Infectious disease clinician proposes changing the name of Lyme disease

In a commentary published in the American Journal of Medicine, Dr. Gary Wormser from New York Medical College proposes changing the name of Lyme disease to Borrelia burgdorferi Senso Lato (Bbsl). [1] Such a move, he says, would be in the best interest of patients and health care practitioners.

 

by Daniel J. Cameron, MD, MPH

In 1977, the disease was initially called “Lyme arthritis,” after a cluster of cases of oligoarticular arthritis in children and adults was reported in the Lyme, Connecticut, area. [2]

In 1979, the name was changed to Lyme disease, after additional symptoms were associated with the infection. Then, in 1982 the pathogenic organism was identified as Borrelia burgdorferi. [3] Several strains were later identified including the original strain Bb sensu stricto (Bbss) and others referred to as Bbsl.

“We propose the name B. burgdorferi sensu lato infection, or Bbsl infection for short, instead of Lyme disease,” writes Wormser. “The name change proposed here,” he adds, “might be immensely helpful to patients and health care practitioners interested in evidence-based medicine and thus should be a topic for future discussions.”

Wormser argues that his proposed new name “conveys that the condition is not solely a clinical diagnosis, but instead a clinical and a microbiologic/laboratory diagnosis.”

Wormser is arguably best known for his conclusions that chronic manifestations of Lyme disease do not exist as a distinct diagnostic entity and that symptoms are nothing more than the “aches and pains of daily living.” [4]

Hundreds of other scientists have discovered numerous pathogens in the black-legged ticks that harbor Lyme disease. New genospecies have been described including Borrelia afzelii and Borrelia garinii in Europe and Borrelia mayonii in the upper Midwest USA. Other pathogens identified include those that lead to Babesia, Ehrlichia and Anaplasmosis. Bartonella, which can cause “cat scratch fever,” is the most controversial of pathogens that black-legged ticks harbor.

Should we change the name of Lyme disease? Click To Tweet

Since the first cases of chronic neurologic Lyme disease were reported in 1990, a growing number of chronic complications caused by the disease have been described, [5] including Lyme encephalopathy, [6] Post-Lyme syndrome, [7] Post-treatment Chronic Lyme Syndrome. [8]

Lyme disease is diagnosed clinically, since serologic tests can be unreliable – not only for Lyme disease but for other tick-borne pathogens, as well.

I am not convinced we need to change the name Lyme disease to Bbsl.

 

References:

  1. Wormser GP. Should Patients Infected with Borrelia Burgdorferi No Longer Be Referred to as Having Lyme Disease? Am J Med. 2018.
  2. Steere AC, Malawista SE, Snydman DR, et al. Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities. Arthritis Rheum. 1977;20(1):7-17.
  3. Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwaldt E, Davis JP. Lyme disease-a tick-borne spirochetosis? Science. 1982;216(4552):1317-1319.
  4. Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43(9):1089-1134.
  5. Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med. 1990;323(21):1438-1444.
  6. Logigian EL, Kaplan RF, Steere AC. Successful treatment of Lyme encephalopathy with intravenous ceftriaxone. J Infect Dis. 1999;180(2):377-383.
  7. Gaudino EA, Coyle PK, Krupp LB. Post-Lyme syndrome and chronic fatigue syndrome. Neuropsychiatric similarities and differences. Arch Neurol. 1997;54(11):1372-1376.
  8. Rebman AW, Bechtold KT, Yang T, et al. The Clinical, Symptom, and Quality-of-Life Characterization of a Well-Defined Group of Patients with Posttreatment Lyme Disease Syndrome. Front Med (Lausanne). 2017;4:224.


2 Replies to "Infectious disease clinician proposes changing the name of Lyme disease"

  • Carolyn
    08/13/2018 (1:38 am)
    Reply

    Dr. Wormser is responsible for millions of patients suffering. He should have his medical license taken away. His words should have absolutely no credibility. It is time for him to retire.

  • Donna Falcone
    08/13/2018 (9:23 pm)
    Reply

    I don’t even care what they call it. I have a long held theory, based on human nature being what it is, that until Dr. Wormser “discovers” chronic Lyme, nothing will go forward and deniers will continue denying. The feather in his cap will be ‘discovering’ persistent Borrelia burgdorferi Senso Lato. Whatever. If he needs a feather in his cap, as much as I’d like to see him eat crow, I am more interested in seeing some path for acceptance and legitimizing the struggle that is real for so many, opening the door to more support for research and insurance coverage! If changing the name means that can happen, so be it…. he’ll never eat crow.


Got something to say?

Some html is OK