Recurrent Lyme Disease: Old or New Infection?

Lakshmi Ganapathi, MBBS; Neeraj Surana, MD, PhD

Disclosures

October 21, 2013

Immunity to B burgdorferi

The fact that the patients in the study described above were symptomatically reinfected with B burgdorferi suggests that their immune responses to the initial infection -- similar to that of the patient in the case vignette -- were inadequate to prevent reinfection. Animal experiments evaluating an outer-surface protein-based B burgdorferi vaccine have demonstrated the development of protective, type-specific immunity. Along these lines, patients who develop Lyme arthritis and therefore have longer to elaborate an immune response against B burgdorferi develop protective immunity that lasts for several years. Taken together, these data suggest that prompt antibiotic treatment of early forms of Lyme disease prevent later, persistent forms of disease; however, patients remain susceptible to reinfection because of insufficient time to generate a robust immune response.

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