In reply to bentley's biceps:
I'm not sure if you are a Doctor, but if you are, you will be aware of the saying 'treat the patient, not the tests'. I think this is a wise statement. In the case of Lyme, you are correct, the tests used in the UK are currently unreliable.(However, There is a new test, just developed in America and only available there which claims to be much more reliable, it is a culture test rather than an indirect antibody test, and I think there is much merit in this approach- but I digress).
The test manufacturers all state that a negative test should not be used as evidence that the patient does not have Lyme and that clinical judgement should be used. The problem is that many of the symptoms of Lyme are vague and non-specific, and it mimics many other illnesses. In the UK, there are not enough cases of Lyme for regional Infection consultants to gain enough experience, they are spread too thinly, and so these consultants are not seeing the patterns. In addition, Lyme is extremely variable, no two patients are alike. However, that said, it is still possible to diagnose on clinical grounds alone if you have enough experience. I have been diagnosed with Lyme clinically by 5 lyme-specialist doctors (with later positive blood tests). All of these people are seeing several new Lyme patients each day, as opposed to one a month or so that an ID consultant might see. All of these doctors go to Lyme conferences, keep up to date with the literature, LISTEN CAREFULLY TO THEIR PATIENTS AND HAVE CONSULTATIONS THAT LAST BETWEEN 1 AND 3 HOURS, carefully monitor their patients when they are on long term antibiotics and importantly, they follow up their patients for long periods of time and see results. They see that skilled use of long term antibiotics can produce very good results- people are transformed from often having an exceedingly poor quality of life, sometimes bed bound, to leading fulfilling, productive lives again.
I would agree that there need to be more clinical trials on long term treatment of Chronic Lyme disease. One of the trials that I cited is actually a double-blind placebo controlled study (Fallon).There is a study in the Netherlands that is ongoing (double-blind placebo controlled).
One of the problems is that double-blind placebo controlled studies are ethically difficult, and also, as no two Lyme patients are alike, having a one-size fits all approach doesn't really make sense. Some patients require less than 4 weeks of antibiotics and they seem well again, some need years of antibiotics and may experience only partial recovery. There are so many factors- co-infections, duration of infection, hormonal, metabolic and immune dysfunction, and strain or genospecies of Lyme itself.
I have never met Andrew wright, and I do disagree with some things he has said, but I also think some of his approaches (especially the use of microscopy) had some merit and although he was skating on thin ice using this for diagnostic purposes, I think he was onto something. I have seen my spirochetes under a microscope (I used one for work), it wasn't that difficult and although I do not know what species they were, I'm pretty sure I don't have Syphilis or Leptospirosis. I do not think the GMC were conspiring, infact when they were called to investigate other Lyme specialist doctors in the UK, they decided it was not within their remit to arbitrate in a controversial area of medicine and decided not to pursue the case.
You say that there is no evidence that Chronic Lyme disease exists. I can find you upwards of 77 peer-reviewed studies which show that Borrelia burgdorferi can survive short (and sometimes several months) of antibiotics, and many papers showing that these spirochetes are viable, and can be cultured and when infected into uninfected animals, caused disease. So I think you are incorrect in saying there is no evidence to support the existence of Chronic Lyme.