The Lyme disease article on page 12 of the summer edition [“Conventional Lyme Treatment Found Effective,” Summer 2000] appears to denigrate physicians who use longer-term antibiotic therapy, with the strong message given that “a short-term regimen of antibiotics is adequate to treat the disease.” However, the 30-day limit has been found to be unrealistic, especially when diagnosis and treatment are delayed. Patients and physicians will not accept that continuing symptoms are due to “post-Lyme syndrome.”

Nationwide evidence supports longer-term therapy for many patients. The study described in the article does not address several questions, including elapsed time between symptoms and diagnosis. The difficulties presented by Lyme disease include uncertainties about test results with resultant delayed diagnosis, penetration of the spirochete into cells, the changing forms of Borrelia burgdorferi, and its ability to cloak itself in DNA of the host.

Evidence of long-term disability from inadequate treatment of Lyme disease is documented. And because of the potential for serious disability, I believe CDC treatment guidelines need to be re-examined. I would also like to see Yale involved in the development of more effective antibiotics for Lyme disease.

Your article states that “Lyme disease has been a lightning rod for controversy for years.” My expectation is that Yale will provide accurate and balanced information on both viewpoints regarding short-term and long-term treatment.

Constance A. Bean, M.P.H. ’50
Wayland, Mass.