An unfavourable trend

We regularly discuss new scientific research about Lyme disease, but what is the state of Lyme research in general? When you search the PubMed database (which records most of the biomedical research done in recent decades), the search results also display a chart with the number of publications per year. This gives you an impression of how the interests of researchers in a subject have changed over the years. Such a chart usually shows a clear upward trend and for popular subjects the trend even increases exponentially. This makes sense of course: Scientific research is based on previous publications and proper research often raises new questions. That is how knowledge about a specific subject gradually, and sometimes even explosively, expands. Once in a while, the chart shows you that there was a ‘hype’: after a very rapid rise, the interest quickly collapses.

One glance at the chart is enough to realize that something strange is going on with Lyme research. The first publication was in 1977 (Allen Steere’s study about a ‘cluster of arthritis cases’). About five years later, following the discovery of the Borrelia burgdorferi pathogen, the number of publications rapidly increased. The number peaked in 1993 and subsequently was stable or decreased slightly, somewhat depending on the search term used. This is very unusual for biomedical research, especially for a rapidly growing problem that still raises a lot of questions! To give you an indication of how strange this is, I have made a comparison with trends for a number of other biomedical topics, either Lyme-related or not. Most other tick bite diseases, other infectious and non-infectious diseases show a very different picture!

trend2Apparently, Lyme disease hardly experiences any actively growing knowledge. I fear that the reality might be even worse than what the chart indicates. Because what the numbers do not show is that more and more old research is rehashed by a select group of authors in yet another “new” publication and other new publications amount to little more than a read-through and error analysis of a few PubMed abstracts (a phenomenon referred to in terms such as publication bias, amplification and invention). This results in the fabrication of more and more pseudoscience and less and less useful research. This problem occurs in all branches of science, but has taken on extreme forms with respect to Lyme.

What is also interesting, is the peak in 1993: it is the year of the build-up to the Dearborn conference, for which all kinds of agreements were made and patents were registered in connection with the development of a Lyme vaccine by the US CDC/NIH and IDSA, expecting to divide huge profits. This meant that Lyme research was monopolized by a small group of American clinicians and since then, the IDSA and CDC have kept up strict supervision, even far beyond US borders. People who do not strictly adhere to the IDSA Lyme doctrine, do not receive research money or publishing is made impossible for them. It is therefore not surprising that the number of useful Lyme publications decreases instead of increases.   It is not easy to uncover the spending for Lyme research over the years, but even in this area, the trend seems to be falling rather than rising (especially if you deduct the commercially driven Lyme vaccine research).

Anyone who has followed Lyme for some time, knows that in many areas, such as diagnostics and treatment, precious little has changed in the past 20 years. The problems with diagnostics and serological testing in particular, persistence of Borrelia after antibiotic treatment, transmission from mother to unborn child: in the second half of the 80s, this was all known and openly talked about, until 1993. The IDSA has managed to replace the scientific knowledge of that time with their own fairy tales where this suited them better. Fairy tales that are now being distributed everywhere in the medical sector, to the public and to future physicians. Unfortunately, it is difficult to perform scientific research based on fairy tales. If you are wondering why more Lyme cases keep emerging and why there are virtually no improvements for Lyme patients, then these charts show you an important part of the answer.

Explanation of charts

Each vertical bar represents one year and the height indicates the number of publications for that year. The various charts are not to scale vertically and sometimes neither horizontally if it is a relatively recent topic. We are dealing with trends (for absolute numbers of publications check PubMed). The last bar in the chart represents 2015 (partial year) and is therefore relatively small. If you do not know the meaning of a particular term, please look it up in PubMed or English Wikipedia.

1st row: publications about Lyme and related matters
2nd row: other diseases (the first four have similar symptoms to Lyme)
3rd row: other diseases/pathogens where ticks play an important role
4th row: other spirochete diseases and viruses that involve little or no transmission via ticks
5th row: various biomedical techniques and concepts

Published: June 15, 2015

Aangepast: 8 december 2015