Lyme disease

{{bronze}}[[Image:Erythema migrans.jpg|thumb|upright|The rash caused by Lyme disease, known as ''Erythema migrans''.  Or some creepy Target ad placement.]]{{biology}}
'''Lyme disease'''  is an infectious [[disease]] carried by certain types of ticks, especially deer ticks. It is named for {{wpl|Lyme, Connecticut|the town}} in [[Connecticut]] where researchers discovered it while investigating why so many children from there and the neighboring town of Old Lyme were getting what appeared to be juvenile rheumatoid arthritis. The disease is caused primarily by the [[bacteria]] ''Borrelia burgdorferi'' in the [[United States]], and by ''B. afzelii'' and ''B. garinii'' in [[Europe]].  Symptoms include headache, fever, fatigue, and a distinctive rash.  Diagnosing Lyme disease without a visible rash can be confirmed by performing tests known as an ELISA and a Western blot, though this is not recommended for those with non‐specific symptoms like [[Chronic fatigue syndrome|chronic fatigue]].<ref name="quackwatch">[http://www.quackwatch.com/01QuackeryRelatedTopics/lyme.html Quackwatch: Lyme Disease]</ref> Because doctors only recently discovered it in 1977, Lyme is not as well understood as other diseases.  This leaves it rife with [[woo]].

When Europeans first came to North America, Lyme disease was rampant among them and the Native Americans who lived in or near forests. Accounts of North America dating back to the 1700s clearly describe its hallmark symptoms, and as early as 1762 a Scottish doctor managed to connect them to the presence of ticks. As colonists deforested large swathes of the eastern United States it became far less frequent, as the forest provides the habitat for ticks and their hosts. When much of this area was reforested, especially [[New England]], the disease made a significant comeback. The rise in the occurrence of Lyme disease is also linked to the [[extinct]]ion of the {{wpl|passenger pigeon||,}} as since the pigeons fed on a large amount of acorns, they were able to keep the population of deer mice, which also depended on the acorns and are the main carriers of the ticks that spread Lyme disease, in check. The [[Native American]]s had previously kept the passenger pigeon population in check since they fed on things like acorns and tree nuts that certain tribes depended on for food, hence why Lyme disease was a problem back then, but the population of passenger pigeons exploded as a result of the [[Native American genocides]].<ref>[https://news.mongabay.com/2005/11/demise-of-passenger-pigeon-linked-to-lyme-disease/ Demise of passenger pigeon linked to Lyme disease], Tina Butler, ''Mongabay'' 14 November 2005</ref>

==Treatment==
Early stage Lyme disease is treated with oral antibiotics for 2–3 weeks. Lyme disease diagnosed at a later stage is treated with intravenous antibiotics for 2–4 weeks.<ref name="Mayo"/> Some research suggests that a single dose of antibiotics within 72 hours of being bitten can prevent development of Lyme disease,<ref>[http://www.ncbi.nlm.nih.gov/pubmed/11450675 Prophylaxis with single‐dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite.]</ref> though cost‐effective analysis demonstrates that this prophylactic treatment is suitable for only those with a high risk of Lyme disease.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/1298217 Prevention of Lyme disease after tick bites. A cost‐effectiveness analysis.]</ref> Thus the Infectious Diseases Society of America (IDSA) recommends it only for those living in areas where the infection rate in ticks is greater than 20%.<ref name="IDSA">[http://cid.oxfordjournals.org/content/43/9/1089.full IDSA Lyme disease guidelines]</ref>

===Vaccines===
LYMERix, a vaccine for Lyme disease, was licensed by SmithKline Beecham in 1998, but withdrawn from the market in 2002.<ref name=history>[https://www.historyofvaccines.org/content/articles/history-lyme-disease-vaccine The History of the Lyme Disease Vaccine] (Last update 17 January 2018) ''The History of Vaccines''.</ref> Pasteur Mérieux Connaught separately developed a Lyme disease vaccine, but decided not to market it even though it was shown to be efficacious in a Phase III clinical trial.<ref name=history/> LYMERix, though not a perfect vaccine, was effective and had relatively few side effects.<ref name=resnick>[https://www.vox.com/science-and-health/2018/5/7/17314716/lyme-disease-vaccine-history-effectiveness The incredibly frustrating reason there’s no Lyme disease vaccine: Your dog can get vaccinated for Lyme. You cannot.] by Brian Resnick (May 7, 2018, 12:20pm EDT) ''Vox''.</ref><ref>[https://academic.oup.com/cid/article/52/suppl_3/s253/444754 Vaccines against Lyme Disease: What Happened and What Lessons Can We Learn?] by Gregory A. Poland (2011). ''Clinical Infectious Diseases'' 52(Suppl. 3): s253–s258.</ref> This timing for the release of the vaccines was unfortunate because it coincided with the rise of [[anti-vaccine]] hysteria that was brought on by the discredited 1998 study of [[Andrew Wakefield]].<ref name=resnick/>

===Dubious Alternatives===
Like most diseases, Lyme disease has a number of [[alternative medicine|alternative cures]] that can range from ineffective to dangerous.  
*[[Bismacine]], sometimes known as Chromacine, is an injection containing the metal bismuth. The American Food and Drug Administration has put out a warning on Bismacine, which has not been shown to help with Lyme disease and can lead to heart and kidney problems.<ref name="Mayo">[http://www.mayoclinic.com/health/lyme-disease/DS00116 Mayo Clinic: Lyme Disease]</ref><ref name="quackwatch"/> The attempted use of Bismacine to treat Lyme disease has caused at least one death.<ref name="Bismacine Death"> [https://www.fdanews.com/articles/61324-fda-warns-against-use-of-bismacine-for-lyme-disease FDA News Article, 2006]</ref>
*[[Colloidal silver]]<ref>[http://www.colloidal-silver-colloids.com/1568940264asf589d516d3615d746afdfafd/lym-book.htm Advertises colloidal silver to people who believe they have "chronic Lyme disease"]</ref> is the suspension of silver particles in water and can be taken either topically (on the skin) or orally. It has shown no efficacy as an antibacterial inside a living body, and can lead to 
Smurfism
 a bluish discoloration of the skin called {{wpl|argyria}} and possible kidney damage.
*[[Oxygen therapy|Hydrogen peroxide]] injections<ref>[http://www.cbsnews.com/stories/2005/01/12/60II/main666489.shtml 60 Minutes: A Prescription For Death?] ''CBS''</ref> can lead to death, and are not recommended by the IDSA.<ref name="IDSA"/>
*[[Hyperbaric oxygen therapy]]<ref>[http://www.hbotreatment.com/lyme.htm HBO treatment]</ref><ref>[http://www.hbot4u.com/lyme6.html An Overview of Lyme Disease and Hyperbaric Oxygen Therapy]</ref><ref>[http://www.personalconsult.com/articles/hyperbaricoxygenefficacy.html Efficacy of using Hyperbaric Oxygen Therapy In treatment for Chronic Lyme Disease]</ref> is the practice of subjecting a patient to a large amount of oxygen.  It is not recommended by the IDSA.<ref name="IDSA"/> [[NASA]] also recommends avoiding this so-called treatment, and has done so since shortly after the conclusion of the Apollo 1 mission.
*Malariotherapy<ref>[http://www.scribd.com/doc/2198707/1993-CDC-response-to-Heimlich-Institute-AIDS-research-proposal 1993 CDC response to Heimlich Institute AIDS research proposal]</ref><ref>[http://www.nytimes.com/1995/02/21/opinion/l-lyme-disease-offers-a-diagnostic-puzzle-try-malariotherapy-526195.html Letter: Lyme disease offers a diagnostic puzzle; try malariotherapy]</ref> involves purposely infecting the patient with [[malaria]] through an injection of infected blood, in the belief that the high fever will kill the bacteria (first proposed by [[Henry Heimlich]], creator of the Heimlich maneuver). This is strongly discouraged by the [[Centers for Disease Control]] (CDC)<ref>[http://www.circare.org/lyme.htm Induced Malariatherapy for Lyme Disease]</ref> and the IDSA.<ref name="IDSA" />

=="Herxing"==
About 15% of those undergoing normal antibiotic treatment experience pains and fever within the first 24 hours of treatment because of the Jarisch–Herxheimer Reaction,<ref name="IDSA"/> where the death of bacteria can release toxins faster than the body can handle them. However, some may believe that they have "herxes" weeks after antibiotics are finished, that they "herx" cyclically for weeks at a time, or that "herxing" is necessary and should be evident in all treated cases.<ref name="herx">[http://lymebook.com/blog/the-recovery-process/herx-reactions/herx-reaction-fundamentals/ Herx Reaction Fundamentals]</ref> Symptoms occurring over 24 hours after initial treatment are '''not''' a Herxheimer Reaction.<ref name="IDSA" /> These misconceptions stem from a misguided belief that antibiotics are supposed to make a patient feel worse if they are working.<ref name="quackwatch"/>  As a result, "herxing" people often do not get their Lyme‐unrelated symptoms checked out and continue to suffer unnecessary pain.

