For decades, ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) has been linked to a number of viral infections, particularly Epstein Barr virus (EBV) and human herpesvirus (HHV). However, bacterial infections may be another possible source of infection in ME/CFS.
Lyme disease is a bacterial infection spread to humans by infected ticks. It is also known as Lyme borreliosis. Ticks are tiny, spider-like creatures found in forests and marshes that feed on the blood of birds and mammals. They can transfer to humans during feeding and introduce bacteria into the bloodstream.
The great imitator
Lyme disease is often described as “the great imitator” – a name given to syphilis (another spiral-shaped/spirochete) in the 19th century, but is now also applied to Lyme disease because it can cause a wide range of medically unexplained symptoms that mimic other diseases, such as fever, joint pain, arthritis-like symptoms, heart palpitations, sleep disturbances, or neurological symptoms such as muscle twitching.
Most importantly for ME/CFS, Lyme disease can cause severe fatigue and pain, meaning that undiagnosed Lyme infection can easily fall under the ME/CFS diagnosis.
Borrelia Burgdorferi and Borrelia Miyamotoi
In the UK and Northern Europe, most cases of Lyme disease are caused by spirochaetes (spiral-shaped bacteria) belonging to the Borrelia burgdorferi genotype.
According to Prof. De Meirleir, many of his patients tested positive for B. miyamotoi, another genotype that is more common in the United States and originates in Japan. De Meirleir’s controversial claim is that many ME/CFS patients test positive for B. miyamotoi, in contrast to a healthy control group.
The exact details of these data remain unclear, as they have not been fully published, and this result has not been replicated in other studies investigating Lyme disease in ME/CFS patients.
De Meirleir also reported finding elevated levels of toxins called lipopolysaccharides, produced by Lyme bacteria, in ME/CFS patients. He went on to say that Lyme bacteria can also enter the digestive system and disrupt the mucosal lining, leading to increased allergies, inflammatory bowel problems and disruption of the gut microbiome, known as gut dysbiosis.
Ongoing controversy
While many ME/CFS patients may be aware of the controversies surrounding ME/CFS science, chronic Lyme disease is another area of medicine where there is no clear consensus. Medical experts in the United Kingdom argue that most cases of so-called chronic or persistent Lyme disease are not Lyme disease, but rather patients with chronic fatigue syndrome. However, some commentators argue that this view is completely inaccurate and that undiagnosed, persistent, chronic Lyme disease is much more common than official surveillance statistics suggest.
There are few or no NHS centres in the UK that specialise in diagnosing or treating Lyme disease, and many patients end up paying for private treatment in the UK or abroad, with some even travelling to the US or Germany for treatment.
Researchers continue to debate whether ME/CFS is caused by a specific pathogen or even a combination of infections that overwhelm the immune system and overload the body’s control mechanisms. If we accept that viruses can trigger ME/CFS, perhaps we should also remain open to the idea that hidden bacterial infections may play a role in a subgroup of sufferers.
Doctors should remain alert to the possibility that some ME/CFS patients may have undiagnosed Lyme disease or other bacterial infections that could be causing their symptoms.
(C) Lyme Borreliosis Foundation
