In the lymelight: law and clinical practice guidelines

Almost from the beginning, the Ixodes scapularis and I pacificus, adult deer ticks, have been a breeding ground not only for Lyme disease, but also for political dissent. Most recently, the battleground moved into the arena of clinical practice guidelines. Both camps in the "Lyme Wars"-the Infectious Diseases Society of America (IDSA) and the International Lyme and Associated Diseases Society (ILADS)-have published Lyme disease practice guidelines. The guidelines conflict regarding diagnosis and treatment. The state of Connecticut's Attorney General's office conducted an investigation, under antitrust laws, into the development and promulgation of IDSA's 2006 guidelines. In an unprecedented move, IDSA and the AG have entered into a legal agreement that necessitates a rethinking of the guidelines, requiring a new review panel reflecting balanced, conflict-of-interest-free perspectives on Lyme disease.