Lyme Disease Myths


Introduction

There are a variety of myths in circulation regarding Lyme disease in Australia. Below is a list of the most common myths along with an explanation to assist in dispelling such.

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Dispelling myths
There is no Lyme disease in Australia - FALSE

This is false. The misconception that Lyme disease does not exist in Australia is based on a study in 1994 by Russell and Doggett.  There were numerous problems with this study and it’s methodology, which are the focus of an upcoming article in the Medical Journal of Australia.  By contrast Willis was able to identify the bacteria that causes Lyme disease in Australian ticks in 1995.  In addition to this Carly and Pope found an Australian strain of Borrelia, Borrelia Queenslandica in 1962. A 1959 study by Mackerras isolated Borrelia on Australian fauna – kangaroos, wallabies and bandicoots, this was also omitted.  Adding to this is the fact that a large number of diagnosed Lyme disease patients in Australia have never travelled out of Australia.  More study desperately needs to be done on Lyme disease in Australia. 

Putting Methylated Spirits, Vaseline or Ether on a tick will help remove it - FALSE

This is false and dangerous. It is vital that nothing is added to the tick and that the tick is not squeezed or it will inject its host with the disease ridden contents of its stomach. Please visit our tick removal section for the correct removal process.

The tick that causes Lyme disease is not in Australia - FALSE

This is false. This assumption is based on the false understanding that only deer ticks can transmit Lyme disease – this has been proven to be false for many years in the USA and Europe, where there are numerous ticks that transmit Lyme disease – some of which are in Australia.  The main tick areas in Australia are outlined here.

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Lyme disease cannot be transmitted from one person to another - FALSE

This is false. Lyme disease has been found in stillborn babies who’s mother was infected with Lyme disease (see here for numerous citations).  There are a growing number of children in Australia diagnosed with Lyme disease who have never travelled out of Australia and who’s mother has Lyme disease.  Syphilis and Lyme disease have similar etiologic, clinical, and epidemiologic characteristics (and both are caused by spirochete bacteria).

Because Syphilis can be transmitted sexually there is a theory that Lyme disease can also be transmitted sexually (backed up by the fact that the bacteria that causes Lyme disease has been found in semen and vaginal secretions).  More study needs to be done on the sexual transmission of Lyme disease, which is currently a controversial diagnosis.

Lyme disease testing is 100% reliable - FALSE

This is false. Testing for Lyme disease is not currently reliable, and so the diagnosis of Lyme disease is a clinical diagnosis based on medical history and clinical symptoms.  The testing is unreliable for two reasons – firstly the bacteria that causes Lyme disease often does not reside in the blood but in tissues, heart, nervous system, in collagen and in joints, which makes it very difficult to isolate during a blood test.  Secondly, testing for an immune response to the Lyme disease bacteria is hampered by the fact that the Lyme disease bacteria directly supresses the immune system and the production of antibodies against the bacteria.  This means that there is a high level of false negative blood test results for Lyme disease.  The consequences of this fact are that a negative result for a blood test for Lyme disease is not proof that a patient does not have Lyme disease, rather that their immune system has not been able to mount an adequate defence against the infection.  Anecdotally it has been found that the sicker a patient is with Lyme disease, the higher the chance that they will receive a negative blood test – sometimes after successful treatment of the Lyme disease and resolution of symptoms, the blood test will come back positive, when it was previously negative.  Adding to this is the fact that the testing for Lyme disease in Australia is very unreliable – most Lyme disease patients send their blood to the USA or Germany for testing.

Two tier testing of Lyme disease is accurate - FALSE

This is false. “The step 1 tests are insufficiently sensitive to be used as “screening” tests. [Trevejo R, JID 1999; 179:931–8.] Western blots, increase specificity but, following a step 1 test, further decrease overall sensitivity. The bands included in the Western blot interpretation schemes were chosen on a statistical, rather than a clinical, basis.[Dressler F. JID 1993; 167:392-400.] Recently, the C6 peptide ELISA alone was proposed as an alternative to the two-tier approach. Unfortunately, the C6 ELISA also lacks adequate sensitivity for clinical use.[Bacon R. J Infect Dis 2003; 187:1187- 99.]” (quoted from the ILADS website – we couldn’t explain it better ourselves).

