Lyme Disease Study: New Infections Explain Relapses

The classic “bullseye rash” of Lyme Disease

 

Parts of Lyme disease are clear: It’s caused by bacteria, which are carried by ticks, and it’s a growing problem across much of the United States.

And parts of Lyme disease are so contentious that people talk about “the Lyme Wars.”

Chronic effects from Lyme disease — including terrible fatigue, trouble thinking and pain — constitute the central Lyme Wars battlefield, and the central practical issue is whether chronic sufferers should take long-term antibiotics. Mainstream medical experts warn that the longterm antibiotics are dangerous and ineffective; some patients and doctors disagree.

Now comes the latest salvo, in the New England Journal of Medicine: A gene study that found that in Lyme patients with relapses, the bacteria were different the second time around, and thus the recurrence must be due to a new infection by new bacteria rather than a relapse from bacteria that lingered in the body despite antibiotic treatment.

In an accompanying editorial, Lyme disease pioneer Allen Steere writes: “The issue of relapse versus reinfection has a broader context because of patient-advocacy groups that promote months or years of antibiotic therapy for ‘chronic Lyme disease.’” But, he writes, there is no evidence of a persistent Lyme infection, and “the weight of evidence is strongly against persistent infection as the explanation for persistent symptoms in antibiotic-treated patients with Lyme disease.”

The New England Journal study is here, and an accompanying editorial is here. NPR reports on the research here, and the New York Times here.

It will be interesting to see how the Lyme disease advocacy community responds. Personally, I find it comforting that if I do catch Lyme disease, it now seems somewhat less likely that I’ll suffer endless relapses despite antibiotic treatment. But I feel no less sympathy for the people who struggle for years on end with Lyme diseases’s effects, whatever the cause.

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  • unknown

    There is no actual bona fide science behind the concept of “Chronic Lyme Disease” once one has had adequate antibiotic therapy for the infection as dictated by the appropriate stage of the illness, as in the treatment of the stages of syphilis. And there are no scientific studies to support the prolonged multi-antibiotic therapy used by some practitioners for these unfortunate patients that more likely are suffering an aberration of their immune system triggered by the initial Lyme infection – not a “co-infection” or a prolonged presence of the Lyme organism itself.

    the following is an excellent balanced commentary on the sad situation

    The Lancet Infectious Diseases, Volume 11, Issue 9, Pages 713 – 719, September 2011

  • KATHY

    ALL I CAN SAY IS THIS “LUCKY ARE THOSE WHO KNOW THEY HAVE HAD A TICK….AND DEVELOP A BULLS EYE RASH” THE REST OF YOU BETTER HAVE A VERY CARING, CONCERNED PRIMARY CARE WHO BELIEVES IN YOU….OTHERWISE YOU ARE IN FOR A VERY LONELY, CHALLENGING,PAINFUL BATTLE.

  • KATHY

    IT SEEMS TO ME THAT IN THE MIDST OF THE LYME WAR THERE ARE TWO DISTINCT SIDES….THOSE WHO KNOW SOMETHING IS WRONG AND SUFFER AND THOSE WHO FEEL FINE AND WILL NOT CONSIDER CHRONIC LYME….THIS SEEMS TO BE THE CASE UNTIL THEY OR ONE OF THEIR LOVED ONES CAN NOT SEEM TO FEEL WELL…I THINK UNTIL THIS HITS HOME THERE ARE TOO MANY “KNOW IT ALLS” WHO MAY BE VERY BOOK SMART BUT CAN NOT SEE PAST THEIR NOSES.

  • Manya Cetlin-Salter

    As a sufferer of Lyme disease who had no bullseye rash and have no idea when I actually became infected (somewhere between 1975 – 2008, I find the author’s final paragraph to be disgusting and a slap in the face to those of us who are suffering in the different stages of Lyme and with the many co-infections….

    “It will be interesting to see how the Lyme disease advocacy community responds. Personally, I find it comforting that if I do catch Lyme disease, it now seems somewhat less likely that I’ll suffer endless relapses despite antibiotic treatment. But I feel no less sympathy for the people who struggle for years on end with Lyme diseases’s effects, whatever the cause.”

    I am now on day 31 of antibiotics and I STILL have the meningitis symptoms related to Stage 2 Lyme, along with the several other symptoms that terrify me, make me wonder what my future health will be and that I fight every day to function normally and take care of my three young children. “I” don’t find that very comforting. Has this author viewed “Under Our Skin”? I bet not.

    • kathy

      MANYA CETLIN-SALTER
      PLEASE KNOW THERE ARE SO MANY WHO SUFFER ALONG WITH YOU….THIS CAN BE SUCH A LONELY DISEASE ESPECIALLY WITH SUCH CONTROVERSY INVOLVED.
      THERE ARE CERTAINLY MANY STAGES OF LYME DISEASE ….NOT EVERYONE IS FORTUNATE ENOUGH TO KNOW THEY HAVE A TICK ON THEM, BECOME ILL AND DEVELOP THE BULLS EYE RASH.
      STAY STRONG AND OPTOMISTIC…YOU ARE NOT ALONE.

  • MikeLaBonte

    I think some key questions should be addressed in this story:

    1) Why is a sample of 22 episodes enough to make the conclusion?

    2) How can they know for sure that the ospC genotype of the new Borrelia absolutely could not have evolved from the old?

    My Lyme was undetected for at least 6 months, and I was treated with 3 months of antibiotic. I’m aware of the Lyme Wars. Mostly I wonder why part of the medical community is so adamant about claiming that treatment is not needed for people who have clear long-terms symptoms, that the Lyme deniers have have failed to help.

    • Melia

      Hi Mike, were the 3 months of treatment sufficient? Are you symptom free? I have had the symptoms since October and I think I was bitten back in early August. Waiting for the lab work to come back. I am worried that I waited too long and the symptoms will be long lasting.

      • MikeLaBonte

        I am completely healthy a year later. It may be that only two months of treatment would have been enough, that was about when I was symptom free. But it seems every case is different. Ever since that episode when people tell me they have untreatable issues I suggest they should get a Lyme test.

  • Tom

    http://www.SecondOpinion-TV.org has a new ( Nov 2012) episode on Lyme Disease with 6 doctors and one patient with chronic Lyme on their panel. Allen Steere is one of the doctors. You can watch on the SecondOpinion’ site or on YouTube http://www.youtube.com/watch?v=Okwl4RBhZBY

  • http://www.facebook.com/people/Paul-Mall/100001648150849 Paul Mall

    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/

  • silvermaran

    What part of Latent Syphilis do these idiots not understand? Borrelia has 1000 times the stealth genes of Syphilis and 1/3 the amount of genes a HUMAN has and you want to listen to criminals who won’t tell you it is the real cause of AIDS, NOT HIV….
    I
    guess all these idiots like looking so incredibly stupid knowing 1 in 29 kids
    are now being born with it…I despise these stupid people who only work to kill USA.
    http://www.youtube.com/watch?feature=player_embedded&v=yOno_2m_8LY

  • http://www.facebook.com/carl.tuttle.5 Carl Tuttle

    These researchers continue to focus on the acute or early stage of the disease while patients who are the sickest went years or decades before obtaining a diagnosis.

    This is yet additional propaganda to deny and ignore the late stage Lyme epidemic seen all across this nation.

    I fall under the category of patients who had a “prolonged exposure to the organism prior to the initial diagnosis and antibiotic treatment of Lyme disease” as it took twelve years to obtain a diagnosis.

    Nadelman, Steere and Wormser should prove their theories that persistent infection does not exist by infecting themselves with the Borrelia spirochete (similar to Barry Marshall’s experiment) and forgo treatment for a year or so and then treat the infection following the recommended IDSA one size fits all protocol because after all, in their minds, this is little more than a nuisance disease.

    Carl Tuttle
    Hudson, NH
    Website: New Hampshire Lyme Misdiagnosis
    http://home.comcast.net/~runagain/site/?/home/

    Letter to the Editor, The Lancet Infectious Diseases Published May 2012
    http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70054-3/fulltext

    Change.org Petition Site#1:
    http://www.change.org/petitions/subjective-symptoms-after-treatment-of-lyme-disease

    Change.org Petition Site#2:
    http://www.change.org/petitions/medscape-remove-or-correct-barbara-johnson-s-misleading-lyme-disease-presentation

    The Tuttle family was featured on New Hampshire Chronicle’s “Living with Lyme” with the program archived on their site in six small segments for viewing on the computer
    Part 1, Part 2, Part 3, Part 4, Part 5, Part 6

    Testimony in support of New Hampshire House Bill 295 posted on Dr Phil.com
    http://community.drphil.com/profile.blog/lymemisdiagnos/?EntryID=31982

    Letter to New Hampshire Governor John Lynch summarizing the Dept of Health Lyme Discussion with agenda link
    http://home.comcast.net/~runagain/Governor%20Lynch%20Aug%2022%20Letter.doc

    Anthem Blue Cross Denial of Health Insurance Due to Lyme Disease
    http://home.comcast.net/~runagain/Anthem%20Denial%20Letter.pdf

  • Paul Mall