Friday, 15 July 2011


At last a slight change in direction from the overly dependence on the IDSA Guidelines, well done to these doctors for producing these new Guidelines and referencing to more of the doctors who specialise in Chronic Lyme disease and have a better understanding than the narrow minded doctors who only see an acute form and thus they believe we can all be cured in just a couple of weeks antibiotics!

Most of the patients I am in touch with failed the IDSA's treatment of a couple of weeks antibiotics but have made significant progress on longer courses of treatment.

Deutsche Borreliose-Gesellschaft e. V.
Diagnosis and Treatment of Lyme borreliosis
Guidelines here

Just a few points mentioned
Chronic Lyme
Latency 8 years before symptoms developed.
50% not aware of tick bite
50% no EM
Seronegativity following early anti-biotic treatment therefore does not rule out Lyme borreliosis in any way.
Chronic stage
Lyme borreliosis can lead to numerous symptoms. The following are particularly frequent:
• fatigue (exhaustion, a chronic feeling of illness)
• encephalopathy (impaired cerebral function)
• muscular and skeletal symptoms
• neurological symptoms (including polyneuropathy)
• gastrointestinal symptoms
• urogenital symptoms
• ocular symptoms
• cutaneous symptoms
• heart diseases.
The success of treatment must be assessed clinically
A negative serological finding does not rule out Lyme borreliosis
There may be a disease requiring treatment even without the detection of antibodies. (Causes: e. g. antibi-otic treatment starting early but inadequate with immunodepressants, including cortisone, exhaustion of the immune system, masking of the causative agents, genetic disposition.)
Co-infections can be transmitted by ticks or by other routes of infection
The scientific basis for antibiotic treatment is still inadequate at the present time, with the exception of the localised early stages (EM). The considerable shortcomings in the scientific-clinical analysis are reflected in therapeutic guidelines, which are severely limited in the reli-ability of their recommendations and in their evidence base in the international litera-ture,(159) and they do not meet the requirements from the medical and health-policy aspects.

Successful antibiotic treatment is possible only if the individual has an effective immune sys-tem. With regard to antibiotic treatment, problems also arise with Borrelia due to natural or acquired resistance. The causative agent of Lyme borreliosis can evade the immune system by what are known as “escape mechanisms”


  1. Joanne,

    Thanks very much for posting this. I shared it immediately with my fellow Canadians at and with those at LymeNet Europe because I wasn't sure if you ever post there.

    I'm so thankful that any country is leading the way when it comes to treating Lyme disease patients with persistent symptoms -- regardless of the cause(s). There's a clinic due to open in Vancouver, BC this fall, and I hope they will adopt these guidelines or come up with their own. Hopefully Canadians will be able to partner with other countries to carry out some meaningful research that will benefit people the world over.

    Those who look back on this shameful period in medical history will likely be appalled at the behaviour of doctors who deliberately withheld treatment from those who suffered as a result of IDSA guidelines being almost universally and blindly followed. Tick-borne illnesses are complex, and is the oversimplification of Lyme and related diseases by a relatively small, but powerful, group of medical professionals that really bothers me.

    Let's hope the future holds more promise for humane and effective care for those who are unfortunate enough to have illnesses like Lyme disease, chronic fatigue syndrome and fibromyalgia.

    Thanks for all you do.

    Rita A

  2. Hi Rita Nice to meet you I meant to comment back on Camp Other blog but where does all the time go. I only occasionally pop by other forums because again it is time but do have a few peole I am in touch with from Canada through Eurolyme. Good to hear about Vancover clinic hear's hoping. I think my friend Alison has occasionally posted about my blog on Canlyme.

  3. Joanne,

    Thanks for posting about these guidelines. I've been reading them carefully, and have yet to look at the references/citations more closely - the German doctors and researchers who created these guidelines refer to recent studies as well as old ones conducted by *drumroll* members of the IDSA. Funny, that.

    I am thinking about doing a compare and contrast between the different definitions of stages mentioned here and in the 2006 Lyme disease panel guidelines. There's something worth pointing out there.

  4. Yes interesting that they acknowledge so much of the Drumroll members whilst introducing a more open minded approach.

    Ben Luft, with his sequencing the Genome finding such a variety of strains, gave the IDSA cohort such a good get out of Jail card but seems they are still too arrogant to take it.

  5. I look forward to reading your take Camp on the German Guidelines and no doubt CALDA may well do something on them too which would be interesting