Dr. Montgomery McFate, Professor, U.S. Naval War College, published, “The Myths of Lyme Disease: Separating Fact from Fiction for Military Personnel,” in Joint Force Quarterly, 100, Feb. 16, 2021.
Dr. McFate addresses, in the well-cited article, many damaging myths regarding Lyme that have proliferated in the medical system since its discovery over 40 years ago. She describes how these myths harm military personnel, a population that is particularly at risk for exposure to Lyme disease. She presents several stories of military personnel harmed by Lyme and tick-borne diseases.
Military members are at higher risk of exposure to Lyme disease because service members, along with their families, live, work, and play on bases where Lyme is rampant. McFate writes, “Some 75 percent of all U.S. military installations are located in states where 99 percent of the approximately 500,000 tickborne disease cases reported to the Centers for Disease Control and Prevention (CDC) from 2004 to 2016 occurred.” Additionally, veterans often retire in rural counties where Lyme disease incident rates are higher due to ample forestation, damp conditions, and mid-range temperatures.
According to McFate, “In short, Lyme disease has already reached epidemic proportions in the United States, and the situation will certainly get worse. As the disease spreads, military personnel, veterans, and their families will be at even higher risk for contracting the disease.”
The author tackles the myth, “Lyme is not that severe,” and elaborates on the serious potential impacts that Borrelia burgdorferi can have such as penetrating the heart, crossing the blood-brain barrier, infecting the central nervous system, as well as the serious complications caused by transmission from pregnant mother to unborn baby. McFate also addresses the serious issue of increased risk of suicide amongst military members and veterans.
When it comes to “Lyme is easy to diagnose,” McFate emphasizes the lack of knowledge many VA doctors have regarding Lyme disease as well as inadequacies with the two-tier testing used by most doctors. She explains, “This two-tier diagnosis system was never intended to be used for the diagnosis of Lyme disease. Rather, it was developed by the CDC as a ‘surveillance case definition,’ which is ‘a set of uniform criteria used to define a disease for public health surveillance’.”
The common misconception, “Lyme is easy to treat” with the standard medical practice prescribing 28 days of antibiotics is also addressed. “Unfortunately,” McFate writes, “In more than 50 percent of cases, Lyme disease is not cured by a single round of antibiotic therapy.” She goes on to explain a common phenomenon that those with chronic Lyme disease know all too well, “Individuals may appear to respond well to the initial treatment with antibiotics and experience a relief of symptoms, but then relapse either months or years later.” It has been estimated that the number of people in the US suffering from PTLD exceeded 2 million at the end of 2020.
McFate calls attention to the work of the Tick-Borne Disease Working Group (TBDWG) and their 2018 report to Congress noting that, “progress has been hampered by a lack of attention at the Federal level and by divisions within the field.” She explains that, despite the widespread proportion of Lyme disease in the US, Federal funding for tick-borne diseases is considerably less per new case than for other diseases.
The author concludes that new basic research into Lyme and the repurposing of existing drugs such as disulfiram provide hope for patients. She emphasizes that, currently, there is no cure and no simple treatment for this serious and often debilitating disease. McFate writes, “Given the dire health consequences, the poor diagnostic tools, the effects of climate change in increasing tick habitats, and the endemic nature of the disease in geographical areas where the military lives, works, and plays, Lyme should be a serious concern for the entire joint force.”