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	Lyme disease was one of the Natural sciences good articles, but it has been removed from the list. There are suggestions below for improving the article to meet the good article criteria. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones Date Process Result October 1, 2006 Peer review Reviewed February 27, 2007 Good article nominee Listed March 20, 2007 Featured article candidate Not promoted June 20, 2008 Good article reassessment Delisted March 19, 2013 Peer review Reviewed Current status: Delisted good article

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Typo?

"Although it was known that Lyme disease was a tick-borne disease as far back as 1978, the cause of the disease remained a mystery until 1981" 'as far back' with three years of difference in time seems a bit of a weird choice of words. Maybe 1798 or another year was meant? — Preceding unsigned comment added by 217.233.215.150 (talk) 10:15, 12 September 2013 (UTC)

Copy-edit

I was indirectly directed to this article via BBC:Lyme disease risk from dogs 'higher than thought' and found our Lyme disease article interesting. However, there appears to be a mistake in the cause section thus "At least eleven Borrelia species have been discovered, twelve of which are known to be Lyme-related" --Senra (talk) 12:29, 25 January 2012 (UTC)

Wiki Entry: "Bell's palsy"

For whomever most regularly writes and edits the Lyme (borrelia) information, I wanted to call attention to the Wiki article on Bell's palsy wherein it's stated, "Lyme disease may produce the typical palsy, and may be easily diagnosed by looking for Lyme-specific antibodies in the blood or erythema migrans. In endemic areas Lyme disease may be the most common cause of facial palsy." The incorrect information being, "...easily diagnosed by looking for Lyme-specific antibodies in the blood or erythema migrans." I suspect that "in endemic areas" is also questionable, given the great geographical range/distribution of borrelia. Thanx, 07:43, 6 March 2012 (UTC) — Preceding unsigned comment added by Pillartopost (talk • contribs)

The current facts remain - Lyme disease in it's disseminated stages; typically after 8 weeks of onset and post erythema migrans, is EASILY diagnosed using modern sensitive ELISA testing. There is currently a TON of misinformation citing the ineffective nature of ELISA testing for lyme disease. Understand that this misinformation is a parroting by a few "lyme activists" of grossly outdated information on testing modalities of lyme disease. In the modern world of 2012, if one were to examine the blood of 100 confirmed lyme disease patients and subject it to modern ELISA testing, ALL 100 patients would test positive for lyme antibodies. Hope this helps. 72.77.73.2 (talk) 23:01, 7 May 2012 (UTC)

Cardiac manifestations

I've just read this for the first time, and know nothing about Lyme disease or cardiology.

The article mentions "heart palpitations and dizziness caused by changes in heartbeat" and "The disease may also have cardiac manifestations such as AV block" in the section on early disseminated infection. Both statements are unsourced. This source

Lelovas P, Dontas I, Bassiakou E, Xanthos T (2008). "Cardiac implications of Lyme disease, diagnosis and therapeutic approach". Int. J. Cardiol. 129 (1): 15–21. doi:10.1016/j.ijcard.2008.01.044. PMID 18508142. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

says

Cardiac manifestations in LB appear to be rare. Most frequently they can be observed with or shortly after an EM, or in association with neurological symptoms or arthritis. Conduction abnormalities with varying degrees of atrioventricular conduction defects are typical manifestations.

This source

Bratton RL, Whiteside JW, Hovan MJ, Engle RL, Edwards FD (2008). "Diagnosis and treatment of Lyme disease" (PDF). Mayo Clin. Proc. 83 (5): 566–71. doi:10.4065/83.5.566. PMID 18452688. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

says

Cardiovascular symptoms are less common (present in 8% of those infected) but may include temporary atrioventricular blocks of varying degree. Although temporary pacing may be necessary in more than 30% of patients with cardiac involvement, complete heart block rarely develops.

Could we improve on our present description of the cardiac implications? I'll re-read this in a few days and compose something if no one else has - and if it still looks like it needs improvement after a second reading. --Anthonyhcole (talk) 06:47, 2 April 2012 (UTC)

Magazine article moved to Media section

Self-explanatory: magazine is media, doesn't need its own section. I'll check back late next week (going on vacation). Postpostmod (talk) 21:40, 7 April 2012 (UTC)

Placement in the "Media" subsection does not make sense; the media section should describe how it is perceived or reported in the media. The material you moved is about harassment, not media coverage, and therefore does not belong in the media section and probably deserves its own subsection. I have therefore reverted your move. That it was reported by a magazine doesn't make it a "media" related material. Yobol (talk) 23:29, 7 April 2012 (UTC)

Well, the WP:MED team will always prevail. But someone has to speak up for the patients, who are being accused of serious crimes here, and tried in the press.

The story itself is the media event. It was planted by a PR agency hired by Steere (see the article itself). Read the whole article, and note the hyperbollic, sensationalized use of language, and the extreme bias toward Steere.

It doesn't meet journalistic standards for news. It's a "human interest story" in a magazine. And an 11-year-old one, at that. Postpostmod (talk) 11:02, 8 April 2012 (UTC)

Disagree with your characterization. That it was reported in the media doesn't make it about the "media". Yobol (talk) 13:34, 8 April 2012 (UTC)

I agree with Yobol. Axl ¤ 20:01, 8 April 2012 (UTC)

I too agree with Yobol. -- Brangifer (talk) 20:26, 8 April 2012 (UTC)

What is the evidence that Steere (or a PR agency working on his behalf) "planted" the New York Times Magazine story? That's a contentious assertion about a living person, and it's not contained in the article itself. MastCell  04:02, 9 April 2012 (UTC)

Hi MastCell,

From the Grann story:

When I called the public-relations firm that he had recently hired, the spokeswoman told me that he was afraid for his life. "He's been getting death threats," she said. "These people won't leave him alone." Initially, she set up a luncheon for the three of us to get together in New York...

Here is some information to get people started on understanding what PR agencies do. It's important for Wikipedians to get up to speed on this; we seem to be acting on a naive model of how news stories, let alone magazine articles, get written and published.

About public-relations ("PR") agencies and the NYT:

http://publiceditor.blogs.nytimes.com/2011/07/14/p-r-professionals-bane-or-boon/

About PR agencies and the media in general:

http://www.propublica.org/article/pr-industry-fills-vacuum-left-by-shrinking-newsrooms/single

About "Pseudo-events":

http://www.nku.edu/~turney/prclass/readings/events.html

Best regards, Postpostmod (talk) 23:53, 14 April 2012 (UTC)

Thanks; I'm familiar with how public-relations agencies operate, but was trying to understand the basis for your belief that a PR agency "planted" the Grann story. I still don't see the basis for your claim in the article. Quite the opposite; it sounds like Steere declined to be interviewed because he didn't want publicity. You carefully placed an ellipsis in your quote from the article; here's the context you chose to omit:

Initially, set up a luncheon for the three of us to get together in New York, but on the day before the meeting, Steere backed out. "He's worried that any publicity will only make him more of a target," the publicist said. Finally, after several more entreaties, he agreed to meet in his office at the New England Medical Center.

It doesn't exactly sound like he was desperate to get his side of the story into the Times. And there is definitely nothing remotely supporting your claim that the Times story was "planted" by Steere and his henchmen. Am I missing something? MastCell  00:15, 15 April 2012 (UTC)

Modified part of "Tick removal"

Modified "avoiding ... removing the head from the body" to "avoiding ... removing the head from the tick's body". Initially might have meant avoiding to remove the head from the victim's body. It most probably refers to the tick's body. I know letting the tick's head into the victim's body is dangerous. Nevertheless, if you have arguments I might have been wrong, please post them here. Ferred (talk) 18:46, 4 May 2012 (UTC)

Controversy and Politics

Hi. Under the Controversy and Politics section there reads: "The campaign of Mitt Romney and Paul Ryan favors a law that will provide "physicians with protection from lawsuits to ensure they can treat the disease with the aggressive antibiotics that are required.". Now, though this does fall under the section of politics, the statement sounds a bit controversial itself. First off, it only giving one party's candidates opinion on the matter. Do other parties have an opinion on the protection of doctors or the course of proper treatment in regards to Lyme disease? Second of all, given that it is nearing election time, the statement seems suspect. Finally, the statement is a partial representation of the information in the source material (a campaign flyer by Romney for President, Inc). I propose the deletion of this statement until an assessment of other party's platforms on Lyme disease can be completed and summarized. I would greatly appreciate the input of others, including the original contributor, so that we may discuss and resolve this query. Helihax (talk) 23:46, 7 October 2012 (UTC)

When I first saw this edit go in, I also thought it didn't fit in the article and should come out. However, I took a close look at the rest of the items in the "Controversy and politics" section, and came to the conclusion it fits in there easily. I had no idea how heavily politicized this issue was. The fact that the Romney campaign has sent out this literature isn't under question, what might be questioned is the noteworthiness of the item, so we're looking to see if reliable secondary sources are reporting on it. The sourcing for the content isn't the best, but it's not terrible: one is a blog post, but it's a blog post of John McCormack, a staff writer at the Weekly Standard; and the other is a regular news article from Slate. The Slate article is fine, and I'm only lukewarm about a news-blog, but given the other stuff in this section, it passes and I don't see a policy-based reason to remove it. I doubt this campaign item will have a lasting effect worthy of inclusion in an encyclopedia article, but because of WP:NOTPAPER I can't come up with a good enough reason to see it removed. Zad68 14:26, 8 October 2012 (UTC)

Prolonged therapy - edits reverted

These edits, which I reverted, are problematic. First, the claim of "Several...textbooks..." is unsupported. More clearly, the reference used as an example does not appear to support this; to wit, in the chapter on Lyme disease (242, Borrelia burgdorferi...), the section about conventional treatment is followed by this paragraph:

Following appropriately treated Lyme disease, a small percentage of patients continue to have subjective symptoms, primarily musculoskeletal pain, neurocognitive difficulties, or fatigue, in some instances, for years. Among such patients, three double-blind, placebo-controlled trials failed to show a benefit from additional courses of antibiotic treatment. In the largest of these studies, patients with post–Lyme disease syndrome received intravenous ceftriaxone for 30 days followed by oral doxycycline for 60 days or intravenous and oral placebo preparations for the same duration. However, there were no significant differences between the groups in the percentage of patients who felt that their symptoms had improved, worsened, or remained the same. Such patients are best treated symptomatically rather than with prolonged courses of antibiotic therapy. Prolonged ceftriaxone therapy for unsubstantiated Lyme disease has resulted in biliary complications; in one reported case, prolonged cefotaxime administration resulted in death.

