Academic Writing

Fearing Death: A Philosophical Absurdity

Fear of death in survival terms may seem natural as it helps ensure the preservation of a species. But many fear the pain or associative separation from loved ones they correlate to death, or harbor concerns of what awaits them in an afterlife, easily becoming overwhelmed while still among the living.  However, with the evolution of civilizations and social organizations, such fears began to be seen as erroneous. Indeed, many philosophers throughout the ages had very peaceful, even welcoming thoughts and views concerning their physical departure from earth. Socrates, Buddha and Epicurus are all classical seekers of wisdom who saw death as nothing to be afraid of. Specifically, each saw death as being a natural process which could not do lasting harm.

Socrates, first under consideration, told his disciples on the day he was to be put to death that, like himself, “those who truly grasp philosophy pursue the study of nothing else but dying and being dead” and so asked, “why, having had the desire of death all his life long, should he repine at the arrival of that which he has been always pursuing and desiring? (Dillon)” Delving into his philosophical methodology behind these assertions, we learn in Plato’s Phaedo that Socrates believed that death is nothing “but the separation of soul and body.” So then, death is nothing more than the severance of body and soul and, it should be noted, this is a good thing (Plato). For, “when the soul exists in herself, and is parted from the body” the soul is free from the human form, which Socrates calls an “inaccurate witness” and a hindrance in attaining pure knowledge. Socrates even went so far as to explain that thought, once “gathered into itself” after death, is “best” or more pure (Dillon).” This was not universally accepted by his students, however.

Cebes tells Socrates, his teacher, that “the wisest of men should be willing to leave this service in which they are ruled by the gods who are the best of rulers is not reasonable” and that only a person who is foolish should “rejoice at passing out of life (Plato).” Yet in typical Socratic fashion, Socrates rebuttals his student in Phaedo, telling him that just like the other students, Socrates , too, believes “that the gods are our guardians, and that we are a possession of theirs”(Plato). Using this common belief, Socrates makes the case that dying is not meant to be distressful. He explains that all men are summoned to it by divinity, as it was summoning to Socrates then.  Still, Cebes is unsatisfied and makes another argument; this time regarding Socrates’ view of the afterlife.

Asserting that “much persuasion and many arguments are required in order to prove that when the man is dead the soul yet exists, and has any force of intelligence” Cebes is quickly subdued by his teacher.  Socrates states that “[t]he ancient doctrine of which I have been speaking” and teaching to his students reveals that after death, souls “return hither, and are born from the dead” in accordance with  what Buddha would later call Karma, but at this time was simply called by Socrates the “merits of its former life” (Plato). The point of this reincarnation was for each soul to “gradually purify… itself” so that it can eventually evolve “into pure essence” and no longer be weighed down by earthly bonds or “corporality” (Plato).

Socrates continues to refute Cebes’ claim, saying that “…if…the living come from the dead, then our souls must be in the other world, for if not, how could they be born again? (Plato).” Socrates continues his discourse in Phaedo by instructing that all things are generated out of their opposites and since “[d]eath is opposed to life” all things are, necessarily, “generated from the dead”(Plato). So convinced does Cebes become of Socrates’ words that he even reminds his teacher of his own prior assertion that “knowledge is simply recollection”  which “necessarily implies a previous time in which we learned” (Plato).”  In this way, Cebes nullifies his own final argument against his teacher. Despite the geographical and generational differences, several of the most basic views of death and afterlife are strikingly similar between Socrates and Gautama Buddha.

