Current CDC on Lyme Diagnosis 
Author Message
 Current CDC on Lyme Diagnosis

Q. What are the signs and symptoms of Lyme disease?
A. Within days to weeks following a tick bite, 80% of patients will
have a red, slowly expanding "bull's-eye" rash (called erythema
migrans), accompanied by general tiredness, fever, headache, stiff
neck, muscle aches, and joint pain. If untreated, weeks to months
later some patients may develop arthritis, including intermittent
episodes of swelling and pain in the large joints; neurologic
abnormalities, such as aseptic meningitis, {*filter*} palsy, motor and
sensory nerve inflammation (radiculoneuritis) and inflammation of the
brain (encephalitis); and, rarely, cardiac problems, such as
atrioventricular block, acute inflammation of the tissues surrounding
the heart (myopericarditis) or enlarged heart (cardiomegaly).

Where do these fools get their information? Certainly not from the
illustrious Dr. Steere, who NEVER promoted himself and Lyme via
Bullseye Bullshit.
Maybe they get it from Yale{*filter*}leader Malwista, who insisted that the
recent paean to their collective madness be titled "Bullseye"
(Yale{*filter*}University Press).
God, even the CDC can't keep up with Steere/Yalecrap's shifting
revisions of their past criminal negligence.
What's a doctor in community based medicine to do??????



Sat, 13 Jan 2007 07:18:56 GMT
 Current CDC on Lyme Diagnosis

Quote:

> Q. What are the signs and symptoms of Lyme disease?
> A. Within days to weeks following a tick bite, 80% of patients will
> have a red, slowly expanding "bull's-eye" rash (called erythema
> migrans), accompanied by general tiredness, fever, headache, stiff
> neck, muscle aches, and joint pain. If untreated, weeks to months
> later some patients may develop arthritis, including intermittent
> episodes of swelling and pain in the large joints; neurologic
> abnormalities, such as aseptic meningitis, {*filter*} palsy, motor and
> sensory nerve inflammation (radiculoneuritis) and inflammation of the
> brain (encephalitis); and, rarely, cardiac problems, such as
> atrioventricular block, acute inflammation of the tissues surrounding
> the heart (myopericarditis) or enlarged heart (cardiomegaly).

> Where do these fools get their information? Certainly not from the
> illustrious Dr. Steere, who NEVER promoted himself and Lyme via
> Bullseye Bullshit.
> Maybe they get it from Yale{*filter*}leader Malwista, who insisted that the
> recent paean to their collective madness be titled "Bullseye"
> (Yale{*filter*}University Press).
> God, even the CDC can't keep up with Steere/Yalecrap's shifting
> revisions of their past criminal negligence.
> What's a doctor in community based medicine to do??????

Steere actually does say from 70-80% of patients who contracted LD
during the vaccine trial had EM - but - maybe they did not recognize
all bona fide cases, since they also relied on seroconversion to
diagnose. He expressed surprise at the finding that 18% presented with
nonspecific symptoms without EM (N Engl J Med. 2003 Jun
12;348(24):2472-4.)

According to the study below, only 9% of the patients had the classic
"bull's-eye."
Ann Intern Med 2002 Mar 19;136(6):421-8

Clinical characteristics and treatment outcome of early Lyme disease
in patients with microbiologically confirmed erythema migrans.

Smith RP, Schoen RT, Rahn DW, Sikand VK, Nowakowski J, Parenti DL,
Holman MS, Persing DH, Steere AC.
Maine Medical Center Research Institute, Lyme Disease Research
Laboratory, 13 Charles Street, Third Floor, Portland, ME 04102.

BACKGROUND: Lyme disease has a wide spectrum of clinical
manifestations. Diagnosis is usually based on the clinical and
serologic picture rather than on microbiological confirmation.
OBJECTIVE: To examine the clinical presentation and treatment outcome
of early Lyme disease in patients with microbiologically confirmed
erythema migrans.
DESIGN: Observational cohort study.
SETTING: 31 university-based or clinician-practice sites in 10 endemic
states.
PARTICIPANTS: 10 936 participants enrolled in a phase III trial of
Lyme disease vaccine; 118 participants had erythema migrans in which
Borrelia burgdorferi was detected by culture or polymerase chain
reaction.
MEASUREMENTS: Clinical characteristics and treatment outcome were
noted. Skin biopsies of erythema migrans were performed for culture
and detection of B. burgdorferi by polymerase chain reaction;
serologic responses were determined by Western blot.
RESULTS: The 118 patients with microbiologically confirmed erythema
migrans presented a median of 3 days after symptom onset. Early
erythema migrans commonly had homogeneous or central redness rather
than a peripheral erythema with partial central clearing. The most
common associated symptoms were low-grade fever, headache, neck
stiffness, arthralgia, myalgia, or fatigue. By convalescence, 65% of
patients had positive IgM or IgG antibody responses to B. burgdorferi.
Most patients responded promptly to antibiotic treatment.
CONCLUSIONS: In major endemic areas in the United States, Lyme disease
commonly presents as erythema migrans with homogeneous or central
redness and nonspecific flu-like symptoms. Clinical outcome is
excellent if antibiotic therapy is administered soon after symptom
onset.



