Dr. Richard Horowitz:
«This review article on Chronic Lyme disease in the International Journal of Family Medicine was just released. It gives a good overview of the complexity of borrelia infections, poor sensitivity of testing, persistence, role of co-infections and the need for Family physicians to work within a multidimensional chronic disease construct to help patients suffering from CLD. The MSIDS model discussed in my book is such a multidimensional construct, and the Lyme-MSIDS questionnaire can help physicians in different sub specialties screen for Lyme as a multi systemic illness. The scientific research discussed in this article, as well as the hundreds of peer reviewed scientific references referenced in my book and in the recently published ILADS guidelines, should allow those in charge of our health care system to become better informed. Lyme disease is the most common vector-borne disease in the US and Europe, and is a rapidly spreading global health threat. We need to carefully to listen to science, bound by compassion for sick and suffering patients, in order to find logical and cost effective solutions for this emerging epidemic.»
16-12-2014
Liesbeth Borgermans,1
Geert Goderis,2
Jan Vandevoorde,1 and
Dirk Devroey1
1Department of Family Medicine & Chronic Care, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium2Department of General Practice and University Hospitals Leuven, Katholieke Universiteit Leuven (KUL), Kapucijnenvoer 33, 3000 Leuven, Belgium
Received 11 July 2014; Accepted 12 November 2014; Published 24 November 2014
Academic Editor: Christos D. Lionis
Copyright © 2014 Liesbeth Borgermans et al. This is an open access article distributed under the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.
http://www.hindawi.com/journals/ijfm/2014/138016/
