Articles Against Science/Patients/Doctors
Articles Against Science/Patients/Doctors
Lyme disease (LD) is an infection caused by Borrelia burgdorferi, a type of bacterium called a spirochete (pronounced spy-ro-keet) that is carried by deer ticks(Click here for pictures of deer ticks). An infected tick can transmit the spirochete to the humans and animals it bites. Untreated, the bacterium travels through the bloodstream, establishes itself in various body tissues, and can cause a number of symptoms, some of which are severe. Often, an erythema migrans (EM) rash appears within 7-14 days at the site of a tick bite (click to see picture of a typical EM rash).
LD manifests itself as a multisystem inflammatory disease that affects the skin in its early, localized stage, and spreads to the joints, nervous system and, to a lesser extent, other organ systems in its later, disseminated stages. If diagnosed and treated early with antibiotics, LD is almost always readily cured. Generally, LD in its later stages can also be treated effectively, but because the rate of disease progression and individual response to treatment varies from one patient to the next, some patients may have symptoms that linger for months or even years following treatment. In rare instances, LD causes permanent damage.
Although LD is now the most common arthropod-borne illness in the U.S. (more than 150,000 cases have been reported to the Centers for Disease Control and Prevention [CDC] since 1982), its diagnosis and treatment can be challenging for clinicians due to its diverse manifestations and the limitations of currently available serological (blood) tests.
The prevalence of LD in the northeast and upper mid-west is due to the presence of large numbers of the deer tick’s preferred hosts – white-footed mice and deer – and their proximity to humans. White-footed mice serve as the principal “reservoirs of infection” on which many larval and nymphal (juvenile) ticks feed and become infected with the LD spirochete. An infected tick can then transmit infection the next time it feeds on another host (e.g., an unsuspecting human).
Borrelia burgdorferi
The LD spirochete, Borrelia burgdorferi, infects other species of ticks but is known to be transmitted to humans and other animals only by the deer tick (also known as the black-legged tick) and the related Western black-legged tick. Studies have shown that an infected tick normally cannot begin transmitting the spirochete until it has been attached to its host about 36-48 hours; the best line of defense against LD, therefore, is to examine yourself at least once daily and remove any ticks before they become engorged (swollen) with blood.
Generally, if you discover a deer tick attached to your skin that has not yet become engorged, it has not been there long enough to transmit the LD spirochete. Nevertheless, it is advisable to be alert in case any symptoms do appear; a red rash (especially surrounding the tick bite), flu-like symptoms, or joint pains in the first month following any deer tick bite could signal the onset of LD.
Manifestations of what we now call Lyme disease were first reported in medical literature in Europe in 1883. Over the years, various clinical signs of this illness have been noted as separate medical conditions: acrodermatitis, chronica atrophicans (ACA), lymphadenosis benigna cutis (LABC), erythema migrans (EM), and lymphocytic meningradiculitis (Bannwarth’s syndrome). However, these diverse manifestations were not recognized as indicators of a single infectious illness until 1975, when LD was described following an outbreak of apparent juvenile arthritis, preceded by a rash, among residents of Lyme, Connecticut.
LD is spreading slowly along and inland from the upper east coast, as well as in the upper midwest. The mode of spread is not entirely clear and is probably due to a number of factors such as bird migration, mobility of deer and other large mammals, and infected ticks dropping off of pets as people travel around the country. It is also prevalent in northern California and Oregon coast, but there is little evidence of spread.
In order to assess LD risk you should know whether infected deer ticks are active in your area or in places you may visit. The population density and percentage of infected ticks that may transmit LD vary markedly from one region of the country to another. There is even great variation from county to county within a state and from area to area within a county. For example, less than 5% of adult ticks south of Maryland are infected with B. burgdorferi, while up to 50% are infected in hyperendemic areas (areas with a high tick infection rate) of the northeast. The tick infection rate in Pacific coastal states is between 2% and 4%.
To view most recent data, click here.
The spirochetal agent of Lyme disease, Borrelia burgdoferi, is transmitted to humans through a bite of a nymphal stage deer tick Ixodes scapularis (or Ixodes pacificus on the West Coast). The duration of tick attachment and feeding is a key factor in transmission. Proper identification of tick species and feeding duration aids in determining the probability of infection and the risk of developing Lyme disease.
Spirochete transmission poster: how long has that tick been feeding on you?
The early symptoms of LD can be mild and easily overlooked. People who are aware of the risk of LD in their communities and who do not ignore the sometimes subtle early symptoms are most likely to seek medical attention and treatment early enough to be assured of a full recovery.
