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The academy of medicine expressed Monday its disagreement with the recommendations on the diagnosis and management of Lyme disease, issued by the High Authority of Health (HAS) two weeks ago. Patient badociations also disagree, for opposite reasons. In the end, nobody approves.
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On the one hand, there are patient badociations, which claim loud and clear that a chronic and late form of Lyme disease exists.
On the other hand, there is the National Academy of Medicine, which, for several months already, denounces insistently " empirical badertions devoid of any scientific base ", including the existence of 'a chronic form of Lyme disease with " polymorphic symptoms poorly defined and subjective ". It also denounces " the claimed efficacy of prolonged treatments badociating antibiotics and various drugs ".
Between the two, there is the HAS, which, at the end of June, issued recommendations as part of the "national plan to fight against Lyme disease and other tick-borne diseases". These recommendations concern, among other things, the chronic form of the disease. The very one who is denied by medicine. Moreover, the Society for Infectious Pathology of the French Language (Spilf), which co-chaired the working group of the HAS, did not sign the final text of the proceedings, which defines the modalities for taking charge of patients.
A Disease That Divides
HAS recommendations have a bitter taste for the National Academy of Medicine. In the press, the latter warns the public authorities " against the temptation to give in to the blackmail of pressure groups by departing from the science" and strongly condemns " campaigns of misinformation carried out by the proselytes of the doctrines of an American badociation, ILADS (International Lyme and Associated Diseases Society) ".
According to the academy, the text of the HAS, claiming " to go beyond controversy and propose a solution to each " is intended to " please everyone " and " does not satisfy anyone ". " She maintains the ambiguity, especially on the notion of chronic Lyme, through what she calls symptomatology / persistent polymorphic syndrome after tick bite or SPPT ", explains the academy. " HAS recognizes in fact implicitly the existence of such a pathology without any evidence with, as a consequence, proposals for heavy management involving numerous investigations, expensive and often unnecessary ".
As to wishing to create " specialized centers of tick-borne diseases ", the Academy insisted on issuing its " most extreme reservations " on an expensive proposition that " tends to disavow the expertise of existing infectious and tropical disease services ".
Another side of the patient's side. Frustration with the recommendations of the HAS also exists, but for opposite reasons. Moreover, the France Lyme badociation also denounces pressures, the opposite of those described by the National Academy of Medicine.
" SPILF lobbied HAS, through a secret letter, estimated to change the content of the text, and block its official release . " The badociation emphasizes a " serious breach of sanitary democracy ".
Welcoming at first recognition by the HAS "persistent and disabling symptoms in patients potentially bitten by a tick and having a priori well-administered antibiotic therapy", which "authorizes even an antibiotic treatment for people with a negative serology and / or having no precise memory of tick bite, or Erythema migrant identified ", it then points out dysfunctions: a methodology that" flew in flush ", lack of financial means" concrete "to establish" city-hospital partnerships as well as research protocols type PHRC (Hospital Clinical Research Program) ".
The showdown is far from over.
M.S.
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