A 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 “risk causing concern in many patients as well as therapeutic wanderings”.
The specialists still furious with the High Authority of Health (HAS). A month later HAS recommendations on Lyme borreliosis and other diseases transmissible by tick bites, “all the learned societies involved in the management of diseases transmitted by ticks” has published A press release refusing to “endorse the recommendation of good practice developed by the HAS”.
“We reproach him for chapter 4 concerning the SPTT (symptomatology / syndrome persisting (e) polymorphic after a possible tick bite)”, explains us France Roblot, vice-president of the French-speaking Society of Infectious Pathology (SPILF). “This is something whose definition we do not know and which risks causing concern in many patients as well as therapeutic wanderings: patients who will have unclear symptoms will be diagnosed as bitten by ticks while ‘they have never seen one and we will miss the right diagnosis, “she worries.
Indeed, in its chapter 4, the HAS decided to recognize that people suffering from recurrent pain and fatigue are very sick but refuses to approve the existence of a chronic form of Lyme disease. Instead, she created the terminology for SPTT to explain the “situation of patients who may have been exposed to ticks and who present with polymorphic, persistent and unexplained clinical signs that can be disabling”.
“We have not managed to find a name that is consensual. All the tired people who come for consultation, we will tell them that 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 express themselves a lot in the media by saying that it is necessary to treat for a very very long time, but we have never had proof of such a benefit “.
“If hundreds of doctors agree, it is because unease persists”
“The early manifestations of Lyme disease, cutaneous, articular and neurological and its late manifestations, we know them and we do not discuss them. They are moreover very well described by the HAS. We know that there are people bitten by ticks who have genuine Lyme disease and are still showing signs (impaired concentration, insomnia) after being treated with antibiotics. he presents 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 him on antibiotics? and this is called a trial treatment. In these cases, he must be told that there is no reason to go beyond 28 days: it is important that these patients be informed “, she explains before deciding er: “perhaps longer treatments will have an interest in the future, but we have to demonstrate it first and that it be decided by international bodies”.
This is why the SPILF and many other medical authorities have asked the HAS to delete Chapter 4. In vain, the authorities have remained deaf. Today, in this press release published on July 19, “all the specialists are gathered around the table. We all agree so after a while we have to ask ourselves questions. If hundreds of doctors are okay, it’s that unease persists “, calls out France Roblot, proposing” to continue working with respect to this famous SPTT by relying on international, English and German recommendations, for example, which come from We want there to be consistent homogeneous care across the whole of the country, so that everyone has access to the same process “. And to conclude: “Our constant concern is to improve patient care and take their symptoms into consideration. We are here to have 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 within a month after the bite, first as a red, round patch that extends in a circle from the stung area. The skin lesion may be accompanied by muscle and joint pain, or even fever. Treated quickly, the disease can go away in a few weeks or months. Otherwise, it can lead to neurological disorders and / or facial paralysis.
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