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    Friday, June 09, 2023

    Sen. Blumenthal's needless Lyme disease act

    Recent legislation concerning Lyme disease introduced by Connecticut's junior senator, Richard Blumenthal, appears on the surface to be well intentioned. A press release issued by his office last week stated the Lyme and Tick-Borne Disease Prevention, Education and Research Act would "combat the growing epidemic of Lyme disease in New England and across the country."

    It is hard to argue with legislation that supposes to combat disease. And it's easy to score political points in crusading against a disease endemic to the state you represent. This explains why Sens. Jack Reed and Sheldon Whitehouse, both Rhode Island Democrats, and Sen. Kirsten Gillibrand, D-N.Y., are cosponsors. Sen. Joe Lieberman of Connecticut also climbed aboard as a cosponsor after the original introduction of the bill.

    This is not exactly political risk-taking. It's not as if anyone is in favor of Lyme disease.

    But by taking a closer examination of the bill and placing it in the context of Sen. Blumenthal's background on the matter, it becomes apparent this is not good legislation. Indeed, it's potentially harmful. It seeks to politicize a subject that lawmakers should leave to the impassioned assessment of the scientific community. It would create another needless layer of bureaucracy when both federal and state governments already have ample resources to assess and deal with Lyme disease.


    First, a little history. During his long tenure as the crusading attorney general of Connecticut, Mr. Blumenthal endeared himself to those suffering from long-term health problems they believed were connected to Lyme disease, so-called chronic Lyme. These groups complain that the U.S. Centers for Disease Control and Prevention (CDC) and the Infectious Disease Society of America (IDSA) use overly strict guidelines and test protocols in detecting Lyme, standards that they consider inadequate in accounting for chronic Lyme. It was no coincidence that, when announcing the legislation, Sen. Blumenthal was joined by Debbie Siciliano and Diane Blanchard, leaders of Time for Lyme, a chronic Lyme advocacy group.

    Mr. Blumenthal also became an advocate for the controversial long-term antibiotic treatment of so-called chronic Lyme. He fought for protection of doctors who provided it and railed against insurance companies that refused to pay for it. The only problem, the treatment is not supported by the science.

    According to the CDC, the vast majority of people who get Lyme disease from a tick bite respond well to antibiotic treatment and fully recover. However, about 10 to 20 percent of patients have lingering symptoms of fatigue, pain, or joint and muscle aches. While informally called chronic Lyme, the CDC considers it "Post-treatment Lyme disease Syndrome."

    Most medical experts believe that lingering symptoms are due to residual damage to tissue and the immune system during infection. However, there is no evidence of persistent infection, therefore no benefit to continued use of antibiotics. In fact, studies have shown that patients treated with prolonged courses of antibiotics do no better than patients getting a placebo. More importantly, long-term intravenous antibiotic treatment can cause health problems and promote development of drug-resistant bacteria.

    IDSA dispute

    Armed with this information, the IDSA guidelines recommend against such treatment. This outraged chronic Lyme advocates and then-Attorney General Blumenthal. In 2006 he accused the IDSA of manipulating its guidelines to benefit the insurance industry, a serious charge that proved unfounded. To settle the dispute, the IDSA agreed to have an independent panel of experts assess its guidelines. After an exhaustive review, the panel unanimously upheld the IDSA guidelines, finding no wrongdoing.

    Now it appears Sen. Blumenthal is at it again with this federal legislation. It calls for establishing a "Tick-Borne Advisory Committee" that would "ensure a broad spectrum of scientific viewpoints" and evaluate "guidelines for effective representation of a wide diversity of views." The committee would be required to have a "diversity of scientific perspectives."

    These appear to be code words for trying to legitimize long-term antibiotic Lyme treatments and other controversial approaches to chronic Lyme. Good science does not come from a diversity of views or perspectives. It comes from the facts, what can be proved and what cannot.

    Sen. Blumenthal's office said they have not determined how much his new committee and mandates would cost. Whatever the cost, it would not be money well spent.

    The CDC, National Institutes of Health, Food and Drug Administration and Department of Health and Human Services already have the ability to manage this disease. Private pharmaceutical companies have the incentive of profit to develop better diagnostic tools, tests and treatments.

    This legislation is unnecessary and potentially counter-productive. It deserves to die in committee.

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