References 107 (<ref name="idsa guideline"/>) and 116 (<ref name="Klempner"/>) are already cited in the article; references 117 (Krupp, PMID 12821734) and 118 (Fallon, PMID 17928580) could be added; however, for now I've added reference to the Mandell chapter to a relevant statement in the article. -- Scray (talk) 19:57, 3 November 2012 (UTC)

Conflicting info on deer population reduction

Prevention:
'A community can prevent Lyme disease by reducing the numbers of primary hosts on which the deer tick depends, such as rodents, other small mammals, and deer. Reduction of the deer population may, over time, help break the reproductive cycle of the deer ticks and their ability to flourish in suburban and rural areas.'

Ecology:
'The risk of acquiring Lyme disease does not depend on the existence of a local deer population, as is commonly assumed. New research suggests eliminating deer from smaller areas (less than 2.5 ha or 6 acres) may in fact lead to an increase in tick density and the rise of "tick-borne disease hotspots".'
—Darxus (talk) 22:45, 26 November 2012 (UTC)

Great catch. Let's check the citations to see if one is actually supported by more research per WP:MEDRS. SkepticalRaptor (talk) 22:50, 26 November 2012 (UTC)

Ticks are also responsible for transmitting 2 other serious tick borne diseases: Babesiosis which can be fatal to those with compromised immune systems and ehrlichiosis or Rocky Mountain Spotless fever. Both are difficult to diagnose as there is no rash and the babesiosis can only be found via blood slides by someone trained to identify it - usually an infectious disease specialist. — Preceding unsigned comment added by 173.2.200.14 (talk) 21:02, 30 January 2013 (UTC)

Lyme Disease Spirochete Needs High Manganese Level

Lyme Disease Spirochete Needs High Manganese Level

A study was released today by Johns Hopkins -- the Lyme spirochete is manganese-based, not iron-based!!!

Scientists reveal quirky feature of Lyme disease bacteria

http://phys.org/news/2013-03-scientists-reveal-quirky-feature-lyme.html

"To cause disease, Borrelia burgdorferi requires unusually high levels of manganese, scientists at Johns Hopkins University (JHU), Woods Hole Oceanographic Institution (WHOI), and the University of Texas reported. Their study, published March 22, 2013, in the Journal of Biological Chemistry, may explain some mysteries about why Lyme Disease is slow-growing and hard to detect and treat. The findings also open the door to search for new therapies to thwart the bacterium by targeting manganese.. ......" — Preceding unsigned comment added by 71.224.145.215 (talk) 01:50, 22 March 2013 (UTC)

In other words: Borrelia bacteria are anaerobe...because aerobe bacteria need iron. So therefore you need to target anaerobic bacteria with any treatment. --178.197.229.27 (talk) 12:56, 4 December 2013 (UTC)

Alternative treatment

Because the section on alternative treatment offers no insights, I have removed it for the following reasons:

• There is no proof that any of these treatments work, in vivo
• There are no published data to confirm any evidendence that these treatments work
• The suggested remedies may give false hope or delay treatment in appropriate cases

IMHO this section was added as part of an agenda, for the article to appear balanced or for the article to appear politically correct. As long as there are no hard data or that the medical community has accepted any of the claims made, I would suggest that this section does not remain part of the article. I have moved the offending section to the area below, should anybody take offence and wish to put it back into place.
Also I would like to point out that initial treatment of Lyme disease varies over time (although most of the antibiotics remain the same). The fact that most children should not be treated with doxycyclin is a matter of dispute. The basis for this is purely hypothetical, wheras the consequences of contracting Lyme disease are not.

Alternative therapies

A number of other alternative therapies have been suggested, though clinical trials have not been conducted, so the therapies are not known to be scientifically sound. For example, the use of hyperbaric oxygen therapy has been discussed by CAM enthusiasts as an adjunct to antibiotics for Lyme. Though there are no published data from clinical trials to support its use, preliminary results using a mouse model suggest its effectiveness against B. burgdorferi both in vitro and in vivo. Anecdotal clinical research has suggested antifungal azole medications, such as fluconazole, could be used in the treatment of Lyme, but the use of these drugs has yet to be tested in a controlled study.

Alternative medicine approaches include bee venom, because it contains the peptide melittin, which has been shown to exert inhibitory effects on Lyme bacteria in vitro; however, no clinical trials of this treatment have been carried out.

References

1. Taylor RS, Simpson IN (2005). "Review of treatment options for lyme borreliosis". J Chemother. 17 (Suppl 2): 3–16. PMID 16315580. {{cite journal}}: Unknown parameter |month= ignored (help)
2. Pavia CS (2003). "Current and novel therapies for Lyme disease". Expert Opin Investig Drugs. 12 (6): 1003–16. doi:10.1517/13543784.12.6.1003. PMID 12783604. {{cite journal}}: Unknown parameter |month= ignored (help)
3. Schardt FW (2004). "Clinical effects of fluconazole in patients with neuroborreliosis". Eur. J. Med. Res. 9 (7): 334–6. PMID 15337633. {{cite journal}}: Unknown parameter |month= ignored (help)
4. Lubke LL, Garon CF (1997). "The antimicrobial agent melittin exhibits powerful in vitro inhibitory effects on the Lyme disease spirochete". Clin. Infect. Dis. 25 Suppl 1: S48–51. doi:10.1086/516165. PMID 9233664. {{cite journal}}: Unknown parameter |month= ignored (help)

77.167.212.162 (talk) 17:46, 5 April 2013 (UTC)

I agree with the removal not necessarily for the reason stated but rather all of these sources are quite outdated, and some of them are primary sources. Certainly by now if any of these treatments had any traction, they'd have been evaluated in clinical testing and be picked up in review articles. Maybe we can find a recent review article that mentions them and also reviews the evidence for their effectiveness and safety. Zad68 17:55, 5 April 2013 (UTC)

The root of Japanese Knot Weed is used in eastern medicine to treat Lyme disease if someone wants to add it94.172.127.37 (talk) 02:27, 22 May 2013 (UTC)

FYI

The edit was reverted as a good faith edit (within five minutes). As I have no interest in starting an edit war. I will leave it here. 77.167.212.162 (talk) 18:03, 5 April 2013 (UTC)

Well your edit looked like this: An anonymous IP removed well-sourced but controversial content without an edit summary. That often looks like vandalism or some form of POV editing. To give your edit a better chance of staying, next time try providing a complete, detailed edit summary, cite the Misplaced Pages policy or guideline supporting your edit, and you could have linked to this Talk page discussion explaining why you were making your edit. Also, consider creating an account... like it or not, IP editors don't often get the same level of respect as logged-in editors. I'll try making the edit and leaving a summary and a link here. Zad68 18:16, 5 April 2013 (UTC)

Oldest known case of Lyme disease

I read that researchers studying the Ice Man found that he had Lyme disease. Is this relevant enough to include in the article?--Ambiesushi (talk) 17:16, 27 May 2013 (UTC)

Yes, IMHO.

World map of infections

The current world map showing countries with reports of the disease does NOT agree with the text of the article; specifically, no map indication in S.America, but the article mentions a case in Brazil. Steve8394 (talk) 05:53, 30 May 2013 (UTC)

2013 University of North Florida Research

In June 2013, Dr. Kerry Clark, University of North Florida associate professor of public health, and his colleagues published research of several significant findings in The International Journal of Medical Sciences:

• They found two species of Lyme disease bacteria that infect human patients but were previously unknown to infect humans: Borrelia americana and Borrelia andersonii
• The commonly found lone star tick, formerly believed by many to be incapable of transmitting Lyme disease, was implicated in some of these cases.
• Because current testing methods and interpretation criteria detect just one previously-discovered species, the new discoveries may explain complaints about Lyme disease test reliability and possibly about the existence of the chronic form of Lyme in general.

References

1. http://www.medsci.org/v10p0915.htm
2. The International Journal of Medical Sciences, May 2013

I added information about this to the Lyme Disease page.

Soon after, Misplaced Pages editor Scray removed it with message:

too soon - WP is not a news source and a finding like this needs secondary sourcing in WP:MEDRS; primary sourcing in a third-tier journal, and secondary sourcing from non-medical sources, is insufficient

The paper is here in the International Journal of Medical Sciences. The International Journal of Medical Sciences is peer-reviewed and available in MEDLINE and PubMed. This is the long list of peers on the editorial board of the journal.

Editor "Scray" quoted https://en.wikipedia.org/Wikipedia:MEDRS . That page says:

Peer reviewed medical journals are a natural choice as a source for up-to-date medical information in Misplaced Pages articles.

I understand and respect Scray's desire to properly identify the information as new.

However, it seems like the complete removal of every character I touched on both this Lyme Disease page and also the other Lyme page was too heavy handed. This was a peer-reviewed journal. It seems like the appropriate thing to have done would have been to add clarifications about it being early research, not to remove it entirely, full stop.

Therefore I will re-add a subset of this material and add more clarifications as to the research status, and reduce the strength of the language.

Please keep an eye out for editors trying to remove all reference to the new study in a peer reviewed medical journal. I hope that the softer language and less-prominent placement will satisfy all.

