of penicillin or third-generation cephalosporins is required for neurological, ophthalmic and cardiac forms, and often for the articular shapes. ”

“Lyme disease is a recognized occupational disease in Belgium. That means that if the Occupational Diseases Fund believes that the necessary criteria are met, a worker can rely on the provisions of the Fund. In principle, there are 5 items included: compensation in the context of disability (temporary or permanent), costs in connection with the preventive removal, health care costs (preventive and curative), third-party assistance and intervention in case of death. Civil applies a custom rule ment ring. Basically the same recognition criteria but fall distributions paid by the state. ”

“This study shows that Lyme disease requires not only a theoretical risk but prevents real and correlates with the degree of exposure. There are two good reasons to establish an intensive prevention campaign. First, there are major complications associated with this disease that can lead, especially in the advanced stages to irreversibility, and then the disease at an early stage is quite easy to treat. Also, simple preventive measures can work where. ”

Borrelia in dogs
The following is the text of Emil Hovius, veterinarian and biologist which is discussed in dogs that the diagnosis should be made on the basis of clinical symptoms, and that the disease may be chronic.

“In the second, small group of dogs, so in practice, there is no stabilizing the titer place in the fourth tick season, but a very strong increase in titer was observed. These dogs have also exhibit fever and lameness go at that time. Research (Western blot assay and DNA analysis) shows that dogs have become sick of repeated infections. These dogs have Lyme disease. The clinical diagnosis is made on the basis of the symptoms that are observed. Because these symptoms can also occur in other infections, the diagnosis is not easy and will never be held in a single consultation to the vet. The amount of antibody in the blood will be determined a number of times and if simultaneously quadruples with a fever peak, it can be assumed a sickening Borrelia infection. Often the dog will have an initially unexplained fever, those with antibiotic treatment or spontaneously disappear. After this fever peak will be a few days, lameness in the dog seen.

In chronic cases, this pattern repeats itself and are also affected organ functions. ”