Based on the idea that “suffering is the condition of all existence” Gautama Buddha believed reincarnation occurred based on one’s personal growth as well. More specifically, he held that the more enlightened one became during each life the fewer cycles one was forced to live in the wheel of suffering of death and rebirth. Additionally, the sooner one became enlightened, the sooner that person would achieve Nirvana, consisting partly of “freedom from future rebirth, old age, and death” (Lester, 908).  To Buddha, the greatest bane to the soul was a “world without end,” which is what awaited those who remained ignorant of the four Noble Truths and the Eight-fold Path.  According to Buddha, these people were “bound by craving, running through the round of birth and death” (Woodward, 182). For the wise man, though, who has achieved “perfect insight” Buddha believed “[s]even times at most that man shall wander round, [t]hen make an end of ill, all bonds destroyed” and achieve Nirvana (Woodward, 184).

Any person can shorten their wheel of suffering according to Buddha, provided s/he “make[s] thyself an island of defense” and “attacks his faults [o]ne after the other…[i]n order due, and rubs them all away…” so that instead of being reincarnated again, “the Saints  shall greet thee entering the Happy Land” (Woodward, 190).  In other words, to Buddha, the cycle of living and dying are little more than a necessary evil for one to achieve the wisdom and knowledge required to achieve eternal rest and perfect peace out of this world (by becoming an Aviha—one born in heaven after death and lives there). Yet it is this very premise which receives strong argumentation from skeptics and non-believers.

The “ultimate destination” that Buddha preaches as eternal reward and freedom “is described only by negatives; it is neither this nor that” and critic Rudolph Steiner further notes that:

[a] careful examination of the teachings of the Buddha will not reveal any real information about the nature of the spiritual world. In fact, the spiritual world is characterized negatively in the teaching of Nirvana, and yet it is true that Buddha demanded of one who sought entry into the spiritual world that one should free oneself from all attachments to the physical world. But in the whole of Buddha’s teachings we do not find any detailed description of the world of the spirit… (Steiner, 10).

Even so, the definition of Nirvana as being “blissful, but not in any sense of worldly pleasure or, for that matter, any pleasure defined by other than the absence of suffering” does seem to address the critic’s contention (Lester, 908). To elaborate, we know that possessiveness, greed, self-centeredness, and egocentrism are some of the causations for the unavoidable suffering in life. For one to be free of suffering, Nirvana must then be free of any items, behaviors or thoughts that can create any worldly distress. While this is vague, it does explain why Douglas Soccio says that “Nirvanna must be experienced; it cannot be described or understood (43).”

Furthermore, since Buddha lived his life with only a beggar’s bowl to his name, materialism can be seen as a central issue of the human condition that pervades our suffering. Bearing this in mind, concrete effects prevalent in the Judeo-Christian’s notion of Heaven, such as pearly gates, God’s throne, trumpet-playing angels, et cetera, would only spoil the bliss that is Nirvana; it would not be the imperceptible state that it is if it was subject to the more  material-based afterlife of other religions. Thus, it seems that Steiner’s assertion has to be quashed as it is trying to compare, for lack of a more enlightened term, apples to oranges. For, while many religions seek an afterlife that is relatable to the human existence on earth, with the addition of a god and removal of evil, Buddhism seeks a release from the human experience entirely.  In that way, the teachings of Buddha and Epicurus can each agree on a statement from the latter’s Letter to Menoeceus: that “understanding that death is nothing to us makes the morality of life enjoyable…by taking away the yearning after immorality” (Epicurus).

Epicurus wrote that the reason why one should not fear death is because “for the body, when it has been resolved into its elements, has no feeling, and that which has no feeling is nothing to us” (Epicurus).  As such, he strongly refuted the (still) popular notion of death being evil.  He said that such a notion would “imply awareness, and death is the privation of all awareness” (Epicurus).  Thus, death can be neither good nor evil since that which is neutral and cannot be perceived is simply of “nothing to us” (Epicurus).  He even went so far as to say in his Letter to Menoeceus that those who fear death are foolish, explaining that a person “who says that he fears death” fears it “not because it will pain when it comes, but because it pains in the prospect.” He explained that since death causes no disturbance to us “when it comes,” fearing it while living is pointless and degrades one’s quality of life. In Epicurus’ own words, “[w]hatever causes no annoyance when it is present [death], causes only a groundless pain in the expectation.”

