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IJE Advance Access originally published online on November 30, 2005
International Journal of Epidemiology 2005 34(6):1437-1439; doi:10.1093/ije/dyi241
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.

Letters to the Editor

Response to meta-analysis of Lyme borreliosis symptoms

Eugene D Shapiro1,2,*, Raymond Dattwyler3, Robert B Nadelman4 and Gary P Wormser4

1 Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
2 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA
3 Department of Medicine, Division of Allergy, Immunology and Rheumatology, New York Medical College, Valhalla, NY, USA
4 Department of Medicine, Division of Infectious Diseases, New York Medical College, Valhalla, NY, USA

* Corresponding author. E-mail: eugene.shapiro@yale.edu

The first 10% of the full text of this article appears below.

Although some Lyme disease patients treated with recommended antibiotic regimens have symptoms post-treatment, the usual course is a slow resolution of these symptoms.1–3 Subjective symptoms, i.e. fatigue as well as musculoskeletal pain, and certain objective extracutaneous signs, i.e. motor paresis, cognitive difficulties, or joint swelling, tend to resolve over the course of weeks to months rather than days. However, whenever studied, the rate of resolution of symptoms or signs is unrelated to the duration of treatment.1,2

Cairns and Godwin4 in their meta-analysis of five selected United States studies5–9 on the outcome of Lyme borreliosis concluded that the prevalence of the symptoms of persistent fatigue, musculoskeletal pains or neurocognitive difficulties (post-Lyme disease syndrome, . . . [Full Text of this Article]


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