==Chronic Lyme disease==
[[File:Adult deer tick.jpg|thumb|right|An adult deer tick]]
A small portion of those who undergo regular antibiotic treatment for Lyme disease suffer muscle aches, pains, and fatigue after their treatment is finished. Many of them believe this is because of "chronic Lyme disease",<ref name="herx"/><ref>[http://autoimmunityresearch.org/lyme-disease/ LYME DISEASE (Borreliosis)]</ref><ref>[http://www.chroniclymedisease.com/ Chronic Lyme Disease]</ref> a persistent infection of Lyme spirochetes that either survived antibiotic treatment or was originally misdiagnosed. However, the Infectious Diseases Society of America,<ref>[http://www.idsociety.org/lymediseasefacts.htm IDSA: Frequently Asked Questions About Lyme Disease]</ref> the Centers for Disease Control,<ref>[http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_treatment.htm CDC: Lyme Disease Treatment and Prognosis]</ref> the National Institute of Allergy and Infectious Diseases (run by the National Institutes of Health),<ref name="NAIAD">[http://www.niaid.nih.gov/topics/lymedisease/understanding/pages/chronic.aspx NIAID on Lyme disease]</ref> and the American Academy of Neurology<ref>[http://www.neurology.org/content/69/1/91.full Practice Parameter: Treatment of nervous system Lyme disease (an evidence‐based review)]</ref> all agree that '''there is no such condition as "Chronic Lyme disease."''' Lest one think this list US‐specific, this claim is supported by the European Federation of Neurological Societies, the European Union of Concerted Action on Lyme Borreliosis, the Canadian Public Health Network, and the German Society for Hygiene and Microbiology.<ref name="baker">[http://www.fasebj.org/content/24/11/4175.full Chronic Lyme disease: in defense of the scientific enterprise]</ref> Dr. [[Allen Steere]], the original discoverer of Lyme disease, disputes the existence of the condition.<ref name="chicago"/> A study of those claiming Lyme disease persistence after an antibiotic course found no traces of ''B. burgdorferi'' in any of the subjects.<ref name="NEJM">[http://www.nejm.org/doi/full/10.1056/NEJMra072023 A Critical Appraisal of “Chronic Lyme Disease”]</ref> Others who claim to be infected have no [[evidence]] of having "regular" Lyme disease in the first place.<ref name="minnesota">[http://www.minnesotamedicine.com/PastIssues/July2008TableofContents/ClinicalKempermanJuly2008/tabid/2638/Default.aspx Dispelling the Chronic Lyme Disease Myth]</ref> Diagnosis is made by "Lyme-literate" doctors, and testing for the disease is often performed by Lyme-specific laboratories that do not follow [[Evidence-based medicine|evidence-based guidelines]].<ref name ="NEJM" /><ref name="minnesota"/> One Lyme-literate lab has a 25% positive rate – the average national rate is 8%.<ref name="forbes">[http://www.forbes.com/forbes/2007/0312/096.html Lyme Inc.] ''Forbes''</ref> People who believe they have a chronic infection often take antibiotics for a long period of time in order to fight the infection; there is no evidence to show that this helps with the symptoms and plenty of evidence that it is harmful,<ref name="NAIAD"/><ref name="IDSA"/><ref name="quackwatch"/><ref name = "minnesota"/><ref name="Mayo"/> both to the patient and to the general populace. Use of antibiotics for as little as ten weeks (still over twice the recommended time for treatment) can allow drug-resistant bacteria to develop, infect, and kill a patient.<ref name="chicago"/>

===Post–Lyme disease syndrome===
On the other hand, there is evidence to support the idea that some symptoms do linger past initial treatment of Lyme disease, in what the IDSA and others term "post–Lyme disease syndrome"<ref name="pubmed">[http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002296 PubMed Health: Lyme disease]</ref> (though due to the IDSA guidelines being relatively new, the term "chronic Lyme disease" is occasionally used to mean this syndrome). However, it's important to note that, as stated above, there is no evidence of Lyme disease–causing bacteria in patients with this syndrome, and long-term antibiotic treatments are still '''not''' recommended.<ref>[http://www.johnshopkinshealthalerts.com/reports/arthritis/2140-1.html Chronic Lyme Disease vs. Post–Lyme Disease]</ref> While the exact cause of post–Lyme disease syndrome is unknown, some medical experts, such as Dr. Steere, believe that these symptoms are the result of autoimmune-related effects of the ''B. burgdorferi'' spirochete.<ref>[http://www2.massgeneral.org/rai/index.asp?page=research&subpage=steere Allen Steere, MD] Research profile</ref>  There is preliminary evidence to support this [[hypothesis]].<ref>[http://www.niaid.nih.gov/topics/lymedisease/research/pages/autoimmune.aspx Lyme Disease – The Role of Autoimmune Reactivity]</ref>

Scientists have discovered a new tick that causes similar symptoms to lyme disease and is antibiotic resistant.<ref>[http://www.telegraph.co.uk/news/health/news/11953087/New-illness-spread-by-ticks-found-similar-to-Lyme-disease.html]</ref> Be aware that this is not confirmed yet. Do not jump to conclusions.

===Lawsuit===
In 2008, Connecticut Attorney General Richard Blumenthal (he of "When I served in Vietnam" fame a few years later, and US Senator as of 2011) launched an anti-trust investigation of the IDSA for not citing (non‐existent) evidence about chronic Lyme disease in its 2006 guidelines.<ref name="baker"/> Blumenthal's office ordered the IDSA to create a new panel with an independent head to evaluate the original guidelines.<ref>[http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284 Attorney General's Investigation Reveals Flawed Lyme Disease Guideline Process, IDSA Agrees To Reassess Guidelines, Install Independent Arbiter]</ref> In 2010, the new panel unanimously upheld the 2006 guidelines.<ref name="baker" />

===Legislation===
[[Pennsylvania]] bill SB 1199 proposed the construction of a Lyme-disease task force. The composition of the task force would have included two physicians, both of whom are required to be members of the International Lyme and Associated Diseases Society,<ref>[http://www.legis.state.pa.us/cfdocs/legis/PN/Public/btCheck.cfm?txtType=HTM&sessYr=2009&sessInd=0&billBody=S&billTyp=B&billNbr=1199&pn=1612 Pennsylvania SB 1199]</ref> a large proponent of chronic Lyme disease.<ref>[http://www.ilads.org/ ILADS]</ref> This is despite the organization being cited by the ''Pediatric Infectious Disease Journal'' as a source of inaccurate information (ranking either "inaccurate" or "not found" in every one of their categories).<ref name="inaccurate">[http://www.cdc.gov/ncidod/dvbid/lyme/resources/LD_Internet.pdf Inaccurate Information About Lyme Disease on the Internet]</ref> The bill is, as of January 2011, still pending. [[Massachusetts]] and [[Connecticut]] passed laws, in 2010 and 2009 respectively, protecting the rights of physicians to prescribe long‐term antibiotics to fight "chronic Lyme disease."<ref>[http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20100717/NEWS/7170319 Law clears aggressive Lyme disease therapy.] ''Cape Cod Times''</ref> [[Rhode Island]] and [[California]] have similar laws, and [[Minnesota]] dropped its legislation after the state medical board 
lost its professional dignity
 agreed to put a five-year ban on investigating doctors who treat "chronic Lyme disease" without the board first receiving a specific complaint from a patient.<ref name="chicago">[http://articles.chicagotribune.com/2010-12-08/health/ct-met-chronic-lyme-disease-20101207_1_lyme-disease-chronic-lyme-raxlen Chronic Lyme disease: A dubious diagnosis.] ''Chicago Tribune''</ref>

==Lizards==
The western fence lizard (''Sceloporus occidentalis'', known as blue-bellies) have an anti-lyme disease protein in their blood. If a tick nurses on the lizard, it won't have lyme disease.<ref>http://articles.latimes.com/2013/aug/20/news/la-ol-lyme-disease-lizard-20130820</ref>

