No Small Thing

• http://www.poughkeepsiejournal.com/section/lyme?template=odytheme&theme=lyme
• http://pojonews.co/RMG7GL
• http://www.poughkeepsiejournal.com/VideoNetwork/1791355261001/FACES-OF-LYME-FULL-VIDEO
• http://pojonews.co/SsoVHl

Provide names of other journalists involved.

Stuart Shinske — Executive Editor Spencer Ainsley — Director of Multimedia Chris Cusumano — Interactive Developer Chrissie Williams — Multimedia Artist John Ferro — Environmental Writer

List date(s) this work was published or aired.

SPECIAL REPORT: No Small Thing Part 1 August 17, 2012: Lyme disease hits home — “Dutchess leads nation in Lyme” — “New tick-borne threat emerges” Part 2 August 19, 2012: Doctors & Lyme disease — “Antibiotics fuel debate over Lyme” — “Writer has a bout with Lyme” Part 3 September 9, 2012: Ticks & Lyme disease — “Tick research lags in war vs. Lyme” Part 4 September 10, 2012: Foxes & Lyme disease — “Where foxes thrive, Lyme disease doesn’t” Part 5 October 21, 2012: Flunking the Lyme disease test — “Dicey path to Lyme diagnosis” — “CDC researcher answers questions on disease, tests” Part 6 November 18, 2012: Counting the Lyme disease toll — “Lyme Disease Counting Is Uncertain, Imprecise” — “Lyme treatment guidelines flawed, researcher says” Part 7 December 23, 2012: Babesiosis and the blood supply — “Tiny tick, big threat” Part 8 December 24, 2012: The next tick scourge — “Dutchess at center of rising tick threat”

Provide a brief synopsis of the story or stories, including any significant findings.

The Poughkeepsie Journal series “No Small Thing” goes where no other newspaper or media outlet has — it challenges the mainstream medical dogma on Lyme disease. In rigorously documented articles, Projects Writer Mary Beth Pfeiffer concludes that the major actors in this public health scandal — chiefly the U.S. Centers for Disease Control and Prevention and the Infectious Disease Society of America — have minimized and mismanaged a burgeoning epidemic of tick-borne disease at great harm to thousands of infected people. These two powerful institutions have relied on a body of incomplete and sometimes flawed medical research to foster the notion that Lyme disease is easy to diagnose and easy to cure. It is neither. In a series that is at once expose, scientific analysis and public service, Pfeiffer uses solid medical research and a balanced array of medical, scientific and patient sources to question why physicians who prescribe longer courses of antibiotics risk losing their licenses, why patients cannot find doctors to care for them, and why the CDC says Lyme tests will, after a certain point, “almost always” test positive when the research isn’t nearly so definitive. Indeed, Pfeiffer’s seminal article on the flaws of Lyme testing (part 5, “Dicey path to Lyme diagnosis”), is, we are convinced, the most authoritative piece ever written on the subject and, coupled with a detailed graphic that explains the test flaws, itself is worthy of this award. Similarly, her piece on probes of Lyme physicians by the New York State Health Department (part 2 “Antibiotics fuel debate over Lyme”) lays bare the political and scientific intrigue that has put doctors in the crosshairs of health officials rather than a spirochete that is wreaking havoc for untold legions. We submit here the entire series as context while urging special consideration to the stories listed above as well as part 6 on tracking this “endemic” and parts 7 and 8 on the emerging threat of babesiosis, its threat to the blood supply and the issue of ticks carrying more than one infection. In these stories, as in the entire No Small Thing series, the Poughkeepsie Journal breaks new ground and acts as a keen advocate for the local, and indeed, national public health. Thank you.

Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?

The Poughkeepsie Journal relied heavily on medical and science journal articles; its graphic on the flaws of the two-tier Lyme test, for example, alone cites 14 science journal articles. Perhaps two dozen others were consulted throughout the research and many are cited in the text of this and other articles. Beyond this, the Journal used state and federal statistical reports to compute and rank per-capita Lyme disease incidence. It was the first newspaper to obtain CDC babesiosis data by county nationwide.

Explain types of human sources used.

This series relied on Lyme patients and their advocates and physicians to tell the story of the extent and damage of Lyme misdiagnosis and delayed care. Scientists and physicians on both sides of the controversy were interviewed as were local, state and national health officials.

Results:

This series has generated unprecedented feedback: 5,000 hits on two separate web postings in Australia; 200 to 600 Facebook “recommends” for major Sunday articles (as a small paper, we get perhaps a dozen on major stories); scores of emails from at least 20 states and Canada; and two live chats that could not accommodate all the people anxious to weigh in. The Journal clearly has identified a problem of national significance and connected with a constituency hungry for information — and validation. We cannot say that we have moved the CDC or state health department to change course but we have clearly gotten their attention and called on authorities to revisit long-held policies.

Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.

There has not been a single challenge of fact to this series. After the article on flaws in the Lyme test, the CDC expressed concern about being the central focus of the critique; it could not cite any errors. There was one correction published due to a copy editing error in the main story of the first installment, third paragraph. The number of local Lyme cases read 6,40; it should have read 6,400.

Advice to other journalists planning a similar story or project.

Read the science. It’s arduous and technical but it can be understood. Ask researchers to aid in interpretation. Test your interpretations and conclusions on many sources to see if they are correct and stand up. Double and triple check figures and citations. Use graphics and videos to tell the story. These resonate with readers and make the story more approachable and understandable. Our “Faces of Lyme” video was spread widely by Lyme support groups and got incredible response. Be a conduit for dialogue and information. Two Q&As with the CDC served to give Lyme groups up-to-date information on what public health officials were thinking. Web chats let them connect. This is basic, of course, but worth mentioning: consult and prominently feature both sides of the debate. One of the common adjectives applied to the series was that it was unbiased.