Garkbit (talk) 21:06, 30 June 2013 (UTC)

---

Your addition is based on a primary report - most such reports turn out to be wrong (particularly in a journal like IJMS). Until it's reflected in high-quality secondary medical sources, this should not be added except perhaps in a "Research" section (even that may violate WP:UNDUE). Furthermore, there's no need to promote the "discoverers" and their institution by naming them in our article, and commenting on the journal title is unencyclopedic. -- Scray (talk) 22:26, 30 June 2013 (UTC)

--

The Misplaced Pages:Identifying reliable sources (medicine) page says:

As mentioned above, the biomedical literature contains two major types of sources: primary publications describe novel research for the first time while review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments; secondary sources include meta-analyses, which combine the results of many clinical trials in an attempt to arrive at an overall view of how well a treatment works. It is usually best to use reviews and meta-analyses where possible, as these give a balanced and general perspective of a topic—and are usually easier to understand!

Peer reviewed medical journals are a natural choice as a source for up-to-date medical information in Misplaced Pages articles. They contain a mixture of primary and secondary sources as well as less technical material such as biographies. Although almost all such material will count as a reliable source for at least some purposes, not all the material is equally useful, and some, such as a letter from a non-expert, should be avoided. Journal articles come in many types: original research, reviews, case reports, editorials and op-ed pieces, advocacy pieces, speculation, book reviews, letters to the editor and other forms of commentary or correspondence, biographies, and eulogies.

I'm not super experienced with WP protocols, but from my reading, this does not say that primary sources are disallowed as sources and should be removed from Misplaced Pages if there aren't followups. It says use reviews and meta-analyses where possible, which is hardly the same thing. It's not as if in this case we are trying to balance conflicting views and weighting the May 2013 research and a later-published meta analysis that disagrees with it. The "Identifying reliable sources" section goes on to recommend peer reviewed medical journals and the exceptions they mentioned (e.g. a letter from a non-expert) do not apply here.

Your comment on *this* page that says "most such reports turn out to be wrong" seems to be a form of "original research".

I totally get why you wanted the original article to be toned down in terms of stating things factually, but it seems like the now revised article wording including nothing in the intro paragraph and adding "but has not yet been confirmed by other teams, and may be controversial until then" takes care not mislead the reader about the status of the research.

Frankly, so much is controversial about Lyme Disease, that if everything that were potentially controversial were removed from Misplaced Pages entirely there would be only a handful of words in the entire article. :-)

As for mentioning the guy's name, I don't know him and have no stake in his promotion, but it seems like an odd claim that it's inappropriate to mention his name in the context of the article. Nearly every paragraph in the history section mentions someone's name who did some research:

• "Carl Lennhoff, who worked at the Karolinska Institute in Sweden"
• "In 1970, a dermatologist in Wisconsin named Rudolph Scrimenti"
• "In 1980, Steere, et al., began to test"
• "At a 1909 research conference, Swedish dermatologist Arvid Afzelius presented a study"

I should also note that your reversion contained an explicit link in your reversion quoting the policy for "Misplaced Pages is not a newspaper" ( https://en.wikipedia.org/Wikipedia:NOTNEWS). I read it and does not seem to support your case for complete reversion. It mentions things like "Misplaced Pages does not constitute a primary source" and discouraging "routine news reporting on things like announcements, sports, or celebrities", but this doesn't seem to apply in either case. This was pointing to research in a peer reviewed medical journal as a primary source.

I'll reduce the references to the journal name, i don't feel strongly about it, and since you do, I'll comply.

After I've made these changes, I request that the information not be deleted entirely. Perhaps I'm mistaken, and if so I apologize, but I don't see what you've pointed to to support the idea that a peer reviewed medical journal is by definition NOT a valid source to be mentioned in some form, especially when there are various caveats in the revised version I made to reflect your feedback. From the guidelines "Peer reviewed medical journals almost all such material will count as a reliable source for at least some purposes". I'm trying in good faith to address your issues and comply with WP guidelines, and i hope that you will let the revised version stand. Thank you, Garkbit.

Garkbit (talk) 23:45, 30 June 2013 (UTC)

No, we can't use it. It's primary research. Wait for reviews. Also, per WP:BRD, don't restore that material before you have a consensus of editors for such content. Restoring it is edit warring which can get you blocked. See WP:3RR. -- Brangifer (talk) 23:56, 30 June 2013 (UTC)

My reading of WP:PRIMARY shows that primary sources can be used, but with great care. As such, mention of tentative findings that are awaiting replication may be noteworthy, as if nothing else, it shows that further research is still ongoing. This is noteworthy, as the efficacy of Lyme titer is rather variable in some cases. This may explain the otherwise inexplicably high number of negatives that respond to presumptive treatment. That said, I'd suggest mention of a tentative discovery of additional organisms, with the primary source listed and reinforcing the tentative nature, as well as no replication of results has been attempted as of yet.Wzrd1 (talk) 00:28, 1 July 2013 (UTC)

It is indeed interesting when there's new research uncovering a previously unreported, possibly important new finding regarding a still-mysterious disease like Lyme. It's tempting to want to get this research out there as soon as possible, using a primary study result like this, but this is absolutely not the kind of primary source we want to include in an encyclopedia, at least not yet. The research is far too tentative to include: Clark 2013 only discusses findings of DNA of related tick species of Lyme victims or people who just live in areas where Lyme is found, there is absolutely no causative finding. The study states only "several B. burgdorferi sensu lato species may be associated with Lyme disease-like signs and symptoms" based on a handful of individuals. Lyme is extremely well-studied and has the attention of the most influential medical organizations. It's inappropriate to include this primary research so early, we need to please wait for the findings to be reproduced and picked up in reliable secondary sources before including. If the findings are indeed significant they'll be picked up in the next year, and we can use the information then. Zad68 02:31, 1 July 2013 (UTC)

It sounds like you read the paper. A small sample size is already something of concern. It also sounds like a correlation is not causation error may be present as well. Didn't get the chance to try to read the paper due to my father's ill health challenging my available time significantly, as well as distracting me, as he is currently hospitalized secondary to a sudden loss of consciousness during his pre-operative screening on Friday. Fortunately, I had brought his hypotensive state at that time to the attention of the physicians evaluating the cause of his LOC. The consensus now is that his anti-hypertension medications need to be lowered in dosage, as he's now in ESRD and on dialysis. Hopefully, once he's released from the hospital, I'll have the time available to read papers as I hear of them.Wzrd1 (talk) 02:58, 1 July 2013 (UTC)

Wzrd1, very sorry to hear about your father's health, I wish for a speedy recovery for him. Taking care of your family takes far higher priority. Don't worry, Misplaced Pages and this article will still be here in a few weeks or months, or whenever you have time later. Zad68 13:36, 1 July 2013 (UTC)

US-centered?

The intro says that Borrelia afzelii and Borrelia garinii are the main cause in Europe and Borrelia burgdorferi sensu stricto in the US. But the pathophysiology section appears to be solely about the latter.
Also, the article says "Many of the signs and symptoms of Lyme disease are a consequence of the immune response to the spirochete in those tissues." But from the Dutch article I understand that an important difficulty in diagnosing the disease is that there are often no anti-bodies. Now I have little medical knowledge, but don't those two statements contradict each other? Might they be about the different strains?
Confusingly, the Europe-section only mentions burgdorferi. And it says that here, the disease is a European genospecies of bugdorferi. But isn't it the other way around, the American version being a variation of the originally European disease? At least, the Dutch article suggests that (Scottich immigrants taking the disease with them).

I haven't read much of the article because I spend a lot of time walking off-track in forests and therefore absolutely don't wish to be misinformed.
Am I getting something wrong here? If not, this is a rather serious omission since it is a rather common disease that (in Europe) is difficult to diagnose and may have very serious consequences. Which makes this a very important article. At the very least, where there are any differences between Europe and the US, this should be made clear. DirkvdM (talk) 08:03, 16 July 2013 (UTC)

Wright 2012 - second round?

In this edit, it is suggested that Wright 2012 advocates a second round of treatment for "arthritis symptoms" that "fail to respond". My guess is that this is based on Wright's Table 4, which restricts this suggestion to persistent or recurrent joint swelling (an objective sign, not just a symptom). Our article currently makes a much broader recommendation than the cited source, IHMO. -- Scray (talk) 03:47, 8 August 2013 (UTC)

I tried to reuse previous wording, possibly inappropriately. Thanks for catching, will fix tomorrow (if you don't get to it first!). Zad68 03:56, 8 August 2013 (UTC)

I took a shot - if not quite right we can refactor again. -- Scray (talk) 04:10, 8 August 2013 (UTC)

Lyme Disease in Australia

I'm a bit concerned about this section, as while most of the references appear to be the work of a single GP who specialises in the treatment of "Chronic Lyme Disease" - indeed an ad for his clinic is the first (sponsored) link that comes up when searching from Google's Australia portal. Also one of the sources (Piesman 1991) seems to contradict the statement it is being used for - it actually found that the ticks being tested were unable to act as a vector for the strain of B. burgdorferi used. I'm happy to do a bit of research to find some better references, but as a complete Misplaced Pages novice I'm not quite sure what the process is to change this. Thank you.118.208.108.75 (talk) 13:07, 7 September 2013 (UTC)

The process is very simple: you just remove the section entirely :)

It seems pretty cut and dried. If you search on google, it's basically all patients saying "lyme disease exists". The Australian government just says they are monitoring it. Also there are a few results from Dr Mayne. If you look in google scholar it basically says the vectors don't exist. If anyone does want to put it into the article again you will need a good review as per WP:MEDRS. --sciencewatcher (talk) 13:35, 12 September 2013 (UTC)