==Conspiracy theories==
{{main|Conspiracy theory}}
Because Lyme disease was discovered relatively recently, there are some who believe Lyme is either a man-made disease<ref name="chicago" /><ref name="rense67">[http://www.rense.com/general67/plumislandlyme.htm Plum Island, Lyme Disease And Operation Paperclip], Patricia Doyle, [[Rense.com]]</ref> or a genetically engineered version of an older form.<ref name="rense63">[http://www.rense.com/general63/lyme.htm Lyme Disease – A Biological Weapon?], Marjorie Tietjen, [[Rense.com]]</ref><ref>[http://sci.tech-archive.net/Archive/sci.med.diseases.lyme/2005-09/msg00122.html Update/Plum Island (the ONLY biocontainment level 5 facility in the U.S.?)]</ref> Most of these claims center around the Plum Island Animal Disease Center in [[New York]],<ref>[http://query.nytimes.com/gst/fullpage.html?res=9E03E3DD133AF936A25751C0A9629C8B63&sec=health&spon=&pagewanted=all Heaping More Dirt on Plum I.] ''New York Times''</ref> and many of them come from the website of [[Bullshit|bullshitter]] extraordinaire [[Jeff Rense]].<ref name="rense63"/><ref name="rense67"/> Like other conspiracy theories, claims abound that there's a government cover-up involving murder,<ref>[http://lymebusters.proboards.com/index.cgi?board=rash&action=print&thread=9548 A particularly crazy message board]</ref> or that there's a [[Hitler]]/[[Nazi]]/[[Third Reich]] connection.<ref name="rense63" /><ref>[http://sci.tech-archive.net/Archive/sci.med.diseases.lyme/2007-07/msg00087.html What they Won't Tell You about Lyme History]</ref> Why the US government would invest so much money in a disease that mostly affects US citizens and rarely causes death is unknown. Lyme disease has also been claimed to have connections to [[Morgellons disease]]<ref>[http://theuniversalseduction.com/articles/morgellons-new-disease-or-man-made-weapon-of-terror Morgellons – New Disease, or Man‐Made Weapon of Terror?]</ref> and [[autism]]<ref>[http://www.defeatautismyesterday.com/lyme.htm Defeat Autism Yesterday: Lyme Disease]</ref><ref>[http://www.lymeinducedautism.com/ Lyme Induced Autism]</ref> (the fact of which [[Big Pharma]] obviously doesn't want you to know).

==See also==
*[[Brown recluse]] — a spider whose bite can be confused with the symptoms of Lyme disease

==External links==
===Accurate===
All of the following sites received at least four "accurate" ratings in eight categories by the Pediatric Infectious Disease Journal, and no "inaccurate" ratings:<ref name="inaccurate" />
*[http://www.acponline.org/ American College of Physicians]
*[http://www.aldf.com/ American Lyme Disease Foundation] "Of eight websites with "Lyme" in the domain name, only the American Lyme Disease Foundation provides accurate information." —PIDJ
*[http://www.cdc.gov/ Center for Disease Control]
*[http://www.fda.gov/ Food and Drug Administration]

===Inaccurate===
All of the following sites received at least five "inaccurate" ratings and two or fewer "accurate" ratings:<ref name="inaccurate" />
*[http://www.lymediseaseassociation.org/ Lyme Disease Association, Inc.]
*[http://www.lymenet.org/ Lyme Disease Network]
*[http://igenex.com/Website/ iGeneX], a laboratory that specializes in testing for Lyme disease
*[http://www.lymedisease.org/ California Lyme Disease Association]
*[http://www.lymedisease.org.au/ Lyme Disease Association Australia]

===Recommended readings on "chronic" Lyme disease===
*''[http://www.forbes.com/forbes/2007/0312/096.html Lyme Inc.]'' – David Whelan, Forbes
*''[http://articles.chicagotribune.com/2010-12-08/health/ct-met-chronic-lyme-disease-20101207_1_lyme-disease-raxlen-medical-boards Chronic Lyme disease: A dubious diagnosis]'' – Patricia Callahan and Trine Tsouderos, Chicago Tribune

==References==
{{reflist|2}}

[[Category:Medicine]]
[[Category:Biology]]
[[Category:Conspiracy theories]]
[[Category:Disease]]

Categories: Medicine, Biology, Conspiracy theories, Disease