Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group

Abstract
Objective: Chronic Lyme disease has been a poorly defined term and often dismissed as a fictitious entity. In this paper, the International Lyme and Associated Diseases Society (ILADS) provides its evidence-based definition of chronic Lyme disease. Definition: ILADS defines chronic Lyme disease (CLD) as a multisystem illness with a wide range of symptoms and/or signs that are either continuously or intermittently present for a minimum of six months. The illness is the result of an active and ongoing infection by any of several pathogenic members of the Borrelia burgdorferi sensu lato complex (Bbsl). The infection has variable latency periods and signs and symptoms may wax, wane and migrate. CLD has two subcategories, CLD, untreated (CLD-U) and CLD, previously treated (CLD-PT). The latter requires that CLD manifestations persist or recur following treatment and are present continuously or in a relapsing/remitting pattern for a duration of six months or more. Methods: Systematic review of over 250 peer reviewed papers in the international literature to characterize the clinical spectrum of CLD-U and CLD-PT. Conclusion: This evidence-based definition of chronic Lyme disease clarifies the term’s meaning and the literature review validates that chronic and ongoing Bbsl infections can result in chronic disease. Use of this CLD definition will promote a better understanding of the infection and facilitate future research of this infection.

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  1. Janice Holdershaw on said:

    What a relief that an ‘evidence based’ definition of Chronic Lyme disease has been declared. It boggles my mind that it is happening now, in 2020, after dozens, maybe hundreds, of peer reviewed scienctific works dating back to the early 1980’s have revealed persistence of Borrelia, even after aggressive treatment, in both human and mammalian populations. Agreed upon science regarding this disease, which has devastated, and continues to devastate hundreds of thousands of lives, is moving in the slowest motion possible.

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