Sun, 14 Jan 2007 15:04:57 GMT
 Current CDC on Lyme Diagnosis
Exactly, Phyliss..Thank you.. The Bullseye is a late presentation,
after the rash has begun to clear. The rash is indeed a "spreading
redness", and only in less than 10% of the cases, and those are the
ones seen late, is it a "Classic" or
"characteristic"....Steere/Yale{*filter*}have decieved the entire medical
and patient community for over 25 years by insisting on a badly
distorted description of Lyme presentation. Of course, the "Classic "
description of a Bullseye and swollen major joints served to direct
just about all the Fedreral research money their way.
   The Forchner's, thank god, were on top of promoting an accurate
description
of Lyme presentation, but many here in the Northeast have had their
lives ruined by the Steere/Yale{*filter*}criminal negligence...
    As I have said, Steere's description of a rash expanding from a
clear center is pure fiction. He never saw anything like that, but
passed it off as "evidence based medicine".
     You know, a phone call from Steere to the CDC would get that
distortion
straightened out in no time...but Steere has never shown any real
concern about human wellbeing. For me anyway, the hardest thing to
believe is the utter lack of concern about patient wellbeing. What's a
kid's life compared to
a spread in the NY times? You don't get to be world famous by getting
bogged down in unimportant lives.


Sun, 14 Jan 2007 22:16:28 GMT
 Current CDC on Lyme Diagnosis

Quote:


> > Q. What are the signs and symptoms of Lyme disease?
> > A. Within days to weeks following a tick bite, 80% of patients will
> > have a red, slowly expanding "bull's-eye" rash (called erythema
> > migrans), accompanied by general tiredness, fever, headache, stiff
> > neck, muscle aches, and joint pain. If untreated, weeks to months
> > later some patients may develop arthritis, including intermittent
> > episodes of swelling and pain in the large joints; neurologic
> > abnormalities, such as aseptic meningitis, {*filter*} palsy, motor and
> > sensory nerve inflammation (radiculoneuritis) and inflammation of the
> > brain (encephalitis); and, rarely, cardiac problems, such as
> > atrioventricular block, acute inflammation of the tissues surrounding
> > the heart (myopericarditis) or enlarged heart (cardiomegaly).

> > Where do these fools get their information? Certainly not from the
> > illustrious Dr. Steere, who NEVER promoted himself and Lyme via
> > Bullseye Bullshit.
> > Maybe they get it from Yale{*filter*}leader Malwista, who insisted that the
> > recent paean to their collective madness be titled "Bullseye"
> > (Yale{*filter*}University Press).
> > God, even the CDC can't keep up with Steere/Yalecrap's shifting
> > revisions of their past criminal negligence.
> > What's a doctor in community based medicine to do??????

> Steere actually does say from 70-80% of patients who contracted LD
> during the vaccine trial had EM - but - maybe they did not recognize
> all bona fide cases, since they also relied on seroconversion to
> diagnose.

I believe that the 70-80% refers to ONLY those who fell into the
category they called "definite" Lyme disease (partly because EM rash
was one of only a few "objective" symptoms that they accepted, and
also required a photograph of the rash along with a "positive" {*filter*}
test).

Here's their definitions:

------------------------------------------------------------------------------
Table 1.
Case Definitions for Lyme Disease  Definite Lyme Disease
Any of the following clinical manifestations observed by the
investigator and at least one confirmatory laboratory test. In
subjects with erythema migrans, a photograph of the lesion was also
required.

Clinical manifestations
Erythema migrans (an expanding red skin lesion, often with partial
central clearing)
Neurologic manifestations (meningitis, cranial neuritis)
Musculoskeletal manifestations (with objective evidence of joint
swelling in one or a few joints)
Cardiovascular manifestations (atrioventricular block)
Laboratory confirmation
Positive culture for B.burgdorferi from skin-biopsy sample
Positive PCR result for B.burgdorferi DNA from skin-biopsy sample,
cerobrospinal fluid or joint fluid.
Seroconversion on Western blotting (defined as a negative result
followed by a positive result)
Positive IgM blot--at least 2 of the following 3 IgM bands: 23kd
(outer-surface protein C), 39kd, and 41 kd.
Positive IgG blot--at least 5 of the following 10 IgG bands: 18, 23,
28, 30, 39, 41, 45, 58, 66, and 93 kd
Laboratory-confirmed asymptomatic B. burgdorferi infection

No symptoms
IgG seroconversion on Western blotting between month 2 and month 12 in
the first year or between month 12 and month 20 in the second year
Possible Lyme disease

Influenza-like illness--fever, fatigue, headache, chills, muscle
aches, mild stiff neck or backache without cough, coryza, diarrhea or
vomiting-- with IgM or IgG seroconverion on Western blotting
Physician-diagnosed erythema migrans lesions >5cm without laboratory
confirmation
Unconfirmed Lyme disease

All suspected cases that could not be confirmed
--------------------------------------------------------------------------

These stringent criteria probably effectively skewed the number of EM
rashes higher than in a "normal" clinical setting (if there is such a
thing).

