Lyme disease: HAS recommendations may "lead to therapeutic wanderings"

One month after the recommendations of the High Authority of Health (HAS) on Lyme disease, doctors are very worried. According to France Roblot, a specialist interviewed by Why Doctor, they "may cause concern among many patients and therapeutic wanderings".

The specialists always furious against the High Authority of Health (HAS). One month after the HAS recommendations on Lyme borreliosis and other tick-borne diseases, "all learned societies involved in the management of tick-borne diseases" issued a press release refusing to "endorse the recommendation of good practice developed by HAS".

"We reproach him for chapter 4 concerning the SPTT (symptomatology / persistent polymorphic syndrome after a possible tick bite)", explains France Roblot, vice-president of the Society of Infectious Pathology of French Language (SPILF). "This is something that we do not know the definition and that may cause concern for many patients and therapeutic wanderings: patients who will have unclear symptoms will be diagnosed as stung by ticks while 'They have never seen one and we will miss the right diagnosis,' she worries.

Indeed, in its chapter 4, the HAS has decided to recognize that people suffering from recurrent pain and fatigue are very ill but refuses to approve the existence of a chronic form of Lyme disease. Instead, she created the SPTT terminology to explain the "situation of patients who may have been exposed to ticks and who have polymorphic, persistent and unexplained clinical signs that may be disabling".

"We have not managed to find a name that is consensual.All the tired people who come in consultation, we will tell them they have the SPTT?" Asks France Roblot. "I do not know why there is such a controversy around this disease," she laments, blaming "some doctors who speak a lot in the media saying that it must be treated for a very very long time, but we have never had evidence of such a benefit. "

"If hundreds of doctors agree, it's uncomfortable"

"The early manifestations of Lyme disease, cutaneous, joint and neurological and its late manifestations, we know them and we do not discuss them.They are well described by the HAS. ticks that have genuine Lyme disease and still show signs (problems with concentration, insomnia) after being treated with antibiotics.If anyone is certain that Lyme disease is it presents with acute manifestations, the durations recommended by the HAS are perfectly adapted, but for the patient who has just been exposed to ticks and who presents some non-systematized manifestations, we will say to ourselves: why not put it on antibiotics? this is called a trial treatment, in which case it must be said that there is no reason to go beyond 28 days: it is important that these patients be informed ", det she goes on before deciding: "maybe longer treatments will have an interest in the future but it must be demonstrated first and that it is decided by international bodies".

This is why SPILF and many other medical authorities have asked the HAS to delete Chapter 4. In vain, the authorities remained deaf. Today, in this press release published on July 19, "all the specialists have come together at the table, and we all agree that after a while we must ask ourselves questions. OK, it is that a malaise persists ", calls France Roblot, proposing" to continue working with respect to this famous SPTT relying on international recommendations, English and German, for example, which come from "We want there to be consistent homogeneous care throughout the territory that everyone has access to the same approach". And to conclude: "Our constant concern is to improve the management of patients and to take into consideration their symptoms.We are here to have a support adapted to their pathology, not to tell them stories".

As a reminder, Lyme borreliosis, is an infectious vector disease, transmitted by the bite of a tick - note that not all ticks carry the bacteria. The infection may appear in the month following the sting, first in the form of a red and round plate that extends in a circle from the stung area. The lesion of the skin can be accompanied by muscular and articular pains, or fever. Treated quickly, the disease can disappear in a few weeks or months. Otherwise, it can lead to neurological disorders and / or facial paralysis.

Video: Lyme Disease. Chriss Story (February 2020).