Last week, the Swedish channel SVT broadcasted the Lyme movie: “Lyme Disease: A Silent Epidemic” by the French movie maker, Chantal Perrin. Without her knowing, the Swedish channel added 4 statements before the movie started. Read SVT’s statements and Perrin’s answers below:
Perrin’s answer to SVT:
Some countries like Switzerland, the Netherlands or the United States have made a serious step forward to a better understanding of Lyme disease. The 4 statements below represent the old vision. Canada, more than 10 US states have passed laws in order to allow Lyme doctors to treat their patients on a long term basis. Virginia has passed a law so that patients must be warned against the low accuracy of the serologic tests (the physician must warn their patient that negative tests do not mean that they are not carrying the infection) .
1) The film is produced in France and naturally reflects the french debate rather than the Swedish one.
(Filmen er producerad i Frankrike och speglar främst franska förhållanden och fransk debatt)
Answer: The film reflects the situation in most industrialized countries and not only France. A few countries have made an update and state that the description of the illness made in 2006 (the official guidelines), and the recommendations for diagnosis and therapy are not accurate and should be reviewed at the light of recent publications.
2) Swedish health authorities are convinced that Lyme disease as we know it is not chronic, and that antibiotics for more than three weeks is not scientifically motivated.
(Läkemedelsverket och Socialstyrelsen rekommenderar högst tre veckors antibiotika med hänvisning till att längre behandlingar inte visat sig ha bättre effekt)
Answer: Health authorities in some countries still maintain that Lyme disease can be cured with 3 weeks of antibiotic therapy. If that was the case there wouldn’t be a Lyme problem. It has been proved scientifically in several animal species and in humans that the bacteria Borrelia could resist after several months of antibiotic treatments. A major paper published by Monica Embers et al. in PLOS One confirmed this fact. Several open studies showed the efficiency of prolonged antibiotic treatment. Two randomized studies, which are published, showed the superiority of antibiotic versus placebo when a precise end-point was measured. A huge number of people around the world have seen severe symptoms diminished or disappear after a few months of combined anti-infectious drugs (antibiotics or natural treatments). The chronic or non chronic debate is irrelevant; These bacteria are persistent. They can take different forms to avoid the immune system and atbx treatments. The aim is to attack them in their different forms and that is the ground of research for many scientists around the world. Unfortunately, research on this topic is usually not very well funded because of the controversy.
3) The African borrelia is a different disease, caused by another bacteria than ours.
(Afrikansk borrelia ä en annan sjukdom än den i Sverige och vållas av en annan bakterie)
Answer: The African borrelioses are caused by one of borrelia species. It is still borreliosis. Lyme disease is the name that was given to the illness when it was discovered in the Lyme district at the end of the 70s. In Germany and Eastern Europe, scientists speak about borrelioses. B. crucidurae, found in Africa, is giving relapsing fever, that is the reason why it is often mistaken for malaria. This species is now isolated in Morocco, Spain and in the south of France. There are more than 30 strains or Borrelia found in humans and they each give different signs and symptoms (neurological, arthritic, cardiac ). New strains are discovered each year. B. miyamotoi is now identified in patients in Asia, Eastern and Western Europe, Canada and the USA. This species is usually not detected by routine serologic tests. It is responsible for both clinical pictures, either Lyme disease or relapsing fever.
The new Borrelia that have been discovered recently, especially Borrelia miyamotoi can be responsible in man for either Lyme-like disease or relapsing fever. This species, as the novel Borrelia sp. discovered in Boston (Lee et al. Int J Mol Sci 2014,15, 4284) are genetically belonging to the relapsing fever borreliae as the African strains like Borrelia crocidurae.
4) There is no evidence that rodents in our homes spread ticks. In Sweden the predominant agent is roe deer.
(I Sverige beror inte en eventuell ökning av borrelia på möss och råttor i bostäderna.)
Answer: Rodents are the reservoir of all borrelioses. The tick will be infected by biting a rodent and then will transmit to bigger mammals like dogs or human beings. The role of deer is to host the tick, especially when breeding. But the deer is not a reservoir of the disease as huge as the rodents are. You can find Lyme disease in forests without any deer. But a lot of deers or cattle means a lot of dwellings for ticks and thus an even greater number.
Conclusion : In my opinion, the film was giving a mild account of reality. We did not want to say all that we learned about those tick-borne diseases. We avoided talking about transmission although there is more and more evidence that there is foetal and sexual transmission. We also avoided mentioning that B. miyamotoi, one the most dangerous strain of Berrelia, is now found in the ticks of European forests like the Ardennes or in Alsace.
What may be different between France and Sweden is information and prevention, that exists in your country and not in France.