Top 10 Lyme Disease News and Research Stories of 2019

Lyme disease news continues to highlight the complexity of diagnosing and treating tick-borne infections. New Lyme disease research and clinical studies help explain persistent symptoms, testing limitations, and coinfections.

Many of the studies highlighted in this review focus on the wide range of Lyme disease symptoms, which can affect the nervous system, joints, heart, and autonomic nervous system.

Here are the top Lyme disease news stories of 2019 featured on DanielCameronMD.com.

Recent Lyme Disease Research Highlights

1. Many Physicians Treat Lyme Disease Longer Than 21 Days

Tseng and colleagues reviewed insurance claims data from the Northeast United States and identified 488 physicians who treated Lyme disease for more than five weeks.¹

They reported several observations:

• The average length of treatment was 86 days
• Treatment ranged from 35 to 404 days
• 48.8% were treated with more than two antibiotics
• 43% of patients were switched from one antibiotic to another
• 18% were prescribed combinations of antibiotics

These findings highlight how physicians sometimes individualize treatment when patients continue to experience symptoms.

2. Lyme Disease Symptoms May Come and Go

Fallon and colleagues described fluctuating symptoms in Lyme disease patients. A patient may feel extremely fatigued one day, function normally the next day, and then develop significant cognitive symptoms shortly afterward.

These fluctuations can make it difficult for patients and clinicians to understand the illness and may lead others to question whether the symptoms are real.

Reference: Fallon BA et al. Psychiatric Quarterly. 1992.

3. Foot Pain and Plantar Fasciitis May Be Linked to Lyme Disease

I often see foot pain in my Lyme disease patients. Some patients describe painful feet even when walking from the bed to the bathroom.

Miller and colleagues described foot and ankle symptoms associated with Lyme disease in a retrospective case series.¹

In some cases, pain initially diagnosed as plantar fasciitis improved after treatment for Lyme disease.

4. Lyme Disease Can Be Difficult to Diagnose

Lyme disease can be difficult to diagnose, similar to other neurologic illnesses such as multiple sclerosis.

Symptoms may be subtle, examination findings may be limited, and imaging studies may not provide a clear answer. This complexity can delay diagnosis and treatment.

Reference: Katz Sand IB et al. Continuum. 2013.

5. A Wide Range of Symptoms Occur in Lyme Disease

Dr. Robert Bransfield described a wide range of neuropsychiatric symptoms associated with Lyme disease. These may include:

• poor concentration
• memory problems
• brain fog
• fatigue
• mood swings
• sleep disturbances
• anxiety or depression

Lyme disease may also affect multiple body systems including neurologic, musculoskeletal, cardiovascular, and gastrointestinal systems.

Reference: Bransfield RC. Healthcare (Basel). 2018.

6. POTS and Lightheadedness in Lyme Disease

Some Lyme disease patients experience lightheadedness when standing. In certain cases, patients are diagnosed with postural orthostatic tachycardia syndrome (POTS), an autonomic nervous system disorder.

POTS has been reported following Lyme disease and may improve after treatment of the underlying infection.

Reference: Agarwal AK et al. Postgrad Med J. 2007.

7. Early Signs of Lyme Disease May Be Subtle

The earliest signs of Lyme disease may not always include the classic bull’s-eye rash. Early symptoms may instead include fatigue, headaches, sleep disturbance, poor concentration, and joint pain.

Because these symptoms overlap with many other illnesses, Lyme disease may initially be mistaken for other conditions.

8. Lyme Disease Testing Has Limitations

Laboratory testing for Lyme disease can sometimes be negative, particularly early in infection. Most tests measure the immune response rather than detecting the bacteria directly.

Because of these limitations, clinicians often rely on clinical judgment when evaluating patients with suspected Lyme disease.

9. Some Patients Experience Symptom Flares During Treatment

Some patients experience temporary worsening of symptoms after starting antibiotics, sometimes described as a Jarisch–Herxheimer reaction.

Fallon and colleagues described patients experiencing increased anxiety, depressive symptoms, or heightened sensitivity to light during the early days of treatment.

10. Babesia Coinfection Is Common in Lyme Disease

Babesia is a parasitic infection transmitted by the same tick that spreads Lyme disease.

Studies suggest that up to one-fifth of Lyme disease patients may also have Babesia infection. Symptoms may include fatigue, night sweats, shortness of breath, and anemia.

Unlike Lyme disease, Babesia requires different medications for treatment.

Reference: Diuk-Wasser MA et al. Trends Parasitol. 2015.

What These Lyme Disease News Stories Show

The research and clinical observations from 2019 reinforce a key message: Lyme disease symptoms can affect many body systems, diagnosis is often complex, and coinfections such as Babesia may complicate treatment.

Ongoing Lyme disease research continues to improve our understanding of symptoms, diagnosis challenges, and treatment approaches for tick-borne infections.

Many of these issues are discussed further in Why Lyme Disease Tests the Limits of Medicine.

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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