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Acute/Persistent Infection

What is Lyme complex? 

Lyme disease is the most common vector-borne infection in the United States. It is transmitted by the bite of a deer tick or Western black-legged tick carrying a bacterium known as Borrelia. Four major species of Borrelia that carry Lyme disease have been identified in North America, Europe and Asia. In the US, the leading cause of Lyme disease is Borrelia burgdorferi and less commonly, Borrelia mayonii. Possible transmission via insects such as flies, mosquitoes and fleas has been reported, in addition to congenital and sexual transmission.

Acute Lyme is diagnosed from the onset of disease to no longer than 6 weeks of infection.  Persistent or chronic is post 6 weeks infection and more difficult to eradicate.  This may be ongoing infection, or it may be symptoms from remnants left behind in the monocytes (Dr. Bruce Patterson, Lyme).  Working with a Lyme Literate DO, NP, MD or Naturopath can help you make your way through proper testing and appropriate treatment.

Besides the Borrelia that cause Lyme disease, ticks are known to carry more than 20 microorganisms that cause bacterial, viral or parasitic infections in humans. When Lyme disease is present, these are referred to as ‘coinfections’. A typical tick bite is known to transmit an average of 3 infections, which may include may Rocky Mountain Spotted Fever, bartonellosis, anaplasmosis or ehrlichiosis. Babesiosis, caused by a microscopic parasite, is another tick-borne coinfection that frequently accompanies Lyme disease. The combination of Lyme disease and one or more coinfections has been referred to as ‘Lyme Complex.’ The symptoms that result from several tick-borne infections can be multiple. They may overlap, which can make diagnosis and treatment extremely challenging, but not impossible.

Persistent/Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group †.

​Lyme disease, resulting from an active infection with any of several pathogenic members of the Borrelia burgdorferi sensu lato complex (Bbsl), often affects multiple systems. It is the most common vector-borne illness in the United States [1] and Europe [2]. The Centers for Disease Control and Antibiotics 2019, 8, 269; doi:10.3390/antibiotics8040269

Antibiotics 2019, 8, 269 2 of 20 Prevention (CDC) estimates that the annual incidence of Lyme disease in the United States exceeds 329,000 [3]. It is well-documented that many patients present with manifestations of late disease prior to receiving antibiotic therapy and investigators in the field have long known that the illness can be chronic [1,4–6]. While a history of a known blacklegged tick bite or erythema migrans (EM) rash allows for a timely diagnosis, few patients were aware of a tick bite prior to infection [7,8] and the incidence of EM rashes varies by geographic location and Borrelial species such that some patients never develop an EM [1,8,9]. Thus, chronic manifestations of Lyme disease may result from diagnostic delays.


Chronic manifestations of Lyme disease may also result from failed antibiotic therapy as commonly prescribed regimens can be non-curative [4,10–15]. Researchers have documented that patients with acute and/or long-standing Lyme disease frequently remain ill for prolonged periods of time following treatment and that some experience disease progression despite treatment [4,15–18]. Chronic manifestations of Lyme disease are associated with significant and long-standing quality-of-life (QoL) impairments in some patients [16–20]. QoL scores of participants in the four National Institutes of Health (NIH)-sponsored Lyme disease retreatment trials were consistently worse than those of healthy populations [16–18].  


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