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December 8, 1993

The Overdiagnosis of Lyme Disease

JAMA. 1993;270(22):2683. doi:10.1001/jama.1993.03510220038019

To the Editor.  —We were saddened and disturbed by the article by Steere et al.1There exists in the scientific literature ample evidence of persistent chronic infection despite recommended treatment, documentation of seronegativity as a real phenomenon in Lyme disease, sufficient information regarding the mechanisms of evasion of the organism by antibiotics and the immune system, and evidence for the unreliability of diagnostic tests. This type of study fosters complacency, a hesitancy on the part of physicians to diagnosis and treat, and a decline in the numbers of reported cases with the potential for a reduction in funds for Lyme disease research.We would like you to understand what it is like living in a highly endemic area where Lyme disease affects families, friends, and acquaintances by the score. We are not getting well, and our families and friends are not getting well. There are now many thousands of