There are some Lyme disease (LD) patients who continue to suffer from Lyme arthritis following antibiotic treatment. It has been suggested that ongoing symptoms may be due to “pronounced TH17 inflammatory responses.”  That is, an autoimmune response is the culprit, not the actual Borrelia infection.
Ticks seem to be popping up everywhere. B. garinii, B. valaisiana, B. afzelii and B. miyamotoi-infected ticks have been found in urban- and peri-urban areas of southern England, according to a recently published paper in Ticks and Tick-borne Diseases. 
When making treatment decisions, doctors often turn to the Cochrane review, a leading resource for systematic reviews in health care. The Cochrane review includes several trials of Lyme Neuroborreliosis (LNB), based on European studies.  But none on neurologic complications of Lyme disease in the USA.
Rhode Island Ixodes scapularis ticks survived just as well under northern and southern conditions. "Newly-emerged larvae from Rhode Island parents did not differ consistently in mortality under northern and southern conditions, possibly because of their younger age,” according to Ginsberg from the USGS Patuxent Wildlife Research Center, University of Rhode Island.
In a recent study conducted in Germany and Austria, researchers applied a 10% azithromycin gel to the site of a tick bite for 3 days. The trial was stopped early after it failed to prove that the gel worked in preventing Lyme disease (LD) for the 995 subjects.
The topical treatment failed to prevent a combination of seroconversion or an EM rash in 11 (2%) of 505 individuals in the azithromycin group and 11 (2%) of 490 participants in the placebo group.
A recent study on the transmission of Borrelia burgdorferi (Bb), the spirochete associated with Lyme disease, in the Outer Banks of North Carolina (NC), highlights the difficulties in determining the actual risk of Bb-infected ticks present in particular regions. 
As another year comes to a close, we share with you the most popular blogs for 2016 from our All Things Lyme blog series. Throughout the year, dozens of studies, published in leading scientific journals, continued to demonstrate the potential seriousness of Lyme disease and other tick-borne diseases when left untreated or improperly treated. The ramifications for patients can be life-altering.
A study by Arsnoe and colleagues  suggested that ticks in the Southern USA behave differently than in the Northern USA. They found fewer questing ticks in the Southern USA than the the Northern USA. The answer could be that Southern ticks are not as likely to quest during the hottest and driest months.
Much attention has been given to the Southern Tick-Associated Rash Illness (STARI), transmitted by the Lone Star tick (Amblyomma americanum) in the South.  However, a new study reminds us that the causative agent of Lyme disease, Borrelia burgdorferi sensu stricto has been in the South since at least 1991. 
“Why should an ophthalmologist have a good understanding of Lyme diagnosis and treatment?” asks Sathiamoorthi , from the Mayo Clinic, in an article published in the Current Opinion in Ophthalmology. “Vision-threatening ophthalmic manifestations are relatively common in Lyme disease (LD) and Rocky Mountain spotted fever.”