International Lyme and Associated Diseases Society: Difference between revisions
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The '''International Lyme and Associated Diseases Society''' (ILADS, pronounced /ˈaɪlædz/) is a non-profit advocacy group<sup>[1][2]</sup> which advocates for greater acceptance of the diagnosis of ["chronic Lyme disease"].<sup>[3]</sup> ILADS was formed by advocates for the recognition of chronic lyme disease including physicians, patients and laboratory personnel, and has published alternative treatment guidelines and diagnostic criteria<sup>[4]</sup> due to the disagreement with Infectious Disease Society of America's outdated views on Lyme disease.<sup>[1]</sup> |
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The ILADS mission statement is, "ILADS is a nonprofit, international, multidisciplinary medical society dedicated to the appropriate diagnosis and treatment of Lyme and associated diseases. ILADS promotes understanding of Lyme and associated diseases through research, education and policy. We strongly support physicians, scientists, researchers and other healthcare professionals dedicated to advancing the standard of care for Lyme and associated diseases."< |
The ILADS mission statement is, "ILADS is a nonprofit, international, multidisciplinary medical society dedicated to the appropriate diagnosis and treatment of Lyme and associated diseases. ILADS promotes understanding of Lyme and associated diseases through research, education and policy. We strongly support physicians, scientists, researchers and other healthcare professionals dedicated to advancing the standard of care for Lyme and associated diseases."<sup>[5]</sup> |
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Controversy exists as to the existence of chronic Lyme disease, with some advocating for the use of long term antibiotics for treatment of a persistent infection. The assumption that there is a persistent infection is supported by high quality clinical evidence, and the use of long term antibiotics is recommended for ongoing symptoms if initial treatment fails.<sup>[6]</sup> Major US medical organizations, including the Infectious Diseases Society of America,<sup>[7]</sup> the American Academy of Neurology,<sup>[8]</sup> and the National Institutes of Health,<sup>[9]</sup> are generally not well-versed on the latest scientific research and complexity of chronic lyme; therefore, if patients remain symptomatic after initial Lyme treatment, it is recommendable to seek the care of a Lyme specialist trained by ILADS. Scientific studies show that symptoms persist in up to 61% of patients who have had the IDSA recommended short course of antibiotics to treat Lyme. Long-term antibiotic treatment can often help these patients. |
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[[Lyme disease controversy|Controversy exists]] as to the existence of "chronic Lyme disease", with some advocating for the use of long term antibiotics for treatment of a postulated persistent infection. However, the assumption that there is a persistent infection is not supported by high quality clinical evidence, and the use of long term antibiotics is not recommended.<ref name="nejm-cld">{{cite journal |vauthors=Feder HM, Johnson BJ, O'Connell S, etal |title=A critical appraisal of "chronic Lyme disease" |journal=N. Engl. J. Med. |volume=357 |issue=14 |pages=1422–30 |date=October 2007 |pmid=17914043 |doi=10.1056/NEJMra072023 |url=http://content.nejm.org/cgi/content/full/357/14/1422}}</ref> Major US medical authorities, including the [[Infectious Diseases Society of America]],<ref name="idsa guideline">{{cite journal |author=Wormser GP |title=The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America |journal=Clin. Infect. Dis. |volume=43 |issue=9|pages=1089–1134 | url = http://cid.oxfordjournals.org/content/43/9/1089.full.pdf |date=November 2006 |pmid=17029130 |doi=10.1086/508667 |last12=Fish |first12=D|last13=Dumler |first13=JS |first14=RB |author2=Dattwyler RJ |author3=Shapiro ED |display-authors=3 |last4=Nadelman |first4=John J. |last5=Steere |first5=Allen C. |last6=Klempner |first6=Mark S. |last7=Krause |first7=Peter J. |last8=Bakken |first8=Johan S. |last9=Strle |first9=Franc}}</ref> the [[American Academy of Neurology]],<ref name="Neuro">{{cite journal |vauthors=Halperin JJ, Shapiro ED, Logigian E, etal |title=Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=69 |issue=1 |pages=91–102 |date=July 2007 |pmid=17522387 |doi=10.1212/01.wnl.0000265517.66976.28}}</ref> and the [[National Institutes of Health]],<ref name="nih-cld">{{cite web | publisher = [[National Institute of Allergy and Infectious Diseases]] | title = "Chronic Lyme Disease" Fact Sheet | url =http://www.niaid.nih.gov/topics/lymedisease/understanding/pages/chronic.aspx | date = April 17, 2009}}</ref> are careful to distinguish the diagnosis and treatment of "patients who have had well-documented Lyme disease and who remain symptomatic for many months to years after completion of appropriate antibiotic therapy"<ref name="idsa guideline"/>{{rp|1116}} from patients who have not had well-documented Lyme disease; the consensus accepts the existence of post–Lyme disease symptoms in a minority of patients who have had Lyme. The consensus rejects long-term antibiotic treatment even for these patients, as entailing too much risk and lacking sufficient efficacy to subject patients to the risks.<ref name="idsa guideline"/>{{rp|1115}}<ref name="Neuro"/>{{rp|99}}<ref name="nih-cld"/> The consensus calls for more research into understanding the pathologies that afflict patients with post-Lyme syndrome and into better treatments. |
