November 15, 2012 2:02 pm
Chronic Lyme Disease Is Probably Not a Real Thing
Lyme disease is caused by bacteria carried by deer ticks. Photo: Michiey
Lyme disease, an infection that leaves you with a rash, a headache, aches and fatigue, and, in serious cases, nervous system or heart problems or arthritis, is caused by a family of bacteria that can be transmitted if you happen to get bit by a deer tick.
Normally, when faced with a diagnosis of Lyme disease, you’re given a round of antibiotics and sent on your way. Some people, however, catch what has been dubbed “chronic Lyme disease,” a disorder that they claim is a recurrent version of the disease—one that fights back the regular antibiotic treatments and causes the affected person to relapse later on. The problem with chronic Lyme disease, however, is that it likely doesn’t actually exist, says a new study reported on by The New York Times. It seems that, rather than having relapses, patients with chronic Lyme disease are just getting infected all over again, says the study.
The conclusion that new symptoms come from new infections is based on genetically fingerprinting the Lyme bacteria in people who have had the illness more than once, and finding that the fingerprints do not match. The result means that different episodes of Lyme in each patient were caused by different strains of the bacteria, and could not have been relapses.
The link between Lyme disease and the bacterium Borrelia burgdorferi was first discovered in 1981, and in the time since, researchers have been working out the specifics of the disease.
The scientists gathered bacteria for people who had multiple bouts of Lyme-disease rashes, culturing the samples and checking their genetic make-up. In every case but one, the rashes were caused by different bacterial strains. In that last hold-out case, however, where the person’s Lyme disease was caused by the same bacterial strain in two separate cases, they also had a third case caused by a second bacterial strain. The odds of all this happening by chance, says the Washington Post, are “one in five million.”
More from Smithsonian.com:
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It would be very useful to know the studies sample size.
Comment by Matt — November 15, 2012 @ 4:21 pm
Hi Matt,
The study looked at the histories of 17 different people, each with multiple bouts of Lyme
Comment by Colin Schultz — November 15, 2012 @ 4:38 pm
This is one of several articles I have seen which conflates this study on new rashes associated with new infections which somehow ties in the issue of chronic Lyme disease or persisting post-treatment symptoms when the two issues are distinctly separate ones.
Even if one does not believe that Lyme disease can be a chronic infection (which in the scientific world it continues to be a matter of debate if a study like Dr. Embers’ Persistence of Borrelia Burgdorferi after antibiotic treatment in Rhesus Macaques has been published recently and the NIH-NIAID is funding a xenodiagnosis study to see if human hosts with chronic Lyme disease can pass their infection onto lab-raised ticks), even the IDSA itself recognizes that a percentage of patients who were treated for Lyme disease go on to have persisting symptoms for months to even years after initial infection. They think it is autoimmune and call it Post-Lyme disease syndrome; there are now proteomics studies that have been done which provide markers for this condition.
I think that one has to be careful about the utility of the EM or bulls’ eye rash in proper diagnosis of Lyme disease in general: According to Dr. Jorge Benach of Stonybrook University, if more satellite rashes erupt after the initial rash (usually within weeks to months) the infection has disseminated. Also, not all cases of Lyme disease present with an EM rash, and research by Dr. Benjamin Luft has shown that some strains of Borrelia which disseminate with a rash do not cause disease and some without rashes do cause disease.
One study like this is not enough to set the course for Lyme disease, which is an emerging infectious disease which requires more research.
Comment by Camp Other — November 15, 2012 @ 5:12 pm
Of course re-infections are very common in this epidemic of Lyme disease. The epidemic is, however, unnecessary since we already know how to stop it. The wise residents of Monhegan Island ME and Mumford Cove Ct ended their Lyme epidemics by getting rid of the deer. The deer epidemic caused the Lyme epidemic. In 1930 there were 300,000 deer in the US. Today there are 30 million. The deer are key to the reproductive success of the deer tick, which spreads not only Lyme but also babesiosis and anaplasmosis, both of which can be fatal. The adult egg-laying deer tick requires a sizeable mammal to feed on, and 95% feed on deer. They cannot feed on mice, for instance. It is estimated that ticks from just one deer can produce up to one million tick eggs per season. Removing the deer disrupts the tick life cycle. In fact, the deer tick life cycle has never been successfully sustained, so as to cause a Lyme epidemic, in the absence of deer.
Comment by Alexander Davis — November 15, 2012 @ 5:54 pm
It is not surprising that these same authors continue to churn out articles that completely disregard what a large body of patients actually experience. These patient reports are described as anecdotal. The plural of anecdotes is data. If patients with symptoms after a short treatment of lyme find someone who figures out that more antibiotics might help, and it does help, then a high school student would realize there could be continuing infection.
What is surprising is that a medical journal would allow authors to make major conclusions about the nature of chronic lyme disease from a handful of cases that dealt only with EM rashes. This is wildly out of the very restricted purview of the study. It is bad science
The other surprising thing is the media blitz that this one small study has received. It has appeared everywhere and here it is on a Smithsonian site, of all things! Is there no one left capable of analytical thought about medical subjects?
Comment by lou — November 15, 2012 @ 6:25 pm
Lyme Disease bullseye rash (Erythema migrans) rarely seen during relapse in chronic cases of the disease
http://lymepedia.org/lyme-disease-bullseye-rash-erythema-migrans-rarely-seen-during-relapse-in-chronic-cases-of-the-disease/
Comment by Paul — November 15, 2012 @ 7:16 pm
The title of this article is grossly misleading and irresponsible reporting. This study does nothing to discount the existence of chronic Lyme. Most people with chronic Lyme, like me, do not take 30 days of antibiotics and feel better, only to fall ill again. People who suffer from chronic Lyme keep taking antibiotics because they don’t get better after 30 or 60 days. It is a slow process with small margins of improvement experienced with each month.
I live in Massachusetts and started taking antibiotics in October. It took 12 months for me to feel I had made enough improvement to stop taking them. Surely, no one is prepared to make the assumption that I was reinfected in December and then reinfected again every month after that? How ironic that I didn’t start feeling better until tick season was again in full force.
Perhaps instead of spending precious time and money trying to disprove–with 17 samples–something that thousands of people can provide overwhelming evidence for, these researchers should have spent the last 20 years searching for a way to help people who are suffering in the real world. What a waste.
Comment by Amy — November 18, 2012 @ 7:27 pm
In response to your article. I had the EM rash in 2004 with flu like symptoms which my doctor misdiagnosed as a spider bite with a weird reaction and I went untreated for Lyme Disease. Within a year I developed sever muscle pain and gained a large amount of weight, needed sinus surgery, developed other rashes, extreme fatigue etc. June 21st 2007 I went of work with the addition of abdominal pains, nausea and vomiting. I then developed kidney impairment, arthritis in multiple joints, an unknown inflammatory condition with elevated inflammatory markers, tendonopathies, tachycardia, labile hypertension etc. In 2012 when trying to research what this is as all my specialists and doctors were stumped I read about the rash that described mine that I had in 2004 bang on. My also expanded in size as it faded in the intensity of colour. In January 2012 I now had a diagnosis of possible third stage lyme disease. For me this was not a case of re-infection. It was a case of being misdiagnosed, not treated and left to continue spiralling down hill for several years until I could not work, my quality of life went out the window, etc. Once told by an infectious disease doctor that he believes I have chronic Lyme I was only given three weeks of antibiotics as that was all he was allowed to give me which is the course of treatment I should have had 8 1/2 years ago. If lyme is so resistant and needs 3 weeks of treatment when first acquired, if allowed to diseminate through your body for many years is 3 weeks enough. Acute sinus infections need a week of antibiotics, chronic ones need several weeks longer. Common sense can tell that a longer does is required thus I continue to suffer and still am not able to work. I have my bachelor of nursing and am mistified as to how the same denial is being portrayed as AIDs. It took years for the government and health care to listen that AIDS was real and any sex, age, or opposite sex couples could get it. It is time to wake up and smell the coffee. Chronic Lyme is not due to re-infection, otherwise I would be getting re-infected with every new symptom I develop even when I can’t get off the couch. Which means my house is crawling with ticks? Ya right! Many people with chronic lyme were not treated early enough, not given adequate antibiotics or a long enough duration of them, or not treated at all. Although in some cases, individuals may become re-infected making them sicker than ever if they hadn’t had the first infection treated. If they can grow lyme spirochetes from dead people’s brains, than that show how resistant this bacteria really is and how long it can live for. Also, a study on 17 people hardly constitudes proof. Findings from a study down on this size of test subjects only shows a need for a much larger scale study of at least a few thousand people to get a fare representation of what is really happening. These test findings were released far to early in my opinion and should have let to a much bigger study rather than making assumptions on those of the general public who have chronic lyme. Last night I woke at 2:30 AM and found I was really dizzy if I even shifted my head slightly, I finally got up and sat on the couch around 3:00 and then began vomiting. Later went back to bed for a couple of hours, the dizziness much better but still there. My blood pressure is normal. Could this new thing of dizziness waking me up out of a sound sleep be re-infection. Certainly not! If so how as I have not been gardening, walking outside except on city sidewalk and parking lots to get to my medical appointments and I haven’t even walked by a tree. Let’s start acknowledging the obvious that Lyme disease is serious and robs one of their quality of life and takes away their means of survival (work). People with Lyme need support to know that it is real, it is acknowledged, treatment is being studied and soon they will be offered treatment as a cure or if not as a means to control this dreadful disease. Too many have taken their lives as they can not handle the pain any longer and the stress. Doctors need to have an open mind and when someone says hey I remember I had a rash that looked like an EM rash and I do have a lot of the symptoms, could that be what I have. The doctor needs to consider this as a possibility rather than saying oh you can’t believe everything you hear/read, oh its too rare so you couldn’t have it, or I just don’t buy into this lyme thing or more commonly than not they will say to be honest I really don’t know much about lyme but also will say they won’t treat chronic lyme as it would be malpractice. Is it malpractice to treat acute ashtma, cancer, leukaemia in children, strokes, high blood pressure, etc. What is going on. As a nurse I really would like to know. Once I do finally beat this thing, it is going to be very hard for me to go back to nursing and act that the health care system wants to help everyone and not speak out if I recognize lyme disease when I see it, which would likely cost me my licence. Things need to change and we need supportive articles to help those in serious need and to help doctors realize it isn’t as rare as the CDC claims it to be.
Comment by Susan — November 28, 2012 @ 1:00 pm