(2 of 2)
The debate gets downright vicious when the subject turns to "chronic Lyme disease," a catch-all term that means different things to different people. Some patient advocates and their medical allies believe the Lyme spirochete tends to persist in the body even after standard antibiotic treatment. This camp generally favors intravenous antibiotic therapy to treat chronic Lyme. On the other hand, some academic researchers and their allies argue that people with chronic Lyme fall into one of two categories: they either have hypersensitive immune systems that have overreacted to an earlier, no longer viable, Lyme infection--in which case antibiotics are useless--or they never suffered from Lyme disease in the first place and are ascribing to Lyme various aches and pains that actually have nothing to do with the disease.
This difference of opinion has significant implications for treatment. Intravenous antibiotics can cost tens of thousands of dollars, especially if hospitalization is required. Moreover, there is a risk that the catheters used to administer the drugs may become contaminated, leading to serious infections of the bloodstream and even the heart. Clearly, intravenous antibiotics should not be withheld from people who truly need them. Who truly needs them is, of course, what's in dispute. The NIH is funding a $4.5 million study in an effort to sort out both the best definitions and the best treatments for chronic Lyme disease.
Meanwhile, a group of biologists in central Texas may have come up with at least a partial solution to the Lyme problem. "We call it the four-poster," says John George, a tick specialist with the U.S. Department of Agriculture in Kerrville. It's a bin full of corn surrounded by specially angled rollers. As deer push in to eat the corn, the rollers coat the animal's head and neck with a pesticide that targets mites and ticks. Pilot studies on 50-acre plots have produced a 95% drop in the local tick population. "What's neat about this is that it's safe for the deer and doesn't involve wholesale spraying," George says. "We're hoping to try this out very soon in the Northeast." It may not seem very sophisticated to the folks in Old Lyme, but at least it targets ticks and not people.