In the tradition of knowing thy enemy, it makes sense to learn a bit about Lyme Disease history. The early period of the disease’s recognition, on through its naming 90 years later, is especially instructive — if only because it sets the stage for understanding the enormous amount of confusion LD has generated since.

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The official Lyme Disease history began in Europe in 1883.

In the Beginning

There’s no telling how long LD has plagued humans. Physicians have recognized some aspects of it as human afflictions for over a century; but it surely existed for quite some time before then — perhaps for hundreds or thousands of years. In any case, it was completely unknown to medical science before the mid 1880s.

That’s when European doctors began reporting a degenerative skin disease in which the dermis thinned and wrinkled up like cigarette paper. It went by a number of names, but German physician Arthur Buchwald’s term “acrodermatitis chronica atrophicans” (ACA), published in 1883, became the standard term.

In 1909, pioneering Swedish dermatologist Arvid Afzelius described an associated ring-shaped rash, in which a central clearing presented a bull’s-eye pattern. He named it “erythema migrans” (EM), and in 1921 speculated that an Ixodes tick caused the disease. He also reported on an associated arthritis.

Not only was Afzelius right on the money regarding the vector of the illness, he  identified the two symptoms that most modern doctors worldwide accept as the most diagnostic of all the symptoms associated with LD. (ACA tends to be a European expression of LD.)

Defining the Disease

For the next few decades, not much happened on the LD front. Physicians began to realize that EM and ACA were also associated with neurological and psychological issues, as well as lymphocytomas (benign skin lumps) and, as Afzelius had already pointed out, recurring arthritis in many cases.

Things came to a head in the mid-1970s, when a team led by Dr. Allen Steere of Yale University investigated an outbreak of juvenile arthritis at a Navy Medical Hospital near Lyme, Connecticut. At first, Steere and his team misdiagnosed the problem as juvenile rheumatoid arthritis.

But that made little sense, because arthritis per se is not transmissible, and this disease clearly was. Eventually, the Steere team isolated it as a distinct disease and named it after Lyme, defining the EM rash as a hard-and-fast diagnostic indicator. The EM became one of the few accepted diagnostic markers, in fact.

The Aftermath

It wasn’t long before the newly-christened disease became politicized. Some doctors denounced LD as a false disease, a position some continue to hold today. Even Steere, who defined LD, refuses to this day believe that a chronic version of the disease exists, dismissing it as a mostly minor immune disorder.

Meanwhile, other researchers have continued to expand our knowledge of LD. While everyone knew that tick bites were associated with the illness, it wasn’t until 1982 that Willy Burgdorfer identified the direct cause of LD, the spirochetal bacterium that now bears his name, Borrelia burgdorferi.

Other researchers tracked down the life cycle of the disease, eventually defining the three stages we know today, and pioneered the use of both oral and intravenous antibiotics to fight the symptoms.

Lyme’s Future History

This brings us up to the early 1980s, whereupon things start to get really complicated. Since we’re running out of space here, we’ll take a closer look at the turbulent decades since in other articles. You can rest assured that they make the first 90 years of Lyme Disease history look remarkably tame by comparison.

 

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