Fear of death residing in the realm of the fool, it should be obvious that Epicurus, too, believed the wise should harbor no such fret.  Indeed he wrote that “[t]he wise person does not deprecate life nor does he fear the cessation of life” (Epicurus). Instead, he encouraged his followers, in archetypal Epicurean fashion, “to enjoy the time which is most pleasant and not merely that which is longest” (Epicurus). But, alas, what of those that refute this notion with the query of while death may not be anything to the person, what awaits the soul?

Epicurus eloquently addressed this issue and explained his own belief quite succinctly; he pointed out that “the belief that heavenly bodies are divine” and “the fear of eternal punishment or of annihilation after death” are two of humankind’s greatest concerns. He combats these false worries by explaining that “[p]eace of mind is freedom from these fears” (Oates, 14-18). Ignoring the summoning Gods of Socrates and Buddha’s theory of moral causation (Karma), Epicurus put forth an entirely different notion. He believed that it is not in the nature of an immortal being to judge the mortal, citing as evidence that “trouble and care and anger and kindness are not consistent with a life of blessedness[read: God], but these things come to pass where there is weakness and fear and dependence upon neighbors[that is, human nature]” (Oates, 13). In other words, man views the “heavenly bodies” as being “blessed and immortal, and yet have wills and actions and motives inconsistent with” being either sanctified or ever-lasting (Oates, 14).

Epicurus’ final rebuttal against erroneous fears concerning life after death comes with his dismissal of the typical notion of heaven as an immaterial world where life goes on. Instead, he wrote that “it is impossible to conceive the incorporeal as a separate existence, except the void…” (Epicurus). He furthers this argument by stating that this void “can neither act nor be acted upon” and even rebukes “those who say that the soul is incorporeal” (Oates, 11).  Epicurus instead believed that he saw the soul as being a “body of fine particles” which gives the body its senses while alive. Upon death, however, the “soul is dispersed and no longer has the same powers…”  and so does not “possess sensation either” (Oates, 10). This is important to note as, according to Epicurus, this means that the soul is not able to be rewarded or punished on merits of the body it enlivened. Thus, one might say that just as death is “nothing” to the body Epicurus believed that an afterlife is “nothing” to the soul.

After studying the philosophers of note and finding a universal acceptance of death supported by fearless ideas of what comes after it, it seems apt to call fear of death a primitive evolutionary adaptation rooted in the “fight or flight” mechanism of our species. Even though avoidance of untimely death is permissible at times the body is threatened, harboring a cogent fear of it in the day to day cannot be warranted by any of the great classical thinkers. For, in every presented instance one can see how, through education, contemplation, observation, and reason, each philosopher taught the importance of limiting the effect this primal response has on modern, civilized cultures and its inhabitants. And by doing this¸ our species will not only survive in one’s environment, but thrive every day of our lives.

 

 

The Silent Epidemic

Such archaic afflictions as yellow fever, small pox, typhoid and polio were epidemics that have largely been erased from the minds of most citizens. These diseases were recognized and analyzed widely by the medical community and eventually treatments and cures were found for them.  Preventative measures like vaccines have also been created and have all but eradicated many olden time diseases. However, there is a disease that has been silently spreading across the United States over the last 100 years, afflicting more and more people, yet is not receiving the same recognition from individuals or the medical community as other infectious diseases.  Lyme Disease is not only failing to be recognized as an epidemic but is failing to be recognized as a disease at all by many medical professionals.  This is in spite of the fact that the number of sufferers in the U.S. alone exceeds 3 million. (“Lyme Disease”) Lyme disease is more prevalent than AIDS, West Nile Virus and Avian Flu—three contemporary diseases with high profiles—put together. Lyme disease is also harder to diagnose, can have more debilitating symptoms, and has means of transmission that are more difficult to protect against, making it a widespread yet little known epidemic.