Safety of antibiotics

The sentence I removed is a quite classic case of original synthesis. "However, blah blah", the sentence is clearly intended to oppose the position of the IDSA, AAN, CDC, and NIH. But that was clearly not the intention of the authors of the cited studies. Antibiotic safety is not an absolute matter; it's a cost benefit analysis, and the NIH and others are quite clearly saying in their citations that the potential benefit is not worth the potential cost. If you want to suggest that the NIH, CDC, AAN, and IDSA are wrong in their opinion, you'll have to find a source that actually suggests that, rather than finding a tangetially relevant paper and making the leap from A+B to C. Someguy1221 (talk) 07:36, 27 July 2011 (UTC)

I'm sorry, but you're wrong. This section of the article deals with "Controversy and politics" and part of the controversy is the implied suggestion that long term treatment with antibiotics is unsafe, when clearly there are differing opinions within the medical community about this, especially in regards to to oral antibiotics. Doxycycline cannot be "safe" for long term treatment of acne, and "unsafe" for long term treatment of LD; this is part of the "controversy" regarding LD. I am going to undo your changes. Damwiki1 (talk) 08:54, 27 July 2011 (UTC)

The above exchange was copied from Damwiki1's talk page. The text in question can be seen here: . I believe my actions were a straightforward application of WP:MEDRS and WP:OR; the cited references do not discuss Lyme disease, but are used to create an illusion of scientific controversy regarding this aspect of Lyme disease treatment. I would appreciate others' input on this. Someguy1221 (talk) 09:27, 27 July 2011 (UTC)

The section under discussion is entitled: "Controversy and politics". "Controversy" implies conflicting points of view, and if there were no conflicting points of view regarding the safety of long term antibiotic therapy, it would not be a topic in this section of the article. I have presented citations showing that long term treatment with doxycycline and minocycline is common practice for the treatment of adult acne, and that it is considered safe. This doesn't imply that long term mino/doxycycline therapy should or should not be used to treat LD, only that the risks of doing so are extremely low. In any event, you should have started this discussion prior to your edits.Damwiki1 (talk) 10:06, 27 July 2011 (UTC)

Hello, Someguy and Damwiki. Maybe you'd both be interested in the thread above this one, which has diffs supporting my observations below. Damwiki, I do think WP:SYNTHESIS, as it is customarily applied by WP:MED, is a technical problem with your particular edit. However, even if you cite an impeccable WP:MEDRS in which one, or a group of, dissenting doctors makes your point about the relative safety of oral antibiotics compared to the dangers of undertreated Lyme disease, it will either be disallowed entirely, or call forth additional citations from, um, higher ranking sources, saying that the dissenters can't be trusted and should be disregarded.

As to why this is, I'll say it again, another way, as I think one needs to understand the politics in order to edit this article effectively. The bottom line is, WP:MED's current membership will not support edits that document credible challenges to the "mainstream view", even in the "Controversy" section. In medical articles, WP:MED can trump WP:NPOV. The preferred solution to controversy seems to be, to identify the more politically powerful side, and then follow it and have faith that it is scientifically correct. This faith makes it more powerful, and so on ad infinitum. A situation where big influential organizations like those mentioned by Someguy, are demonstrably wrong, is thought to be practically impossible, and hence subject to WP:FRINGE. (I'm not suggesting that WP:MED members are acting in bad faith. I can see that if you're going to edit a lot of articles, thus providing medical information on many subjects to millions of people, this would be the quickest way to do it. We all share the hope that the mainstream is usually right, even when we are unfortunate enough to encounter a case where it isn't. ;-)

These are my personal observations, of course; everyone needs to read at least the article and talk-page histories, if not the primary Lyme disease literature and criticism upon which the mainstream view depends. We can each form our own impression of how the politics works.

One might think there is no point in trying to make the article meet WP:NPOV, under these conditions. On the other hand, the areas of the article (and of the LD field) where dissenters are acknowledged to exist, even when they are disparaged, may be useful in alerting readers that there is some kind of problem with the status quo, thus motivating them to investigate further. The templates at the top of the talk page help in this regard, particularly the sarcastic one about the "manifold evils of ..."). So, proceed as you think best; just thought I'd put in my two cents worth. My best regards to all involved in working on this difficult article, Postpostmod (talk) 16:50, 27 July 2011 (UTC)

I fully understand that there is an orthodox view regarding treatment of LD. It is not my intent nor does my edit imply that long term oral antibiotic treatment is preferable to shorter courses of treatment. However, it is not synthesis or OR to suggest that the proven safety of long term oral antibiotic therapy to treat acne demonstrates its safety (but not efficacy) to treat other diseases. For example here: Adverse events associated with prolonged antibiotic use the authors explicitly use medical databases to examine the rate of adverse events with doxycycline (and others) to determine its safety in potentially treating a rare disease (anthrax). The problem of synthesis does arise when it is implied that long term oral antibiotic therapy creates a greater likelihood of serious adverse events while treating LD, than in the general population, yet there are no studies that suggest this, yet the article, as written implies that this is the case.Damwiki1 (talk) 18:05, 27 July 2011 (UTC)

You may be missing the point that Someguy made in his initial post. "Safety" is a relative term and generally depends on the context in which a drug is used. Cisplatin is acceptably safe for treating someone with testicular cancer, but absolutely unsafe to treat, say, acne. Since long-term antibiotic therapy has no proven efficacy in "chronic" Lyme disease, even rare side effects make it unacceptably unsafe. Moreover, the major concern is not necessarily individual adverse reactions, but the generation of antibiotic resistance, which is typically not easily quantified in the studies you're describing.

The underlying point is that we need to accurately convey the state of knowledge in the field. Right now, major medical bodies feel that long-term antibiotic use for "chronic" Lyme disease is unacceptably unsafe. Trying to "rebut" those expert bodies by selecting and juxtaposing individual studies is exactly the sort of editorial intrusion that WP:MEDRS warns against. MastCell  18:53, 27 July 2011 (UTC)

I am trying to "...accurately convey the state of knowledge in the field..." and the long term safety of oral antibiotics is part and parcel of that state of knowledge. The study I linked to, above, shows an overall rate of serious adverse events of .9/100,000 person years of treatment for doxycycline, by way of contrast the probability of a US resident being hit by lightning is .13/100,000 person years: . Perhaps these figures should be included in the article to adress the absolute safety of oral antibiotic therapy? Some US States have laws allowing physicians to treat LD via long term antibiotic therapy, in specific defiance of mainstream LD treatment protocols and the safety of such therapy needs to be addressed within this article. Long term treatment of LD with antibiotics is an established fact, as is the safety of long term oral treatment via antibiotics. The decision as to whether "...long-term antibiotic use for "chronic" Lyme disease is unacceptably unsafe..." is a decision that patients and doctors must make, based upon the available literature, rather than solely on the treatment opinions of any medical association. Again, this is a simple fact, established by law in many jurisdictions, and the article will be remiss if it does not address the issue of the long term safety of antibiotic therapy, especially since legal authority to prescribe long term therapy is part of the "controversy and politics" surrounding LD. Whether long term antibiotics should be used to treat LD and the merits or drawbacks to doing so is a separate issue.Damwiki1 (talk) 19:54, 27 July 2011 (UTC)

If the risks outweigh the benefits with the use of antibiotics, then let's see actual reviews saying that. We should not be committing clear synthesis by implying safety using studies of other conditions. There are clear safety concerns outside of mere adverse events to the patients, including the development of resistance to antibiotics. Please find reviews per WP:MEDRS that state it in the context of this disease before putting any information like this back in. Yobol (talk) 20:29, 27 July 2011 (UTC)

Since this edit has been in the article for some time and is under active discussion, I would strongly urge you to undo your previous edit until consensus has been reached here.This is wikipedia policy.Damwiki1 (talk) 20:36, 27 July 2011 (UTC)

At this point, I see 3 editors noting they think this is inappropriate, with a 4th also noting significant OR problems here. Consensus appears to be coalescing against this material, and should stay out until you such time as consensus is reached it is appropriate. That bad material has stayed in the article for all of two months does not make it immune to removal, especially when it is a clear violation of our policies. Yobol (talk) 20:43, 27 July 2011 (UTC)

That's not how wikipedia is supposed to work and the policy is for disputed articles to remain as is until consensus. However, to return to the topic of antibiotic safety, there are a number of sources that discuss the use of long term antibiotic therapy for LD, with tetracycline class antibiotics, and none of them state safety as an issue: , ,. I have previously provided large scale studies showing a very low rate of severe adverse events: .9/100,000 person years of treatment for doxy, and to draw another comparison, the rate of fatal MVAs in the USA is about 14/100,000 person years. The State of Connecticut is on very solid ground in granting Drs the right to prescribe long term antibiotic therapy, since the science and statistics of long term therapy is well known. Again, it is clearly misleading for this article to remove all references to long term antibiotic safety statistics, from large scale databases, and it clearly violates a NPOV.Damwiki1 (talk) 00:55, 28 July 2011 (UTC)

Agree with others here who have expressed concern about WP:SYNTH with respect to the content regarding long-term antibiotic safety. This has nothing to do with orthodoxy. -- Scray (talk) 01:33, 28 July 2011 (UTC)

Additionally, I don't think the references cited by Damwiki1 actually mean what he thinks they mean.

PMID 8740119 does note that, 15 years ago, many physicians used long-term antibiotics for "chronic" Lyme disease, but the paper explicitly attributes long-term antibiotic use to poor physician education, not as a desirable practice.

PMID 9233665 (which, incidentally, is a 14-year-old conference presentation, not a regular journal article) explicitly states that randomized, controlled trials need to be performed to definitively evaluate the safety and efficacy of long-term antibiotic therapy. Such trials were, of course, subsequently performed, and the negative results of these trials heavily influenced the positions of the IDSA, AAN, CDC, etc. It seems a bit misleading (at best) to cite the observational 1997 conference presentation without acknowledging the subsequent randomized, controlled trials which it called for.

