posted
I am just curious as to what indicates that a lyme case is chronic? Does this mean that treatment has been ineffective or that a person has been infected for a significant amount of time?
And, what is the difference between Chronic and Acute lyme disease?
Thanks
Posts: 55 | From Kingwood, TX | Registered: May 2011
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TF
Frequent Contributor (5K+ posts)
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posted
Dr. Burrascano's definition of "chronic" means that you have had lyme disease for at least 1 year. (Oversimplified)
"Acute" is not a word we generally use, but it means you just contracted lyme (like, in the last week or so).
Here is a relevant quote from pages 3-4 of the Burrascano Lyme Treatment Guidelines:
"GENERAL PRINCIPLES
In general, you can think of LB as having three categories: acute, early disseminated, and chronic. The sooner treatment is begun after the start of the infection, the higher the success rate. However, since it is easiest to cure early disease, this category of LB must be taken VERY seriously. Undertreated infections will inevitably resurface, usually as chronic Lyme, with its tremendous problems of morbidity and difficulty with diagnosis and treatment and high cost in every sense of the word. So, while the bulk of this document focuses of the more problematic chronic patient, strong emphasis is also placed on earlier stages of this illnes where closest attention and care must be made.
A very important issue is the definition of �Chronic Lyme Disease�. Based on my clinical data and the latest published information, I offer the following definition. To be said to have chronic LB, these three criteria must be present:
1. Illness present for at least one year (this is approximately when immune breakdown attains clinically significant levels).
2. Have persistent major neurologic involvement (such as encephalitis/encephalopathy, meningitis, etc.) or active arthritic manifestations (active synovitis).
3. Still have active infection with B. burgdorferi (Bb), regardless of prior antibiotic therapy (if any).
Chronic Lyme is an altogether different illness than earlier stages, mainly because of the inhibitory effect on the immune system (Bb has been demonstrated in vitro to both inhibit and kill B- and T-cells, and will decrease the count of the CD-57 subset of the natural killer cells). As a result, not only is the infection with Bb perpetuated and allowed to advance, but the entire issue of co-infections arises. Ticks may contain and transmit to the host a multitude of potential pathogens. The clinical presentation of Lyme therefore reflects which pathogens are present and in what proportion. Apparently, in early infections, before extensive damage to the immune system has occurred, if the germ load of the co-infectors is low, and the Lyme is treated, many of the other ticktransmitted microbes can be contained and eliminated by the immune system. However, in the chronic patient, because of the inhibited defenses, the individual components of the co-infection are now active enough so that they too add to features of the illness and must be treated. In addition, many latent infections which may have pre-dated the tick bite, for example herpes viruses, can reactivate, thus adding to the illness."
Also, I suggest you read "Treatment Categories" starting on page 19 for more of an explanation of the categories.
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