If you included the number of people with rashes in the other
categories, the percentage might well drop significantly, probably
towards the figure of 40-60% which was cited in the literature from
1975 until the late 1990s (and is also a figure cited by many
"llmds.").

The fact that the percentage of people presenting with rash has been
revised upwards based on studies requiring rash as an entrance
criteria and ignoring the clinical realities is disturbing and
misleading.

I wonder if this is where the figure of 80-90% that we see now comes
from?

Remember these "categores" of Lyme disease were used to artificially
inflate the efficacy of the vaccine, ignoring lower efficacy rates
amongst those who were "unconfirmed" or "possible" so that the vaccine
manufacturer could claim the vaccine was X% effective in preventing
"definite" and "asymptomatic" Lyme disease, hiding the appallingly low
efficacy rates in other categories of patients, a large percentage of
whom very likely had Lyme.

You know the old saying: "figures lie and liars figure."

Quote:
> He expressed surprise at the finding that 18% presented with
> nonspecific symptoms without EM (N Engl J Med. 2003 Jun
> 12;348(24):2472-4.)

If you could post that article, I'd be interested.

I thought he rejected the idea of "non specific symptoms" ever being
Lyme? I know others have. (Query: what is a "non specific symptom"--I
think it is like minor surgery which is defined as surgery on someone
else. I wonder how "non specific" the symptoms would be if Dr Steere
were experiencing them?).

- Show quoted text -

Quote:
> According to the study below, only 9% of the patients had the classic
> "bull's-eye."
> Ann Intern Med 2002 Mar 19;136(6):421-8

> Clinical characteristics and treatment outcome of early Lyme disease
> in patients with microbiologically confirmed erythema migrans.

> Smith RP, Schoen RT, Rahn DW, Sikand VK, Nowakowski J, Parenti DL,
> Holman MS, Persing DH, Steere AC.
> Maine Medical Center Research Institute, Lyme Disease Research
> Laboratory, 13 Charles Street, Third Floor, Portland, ME 04102.

> BACKGROUND: Lyme disease has a wide spectrum of clinical
> manifestations. Diagnosis is usually based on the clinical and
> serologic picture rather than on microbiological confirmation.
> OBJECTIVE: To examine the clinical presentation and treatment outcome
> of early Lyme disease in patients with microbiologically confirmed
> erythema migrans.
> DESIGN: Observational cohort study.
> SETTING: 31 university-based or clinician-practice sites in 10 endemic
> states.
> PARTICIPANTS: 10 936 participants enrolled in a phase III trial of
> Lyme disease vaccine; 118 participants had erythema migrans in which
> Borrelia burgdorferi was detected by culture or polymerase chain
> reaction.
> MEASUREMENTS: Clinical characteristics and treatment outcome were
> noted. Skin biopsies of erythema migrans were performed for culture
> and detection of B. burgdorferi by polymerase chain reaction;
> serologic responses were determined by Western blot.
> RESULTS: The 118 patients with microbiologically confirmed erythema
> migrans presented a median of 3 days after symptom onset. Early
> erythema migrans commonly had homogeneous or central redness rather
> than a peripheral erythema with partial central clearing. The most
> common associated symptoms were low-grade fever, headache, neck
> stiffness, arthralgia, myalgia, or fatigue. By convalescence, 65% of
> patients had positive IgM or IgG antibody responses to B. burgdorferi.
> Most patients responded promptly to antibiotic treatment.
> CONCLUSIONS: In major endemic areas in the United States, Lyme disease
> commonly presents as erythema migrans with homogeneous or central
> redness and nonspecific flu-like symptoms. Clinical outcome is
> excellent if antibiotic therapy is administered soon after symptom
> onset.



Mon, 15 Jan 2007 03:47:13 GMT
 Current CDC on Lyme Diagnosis

Quote:

> Exactly, Phyliss..Thank you.. The Bullseye is a late presentation,
> after the rash has begun to clear.

No that isn't right. First it depends on what you mean by "late." When
they say "early EM presentation" they are referring to the progress of
the rash which is generally seen (if it is an initial rash) within
3-30 days of infection. So the central clearing occurs after the
initial appearance of the rash but typically within days to a week or
ten days thereafter.

If you consider that a "late" manifestation of Lyme disease, then
fine. But that isn't what most people think of as "late" or a "late
symptom" or "late presentation" it is only later within the context of
the rash. (some rashes may last longer and secondary rashes are a
different story entirely).

And your quibble is silly (not surprisingly). OF COURSE the central
clearing comes later given the description that the rash appears, THEN
expands, and THEN the central clearing occurs (in those cases in which
it occurs).

I don't see how that is IN ANY WAY a misleading description
notsogreatclod.

Quote:
> The rash is indeed a "spreading
> redness", and only in less than 10% of the cases, and those are the
> ones seen late, is it a "Classic" or
> "characteristic"....Steere/Yale{*filter*}have decieved the entire medical
> and patient community for over 25 years by insisting on a badly
> distorted description of Lyme presentation.

I think what appears to be distorted is your misinterpretation of
this. Again, I am not defending the diagnostic or treatment criteria
or guidelines of Stere or Yale or the IDSA beyond this point. I'm
simply saying that you are distorting this point.

There's also a problem which is that you are confusing the word
"classic" with the word "typical." The "Classic" rash might be more
atypical than typical. However when seen it is considered
pathognomonic (look it up nsgc).

Quote:
>Of course, the "Classic "
> description of a Bullseye and swollen major joints served to direct
> just about all the Fedreral research money their way.

How so?

Quote:
>    The Forchner's, thank god, were on top of promoting an accurate
> description
> of Lyme presentation, but many here in the Northeast have had their
> lives ruined by the Steere/Yale{*filter*}criminal negligence...

Do you have any idea of the definition of criminal negligence?

Quote:
>     As I have said, Steere's description of a rash expanding from a
> clear center is pure fiction.

Not at all. And nothing Phyllis posted suggests otherwise. In fact it
says that this does occur in about 10% of patients IN THAT STUDY. Also
YOU are distorting the description which is and always has been a red
rash that expands from the site of the tick bite and THEN develops a
central clearing (which has always been caveated by saying that not
all rashes have this apperance or course and that not all patients
develop or notice a rash). I've never seen anything by Steere or Yale
that says otherwise. If you have something, show us. I'm not saying it
doesn't exist just that I've never seen that and I have seen things
like what I say above consistently for the past 25 years in the
literture.

Quote:
>He never saw anything like that, but
> passed it off as "evidence based medicine".

Where? And how do you know what he saw? There are plenty of cases of
rashes following that course. Many documented by photos.

Quote:
>      You know, a phone call from Steere to the CDC would get that
> distortion
> straightened out in no time...but Steere has never shown any real
> concern about human wellbeing.

That's your baseless opinion. Have you been a patient of his? How do
you know what he has done in clinical practice or not?

How'd you like people with no knowledge about you making statements
like that about you in your occupation or profession (which is what,
being a fish? or a clown? Or a clownfish?).

Quote:
>For me anyway, the hardest thing to
> believe is the utter lack of concern about patient wellbeing. What's a
> kid's life compared to
> a spread in the NY times?

Do you think the NY times article was actually complimentary about
him? It portrayed him as the subject of a great controversy and though
it didn't present the patient view in a balanced way, it certainly
didn't hail Steere as a great medical hero, but one who has been
questioned harshly.

Quote:
>You don't get to be world famous by getting
> bogged down in unimportant lives.

Whatever. You're a real jerk you know that? You casually defame others
with no basis.

Once again up on your soapbox blowing bubbles.



Mon, 15 Jan 2007 04:06:29 GMT
 Current CDC on Lyme Diagnosis
"In major endemic areas in the United States, Lyme disease
commonly presents as erythema migrans with homogeneous or central
redness and nonspecific flu-like symptoms."

No shit! That's what people were telling Steere from the begining and
for years afterwards, but he stuck to his Bullseye and Swollen Joints
song and dance, and you know it. Let me ask you this--if a doctor
moves to an endemic area, where do you think that doctor is going to
get Lyme information--by reviewing the obscure details of hundreds of
articles, or by turning to the CDC website?
Your view of medical reality is almost bizzare--as if doctor's get
their
information on new {*filter*} by pouring over the fine points of research
papers.
The world doesn't work that way--Medicine doesn't deliver that way.
Steere and Yale{*filter*}rode the tide of an over simplefied message as far
as they could, without any concern for the wellbeing of people....
An old man and his wife came to our support group meeting a short time
ago.
He had a rash, and his doctor told him they would wait for other
symptoms to emerge before starting treatment....Vintage Steere--had
Allen been paying attention at Lyme, the Medical world would have been
treating an EM with antibiotics from the get go. And that old man
wouldn't be in danger.
But hey, Steere is rich and famous....the old man hasn't got long to
live anyway..Science rules, Medicine is for the less gifted.
You're like Steere--hiding behind revisionist nonsense--with no real
concern for all the damaged lives, no sense even that Medicine is
about human lives,
an twisted apologist for ruthless ambition.



Mon, 15 Jan 2007 12:01:08 GMT
 Current CDC on Lyme Diagnosis

Quote:

> > He expressed surprise at the finding that 18% presented with
> > nonspecific symptoms without EM (N Engl J Med. 2003 Jun
> > 12;348(24):2472-4.)

> If you could post that article, I'd be interested.

> I thought he rejected the idea of "non specific symptoms" ever being
> Lyme? I know others have. (Query: what is a "non specific symptom"--I
> think it is like minor surgery which is defined as surgery on someone
> else. I wonder how "non specific" the symptoms would be if Dr Steere
> were experiencing them?).

non-specific means it could be Lyme or it could be something else -
not specific to any one disease.
Here's the letter for the quote above:
N Engl J Med. 2003 Jun 12;348(24):2472-4.

 The presenting manifestations of lyme disease and the outcomes of
treatment.

 To the Editor: A trial of vaccination against Lyme disease provided
an opportunity for us to determine the relative frequencies of the
presenting manifestations of Lyme disease and the outcomes of
treatment in a large population.1 Our goal was to identify all cases
of Borrelia burgdorferi infection that occurred among the 10,936
participants in 10 states where the infection is endemic during the
20-month study period.

 Of the 1917 participants who were evaluated for Lyme disease, 269 met
the prospectively defined criteria for definite, possible, or
asymptomatic infection.1 After completion of the study, post hoc
analyses were performed for patients who had microbiologically
confirmed erythema migrans,2 systemic symptoms without erythema
migrans,3 or asymptomatic seroconversion.4 In addition, for the latter
two groups, serum samples were retested with a sensitive and specific
enzyme-linked immunosorbent assay that used a peptide of the sixth
invariant region of the VlsE lipoprotein of B. burgdorferi5; this test
had not been available during the vaccine study.

 Seventy to 80 percent of the patients presented with erythema migrans
(Table 1), the initial skin lesion that often occurs at the site of a
tick bite. The unexpected finding was that about 18 percent of the
participants presented during the summer with nonspecific systemic
symptoms without erythema migrans. Headache and arthralgia, sometimes
associated with fever, were their most common symptoms; upper
respiratory tract and gastrointestinal symptoms were absent.3 Only 2
to 3 percent of the patients presented with later systemic involvement
associated with disseminated infection, such as {*filter*} palsy,
trigeminal neuropathy, or Lyme arthritis; among them was one patient
who initially had asymptomatic seroconversion.4

 Table 1. Frequency of Presenting Manifestations of Lyme Disease.
[Table Removed from Email]

 The patients with early infection were treated with {*filter*}doxycycline
or amoxicillin for two to four weeks, except for two patients with
{*filter*} palsy and erythema migrans, who received intravenous
ceftriaxone.2,3 Although 11 to 16 percent of these patients had
subjective symptoms for weeks or months after treatment, late
manifestations of Lyme disease did not develop in any patient.

 The important point is that most of the study participants with Lyme
disease had early symptoms of the infection and had a good response to
treatment. Particularly when erythema migrans is not present early in
the illness, patients may not go to a physician or Lyme disease may
not be recognized until the more debilitating, harder-to-treat late
manifestations of the infection become apparent. The challenge for
patients and physicians is early recognition and treatment of the
infection, particularly when patients present during the summer with
nonspecific systemic symptoms.

 Allen C. Steere, M.D. Massachusetts General Hospital Boston, MA 02129

 Vijay K. Sikand, M.D. Tufts University School of Medicine Boston, MA
02111

 References
1. Steere AC, Sikand VK, Meurice F, et al. Vaccination against Lyme
disease with recombinant Borrelia burgdorferi outer-surface
lipoprotein A with adjuvant. N Engl J Med 1998;339:209-215.
2. Smith RP, Schoen RT, Rahn DW, et al. Clinical characteristics and
treatment outcome of early Lyme disease in patients with
microbiologically confirmed erythema migrans. Ann Intern Med
2002;136:421-428.
3. Steere AC, Dhar A, Hernandez J, et al. Systemic symptoms without
erythema migrans as the presenting picture of early Lyme disease. Am J
Med 2003;114:58-62.
4. Steere AC, Sikand VK, Schoen R, Nowakowski J. Asymptomatic
infection with Borrelia burgdorferi. Clin Infect Dis (in press).
5. Liang FT, Steere AC, Marques AR, Johnson BJ, Miller JN, Philipp MT.
Sensitive and specific serodiagnosis of Lyme disease by enzyme-linked
immunosorbent assay with a peptide based on an immuno{*filter*}
conserved region of Borrelia burgdorferi vlsE. J Clin Microbiol
1999;37:3990-3996.

EM usually is considered an early sign of Lyme, but when you consider
that the spirochetes invade the CNS within HOURS of inoculation,
whereas typical EMs don't appear until the 3rd day, it puts a whole
new spin on things. (The following quotes likely came from JWissmille
- the REAL one - she has a great archive and can usually find
citations for anything)

source:  Mandell, Douglas and Bennett's Principles
and Practice of Infectious Diseases
fourth edition
author :  Allen Steere

pg.  2145
"...It has been shown that virulent strains of Borrelia burgdorferi
are able to resist elimination by phagocytic cells, thereby evading
the first line in the host defense system against infection....
Borrelia burgdorferi seems to cross a cell monolayer at intracellular
junctions, although it can penetrate through the cytoplasm of a cell.
In a rat model, permeability changes in the {*filter*}-brain barrier begin
within 12 hours after inoculation with the spirochete, and the
organism may be cultured from the cerebrospinal fluid within 24
hours..."

-----
CYTOTOXICITY OF BORRELIA BURGDORFERI FOR CULTURED RAT GLIAL CELLS.
Authors: Garcia-Monco JC Fernandez Villar B Szczepanski A Benach JL
Source: J Infect Dis 1991 Jun;163(6):1362-6
__________________

".......Neither the clinical presentation nor routine laboratory tests
accurately predicted which patients had B. burgdorferi DNA in their
CSF
....

from:  Invasion of the Central Nervous System by Borrelia burgdorferi
in Acute Disseminated Infection
JAMA. 1992;267:1364-1367
authors:  Benjamin J. Luft, ......Raymond J. Dattwyler
Our findings demonstrate that B. burgdorferi can disseminate to
the CNS very early on in the course of the infection with little or no
clinical evidence of CNS involvement....."



Mon, 15 Jan 2007 13:10:02 GMT
 Current CDC on Lyme Diagnosis

Quote:

> "In major endemic areas in the United States, Lyme disease
> commonly presents as erythema migrans with homogeneous or central
> redness and nonspecific flu-like symptoms."

> No shit! That's what people were telling Steere from the begining and
> for years afterwards, but he stuck to his Bullseye and Swollen Joints
> song and dance, and you know it.

Are you being deliberately obtuse? Or are you really just this
freaking stupid?

Why do you keep insisting on something that is a total distortion of
what Steere said? It is just silly. And damages your credibility (just
like insisting that b algerae was a borrelia and that anyone who
thought otherwise was a fool).

Listen you show me where Steere EVER said that the rash appears as a
bullseye instead of as a red rash that EXPANDS from the site of tick
bite and THEN DEVELOPS a central clearing.

Show us fishforbrains.

Cause I can show you where he said REPEATEDLY AND FOR YEARS exactly
what I'm saying.

Why do you insist on this distortion?

Listen I am NOT a "fan" of Allen Steere. There are LOTS of legitimate
criticisms of his work and his views on diagnosis and treatment. YOU
DO NOT HAVE TO DISTORT.

This is like what Michael Moore does. Distortions that detract from
otherwise legitimate points. He could make the points with no
distortions (for example, in Bowling for Columbine, the NRA WAS asked
to refrain from holding their convention in Denver a week after the
Columbine shootings. But in the movie while making this point Moore
cuts to a shot of Charlton Heston holding a rifle over his head and
saying "From my cold dead hands" (which is a reference to a favorite
NRA slogan that they will only pry the gun nuts guns away from their
cold dead hands, implying that they will fight for what they
mistakenly believe are second amendment rights for individuals to bear
arms and resist attempts to take the guns away with force*)  (*The
Second Amendment does NOT confer a right for individuals to bear arms,
the reference both textually AND historically is to the right of
militias to arm themselves to be able to resist central goverment
tyrany).

See Michael Moore COULD have made many valid points about the NRA
including the insensitivity of holding their convention within miles
of the site of the worst school shooting in history only a week later
upsetting the already roiled emotions of the local and regional and
national populace WITHOUT THE DISTORTION.

And then the discussion becomes about the distortions NOT the valid
points.

Why not make some valid points and give up these distortions???

Quote:
> Let me ask you this--if a doctor
> moves to an endemic area, where do you think that doctor is going to
> get Lyme information--by reviewing the obscure details of hundreds of
> articles, or by turning to the CDC website?

First you clearly have absolutely no concept of what it means to be a
doctor, how doctors are educated, their responsibilities for
continuing education, or their habits in terms of how they read and
understand journals and their contents and how they stay current on a
wide variety of topics.

Just because it would be impossible for YOU to absorb materials on
wide ranging issues doesn't mean that is true of all doctors or even
most doctors. Doctors, lawyers, and many other professionals are
responsible for staying current in their fields even on a wide range
of issues.

Second, there is nothing "obscure" about the basics of the Lyme rash.
It is YOU who oversimplify it into a bullseye or nothing. NOT Allen
Steere and NOT many doctors (though I certainly have heard of stories
of obvious Lyme rashes, even bullseyes being misdiagnosed or called
"atypical" ironically a common misdiagnosis is brown recluse spider
bite even though many areas where Lyme is endemic have never ever had
a case of brown recluse spider bite since brown recluse spiders
habitate in very limited areas of the country AND spider bites bear
only a superficial resemblance to Lyme rashes, there are more
differences than similarities).

Quote:
> Your view of medical reality is almost bizzare--as if doctor's get
> their information on new {*filter*} by pouring over the fine points of research
> papers.

No I NEVER said that. In fact I think Doctors are appallingly poorly
informed about {*filter*} and rely on pharmeceutical reps who present
promotional items and in recent cases even what amounts to bribes and
illegal incentives to promote their {*filter*}. Even the simple providing
of clipboards, pens, wall calendars, and things like that with their
drug name (along with samples) works to put the name of a drug into
doctor's minds and doctor's often end up prescribing as a result of
aggressive marketing rather than the most effective drug. Often new
{*filter*} are prescribed despite better efficacy and being cheaper (and
safer) due to the effects of this marketing.

But NO it is YOUR view of "medical reality" that is "bizzare" and
TOTALLY IGNORANT.

Quote:
> The world doesn't work that way--Medicine doesn't deliver that way.

As if you really have a freaking clue.

Quote:
> Steere and Yale{*filter*}rode the tide of an over simplefied message as far
> as they could, without any concern for the wellbeing of people....

NO it is YOU who is oversimplifying. And I don't understand why. The
concept is not that difficult yet you seem to DELIBERATELY insist on
misstating it.

And since you do, SHOW US WHERE STEERE SAID WHAT YOU SAY HE SAYS.
Phyllis has posted several things that contradict you. But you ignore
the contradictions and act as if they actually support your
distortions and mischaracteriations.

I don't know if it is cognitive dissonance, total boneheaded bushlike
stubborness, or just plain bushlike stupidity?