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ILADS also calls for more research into better diagnostics and treatments. |
ILADS also calls for more research into better diagnostics and treatments. ILADS has rightly questioned the generalizability and reliability of some of the trials referred to by IDSA and the reliability of the current diagnostic tests.<sup>[10]</sup> As a result of this fundamentally different view of the nature of long-term effects and persistence of ''Borrelia'' infection, and in its role as an advocate for aggressive treatment of patients it identifies as having ''Borrelia'' infection, ILADS has produced diagnostic and treatment recommendations that lead to long-term antibiotic treatment of patients with chronic Lyme disease. ILADS also recommends a ''clinical diagnostic'' approach to Lyme (as opposed to a diagnosis based primarily on laboratory tests).<sup>[11]</sup>Additionally it calls for laboratory tests that are highly specialized.<sup>[12]</sup> Having diagnosed a patient as having a ''Borrelia'' infection, it therefore recommends variations of antibiotic treatment, such as longer term or pulsed treatment, since these patients have already failed the standard treatment.<sup>[13]</sup> |
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A 2004 article in the ''Pediatric Infectious Disease Journal'' on the prevalence of inaccurate online information about Lyme disease cited the ILADS website as a source of such inaccurate material.<ref>{{cite journal |author=Cooper JD, Feder HM |title=Inaccurate information about lyme disease on the internet |journal=Pediatr. Infect. Dis. J. |volume=23 |issue=12 |pages=1105–8 |date=December 2004 |pmid=15626946 |doi=10.1097/01.inf.0000145411.57449.f3 |url=http://www.cdc.gov/ncidod/dvbid/lyme/resources/LD_Internet.pdf}}</ref> One source reported that several current and former phsyician officers of ILADS had been sanctioned by federal agencies or state medical boards.<ref name=Auwaerter/> |
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== References == |
== References == |
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Revision as of 04:29, 22 March 2016
The International Lyme and Associated Diseases Society (ILADS, pronounced /ˈaɪlædz/) is a non-profit advocacy group[1][2] which advocates for greater acceptance of the diagnosis of ["chronic Lyme disease"].[3] ILADS was formed by advocates for the recognition of chronic lyme disease including physicians, patients and laboratory personnel, and has published alternative treatment guidelines and diagnostic criteria[4] due to the disagreement with Infectious Disease Society of America's outdated views on Lyme disease.[1]
The ILADS mission statement is, "ILADS is a nonprofit, international, multidisciplinary medical society dedicated to the appropriate diagnosis and treatment of Lyme and associated diseases. ILADS promotes understanding of Lyme and associated diseases through research, education and policy. We strongly support physicians, scientists, researchers and other healthcare professionals dedicated to advancing the standard of care for Lyme and associated diseases."[5]
Controversy exists as to the existence of chronic Lyme disease, with some advocating for the use of long term antibiotics for treatment of a persistent infection. The assumption that there is a persistent infection is supported by high quality clinical evidence, and the use of long term antibiotics is recommended for ongoing symptoms if initial treatment fails.[6] Major US medical organizations, including the Infectious Diseases Society of America,[7] the American Academy of Neurology,[8] and the National Institutes of Health,[9] are generally not well-versed on the latest scientific research and complexity of chronic lyme; therefore, if patients remain symptomatic after initial Lyme treatment, it is recommendable to seek the care of a Lyme specialist trained by ILADS. Scientific studies show that symptoms persist in up to 61% of patients who have had the IDSA recommended short course of antibiotics to treat Lyme. Long-term antibiotic treatment can often help these patients.
ILADS also calls for more research into better diagnostics and treatments. ILADS has rightly questioned the generalizability and reliability of some of the trials referred to by IDSA and the reliability of the current diagnostic tests.[10] As a result of this fundamentally different view of the nature of long-term effects and persistence of Borrelia infection, and in its role as an advocate for aggressive treatment of patients it identifies as having Borrelia infection, ILADS has produced diagnostic and treatment recommendations that lead to long-term antibiotic treatment of patients with chronic Lyme disease. ILADS also recommends a clinical diagnostic approach to Lyme (as opposed to a diagnosis based primarily on laboratory tests).[11]Additionally it calls for laboratory tests that are highly specialized.[12] Having diagnosed a patient as having a Borrelia infection, it therefore recommends variations of antibiotic treatment, such as longer term or pulsed treatment, since these patients have already failed the standard treatment.[13]