Lyme disease is the most common vector borne disease in the United States (“Surveillance for Lyme Disease”).  It is a multi-system inflammatory disease caused by the spirochete Borrelia burgdorferi (“Lyme Disease”).  This spirochete, or pathogenic parasite, was named after Willy Burgdorfer, the first man to isolate and link it to Lyme disease in 1982 (“Borrelia Burgdorferi and Lyme Disease”). The Borrelia burgdorferi or Bb bacterium is maintained in the bodies of infected animals whose blood is then ingested by ticks and spread to an unwitting host—humans included—while the tick feeds.  While all species of tick ingests the spirochetes of an infected animal’s blood, only a few of species in America have the ability to transmit the spirochetes to another host.  In particular, the Centers for Disease Control states that:

In the [N]ortheastern and [N]orthcentral United States, the black-legged tick (or deer tick, Ixodes scapularis) transmits Lyme disease. In the Pacific coastal United States, the disease is spread by the Western black-legged tick (Ixodes pacificus). Other tick species found in the United States have not been shown to transmit Borrelia burgdorferi. (“Lyme Disease Transmission”)

However, Doctor Lloyd Miller from the Carnegie Mellon School of Computer Science reports that there is another vector species capable of Lyme disease transmission aside from what the CDC reports.  Miller says: “Ixodes dammini (the deer tick) in the Northeast and Midwest, Ixodes scapularis (the black-legged tick) in the South, Ixodes pacificus (the western black-legged tick) in the West and Amblyomma americanum (the lone star tick) found in several regions” can all transmit the Borrelia burgdorferi spirochete to human hosts (“Lyme Disease – General Information and FAQ”).  It is the feeding cycles of these ticks that put animals and humans at risk of contracting Lyme disease.

Specifically, all ticks require a blood meal to move from one active life stage to the next.  If either of the required feedings to move from larva to nymph, or nymph to adult brings a tick into contact with an animal host infected with Lyme disease the tick will then become infected. Those species that “retain infection through the molting process” then transmit the bacterium to their second host (“Lyme Disease”, “Featured Creatures”).  These hosts can then infect future feeding ticks; if infected in their first (larval) feeding said species of ticks transmit the disease to yet another host in their second (nymphal) feeding. The transmission of Bb from the gut of a tick into the bloodstream of an animal or human does not happen instantly, though.

Instead, the American Lyme Disease Foundation states, “Studies have shown that an infected tick normally cannot begin transmitting the spirochete until it has been attached to its host for about 36-48 hours” (“American Lyme Disease Foundation”) Lyme.org reports that while this is a good estimate, “a systematically infected tick or improper tick removal may cause transmission of LD much sooner” (“Lyme Disease”). The New York City Department of Health and Mental Hygiene reports, “Transmission from infected ticks does not occur until a tick has been attached and feeding for at least 24-36 hours” though, so clearly there is no hard and fast rule governing the rate at which the infection is spread to a host (“How is Lyme Disease Spread?”).

Regardless of the exact number of hours required, the affects on the body once the Bb spirochetes have entered the body are serious. The spirochetes are spirally shaped, enabling them to “drill through body tissue” (“Under Our Skin”).  Lyme.org sums up the early spirochetal invasion well when it declares scientific findings that:

the bacterium is able to move around the body through the bloodstream and between tissue. It can also invade tissue, replicate, and leave the cell—destroying the cell as it emerges. Sometimes, as the bacterium emerges, the cell wall collapses around the bacterium, forming a “cloaking device”. This action may aid the bacteria’s ability to hide from the immune system response. (“Lyme Disease”)

Once inside the body, “[t]he Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms” (“International Lyme Disease and Associated Diseases Society”).

