The Scientist: The Search for Persisters

It starts with a tick bite. This may be followed by the characteristic bullseye rash. And then the other symptoms of Lyme disease appear. Fever, fatigue, body aches, and headaches can all set in.

For most patients diagnosed with Lyme disease, the symptoms fade as the infection is cleared following a course of antibiotics. But for a small subset of the population, these symptoms can continue for months or years—even when diagnostic test results suggest the bacteria that causes Lyme disease,Borrelia burgdorferi, have been wiped out. Patients who present with what epidemiologist Eugene Shapiro of Yale Medical School calls “medically unexplained symptoms” are often left to seek alternative (and sometimes dangerous) treatments with limited success.

The medical community is split on post-treatment Lyme disease and a related condition, commonly called chronic Lyme disease, largely because their associated symptoms cannot be explained by B. burgdorferi-specific antibodies or cultivable bacteria. “With a urinary tract infection or something that’s persistent, you can reculture the bacteria and prove that they’re still there,” said Monica Embers, a microbiologist at Tulane University in New Orleans. “With Borrelia,” she added, “you can’t find them and prove that they’re still there.”

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