Saturday, April 5, 2014

Germany's guidelines for Lyme treatment

I have been hearing for a while now about how Germany is more progressive than the US when it comes to reporting, acknowledging and treating Lyme disease. I stumbled across this document today while searching for an official estimate of the number of new cases of Lyme disease in that country. I recently heard some expert saying that Germany estimates a million new cases per year in a country that's a fraction of the size of the United States.

It's refreshing to read this document because clearly Germany recognizes late-stage Lyme disease exists, and further, that the effectiveness of late-stage treatment is very difficult to monitor by serology tests. They state that effectiveness of treatment must be determined solely through clinical evidence -- in other words how the patient looks, functions, and feels. They say that there's actually no reason medically to continue to do serological tests after late-stage (what they call Stage III) disease has been diagnosed. Further, the importance of DNA testing (PCR testing) and culture testing (in the US the only culture test I know of is done by Advanced Laboratory Services in Pennsylvania) is emphasized, although they acknowledge that sensitivity can be low, so negative PCR or culture test does not rule out chronic Lyme.

I'm still reading the document, but thought I would post it now on my blog. I will come back and comment if I have more to say about it. Please add your comments as you read through it. I'd like to hear your thoughts about it.


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