The Elusive Science of Lyme Disease

Science offers tantalizing hints about what might be the issues with our understanding of Lyme disease. There is a fair amount of genetic variation in the bacteria that causes Lyme disease. There are several species globally that lead to different manifestations of symptoms. And among the species, there are multiple strains that have their own different characteristics. The basic clinical approach misses atypical presentations or misdiagnosed patients. The diagnostic tests are lacking in the precision and sensitivity that one sees for many other diseases. The routine antibiotic treatment works in most cases but still leaves 20% of patients with persisting symptoms. This is similar to the mysteries surrounding COVID long haulers. 

What we already know is significant and should be widely known by clinicians. For instance, we’ve known for 20 years that some strains produce more severe diseases. Research has shown that only certain strains produce the tell-tale rash that so many clinicians erroneously rely on for diagnosis. We suspect that persistence of infection, immune evasion, and susceptibility to antibiotics also vary from strain to strain. We are seeing it now with the emerging variants of COVID, which has been evolving for just over a year. The Lyme bacteria has been adapting to infecting a variety of mammal hosts over tens of thousands of years and given the species and strains that have been implicated in human cases has done so reasonably well. 

We are hopeful that science can advance to help improve patient outcomes; through better diagnostics and testing that can distinguish species and strains, effective antibiotic cocktails to treat persistent cases, and a safe and effective vaccine. While we emphasize the role of awareness and prevention to mitigating tick bite risk, people are just not sufficiently cautious or diligent enough for this to work all the time. Of course, a Lyme vaccine will not address other tick-borne diseases but it would go a long way to reducing the public health burden associated with ticks. 

LymeTV is a scientifically-focused organization and its mission is to reduce the incidence of dangerous tick-borne diseases. The organization believes that the problems of Lyme and other tick-borne diseases will ultimately be solved by scientific progress and medical innovation. LymeTV’s Executive Director served on the FY19 Department of Defense CDMRP, TBDRP, and was asked to create a tick education curriculum for the University of New England’s Maine AHEC Cup Scholars distinction program. LymeTV is an all-volunteer 501(c)3 public health organization.