Please see the sixth letter below in this series to the Assistant Secretary for Health as I have included my letter to the editor published in JAMA on Dec 18th.

Controversies About Lyme Disease
Carl Tuttle  Dec 18, 2018
https://jamanetwork.com/journals/jama/article-abstract/2718786

The Journal of the American Medical Association recognized the importance of questioning the propaganda that Wormser and Shapiro continue to propagate using NIH funded taxpayer dollars.

This was the the recent Wormser/Shapiro publication that prompted my letter to the editor:

Lyme Disease in 2018
What Is New (and What Is Not)  August 21, 2018

https://jamanetwork.com/journals/jama/article-abstract/2696480

Wormser and Shapiro reply to my letter using references of their own publications (circular logic). In other words, they are correct because they said so.

-------- Original Message ----------
From: CARL TUTTLE <runagain@comcast.net>
To: Brett.Giroir@hhs.gov, Alex.Azar@HHS.GOV, tickbornedisease@hhs.gov
Cc: (64 Undisclosed recipients)
Date: December 19, 2018 at 9:58 AM
Subject: My letter to the editor published in JAMA Dec 18, 2018

Dec 19, 2018 

U.S. Department of Health & Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Attn: ADM Brett P. Giroir, M.D., Assistant Secretary for Health

Dr. Giroir,

The Journal of The American Medical Association (JAMA) published my letter to the editor yesterday (see below) as they recognize the importance of challenging the propaganda.

The two authors of the article I was writing about have been named as defendants in a Texas racketeering lawsuit. These two individuals have controlled the Lyme disease narrative using their patented circular logic and by ignoring all evidence they don't like (i.e. outside their own old, myopic studies). …see attached response.

Wormser and Shapiro conveniently ignored my question: “What happens to the patient with Lyme disease who goes months, years or decades before diagnosis because of a false negative serological test?”

Untreated Lyme is destroying lives, ending careers while leaving the patient in financial ruin as reported by the disabled Lyme community for the past three decades.

The absence of a bulls-eye rash after tick bite, allows patients to progress to severe neurological disease instead of obtaining a prompt diagnosis and early treatment. This scenario has also gone unrecognized as the disease has been portrayed as “Hard to catch and easily treated.”

My letter to the editor published in JAMA:

Comment & Response

December 18, 2018

Controversies About Lyme Disease

Carl Tuttle1

Author Affiliations

1 Independent researcher, Hudson, New Hampshire

JAMA. 2018;320(23):2481. doi:10.1001/jama.2018.17195
https://jamanetwork.com/journals/jama/article-abstract/2718786

To the Editor: There are a number of inaccuracies in the Viewpoint by Drs Shapiro and Wormser on Lyme disease.[i]

First, they stated that: “….there has not been a statistically significant increase in the number of reported cases of Lyme disease in the United States during the most recent 4 years (2013-2016) for which data are available.” 

Quest Diagnostics has reported a significant increase of positive Lyme disease test results, with Lyme disease being detected in each of the 50 states and the District of Columbia.[ii]

Second, the authors wrote: “The vast majority of patients with Lyme disease (≥90%) develop the characteristic skin lesion, erythema migrans.”

The department of health in Maine reported that between 2009 and 2012 only 48.25% of patients with Lyme disease had a typical rash.[iii][iv]

Third, I disagree with the statement that: “For extracutaneous manifestations of Lyme disease, the sensitivity of antibody tests is excellent (87%-100%).”

A PubMed search for seronegativity in Lyme borreliosis[v]identified a large number of cases. It is well known that untreated streptococcal pharyngitis can progress to rheumatic fever, causing irreversible heart damage. Untreated syphilis leads to progressive disability and dementia, and untreated HIV infection progresses to AIDS with significant disability and death. What happens to the patient with Lyme disease who goes months, years or decades before diagnosis because of a false negative serological test?  Shapiro and Wormser do not discuss the consequences of untreated Lyme disease in their Viewpoint.

Carl Tuttle

Independent Researcher
Hudson, New Hampshire

Corresponding Author:  Carl Tuttle,  Hudson, NH 03051 (runagain@comcast.net).

Conflict of Interest Disclosures:  The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and reported no conflict of interest.

References:

[i]Shapiro ED, Wormser GP. Lyme disease in 2018: what is new (and what is not).JAMA. 2018;320(7):635-636. doi: 10.1001/jama.2018.10974

[ii]Quest Diagnostics News Releases Lyme-Disease-Prevalence-Increasing

URL: http://newsroom.questdiagnostics.com/2018-07-30-New-Quest-Diagnostics-Data-Shows-Lyme-Disease-Prevalence-Increasing-and-is-Now-Present-in-New-U-S-States   Accessed Oct 4, 2018

[iii] Report to Maine Legislature Lyme Disease February 2009

URL:http://www.maine.gov/dhhs/reports/lymereport.pdf  Accessed Oct 4, 2018 

[iv]Report to Maine Legislature Lyme Disease February 2010

URL:http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/lyme/documents/lyme-legislature-2010.pdf   Accessed Oct 4, 2018

[v]Lawrence C, Lipton RB, Lowy FD, Coyle PK. Seronegative chronic relapsing neuroborreliosis.Eur Neurol. 1995;35(2):113-117.