A continuing controversial issue, the question ‘What is Lyme Disease’ can provoke a variety of responses depending on who is asked. There is agreement at least that Lyme disease is an inflammatory condition thought to be caused by the bite of a tick infected with one of (at least) three species of bacteria. The prevalence of these bacteria and the ticks which carry them, along with the purported effects of the disease, are all passionately debated, with some claiming that Lyme disease does not exist in certain regions of the world, and others attributing a wide variety of chronic symptoms to Lyme disease despite no indication of initial or persistent infection. Lyme disease is considered endemic in Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin, although some individual physicians are concerned that the diagnostic label is being used as a ‘catch-all’ term for conditions with no other explanation. The Centers for Disease Control and Prevention (CDC) states that there are around 20,000 new cases identified each year, with cases peaking during summer months after infection in May and June by ticks in the nymphal stage of development.
Characteristics of Lyme Disease
The disease is characterized by a ‘bullseye’ rash called erythema migrans, accompanied by a headache, fever, joint swelling, and a variety of symptoms as the infection progresses. Lyme disease is also referred to as Lyme borreliosis due to it being caused by the Borrelia bacterial species. There is some controversy over the existence of ‘chronic Lyme disease’, and the nature of the symptoms make for a difficult diagnosis in both acute and chronic cases. Lyme disease imitates a number of other conditions such as Chronic Fatigue Syndrome, and Fibromyalgia, and the laboratory tests designed to detect the presence of infection are imprecise and inaccurate in many cases. It is possible that patients classified as having chronic Lyme disease are actually repeatedly contracting the infection from recurrent tick bites leading to persistent symptoms (Krause, et al, 2006).
Lyme Disease Treatment, Vaccines, and Controversy
Where Lyme disease continues without treatment, or is resistant to treatment, it can lead to arthritis symptoms, cardiac problems, facial palsy, viral-like meningitis, radiculitis (nerve inflammation and pain), and neurological issues such as confusion, memory impairment, and even psychosis in some cases. Worldwide, there are thought to be no more than a dozen deaths attributable to Lyme disease. Treatment for Lyme disease involves short-term oral antibiotics, although intravenous, long-term antibiotic treatment is sometimes given by so-called Lyme Literate Medical Doctors (LLMDs) despite official evidence-based medical advice asserting that this is unnecessary, unhelpful, and often dangerous. The Lyme disease controversy has affected the distribution of vaccines created against the infectious bacteria and, to some extent, research on the condition as various medical organizations have been reluctant to lend credence to some of the more far-reaching claims regarding the effects and incidence of the disease. Chronic Lyme disease advocates have also resorted to self-funding research in a number of cases although much of this is questionable due to connections between the researchers and companies providing testing and treatment for Lyme Disease.
Chronic Lyme Disease: Does it Exist?
Studies by the National Institutes of Health into chronic Lyme disease have foundered due to problems in recruiting sufficient numbers of patients with clinical signs of the disease in the long-term. Indeed, patients with suspected Chronic Lyme disease were found in one study to display similar symptom profiles and quality-of-life scores to matched controls without suspected Lyme disease, demonstrating that these patients may have been erroneously diagnosed (Seltzer, et al, 2000). Interestingly, the same study also noted that patients diagnosed with Lyme disease but who did not meet the diagnostic criteria as set out by the CDC experienced increased symptoms and worsening quality-of-life indicators during the study period implying that their treatment with antibiotics failed due to initial misdiagnosis (Gardner, 2000). Some of the symptoms of chronic Lyme disease may also be attributed to damage incurred during the initial infection rather than the presence of continuing bacterial infection. It is agreed that acute Lyme disease is prevalent in certain areas of the world and that a common factor for the spread of the disease is the presence of deer or sheep who act as hosts for the ticks who carry the disease.
The History of Lyme Disease
Lyme disease is named after the town, Old Lyme, in Connecticut where a number of cases were identified in 1975, followed by identification of the transmission of the disease by ticks in 1978. The specific bacteria responsible for the condition were identified in 1981 by Willy Burgdorfer as Borrelia burgdorferi sensu, although other species of the genus Borrelia are now also thought to be involved in the development of Lyme disease, including Borrelia afzelii, and Borrelia garinii. The latter two are considered to blame for most European cases of Lyme disease, with the Burgdorfer bacterial strain accountable for most cases in the US. Lyme disease is the Northern Hemisphere’s most common tick-borne infection and is, arguably, set to increase with climate change. The presence of the deer-ticks in Europe has received considerable speculation recently with the UK identifying more cases each year. In the UK the tick is carried by sheep, in addition to deer and other mammals and birds, and the Health Protection Agency estimates around 3000 cases occurring each year.
Lyme Disease Prognosis
Due to Lyme disease often going undetected or untreated, the number of people suffering from long-term effects of the condition are accumulating over time. This has led to calls by a number of public figures and celebrities with Lyme disease, such as the woodsman and bushcraft expert Ray Mears, for a wider appreciation of Lyme disease and better intervention. Early treatment can be very successful but the disease is much harder to treat in later stages. Rarely fatal, Lyme disease can however cause serious disability and disruption to a sufferer’s life with some patients experiencing severe mobility problems due to joint pain, an inability to concentrate or think clearly, mood swings and psychosis leading to relationship breakdown, job loss, and a variety of other Lyme disease symptoms and effects.