Quote:
> An old man and his wife came to our support group meeting a short time
> ago.
> He had a rash, and his doctor told him they would wait for other
> symptoms to emerge before starting treatment....

Well that is pretty freaking stupid. I disagree STRONGLY with that
approach and would agree that it would be MALPRACTICE even according
to Allen Steere and Yale doctors and SUNY SB doctors.

Quote:
>Vintage Steere

SHOW US WHERE STEERE RECOMMENDS WAITING TO TREAT A RASH UNTIL SYMPTOMS
EMERGE. SHOW US. BECAUSE HE DOES NOT SAY THAT. Show us where other
Yale doctors recommend that? Show us where the CDC recommends that?
Show us where the IDSA guidelines recommend that?

Quote:
>--had
> Allen been paying attention at Lyme, the Medical world would have been
> treating an EM with antibiotics from the get go. And that old man
> wouldn't be in danger.

Whoops. Once again you attempt to add one plus one and get eighthree
to the third power. And I was so impressed at your earlier succesful
attempt at simple arithmetic. Oh well. I was wondering whether you
might be an autistic IDIOT savant with simple math (like in Rainman
although he was able to do difficult math). Turns out you're just an
IDIOT not a savant.

Quote:
> But hey, Steere is rich and famous....the old man hasn't got long to
> live anyway..Science rules, Medicine is for the less gifted.

LOL Science rules what? Gee you are so naive and ignorant it is hard
to comprehend.

Quote:
> You're like Steere--hiding behind revisionist nonsense--with no real
> concern for all the damaged lives, no sense even that Medicine is
> about human lives, an twisted apologist for ruthless ambition.

I'm NOT like steere and you know NOTHING about me. Or about him for
that matter. And despite grand m{*filter*}and ethical pronouncement number
8 million you are still just blowing meaningless bubbles from atop
your soapbox which you keep stumbling off from stupidity naivetee and
ignorance.

Listen how m{*filter*}and ethical is it for you to casually defame people
without a second thought?

I'm NOT an apologist for Steere. I am a critic of his. I am trying to
point out the unecessary distortions that you insist on making which
do nothing but make you even less credible than most other ignorant
morons.



Mon, 15 Jan 2007 18:37:15 GMT
 Current CDC on Lyme Diagnosis
"The unexpected finding was that about 18 percent of the
participants presented during the summer with nonspecific systemic
symptoms without erythema migrans."

Gee, Weisman, during the summer (didn't say when in the summer-maybe
during the warmest weeks) Speaks to me of that temperature adaptation
thing.

I told you I heard Dr. Phillip Malloy, Mr. Lyme Rheumatologist in SE
Mass, and I am told, Steere's roommate at Yale med, and partner in
their CrappyLymeLab,  as well as ACE vaccine researcher, flail an arm
and scoff at the idea of flu- like symptoms, in 99, at the Wareham
library. That's real life, butthead. If you want to bury yourself in
the sorrid details of shifting spin, go right ahead. Makes you feel
like an intelllectual, I guess. That you miss the whole point is
secondary. That fools like you present as "PC professionals and
colleagues" is exactly what Steere/Yale{*filter*}count on. An academic
debate--
The human tragadies get lost in the "How smart we are" babble--just
the way they want it. The Forchners, non-academics, have done more
good in the diagnosis and treatment of Lyme, than all the Weismans put
together--just by being straightforward
Steere/Yale{*filter*}insisted the book be called "Bullseye"--because for
almost three decades they mislead Medicine and the Public about
initial Lyme presentation.
Now its come almost full circle. The Navy docs, the Europeans, were
right.
How many have suffered and died for Yalecraps conceit--or isn't there
anything
about that in the peer reviewed literature --and you know {*filter*}ing well
there's
nothing...nada..Sort of like your own humanity..just not there.



Mon, 15 Jan 2007 23:00:04 GMT
 Current CDC on Lyme Diagnosis
I thought you were going on vacation, Mc Weisman . Wow, what a short
vacation.

Poor old Ed McSweegan, working overtime to keep the Lyme waters muddy.
They got it wrong didn't they? You're not the "Man with no Work".
You're the man with too much work, who works night and day, 24/7,
just to stop anyone expressing the truth about the Steere camp fraud,
or rallying other people to fight the policies that have created so
much suffering.

Does the Steere camp have a labor union? Hmmm, wonder what it's
called? The International Federation of Insurance {*filter*}s, Glaxo
Puppets and Crazy Biowarfaremen. You should get in touch with them.
Tell them they are working you too hard. You need a vacation. You
should be relaxing on a beach. I hear there's a few abandoned islands
in the west Indies where the British had fun testing various biowar
agents years ago, without telling local people. How about it? There's
nothing alive there, you'll have the whole beach just to
yourself......

Stop kicking Greatcod. You're the one distorting words. Steere's focus
on arthritis as if Lyme consisted of nothing else has done enormous
damage to the Lyme community. The Fishbrain is you and your creepy
friend Durland, the three million dollar duck.



Tue, 16 Jan 2007 00:19:11 GMT
 Current CDC on Lyme Diagnosis

Quote:

> "The unexpected finding was that about 18 percent of the
> participants presented during the summer with nonspecific systemic
> symptoms without erythema migrans."

