Diagnostic uncertainty, diffuse symptoms and a failure to notice tick bites (especially when bitten by larvae or nymphs) complicate ID of early disease. Early disease can be effectively treated with short course doxycycline but late stage is more difficult. A licensed vaccine was pulled due to low uptake in part because there was a suggestion that some HLA subtypes developed RA. Gaps exist in Lyme epidemiology necessary for comparisons of symptoms and outcomes by genotype.
Idea No. 7