Pa. Lyme disease measures sought
A Pennsylvania task force called Wednesday for an increase in surveillance, education, and common-sense preventive measures to combat the increasing prevalence of Lyme disease.
A Pennsylvania task force called Wednesday for an increase in surveillance, education, and common-sense preventive measures to combat the increasing prevalence of Lyme disease.
The panel did not issue any recommendations on treatment. But its 64-page report alluded to sharp disagreement on that topic among some of the members.
No surprise, given that the task force was mandated by law to include both mainstream medical practitioners as well as representatives of a group that advocates months of high-dose antibiotics to treat patients with lingering symptoms.
That type of long-term treatment is discouraged by the medical establishment because multiple randomized trials suggest it is not effective against Lyme disease, and because it also carries significant risks, said Paul Auwaerter, an infectious-disease specialist at the Johns Hopkins University School of Medicine.
Some of the antibiotics are administered intravenously, potentially leading to infections or blood clots. And high doses of multiple antibiotics can contribute to the growing problem of drug-resistant bacteria.
Task force member John Goldman, an infectious-disease specialist with Pinnacle Health in Harrisburg, acknowledged the task force engaged in "vigorous debate" about treatment.
"I prefer to concentrate on the things we were in agreement with rather than some of the things that we disagreed about," he said.
In its report, made to the state Department of Health, the task force agreed that Lyme disease was increasing in frequency, that it sometimes was not recognized by physicians, and that more reliable diagnostic tests were needed.
Earlier this year, the state Department of Environmental Protection reported that for the first time, the black-legged deer ticks that transmit Lyme disease had been found in all 67 counties of the state. They have long been present in the southeastern part of the state as well as most of New Jersey.
The task force that published the report was created by law in 2014.
The law specified that the panel include two members of the mainstream Infectious Diseases Society of America, to which Goldman belongs, as well as two members of the International Lyme and Associated Diseases Society - the group that advocates many months of antibiotics for patients with long-term symptoms.
Bloomsburg physician Harold Smith, a representative of the second group, acknowledged the two organizations' different approaches on treatment but said the panel was not mandated to explore that issue.
"It came out with good, broad, general advice regarding public education," Smith said.
When diagnosed early, Lyme disease is commonly treated with antibiotics for several weeks - no argument among physicians there.
But that standard treatment seems ineffective for a minority of patients, who can suffer severe aches, fatigue, and other symptoms for many months.
While mainstream physicians say that long-term antibiotic treatment is not the answer for these patients, they do not have a reliable alternative treatment - leading to patient frustration.
That is why prevention is important, said task force chairman Tomas J. Aguilar, director of the health department's Bureau of Health Promotion and Risk Reduction.
Among the preventive measures recommended in the report was tick management at schools in high-risk areas.
That could consist of spraying insecticide, curtailing the deer population, and cutting back vegetation that may harbor the insects. The report also recommended school staff check children for ticks after outdoor events.
215-854-2430@TomAvril1