Status of Lyme Disease by Sam T. Donta, MD

Frontiers In Public Health has just published a mini review article authored by Sam T. Donta, MD, “What We Know and Don’t Know About Lyme Disease.” In this article Donta discusses the challenges faced in regard to Lyme disease over the past 40 years. He presents approaches to the diagnosis and treatment of persisting Lyme disease based on the best available science and his own experience as a practicing Lyme Literate Medical Doctor (LLMD). 

Donta highlights several key questions that remain greater than 40 years since this disease was discovered in the US:  

• How do we know if the infection has been eradicated?
• Can it become dormant, then reactivate?
• In patients with persistent symptoms, are these due to continuing infection or to non-infectious sequelae?
• Are there treatments that can resolve the infection?

Donta further discusses the evidence for persistent bacteria in a host and the challenges of detection from body fluids or tissues. 

“These results, plus observations by us and others that retreatment of patients with recurring or persisting symptoms following initial antibiotic treatment using specific antibiotic regimens, lend strong support to the hypothesis that it is persistent infection by B. burgdorferi that is the likely cause of persisting symptomatology. In contrast, attribution of post-infectious symptoms to some post-infectious phenomena has only been speculative without any supporting evidence.”

Donta presents diagnostic issues, serologic issues, treatment issues; and proposes future direction for the study of Lyme disease. “There are additional questions that a better understanding of the pathophysiology of Lyme disease might lead to better approaches to the diagnosis and treatment of Lyme disease, especially in its persistent form. These include the possible role of antibiotic-tolerant persisters.”

Read the full test article here

Read other LDA articles regarding Lyme disease here

NOTE: Click here for information on Dr. Donta, who served as a 2019 LDA-Columbia conference facilitator