The first symptom is usually an expanding rash (called erythema migrans, or EM, in medical terms) which is thought to occur in 80% to 90% of all LD cases. An EM rash generally has the following characteristics:
EM rashes appearing on brown-skinned or sun-tanned patients may be more difficult to identify because of decreased contrast between light-skinned tones and the red rash. A dark, bruise-like appearance is more common on dark-skinned patients.
Ticks will attach anywhere on the body, but prefer body creases such as the armpit, groin, back of the knee, and nape of the neck; rashes will therefore often appear in (but are not restricted to) these areas. Please note that multiple rashes may, in some cases, appear elsewhere on the body sometime after the initial rash, or, in a few cases, in the absence of an initial rash.
Around the time the rash appears, other symptoms such as joint pains, chills, fever, and fatigue are common, but they may not seem serious enough to require medical attention. These symptoms may be brief, only to recur as a broader spectrum of symptoms as the disease progresses.
As the LD spirochete continues spreading through the body, a number of other symptoms including severe fatigue, a stiff, aching neck, and peripheral nervous system (PNS) involvement such as tingling or numbness in the extremities or facial palsy (paralysis) can occur.
The more severe, potentially debilitating symptoms of later-stage LD may occur weeks, months, or, in a few cases, years after a tick bite. These can include severe headaches, painful arthritis and swelling of joints, cardiac abnormalities, and central nervous system (CNS) involvement leading to cognitive (mental) disorders.
The following is a checklist of common symptoms seen in various stages of LD:
Localized Early (Acute) Stage:
Early Disseminated Stage:
Late Stage:
If you think you have LD symptoms you should see your physician immediately. The EM rash, which may occur in up to 90% of the reported cases, is a specific feature of LD, and treatment should begin immediately.
Even in the absence of an EM rash, diagnosis of early LD should be made on the basis of symptoms and evidence of a tick bite, not blood tests, which can often give false results if performed in the first month after initial infection (later on, the tests are more reliable). If you live in an endemic area, have symptoms consistent with early LD and suspect recent exposure to a tick, present your suspicion to your doctor so that he or she may make a more informed diagnosis.
If early symptoms are undetected or ignored, you may develop more severe symptoms weeks, months or perhaps years after you were infected. In this case, the CDC recommends using the ELISA and Western-blot blood tests to determine whether you are infected. These tests, as noted above, are considered more reliable and accurate when performed at least a month after initial infection, although no test is 100% accurate.
If you have neurological symptoms or swollen joints your doctor may, in addition, recommend a PCR (Polymerase Chain Reaction) test via a spinal tap or withdrawal of synovial fluid from an affected joint. This test amplifies the DNA of the spirochete and will usually indicate its presence.
Issues and Insights Related to the Diagnosis of Lyme Disease:
Misdiagnosis of Lyme disease: when not to order serologic tests
Executive Summary: 2nd Banbury Conference on the Laboratory Diagnosis of Lyme Disease
Laboratory Diagnosis of Lyme Disease
Straight Talk About the Diagnosis of Lyme Disease
2-tired Antibody Testing for Early and Late Lyme Disease Using Only and Immunoglobulin G Blot with the Addition of a VlsE Band and the Second-tier Test Rapid, Simple, Quantitative , and Highly Sensitive Antibody Detection for Lyme Disease
CDC Issues Cautions Regarding Testing for Lyme Disease —
BBK07 Immunodominant Peptides as Serodiagnostic Markers of Lyme Disease
Single-tier Testing with the C6 Peptide ELISA kit Compared with Two-tier Testing for Lyme Disease
High Frequency of False Positive IgM Immunoblasts for Borrelia burgdoreferi in Clinical
The Nervous System as Ectopic Germinal Center: CXCL13 and IgG in Lyme Neuroborreliosis
Laboratory Diagnostic Testing for Borrelia burgdorferi Infection
Identification of OppA2 linear Epitopes as Serodiagnostic Markers for Lyme Disease
U.S. Healthcare Providers’ Experience with Lyme Disease and Other Tick-borne Diseases
A Concise Critical Analysis of Serologic Testing for the Diagnosis of Lyme
Development of a Metabolic Biosignature for the Detection of Early Lyme Disease
Lyme disease diagnosed by alternative methods: a common phenotype with chronic fatigue syndrome
Understanding Antibody-based Diagnostic Tests for Lyme Disease
The positive predictive value of Lyme ELISA for the diagnosis of Lyme disease in children
Testing practices and volume of non-Lyme tickborne diseases in the United States
Lyme Disease Diagnosis and Serology
New serological test proposed for the diagnosis of infection caused by Borrelia myomotoi
False positive Lyme disease IgM immunoblots in children
Detection of Borrelia burgdorferi nucleic acids after antibiotic therapy does not confirm viability
Evaluation of Modified 2-tiered Serodiagnostic Testing Algorithms for Early Lyme Disease
Metabolic differentiation of early Lyme disease from southern tick associated rash illness (STARI)
High volume of Lyme disease laboratory reporting in a low-incidence State- Arkansas, 2015-2016
FDA clears new indications for existing Lyme disease tests that may help streamline diagnosis
Evaluation of the modified two-tiered testing (MTTT) method in children
Updates and Recent Reports
A Critical Assessment of the New Culture Test for the Diagnosis of Lyme Disease
Announcements from the FDA and CDC on the Diagnosis of Lyme Disease
Updated CDC Recommendation for the Serologic Diagnosis of Lyme Disease
Recommended courses and duration of treatment for both early and late Lyme symptoms are shown in our Table of Recommended Antibiotics and Dosages (see also table footnotes).
