The Lyme Times

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2014 Volume 26 Number 3 5
State of the Science
LLMD presents his “Top-Ten List” of Lyme facts uncovered over the last 25 years
By Raphael Stricker, MD
As we stumble toward 2015, questions about Lyme disease and
related tick-borne co-infections have often caused controversy
and made headlines. Here is a Top-Ten list of the most significant
Lyme-related facts and events of the past 25 years.
1. The Centers for Disease
Control and Prevention (CDC) an-
nounces that the rate of new Lyme
disease cases in the U.S. is greater
than 300,000 per year, more than 10
times higher than the previous es-
timate. Thus the spirochete Borrelia
burgdorferi (Bb), the corkscrew-
shaped bacterial agent of Lyme
disease, causes illness that is twice
as common as breast cancer and
six times more common than HIV/
AIDS. This statistic confirms that
Lyme disease is a major epidemic
in the U.S. and underscores the out-
rageous lack of funding for Lyme
disease research compared to other
diseases.
2. The abysmal state of commercial testing for Lyme disease
becomes obvious, as the tests miss as many as 90% of Lyme disease
cases. The myth that this testing is accurate for late Lyme disease
gradually falls apart as the flawed reasoning
behind this statement is exposed and the
number of missed cases continues to rise.
Calls for better testing get louder.
3. The U.S. House of Representatives
passes HR 4701, the Vector-Borne Disease
Research Accountability and Transparency
Act of 2014. This is the first major legis-
lation in the U.S. that addresses the Lyme
disease epidemic. At this writing, the bill is
now in the Senate. The term "chronic Lyme
disease" (CLD), previously maligned by the
medical establishment, gains recognition
in the U.S. Congress.
4. The Infectious Diseases Society of
America (IDSA) holds hearings on its
opinion-based Lyme disease guidelines fol-
lowing a lawsuit by then-Connecticut At-
torney General (now U.S. Senator) Richard Blumenthal. Although
the hearing and its "do-nothing" conclusions are rigged in favor
of IDSA, the widely-viewed open forum exposes the significant
problems with IDSA "science" and impugns the national Lyme
disease policy based on that "science." The evidence-based Lyme
guidelines of the International Lyme and Associated Diseases
Society (ILADS) are published and refute much of the IDSA
guidelines. Calls for guidelines reform get louder.
5. Treatment for Lyme disease and related tick-borne co-in-
fections remains limited by the IDSA "28 day rule" claiming that
anyone with Lyme disease will be cured with 28 days of antibiotic
treatment even if the person is still sick. Studies critical of the poor
science behind this rule are published, and evidence for persistent
infection via cysts and biofilms in animals and humans with CLD
grows stronger. Calls for better treatment trials and more effective
antibiotics get louder.
6. A "new" relapsing fever spirochete, Borrelia miyamotoi,
is found in deer ticks that carry the Lyme disease spirochete
throughout the U.S. Although testing for B. miyamotoi was de-
veloped a decade ago, there is currently no commercial test
available to screen for this "new" tick-borne disease.
7. Tick-borne co-infections, including Babesia , Anaplasma, Eh-
rlichia, Bartonella and Rickettsia, are increasingly recognized as
complicating factors in patients with chronic Lyme disease. The
risk of these agents to the blood supply creates growing alarm
among blood banks. A study from China describes 237 bac-
terial agents that are carried by ticks and potentially pathogenic
for humans. Based on new evidence, the time required for ticks
to transmit Lyme disease and co-infections decreases from 24-48
hours to less than 12 hours (and even as little as 10 minutes) in
animals and humans.
8. Transmission of Lyme disease during pregnancy gets in-
creased recognition. Congenital Lyme disease is linked to autism,
and prophylactic antibiotic therapy during pregnancy to prevent
Lyme disease transmission is adopted by
Lyme-literate practitioners. At the other
end of the age spectrum, Lyme disease is
linked to Alzheimer's disease, suggesting
a possible prevention strategy for this de-
generative brain disease.
9. A bizarre chronic skin rash known as
Morgellons disease is convincingly linked
to Lyme disease. Treatment of Morgellons
disease mirrors treatment of CLD with the
successful use of prolonged antibiotics.
10. In early 2014, a small study claims
that Lyme disease can be sexually trans-
mitted in humans, as it is in animal
models. Calls for further investigation of
this transmission mode of Lyme disease
get louder.
In this issue of The Lyme Times you will read more about the
many controversial questions related to Lyme disease that are
listed above. The calls to answer these questions are getting louder.
Raphael Stricker, MD, a practicing physician in San Francisco,
is a past-president of ILADS and a member of the board of Lyme-
Disease.org. Email:
Raphael Stricker, MD