Steere, A C · Proceedings of the National Academy of Sciences of the United States of America · 1994 · DOI
Lyme disease is an infection spread by tick bites that can affect multiple body systems and mimic other illnesses. This review explains that Lyme disease has been spreading across North America, Europe, and Asia, and notes an important problem: conditions like chronic fatigue syndrome and fibromyalgia are sometimes incorrectly diagnosed as 'chronic Lyme disease,' partly because diagnostic tests for Lyme disease are unreliable.
This study is important for ME/CFS patients and researchers because it documents the frequent misdiagnosis of ME/CFS as 'chronic Lyme disease,' highlighting diagnostic confusion that can delay appropriate care and treatment. Understanding the distinction between actual Lyme disease and conditions like ME/CFS is critical for accurate diagnosis and ensuring patients receive targeted management.
This review does not prove a causal relationship between Lyme disease and ME/CFS, nor does it establish that ME/CFS and Lyme disease are the same condition. It also does not provide definitive guidance on which diagnostic tests reliably distinguish Lyme disease from ME/CFS, fibromyalgia, or other overlapping conditions. The article does not offer data on the actual prevalence of misdiagnosis or the clinical outcomes of patients incorrectly labeled with 'chronic Lyme disease.'
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
Steere, A C (1994). Lyme disease: a growing threat to urban populations.. Proceedings of the National Academy of Sciences of the United States of America. https://doi.org/10.1073/pnas.91.7.2378
BibTeX
@article{mecfsatlas-steere-1994-lyme-disease,
author = {Steere, A C},
title = {Lyme disease: a growing threat to urban populations.},
journal = {Proceedings of the National Academy of Sciences of the United States of America},
year = {1994},
doi = {10.1073/pnas.91.7.2378},
note = {PubMed: 8146126},
url = {https://www.mecfsatlas.com/evidence/steere-1994-lyme-disease},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/steere-1994-lyme-disease
Contribute
Private, reviewed by a human. Not a public comment thread.