It will be interesting to see who responds to this Johnson/Stricker study from the likes of the IDSA. My guess would be a Wormser/Lantos tag team, and maybe Shapiro, and possibly Marques because it uses CLD and PTLDS interchangeably. I will be surprised if someone doesn't respond because, well, it seems pretty obvious there is no great love for ILADS. And they likely will feel compelled to because it's a study, and they will likely think they need to do damage control. Besides, it's almost become a knee jerk reaction from IDSA types - to me, it appears they think they are falling behind on the LYME PR front.
I suspect they will attack at the definitional level. Perhaps they will claim that using any non-CDC compliant subjects is indicative of the poor research standards embraced by this team, and that it is reflective of unreliable data generated by the study. The abstract alone might lead one to conclude these were all patients clinically diagnosed without any diagnostic lab support, and that is the usual myth folks like these deploy to demean papers and positions supported by ILADS - but that conclusion would be wrong. The paper here makes it clear diagnostic labs were used in a majority of patients in this relatively large survey.
I HOPE they attack the use of the label "chronic Lyme Disease", and I'd be surprised if they don't. Wormser, in particular, has been outspoken about even its existence. But if they do attack the interchangeable use of CLD and PTLD, they leave themselves open to rebuke, because the NIH does it in one of its longest standing Lyme studies ever.
Anyway, expect some kind of response. This is an important paper. It speaks to the fact the Lyme patients post-standard-treatment, still suffer from debilitating symptoms. That more or less runs counter to how the Old Guard typically like to portray PTLDS sufferers. They usually tend to downplay severity. Seems like just last month they published two papers suggesting Lyme patients post treatment with fibro symptoms and those with claims of fatigue didn't really seem all that bad off (at least that's how I interpreted those efforts.)
And yes, the Bourbon virus. Found in Kansas, NOT in the East. It's deadly, too. Makes you wonder how many more pathogens can be packed into those tiny little bugs.
You cannot create sketchy vaccines for all those pathogens. And no amount of tick repellant is going to eliminate the risk. Somewhere down the line authorities will have to get serious about intervening directly at the tick level.