PMID 14586290 is very interesting. The author apparently took patients with vaguely defined symptom constellations and gave them tetracycline and Plaquenil "until patients' symptoms were resolved or improved." Ten points for Gryffindor if you spot the logical flaw here. Hint: if I have a sprained ankle and you treat me with tetracycline "until symptoms resolve", you would (using this paper's logic) conclude that tetracycline heals ankle sprains. The success rate of any treatment is going to be high if it's continued "until symptoms resolve", and if any resolution of symptoms is attributed to the intervention.

But I digress, I suppose. MastCell  23:31, 29 July 2011 (UTC)

I find it interesting that you are willing to find logical flaws in the treatment plans of Drs who use long term antibiotic therapy, but are unwilling to apply the same logic tests to Drs who insist on very short courses of antibiotics.However, it is not our place as wikipedia editors to sit in judgement of Drs, but only to present a neutrally written article for public consumption. Yet it would seem from your comments that you have a non-neutral POV. First off, there are no studies that show that LD patients are more likely to to suffer adverse effects from long term antibiotic therapy than the general population - if such studies existed they would be presented, but it would also be simply amazing and would indicate a severe underlying condition unique to chronic lyme sufferers. The rate of serious adverse effects with the most common antibiotics used are so low, that the patient literally has a much higher chance of dying while driving to see the physician than having a severe adverse event. "Do no harm" is the first rule in medical practise and even if giving antibiotics is no better than placebo in terms of treatment effect, they are also no less safe than placebo, since the rate of adverse events is so low. This is the key point that needs to be addressed since even if oral antibiotics don't work, they are also very "safe", and trying to argue otherwise is complete nonsense, with no scientific validity.
Secondly, antibiotics such as tetracycline, doxycycline and minocycline are noted for their anti-inflammatory and neuroprotective properties. Again, it would be amazing if they did not have some therapeutic effect on a population suffering from neurocognitive and arthritic symptoms. If someone is suffering from 'brain fog' and joint pain subsequent to an LD infection, why wouldn't minocycline be therapeutic? And long term trials do show that patients felt better on antibiotics, only to relapse once they are withdrawn. What's the harm in treating a patient with an antibiotic that makes them feel better, and is safe to use for extended periods and coincidently will destroy any remaining spirochaetes that might be trying to evade destruction in areas of the body with low blood flow? This is a digression as well but it points out the glaring logical fallacy in insisting on very short courses of antibiotics to treat LD since as the length of treatment declines, the rate of incompletely treated patients will increase, but the key point is that there is no scientific basis for disallowing long term oral antibiotic treatment, on the basis of safety and tangentially there are a myriad of studies showing that certain antibiotics have anti-inflammatory and neuroprotective therapeutic properties in addition to their antimicrobial properties. The final point is that the growth in antibiotic resistance is mainly driven by the misuse and overuse of antibiotics in the global livestock industry, and forced animal consumption of antibiotics dwarfs the direct use of antibiotics in humans: farm-animals-get-80-of-antibiotics-sold-in-us.Damwiki1 (talk) 08:44, 30 July 2011 (UTC)

WP:NOTFORUM. At this point, there should be no further discussion about this on this talk page unless you can provide sources that speak to the safety of long term antibiotics use in the context of treating lyme disease. Everything else is WP:SYNTH, as has been noted by several editors already. Yobol (talk) 14:11, 30 July 2011 (UTC)

Like I said...  :-), Postpostmod (talk) 21:38, 30 July 2011 (UTC)

I re-added this from the archive. This is just too good. To the extent possible, I think we should take a deep breath and embrace the controversy.Cool Nerd (talk) 18:47, 27 September 2013 (UTC)

additional references

Correspondence, "Reinfection versus Relapse in Lyme Disease", New England Journal of Medicine, March 14, 2013. — Preceding unsigned comment added by Cool Nerd (talk • contribs)

Hi Cool Nerd, the NEJM is a great journal, but we don't really use correspondence (letters to the editor, etc.) as a source for biomedical info. Can you point to a literature review or a systematic review? Zad68 18:59, 27 September 2013 (UTC)

As information, true. As far as illustrating the existence of controversy, I think this exchange of three letters is very good. It very nicely illustrates that the controversy is still existing, at least as recently as March 2013.

And while we're both here, what do you think of the following idea: Medical associations have recommended . . . However, a minority of doctors . . . <--And if we move too far past this, we risk trying to resolve the issue ourselves. Cool Nerd (talk) 19:04, 27 September 2013 (UTC)

Lyme Culture Test Causes Uproar, Medscape, Janis C. Kelly, Jan 30, 2013.

"Improved Culture Conditions for the Growth and Detection of Borrelia from Human Serum," International Journal Of Medical Sciences (Int J Med Sci), Eva Sapi, Namrata Pabbati, Akshita Datar, et al., Feb. 18, 2013.

Introduction

" . . . The current recommended standard for Lyme disease testing employs an indirect 2-step serological assay that detects host immune reactivity to the Lyme disease bacteria. In a significant number of cases the serologic assays are not sufficiently sensitive or specific in part due to the presence of immune suppressive and modulating agents transmitted by the tick and secreted by the Borrelia spirochete and antigen-antibody complex formation. . . "

posted by Cool Nerd (talk) 17:24, 28 September 2013 (UTC)

Regarding Medical associations have recommended . . . However, a minority of doctors - this may be true but we really cannot use opinions of individual doctors to support a statement like this in the article. It'd be an inappropriate use of primary sources. Can you locate a secondary source that provides a commentary like this in reviewing the primary literature? Regarding the tests, what's the article content change you're looking to make? Zad68 03:17, 1 October 2013 (UTC)

The Int J Med Sci article is above my level, and for my own learning, I'm reading / skimming it. Other reference articles I like to read section by section, pulling and summarizing information, and then I compare my summary to our wiki article. And in particular, do we have any ommissions?

On ezinearticles(dot)com
" . . . About half of the patients have either no rash at all or they have ones that look different. . . "
And yes, I would like something more authoritative. Cool Nerd (talk) 21:01, 21 October 2013 (UTC)

rash not always present (only present 70 to 80% of the time)

Arthritis and Lyme Disease, WedMD Rheumatoid Arthritis Health Center, reviewed by David Zelman, MD on Oct. 1, 2012.

"Erythma migrans. Erythema migrans is the telltale rash which occurs in about 70% to 80% of cases and starts as a small red spot that expands over a period of days or weeks, forming a circular, triangular, or oval-shaped rash. Sometimes the rash resembles a bull's-eye because it appears as a red ring surrounding a central clear area. The rash, which can range in size from that of a dime to the entire width of a person's back, appears between three days and a few weeks of a tick bite, usually occurring at the site of a bite. As infection spreads, several rashes can appear at different sites on the body.
"Erythema migrans is often accompanied by symptoms such as fever, headache, stiff neck, body aches, and fatigue. These flu-like symptoms may resemble those of common viral infections and usually resolve within days or a few weeks."

Signs and Symptoms of Lyme Disease, CDC, page last reviewed: April 12, 2011.
• "Rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite after a delay of 3-30 days (average is about 7 days).
• "Rash gradually expands over a period of several days, and can reach up to 12 inches (30 cm) across. Parts of the rash may clear as it enlarges, resulting in a “bull's-eye” appearance.
• "Rash usually feels warm to the touch but is rarely itchy or painful.
• "EM lesions may appear on any area of the body."

Correspondence. The Presenting Manifestations of Lyme Disease and the Outcomes of Treatment. N Engl J Med 2003; 348:2472-2474, June 12, 2003.

We should add this, probably to the photo captions. Like most things in medicine, not 100%. Some people have Lyme even if they don't have the bull's-eye rash. Cool Nerd (talk) 21:33, 30 September 2013 (UTC)

The article currently states "The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull's-eye lesion and nontarget appearing lesions. The 20% without the erythema migrans and the nontarget lesions can often cause mis-identification of Lyme disease." so there's already mention of this, but the current source in the article supporting this is a primary source. I'd be happy to see the sourcing updated to the CDC and make the article content match. Zad68 03:12, 1 October 2013 (UTC)

Okay, range of appearances including target and nontarget. Why do we then have two pictures of the "classic" bull's-eye, one close-up of the central area, and then one picture we acknowledge is very uncommon? Cool Nerd (talk) 03:38, 1 October 2013 (UTC)

and not always a bull's-eye

Since it sometimes looks this way and sometimes doesn't, for the time being, I'm going to demote one of the two.

We really need to find some additional photos, to illustrate how broadly it can look. Cool Nerd (talk) 03:45, 1 October 2013 (UTC)

Agree it'd be great to have a non-bullseye image to illustrate the range of rash presentations, if such an image can be found. Zad68 03:53, 1 October 2013 (UTC)

Let's keep a look out and hope for the best. And either public domain or a credible (non-stretched) fair use. Cool Nerd (talk) 04:03, 1 October 2013 (UTC)

How often does the rash (when present) look like a bull's-eye, really?

Signs and Symptoms of Lyme Disease, CDC, page last reviewed: April 12, 2011.
• "Rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite after a delay of 3-30 days (average is about 7 days).
• "Rash gradually expands over a period of several days, and can reach up to 12 inches (30 cm) across. Parts of the rash may clear as it enlarges, resulting in a “bull's-eye” appearance. . . "

may clear, that's kind of some weasel words and some hedge language. And the reality is, even on this straightforward point, health care practitioners may not have a really good handle on the percentages. Cool Nerd (talk) 17:24, 1 October 2013 (UTC)

Arthritis and Lyme Disease, WedMD Rheumatoid Arthritis Health Center, reviewed by David Zelman, MD on Oct. 1, 2012.
"Erythma migrans. Erythema migrans is the telltale rash which occurs in about 70% to 80% of cases and starts as a small red spot that expands over a period of days or weeks, forming a circular, triangular, or oval-shaped rash. Sometimes the rash resembles a bull's-eye because it appears as a red ring surrounding a central clear area. The rash, which can range in size from that of a dime to the entire width of a person's back, appears between three days and a few weeks of a tick bite, usually occurring at the site of a bite. As infection spreads, several rashes can appear at different sites on the body. . . "

Sometimes the rash resembles, that's quite a bit more definite. And so, although the bull's-eye is very memorable, it is by no means a 100% deal.

