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Comment & Response
August 28, 2013

Autism and Lyme Disease—Reply

Author Affiliations
  • 1Department of Medicine, Columbia University Medical Center, New York, New York
  • 2Department of Pediatrics, Weill Cornell Medical College, New York, New York
JAMA. 2013;310(8):857. doi:10.1001/jama.2013.194768

In Reply We evaluated the hypothesis that the rate of Lyme disease or associated seroprevalence is increased in children with autism as has been put forward by Dr Bransfield and others.1,2 A key assertion previously made in their Medical Hypotheses articles is that a substantial number of children with autism have active Lyme disease, with associated symptoms presumably resolving through antibiotic treatment.1,2 However, Bransfield and Kuhn now instead suggest that Lyme disease triggered autism in the affected children’s distant past (ie, B burgdorferi infection was no longer present), citing that as a reason why seropositivity could not be detected in any of the autistic children that we studied. Such a claim is contradictory to their previous argument for the association of autism with ongoing and antibiotic-responsive B burgdorferi infection.