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If you have a negative Lyme disease blood test, you don't have Lyme disease - FALSE

This is false. Lyme disease is a clinical diagnosis based on medical history and clinical symptomology.  Please see above regarding testing.

Lyme disease is rare in Australia - FALSE

This is false.  Lyme disease diagnosis is not common, but Lyme disease itself appears to be grossly under diagnosed in Australia. The Lyme Disease Association of Australia estimates, based on United States of America figures that an Australian extrapolation means approximately 18,000 new cases per year. Since the publishing of Russell and Doggett’s 1994 study there are potentially 378,000 patients in Australia.

A one off dose of Doxycycline after a tick bite can prevent you contracting Lyme disease - FALSE

This is false and dangerous. As it increases the chance of you going on to have long term Lyme disease – at least 28 days of specific antibiotics are required to lower the chances of contracting Lyme disease.  Treatment of acute or chronic Lyme disease requires treatment for much longer. 

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Everyone gets the Lyme disease rash - FALSE

This is false. The bulls eye rash (erythema migrans) of Lyme disease is only present in approximately 50% of cases.  Rashes do not always present as perfectly bulls-eye. Solid rashes, and solid spreading rashes without a distinct centre, can also indicate a Lyme disease infection.   Furthermore, many patients do not develop a rash at all.  If you are concerned you may have Lyme disease start by printing and completing Dr Richard Horowitz’s questionnaire.  It’s a great starting place for clarity and discussion with your Lyme-aware doctor.

If you didn't get bitten by a tick you can't have Lyme disease - FALSE

This is false.  Only 30% of people who are diagnosed with Lyme disease remember a tick bite.  The tick injects local anesthetic into your skin before it bites you, so that it may stay attached longer.  This means that most people don’t remember the tick bite at all.

If you remove a tick within 36 hours it cannot give you Lyme disease - FALSE

This is false. At any time during the tick being attached it can regurgitate the infectious disease containing contents of its stomach into your blood stream.  This is why removing the tick carefully is so important, as squeezing the tick has the same effect.

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If you have Lyme disease, you just need 1 month of antibiotics and it is cured - after that it is Post Lyme Syndrome - FALSE

This is false. Lyme disease can affect every system in the body.  Because it is a slow replicating bacteria it is also very difficult to kill.  For this reason some people will be on antibiotics for up to 2.5 years (or longer), especially if they are very sick, have been sick for a long time or have neurological Lyme disease.  Lyme disease is treated until a period of time after all symptoms have resolved (to make sure that the majority of bacteria are killed) – stopping treatment prematurely dramatically increases the likelihood of a relapse, and a higher bacterial load than before treatment, which can prolong treatment even further.

There is only 1 type of Lyme disease - FALSE

This is false. There are 14 genospecies of Borrelia Burgdorferi senso lato (the bacteria that causes Lyme disease) – which includes BB senso stricto.  This diversity is thought to contribute to the antigenic variability of the spirochete and its ability to evade the immune system and antibiotic therapy, leading to chronic infection.

The only symptoms you get with Lyme disease is arthritis - FALSE

This is false.  One symptom of Lyme disease can be atypical arthritis, however, it is not the only symptom. A more detailed symptom list is available here.

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Lyme disease only gives physical symptoms- FALSE

This is false. The bacteria that cause Lyme disease can penetrate into the brain, they can cause numerous neurological and psychiatric symptoms in some patients – for more information, please see here (psychiatric Lyme disease treatment tools).

Lyme disease isn't that serious - FALSE

This is false. Lyme disease (particularly neurological Lyme disease) can be fatal.

The Centres for Disease Control and Prevention's definition of Lyme disease misses a lot of Lyme disease patients- TRUE

This is True. The Center for Disease Control and Prevention (CDC) surveillance criteria for Lyme disease were devised to track a narrow band of cases for epidemiologic purposes. As stated on the CDC website, the surveillance criteria were never intended to be used as diagnostic criteria, nor were they meant to define the entire scope of Lyme disease.

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