Chronic Lyme Disease is a multisystem illness with a wide range of symptoms and/or signs that are either continuously or intermittently present for a minimum of 6 months (as defined by ILADS). The illness is a result of an active, ongoing infection by any of several members of the Borrelia Burgdorferi sensu lato complex. The infection has various latency periods and signs and symptoms may wax, wane and migrate (a keynote sign of Lyme).

• Inclusion criteria: 
  • illness of at least 6 months duration
  • And at least one positive result by:
    • Culture
    • PCR
    • Antigen detection
    • Microscopy with Bb-specific immunohistochemistry

There is a possibility of widespread clinical manifestations, from a minor cutaneous erythema migrans (EM) rash, to severe arthritis and neurological manifestations.

Chronic Lyme Disease is known as the ‘NEW GREAT IMITATOR’ due to the diversity of its clinical manifestations

• 8 most common symptoms:
  • Fatigue
  • Arthralgia
  • Sensory changes
  • Headaches
  • Joint swelling
  • Skin discolouration
  • Impaired memory
  • Myalgia

Only 29% of people with Lyme disease ever remember being bitten by a tick, and approximately 30-50% of people never develop the hallmark erythema migrans rash (bulls-eye).

There is an increasing number of ticks infected with Borrelia due to the increased deer population, as well as an increased geographical range now extending across North America to California, whereas previously they were only found in the eastern US and Canada. Also, Lyme disease is presenting as more complex because ticks are infected with multiple tick-borne diseases such as Babesia, Rickettsia, and Bartonella.

Standard of care for tick bites is 2 weeks of antibiotic treatment. Unfortunately, 39% of patients treated with 3 weeks of antibiotics are still not well at 6 months. There can be a persistence of Borrelia even if treated. The mechanisms for this persistent disease state is due to:

• Borrelia evading immune detection by a change in the way the immune system recognizes the organism
• Immune sequestration – borrelia can reside in a number of cell types like fibroblasts and glial cells
• Biofilm is an adherent polysaccharide matrix that protects the bacteria form a hostile environment, which protects the bacteria from treatment
• Altered ability to generate immunoglobulin response to infection 
• Presence of seronegativity has been characterized with Borrelia, meaning preferred testing methods are VERY important
• Generation of persister cells, round body forms due to environmental pressure such as antibiotics, and then it can shift back into spirochete form (more active infection state)

Do you have more questions about Chronic Lyme Disease or testing? Contact Danielle at the Natural Care Clinic (905) 631-0880.

Dr. Danielle O’Connor ND