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Health committee  Good morning. I'm Dr. Elizabeth Zubek, and I am a clinical instructor with the University of British Columbia Faculty of Medicine, department of family practice. I've also worked, from 2013-14, as a UBC consultant on the treatment of Lyme disease, with the university's complex ch

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  My feeling on that is that we need to publish the ILADS guidelines because they tell physicians that patient preference is important: here's the evidence; how long do we want to treat for; what are the options. Physicians can look at the research and at the patient preference for

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  Doctors are quite afraid to go outside the box of published guidelines. If they look on the PHAC website and it links them to 2006 protocols that say you have a central nervous system infection with Lyme disease, and they then give one antibiotic for two to four weeks, they're wo

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  It has not changed what PHAC posts on their website. They post a link to these 2006 guidelines and do not say that there are other much more evidence-based and current guidelines available. If a physician could look on the website and find those other guidelines, they would then

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  In the U.S., there are a number of different private laboratories. I choose to go to Germany, myself, and the ELISpot test I use from a few different labs in Germany is available in a certain lab in the United States as well. Diagnosis is very difficult. The standard in the U.S

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  They were about both diagnosis and treatment.

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  For the treatment, those guidelines say two to four weeks of antibiotics, but with one single antibiotic—

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  Absolutely. Yes, the ILADS guidelines are far better.

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  They're the ILADS guidelines, which are published on the U.S. National Guideline Clearinghouse.

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  It's published on the National Guideline Clearinghouse. It's by Drs. Cameron, Johnson, and Maloney. It has a big, long name, “Evidence assessments and guideline recommendations for tick-borne infections, erythema migrans...”. The name is a paragraph long.

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  He did.

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  First, it depends on what type of test you're using. We used to use a different type of ELISA first, followed by the Western blot, and now we have a C6 ELISA first, which is a better tool. However, then we were still following it up with the Western blot, and if the Western blo

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  I don't know what references they're using. The references we have and that Ralph has published there show the 84% sensitivity, which is much higher than we're getting from any other test, and we still have good specificity. A 94% specificity means that if we tested 100 people wh

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek

Health committee  I'd love to weigh in here. Family physicians are overwhelmed by an abundance of information, but we also have a relationship with the patient. We've known them for years. We've known them before they got sick; we see the changes in them, and we are not willing to accept the gui

June 8th, 2017Committee meeting

Dr. Elizabeth Zubek