Lyme's fake disease: no, Justin, a tick is not to blame for your dizziness

Singer Justin Bieber is topical for his return to the music scene and for other news much less happy: A few days ago he announced on his Instagram account that he has been suffering from Lyme disease for at least two years. This infection is contracted by tick bites and is quite common. In fact, many celebrities have said they have suffered, such as singer Avril Lavigne, Australian tennis player Samantha Stosur, model Bella Hadid or actor Alec Baldwin. However, under the magnifying glass of the specialists, some of these cases could actually hide very different problems.

For the scientific community, the symptoms and treatment of Lyme disease are well defined: It is an infection caused by bacteria of the genus Borrelia that transmit ticks, causes from fatigue to neurological problems and is treated effectively with antibiotics in just a few days.

However, there are doctors and supporters of alternative medicine who they speak of a "chronic Lyme disease" in which they include a lot of nonspecific problems and that does not seem to have a cure even though they provide their patients with the same antibiotics for long periods of time.

Lyme disease was described in the homonymous town of Connecticut (United States) in the 1970s. In Spain, José Antonio Oteo Revuelta, the head of the Department of Infectious Diseases of the Biomedical Research Center of La Rioja (CIBIR), is well aware of this pathology. "Ticks harbor bacteria in your gut and salivary glands and when they suck the blood they transmit them to the individual they have stung, "he explains in statements to Teknautas.

Different phases

"When the tick bites you and the bacteria inoculate you, a skin condition known as migratory erythema is seen on the skin”, A red spot that grows and forms the pattern of a ring, with the most colored edges and center. If caught in this phase, Lyme disease causes body aches, headache, fever and tiredness, but it can be treated effectively with an orally administered drug called doxycycline. "You will be cured within 10 to 14 days," says the expert.

However, if the bite goes unnoticed or the skin condition is confused with something else and is not treated correctly, the patient may develop different problems after a few weeks or a few months. "The bacterium passes from the skin to the blood and can spread through the nervous system or through the musculoskeletal system; It even reaches the heart. This results in other clinical manifestations. In Spain and in Europe the most frequent are neurological problems, "he says. In children, facial paralysis. In adults, meningoradiculitis, which is characterized by pain and tingling in the extremities, headaches, fever and facial paralysis.

In these later phases, the diagnosis must be supported in the possibility that the tick bite has occurred, but also microbiological confirmation tests are needed. "They test the blood, cerebrospinal fluid or inflamed joint fluid and analyze if the bacteria is present or if there are specific antibodies generated by our body against it," says Oteo.

Depending on the organ affected and the severity, doxycycline will be sufficient or more complex treatments, such as ceftriaxone, that are injected intravenously will have to be used. In this phase, treatments could last between 14 and 21 days, but they are equally effective. The complicated comes later.

Post-lyme syndrome

Only a few patients who have had Lyme disease continue to show fatigue for a long time or develop small sleep disorders, which has been described as post-Lyme syndrome. This phenomenon, which in principle should not be more important, has led to some doctors talking about the possibility of chronic Lyme disease. However, "this is not accepted by the majority of the scientific community," says Oteo.

Therefore, "the big problem with Lyme disease is that patients who do not have it are diagnosed ", says the CIBIR specialist.

We do not recognize the existence of chronic Lyme disease because no one has proven it

All the scientific reference organisms in this subject are against the existence of a chronic Lyme disease, of several years duration as the one confessed by the singer Justin Bieber and other celebrities. The Centers for Disease Control and Prevention (CDC) of the United States, the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) strongly rejects this possibility.

"We do not recognize the existence of chronic Lyme disease because no one has proven it. There are many patients who are tired, who have arthritis and joint pain or concentration problems and, without having a history of tick bite or having developed the typical symptoms, do microbiological tests that are not standardized or approved or recommended for the diagnosis of Lyme disease. Then they tell them that they have this pathology in a chronic way, they propose treatments for months with antibiotics and they are not cured, "Oteo reports.