Okay, WedMD is not a review article in JAMA. But . . . I'd say it's a good middle-brow source, and we'd should be a little cautious saying something different. Or, showing something different. So, the question remains, why have we been carrying two photographs showing the "classic" bull's-eye rash, even though it's far from a 100% deal? Cool Nerd (talk) 17:39, 1 October 2013 (UTC)

If you do a google image search you'll find various ones, such as this. However just be careful - you can't put images on wikipedia unless you have permission from the copyright holder. --sciencewatcher (talk) 18:32, 1 October 2013 (UTC)

Okay, thank you. http://hardinmd.lib.uiowa.edu/dermnet/lymedisease1.html
Okay, so this is the University of Iowa Libraries, Hardn Library for the Health Sciences.
DermNet.com is developed & maintained by Alan N. Binnick & Thomas P. Habif, Dartmouth Medical School, New Hampshire.

Or perhaps fair use in a legitimate way without over stretching it. I am working on other projects. But thanks for the lead. Cool Nerd (talk) 18:47, 1 October 2013 (UTC)

And this CDC page (also discussed below) has one example of an atypical rash.
http://wwwnc.cdc.gov/eid/article/19/5/12-0796-f1.htm

And from The Lyme Disease Foundation, here's a "Uniform color oval EM rash."
http://www.lyme.org/gallery/em_sk7.html
Cool Nerd (talk) 17:51, 3 October 2013 (UTC)

http://wwwnc.cdc.gov/eid/article/19/5/12-0796_article.htm To the Editor:
Yes, this is a letter to the editor CDC, but it sure looks like the first report of a study, appended by the names and professional affliations of six doctors and/or researchers. I'm not really sure how to take it. I myself would really hesitate before including it as a reference, other than perhaps illustrating the controversy surrounding Lyme disease. But, but . . . it includes a number of references :>)
.
.
6. Smith RP, Schoen RT, Rahn DW, Sikand VK, Nowakowski J, Parenti DL, Clinical characteristics and treatment outcome of early Lyme disease in patients with microbiologically confirmed erythema migrans. Ann Intern Med. 2002;136:421–8 . DOI

7. Nadelman RB, Wormser GP. Recognition and treatment of erythema migrans: are we off target? Ann Intern Med. 2002;136:477–9 . DOI

8. Eshoo MW, Crowder CC, Rebman AW, Rounds MA, Matthews HE, Picuri JM, Direct molecular detection and genotyping of Borrelia burgdorferi from whole blood of patients with early Lyme disease. PLoS ONE. 2012;7:e36825. DOI

9. Berger BW, Lesser RL. Lyme disease. Dermatol Clin. 1992;10:763–75.
.

Some of these have links on the CDC page. And from the letter, it seems like reference 6 is particularly good. And this illustrates the twin problems with research. One, you might not be able to find any information in response to a specific question. Two, you ask for a drink of water and you get sprayed by a water hose! Cool Nerd (talk) 18:56, 1 October 2013 (UTC)

seeking non-bulleye's eye sample pictures

Lyme Disease Picture 1, Hardin MD Super Site Sample, from DermNet.com (developed & maintained by Alan N. Binnick & Thomas P. Habif, Dartmouth Medical School, New Hampshire), Last updated Wednesday, Dec 8, 2010.

It seems like non-bulleye's rashes are common enough that we should include at least one picture. (and some Lyme patient's have no rash at all). And let's follow the general principles with fair use without trying to make a political point one way or the other. We don't need to be over-strict, we don't need to be under-strict. Instead, just right down the middle. Cool Nerd (talk) 22:04, 27 February 2014 (UTC)

Covering the controversy without feeling we have to decide one way or the other.

Lyme disease debate moves to San Francisco as advocates call for treatment, diagnoses changes, San Francisco Examiner, Alex Emslie, Sept. 30, 2013.

' . . . The Infectious Diseases Society of America is joining other medical associations for a conference at the Moscone Center from Wednesday to Sunday. At the same time, advocacy groups who want the IDSA to broaden Lyme disease diagnosis and treatment guidelines are planning their own events. . . '

' . . . “The controversy is basically centered around the question of whether or not ‘chronic’ Lyme disease exists,” said Dr. David Margolius, a resident in internal medicine at UC San Francisco. The IDSA has not recognized that Lyme disease bacteria can live through the 28-day treatment and instead calls lingering symptoms “post-treatment Lyme disease syndrome.” . . . '

So, we just present information. We don't need to decide. Cool Nerd (talk) 19:33, 4 October 2013 (UTC)

OK I am not an editor. And I research a lot and am being treated and am not sure..... But I can say that the article is way too much on the side of the CDC. The evidence that I have that the dissenting parties are gaining ground: 1. Blumenthal lawsuit, 6 states passed laws. I am guessing there are fewer than 5 diseases that have any kind of legal history in this scale. 2. Vast amounts of European studies are in conflict with US positions (In reading your notes it sounds like proof is only possible through NEJM and such which is narrowly controlled) I can provide them, but again I think they wouldn't meet the standard. 3. The folks at IDSA have softened their position (again not usable for the same reason) to "And even if chronic lyme disease did exist, so what? We can't be giving long term antibiotics out." I can get the interview. IDSA seems to be focused on the antibiotic crisis because they are losing the Lyme microbiology wars. 4. There are numbers of studies that have shown disease surviving repeated antibiotics in animal studies. It is the belief of Scientists (for example Burgdorfer in an interview) that research is being prevented in the main US medicine(the only parts the Misplaced Pages will cite) despite enormous data elsewhere. Again the conflict is about the use of antibiotics, not the disease. 5. There are studies showing Lyme in brains of 7/9 Alzheimers brains from the Harvard brain bank. In 30% of serology of committed mental patients (I have the links, they just are not from NEJM. 6. There are some serious doctors and researchers (Fallon, Columbia, and others.) openly speaking out. 7. There are open letters of disagreement in NEJM of strong tone. Very. Rare. Indeed. 8. The use of the word advocacy group is imbalanced. The primary advantage that IDSA has is that the CDC cites it. The Advocacy group has more doctors and is spending more money on Lyme research. The 'majority' view is not with the IDSA, the 'official' view is with the IDSA. The 'majority' of doctors are not involved one way or the other, and follow the processes of their employers. It is truly possible for a small number doctors to corner a debate, and the antibiotic overuse debate is really a good reason for the corner. 9. There were attempts at pulling the medical licenses of a half a dozen doctors (you want sources? This is fact, and relevant.) all done on behalf of the IDSA and this was entirely predicated on doctors not following IDSA rules to limit Antibiotic treatments of Lyme to 30 days. 10. Your article does not discuss Herxheimer's reaction, which is the primary means that chronic Lyme is an accepted clinical diagnosis in Lyme clinics. It comes from Syphyllis treatment a hundred years ago. Syphyllis and Lyme are the only two spirochetes that live in humans. Herxheimer's reaction is a well documented Immune response to dying bacteria. 11. if you read the position of the IDSA on published research they are defending 1984 medicine based on inadequate proof. But they also dismiss all animal models and microbiology as proof, and dispute all human samples as having sampling errors because of clinical diagnosis, and want laboratory testing instead. But when new laboratory testing comes out they dispute that for lack of controls on the human samples. There is clearly a lack of good intent. 12. There are large conferences held annually about chronic Lyme and a growing number of legal specialties growing from the conferences. There is an Ivy league medical school department completely focused on Chronic Lyme. How is it possible that the Misplaced Pages article allows this to be suppressed based on the control of a few doctors? 13. For me, I see lots of very sick people who are having Herxheimer reactions and who are getting better. 14. Despite ALL of this, I don't think the other side has a strong argument either. I have met people in treatment who have been through too much, and I think it is terrible. But your article says nothing useful at all, except that the IDSA recommends the 1984 treatment, and there a bunch of greedy quacks out there. I know my positions 1-14 seem like advocacy, but I also know the other side. What drives me crazy is that the other side is doing no research. They are just debunking all the research that is done. IDSA are good Doctors. They are right that Antibiotics are a poor cure for chronic Lyme disease. It would be better to break down biofilm colonies (which are absent in your article) - but no such break through can happen when a few people control the consensus. Sometimes it takes a Generational change of Doctors to get re-grounded. Misplaced Pages is supporting people who are limiting debate.

--- I think I know how to write a balanced approach, but I am a patient so would be disqualified, but I don't think you are capturing the true tone of the issue. 24.16.135.152 (talk) 06:52, 24 December 2013 (UTC) Robert_lovejoy_Goodwin@yahoo.com

History - FIRST penicillin Tx of ACA must be corrected to 1946

Nanna Svarts. Penicillinbehandling vid dermatitis atrophicans Herxheimer. Nord Med 1946;32:2783. Describes very positive effect of treatment with penicillin on 2 patients with ACA lasting 5-6 years (plus one with uncharacteristic chronic dermatitis). Translation from Swedish of the authors last remarks: "The effect of penicillin in these cases of chronic dermatitis of several years duration is remarkable. The explanation for the good effect must be that an ongoing infection is cause of the dermatitis. This relationship is of great theoretic as well as practical importance".

