Sunday, March 17, 2013

Lyme Disease in Montana: Another montana mom with lyme, Great Falls article

http://www.greatfallstribune.com/interactive/article/20130309/NEWS01/303090026/Lyme-disease-divides-experts-Great-Falls-family-s-journey-disease-highlights-struggle-controversial-illness

As with many lyme disease stories I hear or read, there are elements in the story that I could have said myself. The stories in the video as well (more on those aspects my lyme experience in my health blog).

When I started to comment on the article on their website, it just got too long.  So I'm posting it here instead.

Biologists and agencies can't reliably say for sure where we do or don't have large forest carnivores, yet we trust medical doctors to reliably tell us where we do and don't have an organism too small to see.  That kind of certainly is fascinating.  The costs of the kind of survey effort it would take to conclusively disprove the presence of any 'competent' tick vector or specific species of tick would be staggering, and the likelihood that there is truly an agency currently expending that kind of money on tick surveys is much harder to believe than the idea that a bacteria present on all continents and all across this continent couldn't be here in Montana.

That would be a  pretty amazing survey strategy; to accomplish proof of absence would be a biological breakthrough and counter the tenants of biology I learned in school---absence of proof should never be considered proof of absence.  At the very least there should be very rigorous data to support the claim that we know a) the abundance and distribution of tick species throughout the state,  b) that we don't have any ticks or any organism in Montana that could be a vector for lyme disease, and c) that none of the migratory species that carry ticks from state to state continue to carry any of the species of ticks that transit lyme when they enter the state of Montana (apparently those species wait to land in Canada, or pretty much anywhere but Montana).

If we are certain enough of all of these biological assumptions to base medical policy decisions on them, I wonder which agency can afford the data collection efforts it would require to prove them.  The chain of evidence may be out there, but I find it pretty hard to believe.  It was government funded research that led to conclusions about this illness that are entirely consistent with what patients are experiencing (Dr. Burgdorf's comments in the article), but the CDC would rather hang their hats on diagnostic criteria that don't follow a clear chain of logic or proof (unless I'm very mistaken and amazing strides have recently been made in wildlife biology and entomology).

I just don't think the science is their to support the only assumptions that allow doctors (good doctors, mind you, including ones I respect) to claim it is impossible to get lyme in Montana.  And if the data were there, why would it be so poorly disclosed and explained (since it would make their point and would have been very expensive to come by)?

Zoonotic illnesses are an inherent risk of working in any animal related biological field.  But this one is a prevalent risk nationally to anyone who goes outside---how many Americans are aware that "Today, Lyme disease is the most common vector-borne illness in the United States?"

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