Oxford Textbook of Medicine

Edited by John Firth, Christopher Conlon, and Timothy Cox

Previous Edition (5 ed.)

Lyme borreliosis 

Chapter:  Lyme borreliosis
Author(s): Gary P. Wormser, John Nowakowski , and Robert B. Nadelman
DOI:  10.1093/med/9780198746690.003.0137

Lyme borreliosis is a zoonotic bacterial infection caused by Borrelia burgdorferi sensu lato, a spirochaetal agent transmitted by certain species of Ixodes ticks. Small rodents and birds serve as reservoirs. It is the most common vector-borne infection in the United States of America and an important infection in many countries throughout the temperate regions of Europe and northern Asia, where a wider variety of borrelia species account for differences in clinical manifestations in Eurasia compared with the United States. The most common and earliest clinical manifestation is erythema migrans, a distinctive cutaneous lesion that occurs at the site of deposition of the spirochaete by the vector tick. Most people treated for Lyme borreliosis respond well to a 2-week course of antibiotic therapy. Symptomatic treatment is recommended for patients who have or develop subjective complaints of unclear aetiology despite successful resolution of the objective manifestation of Lyme borreliosis following antibiotic therapy.

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Same garbage, different day.  Where to begin?

Two of the authors of this worthless chapter are also authors of the unscientific IDSA Lyme guidelines:

Reptiles are also reservoirs, and although some research has suggested the prevalence of Lyme disease in California is lower due to the Blue-Belly Lizard’s ability to kill the Lyme disease bacteria, since that research, much more has come out on California having far more Lyme than previously thought:

I agree with Dr. Murray that reptiles can bring ticks into your yard and the risk isn’t worth any potential benefit:


Some studies show the tick population plummets in absence of lizard hosts. The removal of Western Fence lizards decreased the number of nymphal ticks and of infected nymphal ticks. It appears ticks get used to their “diet” of lizard and do not find adequate substitutes in their absence. As a result, the population of ticks is greatly reduced. [3]

Inviting Blue Bellies to your property may be inviting the ticks that feed on them, or even their offspring (Nymph Ticks).  Did you know that one tick can lay over 3,000 eggs? The idea of that many potential Nymph Ticks on your property would be problematic. There is no guarantee that every infected tick in the area will feed on a Blue Belly and have the Lyme disease bacteria killed. One lizard with 20 ticks on it could produce over 30,000 eggs (assuming half of them were female) to your property. This could produce a great number of nymphal ticks, causing the opposite effect these people desire.

They are right to admit there is a wider variety of borrelia species and subsequently different clinical manifestations but you can be infected with different species right here in the U.S.  The idea that species are separated by geography is outdated information that was never accurate to begin with.  Migrating birds and animals take ticks and their pathogens everywhere in the world.  

This is a global issue and isn’t restricted to geography.

The most common clinical manifestation is NOT the EM rash.  That too is ancient data that never was accurate.  Only 25-80% get it depending on who’s counting, leaving out a large subset of patients. Often, studies claim that the disappearance of the EM rash proves successful treatment.  The EM rash can come and go at will and its disappearance does not prove treatment was adequate. Lyme disease is a systemic infection that can infect every organ within the body.  It quickly gets into the brain.

The false statement that most people respond to a 2-week course of antibiotic doesn’t account for the thousands of patients with remaining symptoms.  According to microbiologist Holly Ahern, that could be more than 60% of patients.

Symptomatic treatment for those with remaining symptoms dooms patients to a life-time of hell.

For an explanation and references to back up what I just wrote: