Health authorities in Pennsylvania announced last month that deer ticks carrying Borrelia burgdorferi — the bacteria that causes Lyme disease — now reside in every county in the state.

First identified and described in Lyme, Connecticut in 1977, Lyme disease was, until recently, mostly confined to the eastern part of Pennsylvania. David Templeton reports on Pennsylvania’s numbers, which, for the fifth year in a row, led the nation in Lyme disease cases:

Statewide cases totaled 5,758 in 2013, with 1,122 cases in the southwest. That ranks second only to the southeast with 1,391 cases. The largest concentration of cases over the past five years has existed in an area including Armstrong, Butler, Clarion, Jefferson, Elk, Cameron and Clearfield counties. Allegheny County reported four cases or fewer in 2013 and only 10 cases in 2012.


The PediaBlog took a look at Lyme disease two summers ago:

Typical symptoms are not specific: fever, headache, muscle aches, and fatigue. The rash that can accompany a tick bite — erythema migrans or bullseye rash — is not present in all cases. If the diagnosis is made at this early stage, treatment with antibiotics (amoxicillin or cefuroxime under eight years old and doxycycline for those who are older) for 2-4 weeks is usually curative. If this early stage of Lyme disease is not identified and treated, the bacteria can spread to the joints (arthritis), the nervous system (meningitis, bell’s palsy), heart (arrhythmias), and cause severe symptoms of debilitating and chronic fatigue and muscle pain. In people with these symptoms, treatment options and recovery without residual health problems are variable, less than certain, and frequently a simple matter of opinion. This can be frustrating for people who suffer as well as doctors who treat them.


Templeton rehashes the controversy surrounding the 20-year-plus “Lyme War”:

Citing abundant scientific studies and meta-analysis of Lyme disease studies, mainstream doctors and health institutions refer to persistent symptoms as “post-treatment Lyme disease syndrome.” The infection is gone but symptoms remain.

“After treatment, a small number of people still experience some symptoms, such as muscle aches and fatigue,” the Mayo Clinic states. “The cause of these continuing symptoms is unknown, and treating with more antibiotics doesn’t help. Some experts believe that certain people who get Lyme disease are predisposed to develop an autoimmune response that contributes to their symptoms. More research is needed.”


And in the other corner:

But a vocal minority of physicians uses different diagnostic centers and their own treatment centers, where antibiotics are administered, often intravenously, sometimes for months and years.

These so-called “Lyme-literate” doctors say post-treatment symptoms indicate chronic Lyme disease because they contend the bacteria is still present. They prescribe extended antibiotic treatments until symptoms disappear, with claims that symptoms often resume when the patient ceases taking the drugs. The terminology, including chronic Lyme disease, signals the physician’s treatment philosophy.


Obviously, more research is needed. Science should lead the way in finding the truth of why some patients with Lyme disease have persistent and debilitating symptoms. And until there is an overwhelming consensus of evidence that points to that truth, there will be controversy.

But what we’re seeing in the “Lyme Wars” is eerily similar to what’s gone on with some other, made-up “controversies” — over vaccines, tobacco, and climate change — accompanied by the false experts, the mean-spirited and personal attacks on scientists and physicians, and the conspiracy theories.

Once battle lines are drawn, heels are dug in. Deep. I hope, this time, we have a kinder, more satisfying, and more productive conclusion to the debate surrounding Lyme disease.


More PediaBlog on Lyme disease here.