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.”
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.