Lyme disease is a continued and escalating public health issue.
A major problem in assessing the magnitude of this serious public health issue is the undiagnosed cases.
The Diagnosis and Treatment of Chronic Lyme disease (AKA: post treatment Lyme disease)
It is clear that more accurate tests are needed and more so, a test that will tell us if the infection is active.
What are the possible explanations of developing “chronic” Lyme disease?
Persistent Lyme infection. In spite of the IDSA’s treatment recommendations stating that two weeks (range 10 – 21 days) of oral antibiotics (doxycycline, amoxicillin, or cefuroxime), are sufficient to treat Lyme disease diagnosed by ECM (Bull‘s eye) rash, there is culture supported data, suggesting otherwise
Persistent presence of non infective Lyme spirochetes after adequate antibiotic treatment leading to an ongoing disease.
Persistent/ untreated infection of other tick borne agents, transmitted by the same ticks (“co-infections”)
Re infection. Living in a Lyme endemic area, where about 50% of the tick bites go undetected, unnoticed re-infection can result in a “chronic” picture. This includes the “co-infections”.
When facing “chronic” Lyme, with an autoimmune flavor, one should consider treatment with a combination of hydroxy chloroquine and a macrolide.