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June 2006

Can Lyme Disease Become Chronic?

Simple question, complex answer.

Infectious-disease experts say Lyme, once diagnosed, follows a predictable pattern. A short course of antibiotics kills the bacteria, and most people promptly recover. And if the bacteria has already spread, symptoms may linger, but they’ll eventually go away, says Henry Feder Jr., M.D., a Lyme expert at the University of Connecticut Health Center.

Yet some patients report persistent symptoms weeks or months later. “We call it post-Lyme syndrome,” says Feder. Studies indicate these patients no longer have active infections and present symptoms that might arise from other maladies. No one denies they’re sick, but their symptoms haven’t been firmly linked to Lyme, says Gary Wormser, M.D., chief of infectious diseases at New York Medical College. Furthermore, he says, overusing antibiotics could help spawn drug-resistant “superbugs.”

Such positions infuriate Pat Smith, president of the Lyme Disease Association (LDA). “We believe it’s a chronic disease and antibiotics help ameliorate the symptoms,” she says. The LDA and the International Lyme and Associated Diseases Society, a group comprising mostly private physicians, assert that people with lingering symptoms have chronic Lyme and may require months of IV antibiotic therapy. These advocacy groups claim the CDC’s criteria for diagnosing Lyme are too stringent, and that lab tests often miss cases of the disease. Smith admits antibiotics are no cure-all, but says it’s the only treatment these people have.

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