Quaternary lyme disease: Symptomatology, epidemiology and anthropology of an emerging disease

In a press release dated August 19, 2013, the United States Centers for Disease Control and Prevention (CDC) changed its annual estimate of Lyme disease cases from approximately 30,000 to 300,000. This number is 10 times the previous projections, making Lyme disease the most widely reported vector-borne disease in the United States. The CDC estimates that between 10 and 20 percent of Lyme disease patients go on to develop a cadre of post-treatment Lyme disease symptoms that typically resolve within six months of treatment. The agency considers these symptoms to be unrelated to an active Lyme disease infection. A growing number of individuals report that this post-treatment Lyme disease syndrome extends beyond the interval suggested by CDC. This study evaluates 220 adult male and female individuals who report experiencing post-treatment Lyme disease syndrome symptomatology beyond the CDC suggested six-month interval. Based on the symptomatological, epidemiological, social and behavioral characteristics of this study group, this study proposes a new category of Lyme disease called quaternary Lyme disease that includes the symptomatology of post-treatment patients and is inclusive of individuals who experience these symptoms beyond the typical six-month timeframe. The study also proposes a rudimentary algorithm to assist clinicians in determining if patients risk profiles suggests quaternary Lyme disease. The purpose of this is to help identify patients who may need additional palliative care. It is also intended to aid in the identification of individuals who are potential research participants in order for biomedical science to perform more in depth research into the etiology behind persistent symptoms associated with post-treatment Lyme disease.