Early treatment of LD (within the first few weeks after initial infection) is straightforward and almost always results in a full cure. Treatment begun after the first three weeks will also likely provide a cure, but the cure rate decreases the longer treatment is delayed.
Doxycycline, amoxicillin and ceftin are the three oral antibiotics most highly recommended for treatment of all but a few symptoms of LD. A recent study of Lyme arthritis in the New England Journal of Medicine indicates that a four-week course of oral doxycycline is just as effective in treating late LD, and much less expensive, than a similar course of intravenous Ceftriaxone (Rocephin) unless neurological or severe cardiac abnormalities are present. If these symptoms are present, the study recommends immediate intravenous (IV) treatment.
Treatment of late-Lyme patients can be more complicated. Usually LD in its later stages can be treated effectively, but individual variation in the rate of disease progression and response to treatment may, in some cases, render standard antibiotic treatment regimens ineffective. In a small percentage of late-Lyme patients, the disease may persist for many months or even years. These patients will experience slow improvement and resolution of their persisting symptoms following oral or IV treatment that eliminated the infection.
Although treatment approaches for patients with late-stage LD have become a matter of considerable debate, many physicians and the Infectious Disease Society of America recognize that, in some cases, several courses of either oral or IV (depending on the symptoms presented) antibiotic treatment may be indicated. However, long-term IV treatment courses (longer than the recommended 4-6 weeks) are not usually advised due to adverse side effects. While there is some speculation that long-term courses may be more effective than the recommended 4-6 weeks, there is currently no scientific evidence to support this assertion. Click here for an article from the New England Journal of Medicine which presents clinical recommendations in the treatment and prevention of early Lyme disease.
Lyme Disease: Current State of Knowledge
EFNS Guidelines on the Diagnosis and Management of European Lyme Neuroborreliosis
Antibiotic Maximalism: Legislative Assaults on the Evidence-based Treatment of Lyme Disease
Update of the Swiss guidelines on post-treatment Lyme disease syndrome
Why does the CDC only link to one set of treatment guidelines?
Cutaneous Lyme Borreliosis: Guideline for the German Dermatological Society
Review of European and American Guidelines for the Diagnosis of Lyme Disease
Death From Inappropriate Therapy for Lyme Disease
Neoplasms Misdiagnosed as “Chronic Lyme Disease”
Biliary Complications in the Treatment of Unsubstantiated Lyme Disease
Life Threatening Complications of Empiric Ceftriaxone Therapy for “Sero-Negative Lyme Disease”
Current Clinical Studies on Lyme Disease Sponsored by the National Institutes of Health
Neurological Complications of Lyme Disease
Cognitive impairments in patients with persistent symptoms attributed to Lyme disease.
Two Controlled Trials of Antibiotic Treatment in Patients with Persistent Symptoms and a History of Lyme Disease ( The above clinical trials were conducted under the following protocols that were approved by the NIAID Clinical Studies Group, the Institutional Review Board, the NIAID Biostatistics Group, and the Food and Drug Administration (FDA) before the trails were conducted. To ensure complete compliance with the protocols, all procedures associated with the trials were carefully monitored by an independent Data Safety and Monitoring Board (DSMB) that included several distinguished biostatisticians. Note that the protocols stipulated that an interim statistical analysis be performed when 100 subjects have been enrolled.)
