Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Rheuminations: How Tiny Ticks Have Fueled Outrage and Acrimony in Some Communities

Simon M. Helfgott, MD  |  Issue: August 2013  |  August 1, 2013

The Tick and The Iceman

Though the uproar over Lyme disease is a 20th century phenomenon, the origins of the illness go back many centuries. The Tyrolean Iceman, a 5,300-year-old Copper Age individual, whose remains were remarkably preserved, was discovered in 1991 on the Tisenjoch Pass in the Italian Alps.11 An analysis of his genome found genetic sequences that contained approximately 60% of the B. burgdorferi genome, making him the earliest confirmed case of Lyme disease. The Iceman was found buried in a snow bank, having met a violent death. An arrowhead was lodged within the soft tissue of his left shoulder, causing substantial damage to the left subclavian artery. Bull’s eye!


Dr. Helfgott is physician editor of The Rheumatologist and associate professor of medicine in the division of rheumatology, immunology, and allergy at Harvard Medical School in Boston.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

References

  1. Daley B. Drawing the lines in the Lyme disease battle. Boston Globe. Published June 1, 2013. Available at www.bostonglobe.com/metro/2013/06/01/lyme-disease-rise-and-controversy-over-how-sick-makes-patients/OT4rCTy9qRYh25GsTocBhL/story.html. Accessed July 12, 2013.
  2. Steere AC, Malawista SE, Snydman DR, et al. Lyme arthritis. An epidemic of oligoarticular arthritis in children and adults in three Connecticut communities. Arthritis Rheum. 1977;20:7-17.
  3. Afzelius A. Erythema chronicum migrans. Acta Derm Venereol. 1921;2:120-125.
  4. Strandberg I. Regarding an unusual form of migratory erytbema caused by tick bites. Acta Dermatovenereol. 1920;1:422-427.
  5. Burgdorfer W. Discovery of the Lyme disease spirochete and its relation to tick vectors. Yale J Biol Med. 1984;57:515-520.
  6. Drouin EE, Seward RJ, Strle K, et al. A novel human autoantigen, endothelial cell growth factor, is a target of T and B Cell responses in patients with Lyme disease. Arthritis Rheum. 2013;65:186-196.
  7. Feder HM, Johnson BJB, O’Connell S, et al. A critical appraisal of “chronic Lyme disease.” N Engl J Med. 2007;357:1422-1430.
  8. International Lyme and Associated Diseases Society. International Lyme and associated disease treatment guidelines. Available at www.ilads.org/lyme_disease/treatment_guidelines_summary.html. Accessed July 12, 2013.
  9. Connecticut Office of the Attorney General. Attorney General’s investigation reveals flawed Lyme disease guideline process, IDSA agrees to reassess guidelines, install independent arbiter [Press Release]. Published May 1, 2008. Available at www.ct.gov/ag/cwp/view.asp?a=2795&q=414284. Accessed July 12, 2013.
  10. Lantos, PM, Charini WA, Medoff G, et al. Final report of the Lyme disease review panel of the Infectious Diseases Society of America. Clin Infect Dis. 2010;51:1-5.
  11. Keller A, Graefen A, Ball M, et al. New insights into the Tyrolean Iceman’s origin and phenotype as inferred by whole-genome sequencing. Nat Commun. 2012;3:698.

Page: 1 2 3 4 5 | Single Page
Share: 

Filed under:OpinionRheuminationsSpeak Out Rheum Tagged with:Borrelia burgdorferiCDCCenters for Disease Control and PreventionDiagnosisInfectious Diseases Society of AmericaLyme DiseaserheumatologistTick-Borne DiseaseTick-Borne Illnessticks

Related Articles
    The Patient's Choice

    When Rheumatologists Are a Patient’s Second or Third Choice for Medical Opinion

    September 7, 2016

    Outside Exam Room No. 5, the chart rack was empty, so I assumed my new consult was late. Just in case, I looked back over my shoulder as I passed by the partially open door and glimpsed the lower half of a woman holding a three-ringed binder on her lap. I squinted and took a…

    Lyme Arthritis Treatment Protocols Critical as Lyme Disease Spreads

    August 15, 2018

    As Lyme disease and Lyme arthritis spread to new regions in North America, physicians may ned to become aware of their signs and symptoms. Allen C. Steere, MD, says “Lyme arthritis is more complicated to treat than other manifestations of the disease.” Here are some best practices for treating Lyme arthritis…

    David M. Phillips / Science Source

    Lyme Arthritis: Presentation, Diagnosis & Treatment

    July 18, 2019

    A 52-year-old man living in greater Boston with a history of hyper­tension presented at our rheumatology clinic with bilateral knee pain and swelling. He had been in his usual state of health until four months earlier when he developed right knee pain and swelling without an incipient trauma, which did not improve with non-steroidal anti-inflammatory…

    Updated Clinical Practice Guidelines for Lyme Disease, Lyme Arthritis

    February 16, 2021

    A team of healthcare practitioners and researchers, spearheaded by the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the ACR, has developed updated evidence-based clinical practice guidelines for the prevention, diagnosis and treatment of Lyme disease. The 2020 guidelines cover a wide variety of Lyme disease manifestations, including Lyme arthritis. Linda…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences