{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T01:49:54Z","timestamp":1778636994245,"version":"3.51.4"},"reference-count":61,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T00:00:00Z","timestamp":1481760000000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>Some Australians have become convinced of the existence of locally acquired Lyme disease (<jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>). The history of<jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>, since its recognition in the early 1970s, is reviewed as a model for investigative approaches to unknown syndromes. Australian Management Guidelines for<jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>include the requirement for diagnostic testing by National Association of Testing Authorities\u2010accredited laboratories using Therapeutic Goods Administration\u2010licensed tests, which result in the efficient diagnosis of<jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>in overseas travellers. Despite this, patients who have not left Australia pay many thousands of dollars for non\u2010specialist consultations and testing at overseas laboratories. Unproven long\u2010term therapy with multiple antibiotics has resulted in serious complications, including allergies, line sepsis, pancreatitis and pseudomembranous colitis. Studies have shown that<jats:styled-content style=\"fixed-case\">LD<\/jats:styled-content>vectors are not found in Australia, and Lyme Borrelia has not been found in Australian vectors, animals or patients with autochthonous illnesses. I propose that (i) A non\u2010controversial name for the chronic syndrome should be adopted, \u2018Australian Multisystem Disorder\u2019. (ii) Research funding should enable the development of a consensus case definition and studies of the epidemiology of this syndrome with laboratory investigations to identify an aetiology and surrogate markers of disease. Prospective, randomised treatment studies could then be undertaken using ethical protocols.<\/jats:p>","DOI":"10.1111\/imj.13278","type":"journal-article","created":{"date-parts":[[2016,12,17]],"date-time":"2016-12-17T11:50:15Z","timestamp":1481975415000},"page":"1370-1375","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Lyme disease: why the controversy?"],"prefix":"10.1111","volume":"46","author":[{"given":"M. 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