Above is the note I saved in my http://LymeRICK.net article database. I see I have to add a few more articles I was not aware of, Thank you! Svarts findings were mentioned in both my powerpoint/pdf prints of European Borrelia history presentations from lectures given: 1. Hull, UK, 2001 http://lymerick.net/Bb-history.pdf 2. Kassel, Germany, 2006 http://lymerick.net/Bb-historyG.pdf /Marie Kroun, MD, Denmark — Preceding unsigned comment added by 37.205.127.144 (talk) 12:18, 23 October 2013 (UTC)

List of notable people diagnosed with Lyme Disease

Please see the page I helped develop for Chronic Fatigue list of notable people diagnosed with chronic fatigue syndrome for an example of the structure to replicate for a potential inclusion - for a List of notable people diagnosed with Lyme Disease (this is to be a link in template "Lyme disease – Related navpages" (note am not proposing page to be listed in general overview of Lyme Disease but a separate page - see the link list of notable people diagnosed with chronic fatigue syndrome for proposed example) see also Template:Chronic fatigue syndrome as a guide to develop the "Lyme disease – Related navpages" template at the bottom of the Lyme Disease Misplaced Pages page (am proposing link to separate page for list of notable Lyme patients to be placed here), "Lyme disease microbiology" can also be placed within the "Lyme disease – Related navpages", and also Neuroborreliosis, Weather and climate effects on Lyme disease exposure, and any other Lyme related pages with aim to build easy navigational structure.

Please see other lists of notable people with other Diseases: https://en.wikipedia.org/Category:Lists_of_people_by_medical_condition Some other examples: https://en.wikipedia.org/List_of_breast_cancer_patients_by_occupation https://en.wikipedia.org/List_of_people_diagnosed_with_Parkinson%27s_disease

Lyme Disease Treatment: also think inclusion of some of the information from this page Lyme Disease: Two Standards of Care by Lorraine Johnson, JD, MBA Executive Director, CALDA (California Lyme Disease Association) under the Lyme Disease Treatment section may add value to the page potentially?

SpringSummerAutumn (talk) 17:06, 24 October 2013 (UTC)SpringSummerAutumn (talk) 04:18, 5 November 2013 (UTC)

Proposed "List of notable people diagnosed with Lyme Disease" (would need accurate/reliable 3rd party references for all of these if propose to include in list)

some rough sources that can start process to check reliability of to possibly include any notable people who are confirmed have had or still have Lyme Disease:

http://blog.petcarerx.com/10-celebrities-with-lyme-in-the-lyme-light/ 
http://www.huffingtonpost.com/2012/04/23/lyme-disease-celebrities_n_1438726.html#slide=886443 
http://hausfeldaboutlyme.wordpress.com/2010/06/30/celebrities-with-lyme-we-cant-all-be-crazy/
http://celebritieswithyourdisease.com/lymeease-2013224
http://www.usmagazine.com/celebrity-news/news/yolanda-foster-recovering-from-surgery-related-to-lyme-disease-2013224

SpringSummerAutumn (talk) 10:59, 24 October 2013 (UTC)

I'd generally oppose adding this sort of information to a general overview about Lyme, unless the fact that the individual has Lyme is particularly noteworthy and pertinent, adding to the reason that the individual is notable in the first place. For example, a mention of George W. Bush is not at all warranted in this article from the source given. Absolutely no part of Bush's notability is due to Lyme disease, and the source makes it sound like the treatment was precautionary only. Zad68 15:26, 24 October 2013 (UTC)

If adequately referencing, I think maybe including eight or ten famous people will add to our article. Cool Nerd (talk) 19:27, 24 October 2013 (UTC)

SpringSummerAutumn filling up this article with a huge list of people who may or may not have actually contracted Lyme, with sketchy sourcing per BLP standards, is not a good idea. Why not pick just two or three of the most notable individuals who are well-known because of their involvement with Lyme. These people should be notable because of their involvement with Lyme. As it stands right now even this poorly-sourced list of people on this Talk page might be a BLP problem. Zad68 19:27, 24 October 2013 (UTC)

I agree with Zad68 about maybe mentioning two or three of the most notable individuals who are also most strongly linked to Lyme. I do not think a separate list article should be created. If anything, a category may be in order. —C.Fred (talk) 22:47, 24 October 2013 (UTC)

Agree also with Zad68; we should only include those who have changed public perception of Lyme disease or is otherwise strongly linked. Random lists of people with diseases are awfully unencyclopedic. Yobol (talk) 16:30, 25 October 2013 (UTC)

Depending on what the goal of compiling this list is, I disagree, because I think part of what we're fighting is a stigma of Lyme (and particularly chronic Lyme) as being either imaginary or a trendy "new" diagnosis. If there's a question of whether the person actually did have Lyme (e.g. Christie Brinkley is on many lists of celebrities who've had Lyme, yet I agree there is no solid sourcing) then yes, let's take that name off the list. But I wouldn't want to decide who is most notable. To some people a former MLB player is more notable than an actress. I think it helps to demonstrate that plenty of well-regarded people have had this illness -- and it also provides hope to those of us who are recently diagnosed, because a number of them seem to have made good recoveries. It also helps to show the vast and confusing range of symptoms of Lyme (e.g. this list includes people with everything from paralysis to insomnia.) Sorry, I have no user ID here but I added a lot of names yesterday.

P.S. Can no-one else see the irony in taking someone off the list because their diagnosis of Lyme is disputed?

We do want each person to be well-sourced, and then I'm thinking maybe about a dozen people from different walks of life? To me, this adds richness to the article, as well as breadth of coverage. Cool Nerd (talk) 16:20, 26 October 2013 (UTC)

No consensus to include either 8-10 people, as you suggested above, or a dozen for that matter, as you've upped it to here. How about 2-3 people for which reliable sourcing can be provided that demonstrates that their notability is in significant part because of their involvement with Lyme. Zad68 16:10, 27 October 2013 (UTC)

Why not a list of notable persons having chronic lyme disease? Because this can certainly fight the stigma of chronic lyme while not reporting about every infection of a celeb. And moreover you could also mention celebs doing activism against lyme, like Ally Hilfiger. --178.197.229.27 (talk) 13:50, 4 December 2013 (UTC)

I suggest below "Chronic Lyme disease (CLD) and post-Lyme syndrome" a new section "11.4 Celebrities and activism" to put in some of your information. --178.197.236.127 (talk) 14:22, 4 December 2013 (UTC)

"Chronic" Lyme isn't recognized by the medical community so it would not be possible to reliably source such a list. Zad68 14:26, 4 December 2013 (UTC)

That's exactly the problem: Every lyme disease is chronic if not treated appropriately. Acute lyme would be fever, sepsis, death. Chronic lyme is an organism being infected by Borrelia bacteria, not being able to fight it off, with no fever but strongly affected by the produced toxins (e.g. Bbtox1) causing joint swelling, neck stiffness, headache, aso. This btw is scientifically proved through animal testing. So if you're not able to distinguish between an acute and a chronic infection, why you guys attend a medicine school for 6-8 years? --178.197.236.127 (talk) 14:57, 4 December 2013 (UTC)

In our articles all we do is summarize what the best-available reliable sourcing has to say. If the best-available reliable sourcing says that "chronic Lyme" isn't recognized by the medical community, that's what we put into our articles. We keep our own views on the subject out of it. Zad68 15:00, 4 December 2013 (UTC)

No, you summarize only what orthodox medical university professors say. This has nothing to do with real research and scientific knowledge. It seems more like a religion, so orthodox is certainly the most appropriate word...otherwise you should start to use research results as "sources" and not only what university professor say or write in their "secondary source" books. Real science is primary source whatsoever. --178.197.236.127 (talk) 15:16, 4 December 2013 (UTC)

Take a look at WP:MEDRS to see how Misplaced Pages defines what a reliable source is for biomedical information, that's what we use. If you'd like to phrase it as "orthodox medical sources," that doesn't bother me, personally-- Misplaced Pages values orthodox medical sources for biomedical content. Zad68 15:28, 4 December 2013 (UTC)

Another proof that todays othodox medicine isn't evidence-based or scientific: http://www.ncbi.nlm.nih.gov/pubmed/2172819 (med guys you must overcome your religion and deal with the facts only...) --178.197.236.9 (talk) 10:32, 25 May 2014 (UTC)

Zad, you're right. I initially said 8 to 10, and then I said about a dozen. I'm largely undecided. If most people want to go with 2 to 3, that's an improvement from where we are now.Cool Nerd (talk) 21:46, 5 December 2013 (UTC)

Okay, wow, on the question of 'Chronic Lyme,' some members of the medical community, some bona fide MDs do diagnose and treat chronic Lyme. True, the orthodox medical community does not, I think viewing these symptoms as most likely being something autoimmune.

We like review articles in peer-reviewed publications. I think that's the wiki standard, and we want to meet that. But there's a problem. I AM NOT A DOCTOR. I've said that before and I'll say that again. Because, even though I'm good at research, I don't want there to be any misunderstanding. I suspect most of us are not doctors, much less specialists in the relevant fields. So, by all means, let's use review articles and do our dead level best to summarize them. In addition, let's use what could be called middlebrow sources like Mayo Clinic or WebMD. And even pages posted by CDC or WHO could be viewed as middlebrow sources. This acts as a check, because since we are not doctors, we may at times missumarrize the review articles.

And as far as the controversies regarding Lyme, straight journalistic sources like CNN, LA Times, BBC, etc. Cool Nerd (talk) 22:28, 5 December 2013 (UTC)

Sorry to be rude but you don't seem to have a clue about lyme disease. You shouldn't post here because you don't argue with facts, but opinions. Journalists aren't scientists and shouldn't be considered when dealing with science. Not sure who you are working for anyway. But posting anything else than facts is just unscientific, non-empiric blablah, not cool at all. --178.197.236.9 (talk) 10:42, 25 May 2014 (UTC)

11.3 Media

A 2008 article in The New England Journal of Medicine argued media coverage of chronic Lyme disease ignored scientific evidence in favor of anecdotes and testimonials: "The media frequently disregard complex scientific data in favor of testimonials about patients suffering from purported chronic Lyme disease and may even question the competence of clinicians who are reluctant to diagnose chronic Lyme disease. All these factors have contributed to a great deal of public confusion with little appreciation of the serious harm caused to many patients who have received a misdiagnosis and have been inappropriately treated."

