Known Answers

The following are not uncertainties and the short answer to these questions is presented below.

Would homoeopathy be able to cure Lyme disease?

No. Trials in a number of conditions have shown that homoeopathy works no better than a placebo.

A Shang, K Huwiler-Muntener, L Nartey, P Juni, S Dorig, J A Sterne et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy, Lancet 2005, vol 366, pp 726-732

Does EM provide an ‘accurate’ clinical diagnosis of LD?

Yes it does.

Stanek G, Fingerle V, Hunfeld K, Jaulhac B, Kaiser R, Krause A, et al. Lyme borreliosis: clinical case definitions for diagnosis and management in Europe. Clinical Microbiology and Infection. 2011 Jan;17(1):69–79.

Is EM a more or less ‘accurate’ sign of LD in children?

Yes. Reference as above

How is EM defined?

See Stanek et al 2011 as above for description of European manifestations.

Should tests to exclude LD be carried out in patients who have a tick bite but don’t get EM?

In symptomatic patients, yes. EM is not always present

Stanek et al 2011

Tuerlinckx D, Glupczynski Y. Lyme neuroborreliosis in children. Expert review of anti-infective therapy. 2010 Apr;8(4):455–63.

Are there tests for other genospecies of Borreliae?

Yes; blood tests used in Europe include antigens from more than one species of Borrelia burgdorferi sl. However see other uncertainties regarding the genospecies in the UK.

Is there a test which can differentiate persistent active infection versus autoimmune response?

Yes, strictly speaking culture is a test which could be used. However it is not in routine diagnostic use. See related uncertainties on active infection.