Lyme Disease: Taking Shots at Shots

Congress is wading into the murky question of whether people with Lyme disease should get long-term antibiotics or whether the drugs harm more than help. That issue, which has been a never-ending source of friction among biomedical researchers between researchers and patient-advocates, will get congressional hearings next year.

If there were a Nobel Prize awarded for disease-that-causes-the-most-controversy, Lyme disease would be a top contender. For years, the tick-borne illness has been the subject of vicious fights between scientists and patient advocates over whether long-term antibiotics can help. Many affected by the disease say yes, citing waning symptoms after treatment; many scientists say no, and several clinical trials back them up.

Now entering the Lyme fray is Representative Frank Wolf (R–VA), who used to oversee funding for the U.S. National Science Foundation and other science agencies as a powerful spending panel chair when Republicans controlled the House of Representatives. In September, he sent a letter to the U.S. Department of Health and Human Services, demanding that it investigate the treatment guidelines of the Infectious Diseases Society of America (IDSA), which shuns long-term antibiotics. He has also requested that a congressional subcommittee hold hearings as soon as possible, and the office of Frank Pallone Jr. (D–NJ), who chairs the House Energy and Commerce panel's Subcommittee on Health, said they will occur next year. “We want an independent evaluation” of the treatment guidelines, said Wolf in an interview with Science. Patients “have lost confidence—some people are traveling for miles to get treatment.”

“I don’t believe” the IDSA guidelines should be used, he went on, “but I’m not a scientist.” IDSA, no stranger to tumult, says it’s happy to cooperate with any hearings but stands by its recommendations. In fact, IDSA recently began assembling an independent panel of eight to 12 people to review its guidelines for Lyme treatment. A spokesperson told ScienceInsider, "We took this extra step to say, 'Okay [if] you don't believe us, let's put this out for review.' "

Note: Commenter swampcrawler points out that the IDSA's decision to conduct a review of its guidelines was part of a settlement with the Connecticut Attorney General in May

(Item corrected 12/15/08)