Chronic Lyme disease

Chronic Lyme disease is caused by the bacterium Borrelia burgdorferi and transmitted through black legged ticks.

Symptoms
The signs and symptoms of Lyme disease vary and usually appear in stages.

Early Signs and Symptoms
 * Bull's eye rash (Not always present.)
 * Flu-like symptoms

Later Signs and Symptoms
 * Erythema migrans
 * Neurological problems

Less Common Signs and Symptoms
 * Heart problems, such as irregular heartbeat.
 * Eye inflammation
 * Liver inflammation (hepatitis).
 * Severe fatigue

United States

 * CDC two-step process: EIA/IFA and Western Blot.
 * Other Tests - ELISA, PCR, LTT-MELISA.
 * Blood, Urine and Other Tests Not Recommended by CDC

UK

 * BBC1 Lyme Disease Discussion - Some patients have waited up to 30 years for a correct diagnosis. NHS services have only correctly identified the disease in a quarter of the patients. The blood tests are unreliable and often come back negative. The development of an accurate blood test is in need of research funding.

Treatment & Management

 * Approach Considerations
 * Treatment of Early Lyme Disease
 * Post-Treatment Lyme Disease Syndrome (Chronic lyme disease)

Herpesviruses
Lyme may cause reactivation of latent herpesviruses. At the same time, several herpesviruses including varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and HSV-2 may cause false positives on Lyme Disease tests.

Research

 * 2016, Ticks that transmit Lyme disease reported in nearly half of all US counties. ScienceDaily, Entomological Society of America


 * 2013, Quirky Lyme disease bacteria: Unlike most organisms, they don't need iron, but crave manganese, ScienceDaily, Woods Hole Oceanographic Institution


 * 2016, Researchers identify new Borrelia species that causes Lyme disease, ScienceDaily, Mayo Clinic


 * 2016, Gene Signature Could Lead To A New Way Of Diagnosing Lyme, UCSF News Center, Laura Kurtzman

Pathobiome Paradigm
Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.

Lyme Disease vs Chronic Fatigue Syndrome
Lyme Disease and Chronic Fatigue Syndrome are different diseases. Research is published on cerebrospinal fluid, and distinct differences were found.

The are many historical outbreaks of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome that do not correlate with a tick borne pathogen.