Dr. E. Murakami Centre for Lyme

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Much of the information that appears on this site is too important to be deleted, so we're capturing it here for posterity's sake! 


January 2011: A LONG, LONG TIME AGO

Well, okay, maybe not that long ago, although in the depths of a Canadian winter, last August truly does seem like ancient history. Anyway, the point here is that on August 17, 2010, Dr. Murakami did a radio interview about Lyme disease for the Changes radio show on CHLY in Nanaimo, BC. We've recently been provided with the mp3 link for the interview, so if you're interested in hearing what transpired, check out http://lnkd.in/AeXjTe


We've been advised that if for any reason the link doesn't work, you can go to to www.chly.ca, then click on the Podcasts image box on the right hand side. From there, you can scroll to the "Changes" radio show, which will give you three options.... the first one is: Play now, the second one is RSS feed. Select RSS feed and then from the index scroll down to Aug. 17 and click on the media file (not the title).

Many thanks to Roz Powell for sending this on.



Dr. Murakami met with Manitoba's new Deputy Minister of Health, Milton Sussman, as well as additional Ministry representatives on November 1, 2010. Mr. Sussman was very interested to hear Dr. Murakami's thoughts on the biggest problems in diagnosing and treating Lyme. Dr. Murakami explained that the major issue is that those in the medical profession can't get on the same page, and that this divide is such that many US states have felt the need to pass legislation to protect doctors who treat Lyme beyond the restrictive IDSA guidelines. Manitoba Health's efforts to understand Lyme and its impact on the health of its citizens have lead to what is likely the strongest Canadian Lyme incidence data gathering initiative, with physicians required to report clinical cases of Lyme to Manitoba Public Health (Manitoba Public Health Notice). 


Dr. Murakami's lecture to the Canadian College of Natural Medicine on November 2, 2010 was videotaped for future educational purposes.



There was a great turnout at the three lectures Dr. Murakami gave on November 4 and 5, 2010, with approximately 220 people in total attending. As always, there were many great discussions as everyone tried to absorb as much as possible about Lyme, its diagnosis and treatment, and the long-term repercussions when diagnosis or treatment is delayed. Dr. Murakami and Dr. Ben Boucher shared the "lymelight" for the Thursday night presentation. Many thanks to Dr. Boucher!



Roughly 40 people attended Dr. Murakami's November 5, 2010 presentation to the executive members of the Lioness service club and members of the Victorian Order of Nurses. Aside from being graciously welcomed as the purveyor of Lyme information, Dr. Murakami was also enthusiastically received as a long-time member of the Lions organization. This presentation has potentially opened the door to a broader audience as Dr. Murakami may be invited to speak at a Lions annual meeting. 


Shaun Burke of the Nova Scotia Lyme Disease Association (NSLDA) has written an informative article for NSLDA members about Dr. Murakami's visit to Nova Scotia, and has generously agreed to share his message here. In addition, while in Nova Scotia Dr. Murakami was interviewed for an article in The Chronicle Herald, which be viewed here. 


Dr. Murakami has recently become aware that within the last month or so the Ontario Chief Medical Officer of Health sent a message to physicians regarding Lyme disease (Ontario Lyme Disease.pdf). While not as comprehensive as the notice sent to physicians in Manitoba, the Ontario version also mentions the erythema migrans rash appearing in 70 to 80 percent of infected individuals (see Dr. Murakami's thoughts on this in "Interesting News Out of Manitoba"). Sadly, the Ontario message cautions physicians against using private "for-profit" laboratories in the US to test patients because "they may not follow the same testing protocols as most provincial, state and federal laboratories in Canada and the USA."  This caution continues to be a source of frustration, as least insofar as IGeneX is concerned, as this lab's testing procedures have been thoroughly evaluated and approved by The Centers for Medicare & Medicaid Services (CMS), which regulates all laboratory testing on humans in the US through the Clinical Laboratory Improvement Amendments (CLIA). IGeneX is also licensed in the five states with special requirements beyond CMS licensing.


On a positive note, the message to Ontario physicians points out that:

  • Lyme disease can be acquired virtually anywhere in the province (patients don't have to be from, or have visited, an endemic area);
  • it is up to physicians to make the diagnosis and determine treatment; and
  • testing should be used in conjunction with clinical signs and symptoms.


Although progress is slower than we'd all like, it appears that establishing that "you can get Lyme in Canada" is becoming a reality.


On July 29, 2010 Manitoba's Public Health department circulated a notice to that province's physicians advising that clinical cases of Lyme Disease are now reportable in Manitoba. This is a new and welcome development, as the national surveillance definition is more stringent than the clinical criteria used to initiate treatment and currently, clinical suspicion of Lyme is not sufficient for such cases to be counted at the national level.


According to the July 29 correspondence, in 2009 Manitoba's tick surveillance program revealed that 14 percent of ticks submitted were infected with Borrelia burgdorferi, the bacteria that causes Lyme, and about 5 percent of ticks were positive for the bacteria that causes ehrlichiosis. Two percent of infected ticks had both.


Dr. Murakami has made four presentations to Manitoba authorities over the last few years, with the most recent on October 19, 2009, so he is certainly heartened by their new reporting policy for clinical cases of Lyme. However, he noted that the treatment guidelines forwarded to physicians by Manitoba Public Health are based on the IDSA protocol of a three-week course of antibiotics, which can be adequate for recently infected individuals. Patients with late stage Lyme may often require a long-term (three months or more) combination of antibiotics, or antibiotics delivered either intramuscularly or intravenously. He is also concerned that the notice to physicians suggests that the erythema migrans rash appears in 70 to 80 percent of infected individuals. In Dr. Murakami's experience, the rash may only show up in 15 to 20 percent of patients. He posits that this may be due to the size of the tick - a bite from a tiny nymphal tick can equal a tiny, inconspicuous or non-existent rash.


If you are interested in reading the entire Manitoba Public Health notice, please click on "Seminars & Lectures" on the left-hand menu, then "Dr. Murakami's Presentations".



Gaining Momentum

It is a sad fact that there is a great divide among physicians regarding the treatment of Lyme disease. It is an even greater travesty that this divide has resulted in the need for governments to enact legislation to protect physicians who treat Lyme disease outside the controversial guidelines established by the Infectious Diseases Society of America.

The move to protect physicians who treat Lyme disease with long-term antibiotics from investigation, harassment, and withdrawal of medical license is gaining momentum, with numerous US states now having legislation in place, including:

  • Connecticut                  
  • Delaware                            
  • Maryland 
  • New Jersey
  • Rhode Island
  • California
  • Washington                    

In addition, a number of other states are in the process of developing these same laws, including New York (currently only has a verbal agreement with the office of professional conduct that no harassment will occur), New Hampshire, Maine, Florida, and Virginia.

On March 13, 2010 the Minnesota Medical Practice Board voluntarily implemented a five-year moratorium on disciplinary action against physicians who prescribe, administer or dispense long-term antibiotics for chronic Lyme. This initiative is intended to allow time for science to resolve the issue and circumvents the House and Senate bills passing the Legislature to make this protection a state statute.


UPDATE: On June 30, 2010, the governor of Massachusetts signed a bill providing protection to doctors who prescribe long term antibiotics for Lyme disease. The new law gives doctors discretion to diagnose and treat according to their best clinical judgment.