This sentence doesn't make sense. First it says that the media coverage about lyme disease is inappropriate, and then it talks about the "little appreciation of the serious harm caused to many patients who have received a misdiagnosis and have been inappropriately treated". I'd say the exact opposite is true and especially the "non-scientific" media contributed to the acknowledge of lyme as a serious disease, through coverage of how severe it can be.

And finally most of the confusion is primarily caused by the orthodox medicine, because the tests for lyme disease are totally unreliable. So a negative test result doesn't mean anything, while orthodox doctors usually rely on these tests and won't treat a patient without a positive diagnosis.

Only if there would be a reliable test for lyme and a good orthodox treatment program, there wouldn't be any confusion at all. So the mistake happens to be within the orthodox medicine and not the media coverage. --178.197.236.127 (talk) 14:45, 4 December 2013 (UTC)

Articles only include statements that can be supported by reliable sources, even if we personally don't agree with them. If by "orthodox" medicine you mean evidence-based medicine, that is exactly what Misplaced Pages finds authoritative and medical content is based on it. Do you have a particular change to the article you are proposing? Zad68 14:51, 4 December 2013 (UTC)

No, I really mean orthodox medicine. Evidence-based is something else, and although the orthodox medicine claims to be evidence based, I can assure you that in many cases this isn't true. Thanks to the internet it's possible to know everything about lyme disease, all research results aso. So as long as the orthodox medicin doesn't approve the scientific results, and as long as it doesn't approve its inability to accurately test lyme disease, there won't be any improvements in treating lyme patients. However, what I meant with above post: Critisising the media while not being able to correctly diagnose or treat lyme disease isn't fair, but embarrassing. --178.197.236.127 (talk) 15:09, 4 December 2013 (UTC)

Alright, sorry I can't work with you unless you can make a specific proposal for a change to the article, something along the lines of "Change where the article currently says this to that, using this source." You're making general statements based on your general feeling about the topic, but again we don't base article content on that. All we do is summarize the best-available reliable sources. Zad68 15:17, 4 December 2013 (UTC)

Harassment of Researchers

The removed remarks about "poisonous atmosphere" referenced the aftermath of the Connecticut Attorney General's antitrust action, and--I'm assuming--other non-harassment controversies about Lyme Disease. It was made in 2008, several years after the harassment. It was an intellectually dishonest and manipulative attempt to associate legitimate controversy with a particular instance of inappropriate behavior. As such, it deserved to be deleted. Tapered (talk) 16:27, 7 January 2014 (UTC)

In the future, it would probably be better to move appropriate material to the correct section, rather than outright deletion (which I have done). Yobol (talk) 19:11, 8 January 2014 (UTC)

Agreed that you moved this to the right section. I have been in conversations with Dr A. The war is a big problem. Putting it in the same paragraph as a lawsuit implies a context which is not explicit. Hope this was an appropriate correction. If not, would love to understand.Bob the goodwin (talk) 03:49, 16 January 2014 (UTC)

Actually, I wonder. How is a lawsuit by a state against a medical society a harassment of researchers? I know there is a lot of harassment, and I do know there is a problem with fear amongst MDs, but I think lawsuits are in a different category than harassment. No interest in starting a fight on this one, just wondered if you had thought about it.Bob the goodwin (talk) 03:55, 16 January 2014 (UTC)

controversy and politics

This section can be found under the heading "controversy and politics"

A minority view holds that chronic Lyme disease is responsible for a range of unexplained symptoms, sometimes in people without any evidence of past infection. This viewpoint is promoted by many patient advocates, notably an advocacy organization, the International Lyme And Associated Diseases Society. Groups of patients, patient advocates, and the small number of physicians who support the concept of chronic Lyme disease have organized to lobby for recognition of this diagnosis, as well as to argue for insurance coverage of long-term antibiotic therapy, which most insurers deny, as it is at odds with the guidelines of major medical organizations.

A minority view sounds bias?! I think this section should be removed. What is a minority? 10,100,100 000 people? — Preceding unsigned comment added by 46.194.26.146 (talk) 20:13, 21 January 2014 (UTC)

The first thing to do is to check the reference and see what it says. --sciencewatcher (talk) 22:42, 21 January 2014 (UTC)

By the way the symptoms aren't unclear at all. Joint swelling, neck stiffness, headaches, spasms, aso. And there is a lot of evidence that chronic lyme can't be treated by antibiotics at all. I sometimes read that doctors give amoxicillin, but this doesn't work. A long term therapy by tetracycline or high-dosed doxycycline may work, but only if there is no resistancy. And I must warn from long-term penicillin treatment, it destroys renal function. Finally, I think any people else than dealing with lyme personally or professionally should just be quite about lyme disease. They have no clue what lyme is like, so they can't contribute anything except their unscientific opinions. And would I ask a blind person how a picture looks like? No. However, what is most sad in respect to lyme disease are those many unscientifc statements from so called "scientists" - but in fact usually NOT scientists, only health practioners or pharmacy sellers. Scientists already discovered anything about lyme, only the medical establisment still have the blinders on. It's a sociological phenomen already, because the view that "chronic lyme doesn't exist" is considered to be "appropriate" by the medical establishment. That's not science, that's stupidness and incompetence, only. --178.197.236.9 (talk) 11:09, 25 May 2014 (UTC)

Climate change implementation

I added a CC section, this can be expanded further. I suggest we start a deletion process for the other page. Prokaryotes (talk) 13:38, 27 January 2014 (UTC)

Sounds like a good idea. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:40, 27 January 2014 (UTC)

I will start a talk for the deletion process of page https://en.wikipedia.org/Weather_and_climate_effects_on_Lyme_disease_exposure if anyone here is against it say so on the talk page of "Weather and climate effects on Lyme disease exposure". Prokaryotes (talk) 16:44, 27 January 2014 (UTC)

Layout

Here the history section was moved to first. This is against the recommended ordering of sections for disease of current significance as found here WP:MEDMOS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:43, 27 January 2014 (UTC)

Yes, i have acknowledged this already since you brought this to my attention on my talk page as well. Do you want me to revert the moving of sections, then say so. However, my impression is that this particular article here does not necessarily has to begin with the symptoms. Prokaryotes (talk) 16:34, 27 January 2014 (UTC)

Yes would appreciate it if you reverted. There was no discussion on changing this layout. For diseases like small pox we start with history but that is because the disease no longer exists. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:04, 28 January 2014 (UTC)

Done. Prokaryotes (talk) 12:42, 28 January 2014 (UTC)

Thanks Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:06, 28 January 2014 (UTC)

Two Recent Animal Studies

It's hypocritical to refuse to publish studies in the established journals and then say that there's no dissenting studies in "the medical literature". The lines "A review looked at several animal studies that found persistence of live but disabled spirochetes following treatment of B. burgdorferi infection with antibiotics. The authors noted that none of the lingering spirochetes were associated with inflamed tissues and criticized the studies for not considering adequately the different pharmacodynamics and pharmacokinetics of the antibiotics used to treat the animals in the trials versus what would be expected to be used to treat humans. The authors concluded, "There is no scientific evidence to support the hypothesis that such spirochetes, should they exist in humans, are the cause of post-Lyme disease syndrome." Haven't been true since January 2012.

Persistence of Borrelia burgdorferi in Rhesus Macaques following Antibiotic Treatment of Disseminated Infection Published in PlosOne in January 2012 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0029914

"... offer proof of the principle that intact spirochetes can persist in an incidental host comparable to humans, following antibiotic therapy. Additionally, our experiments uncover residual antigen associated with inflammatory foci. ..."

Resurgence of Persisting Non-Cultivable Borrelia burgdorferi following Antibiotic Treatment in Mice Published in PlosOne in January 2014 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0086907

"... our results indicated that mice were responding to the presence of persisting non-cultivable B. burgdorferi. ..."

05:49, 10 February 2014 (UTC) — Preceding unsigned comment added by 68.81.196.253 (talk)

Those don't look like reviews to me. Have a look at WP:MEDRS. --sciencewatcher (talk) 00:01, 14 February 2014 (UTC)

Game Over

Lyme Disease has been passed on in humans, despite antibiotic treatment.

Test for persistent Lyme infection using live ticks shown safe in clinical study Published today, and "Findings appear online in Clinical Infectious Diseases." http://www.sciencedaily.com/releases/2014/02/140212132901.htm

".... Xenodiagnosis was positive for B. burgdorferi DNA in the person with erythema migrans who underwent xenodiagnosis early during therapy and in a volunteer with PTLDS. ...." (Not to mention the two "indeterminate" cases.)

The original study (which is still open) is Searching for Persistence of Infection in Lyme Disease at http://clinicaltrials.gov/ct2/show/NCT01143558

Also today U.S. launches new global initiative to prevent infectious disease threats at http://www.washingtonpost.com/national/health-science/us-launches-new-global-initiative-to-prevent-infectious-disease-threats/2014/02/12/afd9863c-936d-11e3-b46a-5a3d0d2130da_story.html -- they couldn't possibly be related.

23:43, 13 February 2014 (UTC) — Preceding unsigned comment added by 68.81.196.253 (talk)

Dubious lyme tests from igenex

Just wondering how we should discuss this (see also here and here. --sciencewatcher (talk) 23:45, 22 April 2014 (UTC)

Igenex has been often criticized but nothing has ever really born out. The medscape article looks promising though. - Technophant (talk) 14:49, 21 July 2014 (UTC)

Repeated removal of well sourced content in short time

Repeated removal of sourced content without discussion and consensus here is vandalism and edit warring. This is against WP policy and can result in blocking of involved editors. - - MrBill3 (talk) 10:12, 24 October 2014 (UTC)

• Delisted good articles
• Old requests for peer review
• All unassessed articles
• B-Class medicine articles
• High-importance medicine articles
• B-Class dermatology articles
• Unknown-importance dermatology articles
• Dermatology task force articles
• B-Class neurology articles
• Mid-importance neurology articles
• Neurology task force articles
• All WikiProject Medicine pages
• Misplaced Pages controversial topics