Maybe "misconceptions" is a better word. But any way you slice it, there is a lot of outdated, misinterpreted or just plain bad information about Lyme disease floating around out there and some of it is coming from sources that would normally be considered reliable.
So let's take a look at a few of the most common misconceptions that are circulating about Lyme disease these days and see if we can't set a few things straight.
Myth #1: Lyme disease is caused solely by infection with the Borrelia burgdorferi bacterium.
Borrelia burgdorferi is one of several closely related species of bacteria that can cause Lyme disease. It is not currently known how many Lyme disease sufferers in Canada are infected with Borrelia burgdorferi and how many are infected with other species of Borrelia. And it likely won't be known for some time. Diagnostic tests have not yet been developed for many of the species of Borrelia bacteria that exist in this country - some of which have only recently been identified - and until more research is undertaken and better tests are developed, researchers can only guess at who is infected with which species.
Myth #2: Lyme disease is rare in Canada.
The truth is that no one can say for certain how many people in Canada suffer from Lyme disease. There are many reasons for this, including accuracy issues surrounding diagnostic testing, the inadequate education of both doctors and the general public, overly conservative surveillance criteria, and the chronic underreporting of suspected Lyme cases to public health officials by physicians. What everyone involved in the Lyme debate can agree on is that the number of Canadians infected with Lyme is likely to rise significantly over the coming decades due in large part to global warming and the role it is playing in making Canada much more hospitable to the ticks that carry the disease.
Myth #3: 80% of people infected with Lyme disease develop a distinctive bull’s eye rash.
Current research shows that the true percentage of Lyme sufferers who develop a rash – any rash – when bitten by an infected tick is well below 50%. The majority of those who do develop a rash, develop what experts like to call an “atypical” rash (or rashes), meaning they don’t take the form of the classic “bull’s eye” long associated with a Lyme infection. The classic bull’s eye rash is believed to occur in just one out of every ten people infected with Lyme disease.
Myth #4: Existing Lyme disease tests are accurate.
If they were, the debate surrounding Lyme disease would not be nearly as vociferous as it is. The testing for Lyme disease is two-tiered, with a computerized screening test (called an ELISA or EIA) being run first and a more accurate Western blot test being run second (but only if the screening test comes up positive or equivocal). It's never a good sign when two tests need to be employed in an attempt to detect the presence of antibodies to a single organism. If one test was good enough, the second test would be unnecessary. The accuracy of diagnostic tests is determined by three criteria: sensitivity (positive if the disease is present), specificity (negative if it isn't) and reproducibility (the same result each time the test is run on a single sample). Studies have shown that existing Lyme disease tests have challenges in all three areas.
Myth #5: Lyme disease can be cured with two to four weeks of antibiotics.
For those lucky few who are diagnosed and promptly treated in the immediate aftermath of a tick bite, this can indeed be the case. Unfortunately, this is not the way things go down for a lot of Lyme sufferers and a significant percentage go on to develop a chronic illness that requires months or even years of treatment before it resolves. The exact cause of this prolonged illness remains unknown, but many people involved in the Lyme debate believe it to be the result of an ongoing Borrelia infection or possibly an infection with another infectious agent - possibly a virus, a protozoan, a prion, or God knows what else - that a short course of antibiotics fails to eradicate.