Clinical Protocol for the Seropositive Arm of the Trial
Clinical Protocol for the Seronegative Arm of the Trail
Lyme neuroborreliosis in Children: a Prospective Study of Clinical Features, Prognosis , and Outcome
Lyme borreliosis: a European Perspective on Diagnosis and Clinical Management
Antibiotic Treatment of Animals Infected with Borrelia burgdorferi
Lyme Disease: Current State of Knowledge
Lyme Disease in Pregnancy: Case Report and Review of the Literature
Lyme Disease Serology in Amylotrophic lateral sclerosis (ALS
Neurological Manifestations of Lyme Disease
A Case Revealing the Natural History of Untreated Lyme Disease ( Although the data are not shown in the publication, the author confirms that the IgG Western blot was positive by the CDC criteria and showed the presence of 21,28,30,39,41,45,58,66, and 93 kDa bands. )
Long-term Lyme Disease Antibiotic Therapy Beliefs Among New England Residents
On-going and Completed NIH-supported Clinical Trials on Lyme Disease
Biodiversity of Borrelia burgdorferi Strains in Tissues of Lyme Disease Patients
The Amber Theory of Lyme Arthritis: Initial Description and Clinical
The Nervous System as Ectopic Germinal Center: CXCL13 and IgG in Lyme Neuroborreliosis
Spirochete Antigens Persist Near Cartilage after Murine Borreliosis
Differentiation of Reinfection from Relapse in Recurrent Lyme Disease
Common Misconceptions about Lyme Disease
Nervous System Lyme Disease: Diagnosis and Treatment
Evidence for Strain-specific Immunity in Patients Treated for Early Lyme Disease
Functional Outcomes in Patients with Borrelia burgdorferi Reinfection
Xenodiagnsosis to Detect Borrelia burgdorferi Infection: a First-in-human Study —
The Role of Eocosanoids in Experimental Lyme Arthritis
Implications of Gender in Chronic Lyme Disease
Ceftriaxone-induced Hemolysis in a Child with Lyme Arthritis: a case for Antimicrobial Stewardship
NIAID Current Portfolio of Basic Research Grants on Lyme Disease
Insights into Borrelia miyamotoi infection
Fatigue in patients with erythema migrans
Clinical Relevance of Borrelia burgdorferi persisters
Clinical Association: Lyme Disease and Guillian-Barre Syndrome
Borrelia Infection and Risk of Celiac Disease
Oral management for pediatric Lyme meningitis
Borrelia miyamotoi : an emerging tick-borne pathogen
Effect of prolonged antibiotic treatment on cognition in patients with Lyme borreliosis.
Evaluation of the clinical relevance of vancomycin for the treatment of Lyme disease.
“I Don’t Know What to Believe…”
Post-Treatment Lyme Disease Syndrome
Chronic Lyme Disease: in Defense of the Scientific Enterprise
Chronic Lyme Disease: a Dubious Diagnosis
Chronic Lyme disease: misconceptions and challenges for patient management
Chronic Lyme Disease and other Medically Unexplained Syndromes
A Critical Appraisal of Chronic Lyme Disease
Dispelling the Chronic Lyme Disease Myth
Perspectives on Chronic Lyme Disease
Psychiatric Co-morbidity and Other Psychological Factors in Patients with “Chronic Lyme Disease”
Subjective Symptoms after Treatment of Early Lyme Disease
Anti-neural Antibody Reactivity in Patients with a History of Lyme Borreliosis
Chronic Lyme Disease: the Controversies and the Science
The Pain of Chronic Lyme Disease: Moving the Discourse in a different Direction
Chronic Lyme: Diagnostic and Therapeutic Challenges
Neoplasms Misdiagnosed a “chronic Lyme Disease”
Long-term Assessment of Fibromyalgia in Patients with Culture-confirmed Lyme Disease
Long-term Assessment of Fatigue in Patients with Culture-confirmed Lyme Disease
Quality of life, fatigue, depression, and cognitive impairment in Lyme neuroborreliosis
Nervous system Lyme disease, chronic Lyme disease, and none of the above
NIH takes action to bolster research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Causes of neuropathy in patients referred a “idiopathic neuropathy”.
Borrelia burgdorferi peptidoglycan is a persistent antigen in patients with Lyme arthritis
Doctors and Others Indicted in Lyme Disease Case Ticks Aren’t the Only Parasites Living Off Patients in Borreliosis-prone Areas
Lyme Disease in pregnancy: case report and review of the literature
Four Patients Falsely Diagnosed with Lyme Disease win Verdicts Totaling $30 Million
Unorthodox Alternative Therapies Marketed to Treat Lyme Disease
New Insights into the Tyrolean Iceman’s Origin and Phenotype as Inferred by Whole-Genome Sequencing
Confronting the Misnomer of Chronic Lyme Disease.
More Political Science: Proposed laws protect “Lyme literate” doctors from discipline
Misconceptions About Lyme Disease: Confusion Hiding Behind Ill-chosen Terminology
Practice Parameter: Treatment of Nervous System Lyme Disease (an Evidence-Based Review
Bullying Borrelia: When the Culture of Science is Under Attack
Two Controlled Trials of Antibiotic Treatment in Patients with Persistent Symptoms
and a History of Lyme Disease ( The above clinical trials were conducted under the following protocols that were approved by the NIAID Clinical Studies Group, the Institutional Review Board, the NIAID Biostatistics Group, and the Food and Drug Administration (FDA) before the trails were conducted. To ensure complete compliance with the protocols, all procedures associated with the trials were carefully monitored by an independent Data Safety and Monitoring Board (DSMB) that included several distinguished biostatisticians. Note that the protocols stipulated that an interim statistical analysis be performed when 100 subjects have been enrolled.)
Clinical Protocol for the Seropositive Arm of the Trial
Clinical Protocol for the Seronegative Arm of the Trail
Study and Treatment of Post Lyme Disease (STOP-LD) : a Randomized Double Masked Clinical
Cognitive Function in Post-treatment Lyme Disease: Do Additional Antibiotics Help?
NA Randomized, Placebo-controlled Trial of repeated IV Antibiotic Therapy for Lyme Encephalopathy
Treatment Trials for Post-Lyme Disease Symptoms Revisited
Randomized trial of longer-term therapy for symptoms attributed to Lyme disease
Time for a different approach to Lyme disease and long-term symptoms
(For additional perspective on this important issue, see “The Pain of Chronic Lyme Disease: Moving the Discourse in a Different Direction“)
Chronic Co-infections in Patients with Chronic Lyme Disease: A Systematic Review
Co-infections in Persons with Early Lyme Disease, New York, USA
Microbiome analysis of Ixodes scapularis ticks from New York and Connecticut
CDC Webinar on Vaccines for Lyme Disease, 2015
Vaccines against Lyme disease: what happened and what lessons can we learn?
It’s past time for a Lyme disease vaccine
Can a New Lyme Disease Vaccine Overcome a History of Distrust and Failure?
Popular Antibiotics May Carry Serious Side Effects
Types of Antibiotics, How They Work, and Their Side Effects
Beta-lactam Antibiotics Offer Neuroprotection by Increasing Glutamate Transporter Expression
Evaluation of the clinical relevance of vancomycin for the treatment of Lyme disease
Lyme Disease: the Great Controversy
Autism-Lyme Correlation Debunked
Nervous System Lyme Disease: Diagnosis and Treatment.
An Open Letter to the Editors of the Poughkeepsie Journal: In Defense of the Scientific Enterprise
Neoplasms Misdiagnosed as “Chronic Lyme Disease”
Political Science: Chronic Lyme Disease
Chronic Coinfections in Patients with Chronic Lyme Disease: a Systematic Review
Chronic Lyme Disease: In Defense of the Scientific Enterprise
The Pain of Chronic Lyme Disease: Moving the Discourse in a Different Direction
What Do Experts Recommend about the Treatment of Lyme Disease?
Borrelia burgdorferi vs Treponema pallidum- what’s in a name?
False and Misleading Information about Lyme Disease
Lyme Disease (a 2017 review article)
Discovery of the Lyme Disease Agent
A neurologist’s view of Lyme disease and other tick-borne infections
Test your general knowledge of Lyme disease
Test your knowledge of Lyme disease serology
p>Stories from the CDC website
Woman’s Death Connected to Inter-Net Self-Diagnosis of Lyme Disease
The Ultimate Lyme test: Julia’s Story
Are ALL Lyme Disease Fundraisers Scams?
Ginger Savely: Admits Unprofessional Conduct
ILADS Jennifer Armstrong- Admits Professional Misconduct
More Victims of Lyme Quackery- Updated January 25, 2019
Chronic Lyme” VIP, Daniel Cameron, disciplined by New York medical authorities
Legal Actions Brought Against Several Lyme Literate Physicians or LLMDs
Lyme Science: Because Patients Deserve Better
My Son Got Lyme Disease. He’s Totally Fine
The Challenge of Diagnosing Lyme Disease
Readers should note that there is no published, peer-reviewed evidence to indicate that any of the treatments presented in this incomplete listing is beneficial for the treatment of Lyme disease and/or “chronic Lyme disease”. In fact, some of them may even be unsafe when used a prescribed. Consequently, the reader is urged to demand to see documented evidence of their benefit before even considering their use. This listing in no way implies endorsement by the American Lyme Disease Foundation.
Ultraviolet Blood Irradiation Therapy
Natural Remedies for the Treatment of Lyme Disease
How Should Clinician Manage Patients with Chronic Lyme Disease?”
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Last Updated- December 2019
Lucy Barnes
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