Brellier, Florence, Pujades-Rodriguez, Mar, Powell, Emma et al. · PloS one · 2022 · DOI
This study tracked over 2,100 people in the UK who were diagnosed with Lyme disease and compared them to similar people without Lyme disease. Researchers found that people with Lyme disease were much more likely to develop fatigue symptoms afterward, and some developed ME/CFS. Interestingly, the risk was highest when Lyme disease occurred in autumn or winter, though fatigue risks remained elevated even months after the initial infection.
This study provides evidence that Lyme disease may be a trigger or risk factor for ME/CFS development in some patients, supporting long-standing clinical observations. For ME/CFS patients with Lyme disease history, it validates concerns about post-infection fatigue and justifies ongoing symptom monitoring. The findings encourage healthcare providers to recognize and appropriately manage fatigue emerging months or years after Lyme diagnosis.
This study shows correlation between Lyme disease and subsequent fatigue/ME/CFS but cannot definitively prove causation—unmeasured factors could explain both. The study captures only patients consulting their doctor for fatigue, likely underestimating true incidence. It does not identify the biological mechanisms linking Lyme disease to ME/CFS or predict which Lyme patients will develop ME/CFS.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Brellier, Florence, Pujades-Rodriguez, Mar, Powell, Emma, Mudie, Kathleen, Mattos Lacerda, Eliana, Nacul, Luis, et al. (2022). Incidence of Lyme disease in the United Kingdom and association with fatigue: A population-based, historical cohort study.. PloS one. https://doi.org/10.1371/journal.pone.0265765
BibTeX
@article{mecfsatlas-brellier-2022-incidence-lyme,
author = {Brellier, Florence and Pujades-Rodriguez, Mar and Powell, Emma and Mudie, Kathleen and Mattos Lacerda, Eliana and Nacul, Luis and Wing, Kevin},
title = {Incidence of Lyme disease in the United Kingdom and association with fatigue: A population-based, historical cohort study.},
journal = {PloS one},
year = {2022},
doi = {10.1371/journal.pone.0265765},
note = {PubMed: 35320297},
url = {https://www.mecfsatlas.com/evidence/brellier-2022-incidence-lyme},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/brellier-2022-incidence-lyme
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