Lyme disease is on the rise, and so is the controversy surrounding it. While about 20,000 cases are reported in this country each year, some experts say that many times that number may go undiagnosed, misdiagnosed, and undertreated. The basics of the Lyme war:
It's tough to diagnose. Not all who are infected get a "bull's-eye" rash, and the commonly used test is only about 50 percent accurate in early stages.
No one agrees on treatment. More research needs to be done. While many people are cured after taking antibiotics for several weeks, fatigue, headaches, and muscle and joint pain can still linger for some.
It can become persistent. As many as 15 percent develop neurological problems that are misdiagnosed as anything from multiple sclerosis to Alzheimer's. Evidence suggests that many of these patients respond to long-term intravenous or higher-dose oral antibiotics, sometimes for a year or more, but it can be hard to find a doctor who will administer this treatment, as it's not standard.
Patients may need to push. In her book Beating Lyme, Constance Bean tells her own story of dealing with chronic Lyme disease and advises patients not to be afraid to ask for antibiotic treatment early, even if their doctor doubts it is Lyme. "If you could have been exposed to ticks," she says, "consider Lyme disease first, not last." The risks of short-term antibiotics for prevention are far fewer than the symptoms and treatment of persistent illness.
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