Dear Dr McKay,
You recently had syndicated an article in various newspapers across the world and appeared on Australian TV entitled “The great Australian Lyme conspiracy”.
As you are most likely aware by now, this article has been extremely controversial.
I would like to address some of the inaccuracies and omissions in your article about Lyme Disease in Australia.
Your article states “Lyme disease is real, but thereâ€™s no scientific proof that itâ€™s occurring in Australia. ”
This is incorrect. Â B. Queenslandica was found in rats in Richmond, North Queensland in 1962. Â Additionally, other tick borne infections associated with Lyme Disease such as Bartonella, Babesia, Rickettsia etc. are found in Australia.
A more recent ongoing study at Murdoch University has also found evidence of relapsing fever Borrelia andÂ a new type of Neoehrlichia bacterium.
“Only in Europe and North America”
Your article states “this bacteria is transmitted to humans via tick bites in North America and Europe.“.
This is incorrect. Various Borrelia strains have been identified across Asia and Japan.
“Overseas labs are unaccredited”
This is incorrect. Having been pressed by various people, including myself on Twitter, you have said that a valid accreditation is only the NATA one. To summarily dismiss overseas accreditations as bogus is highly illogical.
The two main labs that people use for overseas tests, IgeneX in California, and Armin in Germany, are both accredited. Igenex uses CLIA,Â Clinical Laboratory Improvement Amendments of 1988, and are United States federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except clinical trials and basic research.
This is a very stringent accreditation.
ArminLabs is a German specialist Lyme testing lab run by Dr Armin Schwarzbach, formerly of Infectolab and the BCA clinic who treat tick-borne diseases. ArminLabs works in association withÂ GÃ¤rtner Labs in RavensburgÂ and so has been accredited by the Deutsche Akkreditierungsstelle GmbH (DAkkS) (German Accreditation Board), all tests are CE-certified for use within the EU.
NATA also has reciprocal agreements with many other countries, including the two mentioned above.
Again, dismissing overseas labs with government-accredited approval is not only highly illogical, but by your own insistence that NATA is the only valid accreditation, patently wrong by virtue of the mutual recognition.
Dismissal of criticisms of NATA labs
You state “Lyme activists will tell you that NATA-accredited labs donâ€™t detect Borrelia because their machines arenâ€™t sensitive enough to pick it up. The truth is that unaccredited labs arenâ€™t specific enough, and tend to deliver positive results for Borrelia whether youâ€™ve got Lyme disease or not.”
The truth is that NATA labs in Australia only detect 2 out of the 14 species of BorelliaÂ known to cause Lyme Disease / Lyme-like Disease / Relapsing fever. So when you talk about labs not being specific enough, being specific to the point of only checking a small number of species is certainly going to return fewer positives.
“We donâ€™t know what it is, but we know itâ€™s not Lyme.”
How do you know it’s not Lyme? It’s a logical fallacy to prove a negative. For example, if I claim there are invisible pixies at the bottom of my garden you are not going to be able to prove otherwise.
“Using up to four weeks of antibiotics is the treatment recommended to eradicateÂ Borrelia“
This is only if you follow the outdated and discredited IDSA guidelines, which were recently dropped by the CDC. The latest peer-reviewed guidelines published by ILADS does not recommend only 4 weeks of antibiotics.
Treatment regimens of 20 or fewer days of phenoxymethyl-penicillin, amoxicillin, cefuroxime or doxycycline and 10 or fewer days of azithromycin are not recommended for patients with EM rashes because failure rates in the clinical trials were unacceptably high. Failure to fully eradicate the infection may result in the development of a chronic form of Lyme disease
While continued observation alone is an option for patients with few manifestations, minimal QoL impairments and no evidence of disease progression, in the panelâ€™s judgment, antibiotic retreatment will prove to be appropriate for the majority of patients who remain ill. Prior to instituting antibiotic retreatment, the original Lyme disease diagnosis should be reassessed and clinicians should evaluate the patient for other potential causes of persistent disease manifestations. The presence of other tick-borne illnesses should be investigated if that had not already been done. Additionally, clinicians and their patients should jointly define what constitutes an adequate therapeutic trial for this particular set of circumstances.
“Use ELISA as a screening test”
The CDC itself says that â€œthe diagnosis of Lyme disease is based primarily on clinical findings, and it is often appropriate to treat patients with early disease solely on the basis of objective signs and known exposure.â€ Based on this recommendation, the diagnosis of Lyme disease should not be contingent on a positive ELISA followed by aÂ positive Western Blot.
Both tests rely on antibody proteins produced by the immune system and both HIV and Borellia are known to suppress immune response. If someone tests negative but is still symptomatic, a clinical diagnosis is valid.
Â You didn’t tell us how your Lyme patient fared
“I sent her straight to hospital in an attempt to save her liver and her life.”
You didn’t tell us what your diagnosis was, if this woman does not have Lyme. Presumably she had unexplained neurological, joint, fatigue and cardiac symptoms? CFS/ME, Fibromyalgia and “I don’t know” are all neitherÂ useful nor helpful as symptom labelling rather than a causative explanation.
Can you tell us about all the people you’ve successfully treated who have come to see you with these conditions? How did you treat them? What were their long-term outcomes?
Your article is not only misleading and inaccurate, it is dangerous. There are many chronically ill people in Australia who need help who may now not seek advice in the right place.
Let me propose something to you: If someone presents with symptoms known to be Lyme disease (joint pain, neurological problems, cardiac problems and fatigue, to name a few) what is the likelihood they have a number of concurrent separate issues? If that same person knows when they were bitten by a tick and experienced an EM rashÂ shortly before onset of symptoms, what is the most likely cause? If someone spent years with doctors who cannot make this person better, who then seeks a Lyme-literate physician and undertakes a Lyme-specific protocol and recovers, what is the most likely cause of the original symptoms?
Let’s look at the balance of probabilities here.
I humbly await your response.
Edit:Â I’m attaching a further reference of Karen Smith’s counter argument of the Australian Government’s denialÂ which goes into some scientific detail of why the study performed over 20 years ago was flawed.