> Gee, Weisman, during the summer (didn't say when in the summer-maybe
> during the warmest weeks) Speaks to me of that temperature adaptation
> thing.

First your theory makes absolutely no sense (just like your ridiculous
insistence on the non existent connection between B algerea and B
Burgdorferi originally based on your erroneous conclusion that the B
(in B algerea) meant Borrelia WHICH IT DOES NOT and then your
pigheaded refusal to admit your mistake.

Second your theory makes no sense scientifically or medically.

Third your theory makes no sense factually since it is NOT true that
there are no bullseye rashes and not true that there are none in
summertime.

Fourth your current iteration of your bogus theory depends on the
utter speculation which has no basis that this occurred "maybe" during
the
"warmest weeks" which even if it did, ignores the fact that there is
significant temperature variation within days and weeks during the
summer and other seasons too.

Why don't you just give it up fishforbrains?

Quote:
> I told you I heard Dr. Phillip Malloy, Mr. Lyme Rheumatologist in SE
> Mass, and I am told, Steere's roommate at Yale med, and partner in
> their CrappyLymeLab,  as well as ACE vaccine researcher, flail an arm
> and scoff at the idea of flu- like symptoms, in 99, at the Wareham
> library. That's real life, butthead.

Malloy is NOT Allen Steere is he? We're not holding you responsible
for Kathleen's ridiculous RICO theories or Lisa's {*filter*}(except to the
extent that you supported and "enabled" it).

Second the flu like initial symptoms have been part of the literature
about Lyme disease since the very beginning.

Third given your complete misinterpretation and complete and
apparently deliberate distortions of everything else I have no faith
that you heard or understood whatever Malloy said or are reporting it
accurately.

Show us a written transcript or article where he said such a thing and
then your criticism OF HIM would be valid.

But it wouldn't be valid as to Allen Steere because he has said
otherwise in fact what Phyllis posted shows he said otherwise recently
in fact what you posted from the CDC describes flu like symptoms and
so do the IDSA guidelines (which I differ with substantially and
materially for the record).

Quote:
> If you want to bury yourself in
> the sorrid details of shifting spin, go right ahead.

Whatever that means.

No I want to stick to the facts and NOT YOUR "spin" and distortion and
deliberate misstatement and misinterpretation.

Quote:
> Makes you feel like an intelllectual, I guess.

Well compared to you I at least can understand what I'm reading and
what I'm saying is accurate. If you want to call that being an
intellectual, I guess I'll plead guilty.

Quote:
>That you miss the whole point is  secondary.

I see the point. It is on top of your head pinhead. It is very
obvious.

Quote:
>That fools like you present as "PC professionals and
> colleagues" is exactly what Steere/Yale{*filter*}count on. An academic
> debate--
> The human tragadies get lost in the "How smart we are" babble--just
> the way they want it.

None of that has anything to do with my motivations or my desire to
stick to the facts greatclodfishforbrains.

Quote:
>The Forchners, non-academics, have done more
> good in the diagnosis and treatment of Lyme, than all the Weismans put
> together--just by being straightforward
> Steere/Yale{*filter*}insisted the book be called "Bullseye"--because for
> almost three decades they mislead Medicine and the Public about
> initial Lyme presentation.

Well the book is NOT by Steere, it it? In fact Steere is not portrayed
in the most favorable light in many instances in the book and the
author indicates substantial disagreement with him and documents many
errors he and his colleagues have made and continue to make.

Quote:
> Now its come almost full circle.

You mean full circle like a bullseye rash?  ;-)

 >The Navy docs, the Europeans, were  right.

The docs from Groton were right and so were the Europeans both of
which are FACTS that Jon Edlow documents in his book "bullseye" that
you're objecting to for god knows what reason?

Quote:
> How many have suffered and died for Yalecraps conceit--or isn't there
> anything
> about that in the peer reviewed literature --and you know {*filter*}ing well
> there's
> nothing...nada..Sort of like your own humanity..just not there.

LOL You know less than NOTHING about me or my humanity. Again blowing
bubbles. And clean up your language!


Tue, 16 Jan 2007 04:26:27 GMT
 Current CDC on Lyme Diagnosis

Quote:

> I thought you were going on vacation, Mc Weisman . Wow, what a short
> vacation.

Thanks for your sympathy. It is touching.

<snip annoying drivel lisa impersonation attempt.

Why are you impersonating Lisa? If you want to impersonate a total
psycopathic sociopathic monster why not charles manson?



Tue, 16 Jan 2007 08:05:07 GMT
 
 [ 12 post ] 

 Relevant Pages 

1. CDC/MMRW report on Lyme Diagnosis

2. 2005: Current diagnosis and treatment of lyme disease.

3. Steere in Europe and the CDC's current diagnostic standard

4. Current Surgical Treatment & Diagnosis

5. Early diagnosis of Lyme arthritis - Lyme disease

6. Current Medical Diagnosis and Treatment, 1998 Edition

7. Lyme diseae : info from CDC

8. CDC Lyme Conference in San Francisco, June 1996

9. OLD-Politics-CDC LINKS LYME AND YUPPIES


 
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