Here are some questions for the doctors in "Lyme puzzle" [exploreLI, June 4].
How did the redirection of Lyme and tick-borne disease funding to West Nile virus affect awareness? Doctors diagnose what they're informed about, and patients seek help on that basis, too.
The closure of the Lyme disease clinic in Stony Brook as the main diagnostic center on Long Island is also a likely cause of fewer diagnoses.
Why do health authorities keep repeating the fiction that a bull's-eye rash is the "classic" and "diagnostic" Lyme rash, when we've known since the long-ago LymeRix vaccine trials that's not so?
Dr. Dennis Parenti of SmithKline Beecham reported over a decade ago that the bull's-eye was one of many positive Lyme rashes seen in the course of the LymeRix trials. Various other types of rashes cultured positive in greater numbers for Lyme bacteria: clusters of fluid-filled vesicles, streaks, rectangles and ovals in various shades -- purple, blue, pink and red. How many early, treatable cases are going without diagnosis due to this failure to provide scientifically accurate diagnostic information to practitioners?
Lyme disease has been controversial for many years, with a lot of hyperbole and turf-staking. There has been a long, well-orchestrated campaign of disinformation by some physician organizations to punish doctors who diagnose and treat Lyme disease more readily and longer-term than others. These include fine physicians who are more conversant with the complexities and nuances I've only begun to touch on here. Many doctors have stopped diagnosing and treating Lyme disease or reporting it, due to the harm they've seen come to some of their respected colleagues.
Susan Fein, Huntington