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Asymptomatic Borrelia burgdorferi infection
G P Wormser1, R B Nadelman, J Nowakowski
1Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, New York, USA.
Medical Hypotheses
|October 17, 2001
Summary
Asymptomatic Borrelia burgdorferi infections appear more benign than previously thought. Further research is needed to confirm if this is due to diagnostic accuracy or non-pathogenic bacterial strains.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- The natural history of asymptomatic Borrelia burgdorferi infection remains poorly understood.
- Previous studies on untreated Lyme disease have indicated a less benign course than observed in recent asymptomatic cases.
Purpose of the Study:
- To analyze the natural history of asymptomatic Borrelia burgdorferi infections identified during an OspA vaccine trial.
- To investigate potential reasons for the observed benign course, including diagnostic accuracy and strain pathogenicity.
Main Methods:
- Analysis of serologically diagnosed asymptomatic Borrelia burgdorferi infections from a US-based OspA vaccine trial.
- Comparison of findings with historical data from untreated erythema migrans cases.
Main Results:
- Asymptomatic Borrelia burgdorferi infections in the vaccine trial cohort exhibited a more benign natural history compared to untreated erythema migrans.
- Hypotheses proposed include potential inaccuracies in serologic diagnostic criteria or infection with less virulent B. burgdorferi strains.
Conclusions:
- The benign presentation of asymptomatic Borrelia burgdorferi infection warrants further investigation into diagnostic specificity and strain virulence.
- Developing serologic tests to differentiate between invasive and non-invasive B. burgdorferi strains could clarify the observed differences in disease outcomes.