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Lyme disease: why the controversy?

M H Beaman1,2,3

  • 1Western Diagnostic Pathology, Perth, Western Australia, Australia.

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Lyme disease (LD) is not found in Australia, despite some Australians seeking costly, unproven treatments. A new name, "Australian Multisystem Disorder," is proposed for this chronic syndrome, advocating for research into its cause and effective treatments.

Keywords:
AustraliaLyme BorreliaLyme diseasechronic Lymepost-treatment Lyme disease syndrome

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Area of Science:

  • Medical research
  • Infectious diseases
  • Syndromic surveillance

Background:

  • Lyme disease (LD) recognition in the 1970s serves as a model for investigating unknown syndromes.
  • Australian guidelines mandate accredited testing for LD, effectively diagnosing overseas travelers.
  • Patients without travel history incur significant costs for overseas testing and unproven LD therapies, leading to severe complications.

Purpose of the Study:

  • To review the history of Lyme disease (LD) as a model for investigating unknown syndromes.
  • To address the issue of locally acquired Lyme disease claims in Australia.
  • To propose a framework for future research and management of a chronic, multisystem disorder.

Main Methods:

  • Review of the history and investigative approaches to Lyme disease (LD).
  • Analysis of diagnostic requirements and testing protocols in Australia.
  • Examination of evidence regarding LD vectors, hosts, and autochthonous illnesses in Australia.

Main Results:

  • Lyme disease (LD) vectors, Lyme Borrelia, and associated illnesses are not found in Australia.
  • Patients are undergoing expensive, unproven treatments for presumed LD, resulting in serious health complications.
  • Current diagnostic pathways are effective for LD in travelers but not for alleged local cases.

Conclusions:

  • The syndrome described in patients with alleged locally acquired Lyme disease (LD) lacks evidence of LD aetiology.
  • A new name, 'Australian Multisystem Disorder,' is proposed for this chronic syndrome.
  • Further research is recommended, including developing a consensus case definition, epidemiological studies, etiological investigations, and ethical treatment trials.