Author: Monica Carugatti

New note from La Nación about Lyme in Argentina : “The Lyme enigma: is the disease that Justin Bieber and celebrities have in Argentina?”

Mrs Gabriela Navarra’s note for La Nación gives us a fairly adequate view of the Lyme disease situation in Argentina. I recognize that it was difficult to develop due to the different discourses of patients and health authorities. It is a politically correct publication that allows us, the patients, to replicate some of the concepts issued by representatives of the health authorities.

In this article on my blog I try to explain some of the reasons why I consider the arguments expressed to be controversial and imply taking a position in a debate, others to be empty and highly contradictory arguments, and others just an act intended to deny the existence of Lyme in Argentina.

In all the explanations and in the publication to which the article refers, and signed by some of the professionals interviewed, the objective seems to be more to dismiss the evidence of the existence of a disease with a Lyme clinic after the bite of a tick, and positive in specialized laboratories abroad, than to look for how this disease originated, its characteristics, ticks, vectors, bacterial culture, etc. Nothing is said about this.

Before continuing, I would like to introduce two observations that, in my opinion, help to understand the dissidences in general.

We learned with Covid-19 that science is not unequivocal. The constant presence of infectious disease doctors in the media put us in the position of questioning ourselves about concepts that we often did not know and that were not part of our usual terminology. So the decision of who is right, in the vast majority of cases, goes more through ideology and empathy than through scientific foundation and / or an adequate understanding of dissidence. 

In recent decades, unfortunately, evidence-based medicine replaced MEDICINE. The concept has been used and abused. If doctors base their profession only “on the evidence”, they leave without considering most of the aspects that must be taken into account in the medical care of a patient. Evidence should not be confused with existence. Evidence-based medicine is undoubtedly a fundamental advance for medicine, “but it brings us closer to knowing through a keyhole.” To this we must add the frequent non-compliance with the many necessary conditions in a scientific investigation. But this is a discussion that exceeds this space.

“From the ANLIS Malbrán they indicate that “neither the tick —the vector— nor the bacterium are in Argentine territory and that there are no autochthonous cases of Lyme. ” 

This statement is false:

“In Argentina there are borrelias close to those that cause Lyme in Europe and North America, but they are not the same. It is not known if they cause any disease in humans or animals, they are of unknown pathogenicity.” Santiago Nava (La Nación, November 26, 2021) * (1) * (2) * (3)

1. Ixodes Scapularis is not the only tick that transmits Borrelia Burgdorferi sl and it is also not the only tick that transmits Lyme Disease. I do not know if Ixodes Scapularis exists in Argentina, but I do know that Ixodes Pararicinus, at least, is in Argentina and does transmit Borrelia spp. agent that causes Lyme disease. So Borrelia Burgdorferi sl is not the only Borrelia that transmits Lyme Disease and/or Relapsing Fever.*(4) *(6)

The truth is that there are many strains of Borrelia that cause the disease, for example Borrelia Miyamotoi, Borrelia Garini, Borrelia Afzelii, etc. Others isolated and others without isolation. Amblyomma Cajennense transmits in Brazil a borrelia with a different morphology and that does not belong to the Borrelia Burgdorferi group, which has not been cultivated and which generates a disease called Baggio-Yoshinari or Brazilian Lyme that gives a very serious clinical picture very similar to Lyme. *(5) * (3)

2. The arguments given to us in the note by ANLIS and Dr. Nava indicate a lack of knowledge of the situation in the world, where new ticks carrying different strains of borrelia are constantly being found, generating similar clinical pictures and which are included in the diagnosis of Lyme disease. If we were rigorous with the denominations and only called Lyme disease the borreliosis caused by the borrelia isolated by Willy Burgdorfer, we should give another name to the borreliosis produced by Borrelia Garini, B. Afzeli, B. Miyamotoi, etc., which is not the case. is done or is done less and less.

3. Fundamentally, these arguments deny the reality that we patients with a Lyme Disease clinic have and that in addition to responding to antibiotics (specific and in sufficient quantity), they have positive laboratories by different techniques and that they have been stung in the national territory. .

4. The arguments in the note from ANLIS and Dr. Nava are perverse in intent and want to make the interviewer and the population believe that there is no Lyme in Argentina, using technical language from a place of power and knowledge, to confuse.

“Between 2014 and 2019, Malbrán analyzed 31 clinical samples with suspected autochthonous Lyme; some with positive results in tests carried out with methods not validated by the US FDA.” All were negative, “they indicated.” * (7)

I hope that this study is not the only one that concludes that there are no patients with autochthonous Lyme in Argentina, that the bacteria is not present and neither is the vector. The only thing that this Malbrán study says is that the Western Blot results in a US laboratory are negative. A conclusion cannot be drawn from this publication indicating that there is no indigenous Lyme in Argentina because the conditions are not met.

1. The diagnosis of Lyme is clinical. In mid -2019, the CDC issued a disclaimer where it rightly says that the double standard tests used for research (Elisa and Western blot) “are not suitable” for the diagnosis and treatment of patients, whose diagnosis must be be a clinician * (8) * (9) *(10)

“A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance.