Most Vermonters who are accurately diagnosed and treated appropriately for Lyme disease recover quickly. Unfortunately, some Vermonters treated for Lyme and tick-borne diseases have not had full recoveries. Misdiagnosis, delayed diagnosis, and inadequate treatment can result in disseminated Lyme disease that can have a significant and potentially long-term impact on a person’s daily functioning, cognitive abilities, mood, and overall health. In addition, other tickborne diseases are present in Vermont that can affect the health of Vermonters – even if they do not have Lyme disease.
Vermonters should be aware of the controversy around diagnosis and treatment of Lyme disease so they can make informed choices about their health care. The Infectious Disease Society of America (IDSA) is in the process of creating new guidelines for the treatment of Lyme disease. (Their new guidelines were expected to be published by the end of 2018, and you can watch a video message from the IDSA about this topic here). As of November, 2019 the only U.S. guidelines in compliance with National Guidelines Clearinghouse standards are the peer-reviewed guidelines established in 2015 by the International Lyme and Associated Diseases Society (ILADS).
There is disagreement in the medical community about which guidelines provide the correct approach for Lyme disease treatment. The ILADS treatment guidelines are not endorsed by the Centers for Disease Control (CDC) or the Vermont Department of Health. Some practitioners believe the IDSA guidelines are not the best way to treat Lyme disease, while others will strictly follow IDSA guidelines. This controversy leaves Vermont patients and physicians navigating conflicting recommendations.
It can be challenging to find effective treatment in Vermont for complex Lyme and tickborne diseases. Some physicians believe Lyme disease is always cured by a short dose of antibiotics. Others are wary of the controversies around Lyme disease. Some Vermonters have difficulty finding a medical professional knowledgeable about the variety of tickborne illnesses present in Vermont, trained to treat late, disseminated Lyme disease, or skilled in addressing post-treatment illness. Not all Vermonters are receiving a timely or accurate diagnosis.
There is a reasonable concern among many scientists and physicians about the use of long-term antibiotic treatment and the problem of antibiotic resistance. Some healthcare providers may decide long-term antibiotics are necessary for certain patients. For others, complementary or alternative treatments have worked as well as (or better than) antibiotics. Discuss different treatment options with your healthcare professional.