Should the Name “Lyme Disease” Be Changed?

An infectious disease expert has proposed renaming Lyme disease—but the question remains whether a new name would improve diagnosis or create more confusion.

Lyme disease was first described in 1977 as “Lyme arthritis,” after a cluster of cases in Connecticut. By 1979, the name was changed to Lyme disease as the broader clinical spectrum became apparent.

In 1982, the causative organism, Borrelia burgdorferi, was identified. Since then, multiple related species have been recognized.

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Proposal to Rename Lyme Disease

Wormser has proposed replacing the term Lyme disease with Borrelia burgdorferi sensu lato infection (Bbsl infection).

He argues that this terminology would emphasize that the condition is both a clinical and microbiologic diagnosis, rather than a purely clinical syndrome.

The goal is to align the name more closely with laboratory-based definitions of infection.

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Expanding Understanding of Tick-Borne Infections

Research has identified multiple Borrelia species beyond B. burgdorferi sensu stricto, including B. afzelii and B. garinii in Europe and B. mayonii in the United States.

In addition, ticks may carry other pathogens such as those causing Babesia, Ehrlichia, and anaplasmosis.

This growing complexity raises questions about whether a single disease name adequately reflects the spectrum of tick-borne illness.

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Concerns About Renaming Lyme Disease

Lyme disease is often diagnosed clinically, particularly in early stages when laboratory tests may be negative.

Renaming the condition to emphasize laboratory confirmation could risk underdiagnosis in patients with negative or inconclusive tests.

There is also concern that a new name could create confusion for patients and clinicians, especially given ongoing debates about chronic and persistent symptoms.

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Clinical Perspective

Since early reports of chronic neurologic Lyme disease, a wide range of persistent symptoms and complications have been described, including cognitive dysfunction and fatigue.

These clinical realities highlight the limitations of relying solely on laboratory definitions.

Lyme disease remains, in many cases, a clinical diagnosis supported—but not always confirmed—by testing.

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Clinical Takeaway

Renaming Lyme disease may not improve patient care. Clinical judgment remains essential, especially when laboratory tests are inconclusive.

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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention