Myth: Lyme disease is hard to get and easy to cure. Fact: Tens of thousands of Minnesotans got Lyme disease in the past 10 years, and very few of them will EVER be cured. At least, not before the mainstream medical establishment and Lyme disease specialists stop arguing and figure out how to treat it.

Lyme disease is spread by deer ticks, which are expanding their range in the state. According to the Minnesota Department of Health, one in three deer ticks carry the bacterial agent of Lyme disease, Borrelia burgdorferi (Bb). In high-risk areas of the state, such as Crow Wing and Washington counties, it's two out of three. Climate change affects both their range and their dormancy; as the cold season gets shorter, the tick season gets longer. Deer, rodents and birds can disperse these blood suckers just about anywhere, so even city-folk are a risk. Indeed, the Metropolitan Mosquito Control District has found deer ticks in each of the seven metro counties.

I don't say this to breed panic, but to get people to sit up and take notice: You are a tick bite away from getting Lyme disease. And very few doctors in the state truly understand or are willing to treat Lyme disease aggressively. A recent Minnesota Board of Medical Practice resolution may change all that.

Last month, the medical board voted on a five-year moratorium from investigating doctors who treat chronic Lyme disease with long-term antibiotics, unless a complaint is filed against them by the patient or their guardian. The board agreed with Lyme specialists and activists that the science is unsettled, that much more evidence needs to be gathered in the treatment of the most common vector-borne infectious disease in the country (Minnesota ranks 8th for reported cases). Doctors are still responsible, of course, for informed consent and conscientious, evidence-based medicine.

Inadequate tests, flawed studies
Inadequate diagnostic tests, flawed studies that inform prevailing treatment guidelines, and ignorance about what the infection does in the body result in misunderstandings about the diagnosis and treatment of Lyme disease.

After a person is infected through the bite of a deer tick, Bb doesn't stay long in the blood stream. It burrows into tissues and cells, sabotaging multiple systems along the way. This is why different people react with a varying array of symptoms. The tests are designed to detect antibodies to the bacteria in the blood, not the bacteria itself; for this and many other reasons they cannot be relied upon to prove the existence (or absence) of Bb. Lyme specialists, including those from the International Lyme and Associated Diseases Society, advocate a clinical diagnosis, taking patient symptoms and environmental history into account. Unfortunately, if the person who is bitten waits for symptoms to manifest, they are already infected.

The prevailing guidelines for diagnosing and treating Lyme disease are the work of the Infectious Disease Society of America. It claims, despite evidence to the contrary, that a single oral dose of doxycycline will "cure" a bacterial infection - even one that has likely spread throughout the body, including the heart and/or brain. Studies on animals have show Bb can persist beyond this recommended treatment.

Based on her review of the scientific evidence, the Minnesota Lyme Action Support Group medical advisor, Dr. Elizabeth Maloney, recommends at least 20 days of 100 mg doxycycline (for adults who can tolerate it) immediately after being bitten by a deer tick in a high-risk area. If treatment is postponed after the bite, longer, more aggressive therapy should be discussed and decided upon between the patient and his or her Lyme specialist.

Thanks to the MBMP resolution, doctors who care for Lyme patients won't worry about losing their license in the process.  

Monique Dubos is a freelance journalist; she handles communications and public relations for the Minnesota Lyme Action Support Group.