Harold DeMonaco, MS is one of our most active story reviewers and is fast becoming one of our most active guest bloggers as well. Here is his latest opinion column.
Given the extremes on both sides of the aisle this political season, no ad campaign by either side should be surprising. At least that’s what I thought.
Apparently, there is an epidemic of tick borne disease in Virginia. At least that is what Mr. Romney has suggested in a mailer to potential voters in northern Virginia. The reason I am pointing this out has less to do with partisan politics than with science.
Lyme Disease is caused by a bacteria that has decided to take up residence in deer ticks. When diagnosed, it is usually managed with a short course of antibiotics. For a minority of patients, an ill-defined set of symptoms can continue well beyond the actual infection. The Post Lyme Disease Syndrome has been the source of some controversy in the medical community. Some suggest prolonged treatment with antibiotics is necessary. However, randomized trials to date have not demonstrated a benefit.
The Centers for Disease Control and Prevention website for Lyme Disease suggests there is little in the way of evidence that antibiotics are helpful in alleviating the symptoms. Further, the Infectious Disease Society of America guidelines note, “There is no convincing biologic evidence for the existence of symptomatic chronic B. burgdorferi infection among patients after receipt of recommended treatment regimens for Lyme disease. Antibiotic therapy has not proven to be useful and is not recommended for patients with chronic (6 months) subjective symptoms after recommended treatment regimens for Lyme disease.” Unfortunately, a recent study of attitudes about prolonged antibiotic treatment among New Englanders (see Vector Borne & Zoonotic Diseases. 11(7):857-62, 2011 Jul) suggests that anecdote is far more compelling evidence than are randomized trials and the opinion of most experts in the field
Very few issues in medicine are black or white. Most are shades of gray (except perhaps for death and even that has some definitional issues). So it is not surprising that there are those in the medical community who come down on the side of continued antibiotic treatment for people with the Post Lyme Disease Syndrome. While there are no convincing data to support this approach, there are some well respected folks in the infectious disease community who hold the view.
For reasons that are not evident to me, the Romney campaign has chosen to interject itself into the medical controversy with a mailer sent out to voters in Virginia. The mailer suggests, “Lyme Disease-A massive epidemic threatening Virginia.” According to the CDC, the incidence of Lyme Disease in the United States is 7.8 per 100,000 population; Virginia has a rate of 9.3 whereas Massachusetts has a rate of infection of 27.3. per 100,000. I assume then that everyone in Massachusetts should be concerned (to say nothing of people living in New Hampshire, Maine and Delaware to name a few states). I must have missed my mailer.
Among other things, the Romney campaign promises to support:
“Encourage increased options for the treatment of Lyme Disease and provide local physicians with protection from lawsuits to ensure they can treat the disease with the aggressive antibiotics that are required.”
Journalists have picked up on this story with a variety of slants, both positive and negative. Candidates are welcome to tackle an issue they see as important. But I must admit this is a first from my perspective. Interjecting a political campaign into medical treatment seems a bit over the top. But, it is the silly season. Perhaps the Obama campaign is planning a similar assault on a hidden epidemic as well.
Publisher’s note: On Slate, Laura Helmuth wrote about the Romney mailer: “Here’s a translation: Forget the science, just channel your legitimate fear of a dangerous disease and your misguided fear of the medical establishment into a vote for us.”
Deer tick photo credit: By wackybadger via Flickr – Creative Commons