The key to the problem is in the type of tests used for this diagnosis. Official tests for this disease give them a negative result, so they turn to others. "They are tests that detect an immune response against many microorganisms, are very sensitive but not specific, can detect anything, so they should not be used to diagnose this condition," he says.

In fact, the SEIMC has recently published a decalogue of recommendations on the diagnosis and treatment of this problem in which it denounces the appearance on the market of these microbiological tests that are not adequate. The tests for the diagnosis of Lyme disease are sensitive and specific and therefore have the support of the scientific community. On the contrary, "we do not understand why diagnoses are being made based on techniques not recommended or approved by any serious or official scientific society."

The prolonged use of antibiotics

Once that diagnosis has occurred, "chronic" patients receive the drugs indicated for Lyme disease. It is true that in some cases they improve because doxycycline, in addition to having an antimicrobial effect, blocks inflammation mechanisms, but with this treatment "they are not killing bacteria or curing an infectious disease ".

Generally, discomfort and problems continue. "We have a big problem," says the specialist, "because they are receiving a misdiagnosis and take antibiotics for months or years ". In this sense, there are clinical trials that show that using antibiotics for a long time to treat these patients can cause them more problems. "Antibiotics are not harmless. They alter intestinal microorganisms causing diarrhea, trigger serious allergies and skin problems," says Oteo. To this we must add the widespread problem of antibiotic resistance due to its abusive use.

In summary, "the diagnosis of chronic Lyme disease is incorrect, nobody has shown that it exists," says Oteo, "if we talk about Lyme disease there must be a history or possibility of tick bites and well-defined clinical manifestations, everything others are other things that are not related to the Borrelia bacteria. "

Spaniards who consider themselves "chronic"

The president of the Association of Chronic Lyme of Spain (ALCE), Vicenta Delgado, does not think the same. In his case, he worked in a botanical garden and suffered numerous insect bites, including ticks. "Without having been sick before, I started having dizziness, dizziness, digestive problems and even tendonitis in the elbow. You go from one specialist to another aimlessly and you get desperate, they don't find you anything and start blaming him for psychological problems, "he explains. They also told him it could be fibromyalgia.

After five years without response, He ended up sending the blood to a German laboratory and thus obtained the diagnosis of chronic Lyme disease. "In Spain, the public health system believes that chronic Lyme does not exist, but many studies come to us that show it," he says, "but they don't want to read or listen."

Lyme disease is quite common in northern Spain, where the Ixodes ricinus tick is most present, the species that in our environment transmits the Borrelia burgdorferi bacteria. "It is not a rare disease, there are areas in Europe and in the United States where it is very frequent, they are usually mountain places with loose cattle," says Oteo. The highest incidence occurs in spring, summer and early fall.

José Antonio Oteo recognizes that there are many homeless patients, for example, who suffer from fibromyalgia and chronic fatigue syndrome. "These diseases are recognized, but their origin remains unknown, so sometimes these alternative tests are done and tested positive for chronic Lyme," he says.

Without stringency

In his opinion, "it's terrible" because they end up in the hands of "people who are dedicated to alternative medicine and are not experts in this field. There are doctors and people who come from the scientific world, but who do not have sufficient rigor or use the scientific method well, medicine has to be based on evidence. "

Therefore, the American researcher David Gorski, known for being the editor-in-chief of the Science-Based Medicine website and for his criticisms of alternative medicine, considers it more appropriate to speak of "false diagnoses" than of "false disease", since patients In addition to homelessness, they may feel attacked. Their suffering is real, experts say, but no one has diagnosed them correctly.

In the case of Justin Bieber, he himself described his Lyme as "incurable" and claims to have it for two years. "I don't know what the clinical manifestations are and based on what criteria Justin has been diagnosed," says the CIBIR expert, "it could be a late manifestation of Lyme disease if it did not receive proper treatment. Skin lesions. and neurological manifestations may persist over time, but it is not usual, "he says. In other words, as much as Bieber and dozens of celebrities claim to have been tortured for Lyme disease for years, it is not really Lyme, nor is it chronic.