Lyme Disease classification is most easily divided into “Early Local” and “Disseminated” stages (“Lyme Disease”). The Early Local stage’s most decisive characteristic is the emergence of “an expanding rash called erythema migrans, or em…” (“American Lyme Disease Foundation”). Most often an EM holds the appearance of a bulls eye and always occurs at the bite location in the Early Local stage; it appears anywhere from a day to a month or more after infection and typically goes away on its own within a month (“Lyme Disease”, “Borrelia Burgdorferi and Lyme Disease”). While this is the most notable and least ambiguous symptom of Localized Lyme disease, an em rash is not something that every newly infected Lyme patient exhibits.  An article published by the American Medical Association says that the em rash may be absent in over 50% of Lyme disease cases and the Lyme literate Dr. Bach reported to The Canadian Lyme Disease Foundation that as few as 30% of his Lyme patients displayed the “bull’s-eye rash” (“The Journal of the American Medical Association”, “Canadian Lyme Disease Foundation”).  Other symptoms of Early Localized Lyme disease are hard to differentiate from other, less severe maladies.

Lyme.org reports that physical symptoms “often start with flu-like feelings of headache, stiff neck, fever, muscle aches, and fatigue” along with swollen lymph glands near the bite location (“Lyme Disease”). The American Lyme Disease Foundation  (ALDF) states: “[t]hese symptoms may be brief, only to recur as a broader spectrum of symptoms as the disease progresses” (“American Lyme Disease Foundation”).  If these early symptoms are ignored, then the disease progresses as the spirochetes continue to spread and infect more and more of the body.  When other organ systems become infected the disease has progressed into its much harder to treat Disseminated stage.

Specifically, the ALDF says that “[t]he more severe, potentially debilitating symptoms of later-stage LD may occur weeks, months, or, in a few cases, years after a tick bite” (“American Lyme Disease Foundation”). The symptoms of Disseminated Lyme Disease are diverse, relentless, and are often mistaken for a plethora of other, more well-known diseases such as: Multiple Sclerosis, Parkinson’s’ disease, Hepatitis, Rheumatoid Arthritis, Chronic Fatigue Syndrome, Crohn’s disease, Lupus, Lou Gherig’s disease, and Méniér’s disease (“Basics 2007”).  Consequently, the array of symptoms that the Bb bacterium produces in humans has made Lyme disease known as the “great imitator” (“Basic Information About Lyme Disease”,Lyme Disease”).  Severe fatigue, acute muscle aches and pains, as well as debilitating fevers and headaches are general symptoms that mark Disseminated Lyme disease. Neurologically speaking, nerve conduction defects can begin, and poor reflexes, peripheral neuropathy, cranial nerve abnormalities (including a change in sense of smell/taste), difficulty speaking, chewing and/or swallowing as well as Bell’s palsy can all occur as well.  Additionally, the brain and nervous system can be prone to light/sound sensitivity, and the Lyme suffer may experience stroke, seizures, sleep disorders, cognitive changes, memory loss, difficulty concentrating and even display behavioral changes (“Lyme Disease”).  Specifically within the psychological realm, Disseminated Lyme disease can produce “panic attacks; disorientation; hallucinations; extreme agitation; impulsive violence; manic, or obsessive behavior; paranoia; schizophrenic-like states; dementia; and eating disorders” (“Lyme Disease”).  The Bb spirochetes can also affect vision adversely; eyeball deviation, red eyes, floaters, double vision, retinal damage, optic atrophy and even blindness can all plague the sufferer.  A Lyme disease victim may also have a re-emergence of an em rash; now though the rash often appears in places aside from the location the bite occurred.  Many of the body’s main organs are adversely affected in the Disseminated stage of Lyme disease too, especially if no treatment is being administered.

Expressly, once Lyme progresses to its Disseminated or Late stage the heart and circulatory system experiences tribulations that range from shortness of breath, difficulty breathing and irregular heart beat to heart block, myocarditis, vasculitis, and pneumonia (“Lyme Disease”). Furthermore, liver function is impaired and spleen enlargement and tenderness often occurs; stomach pain and diarrhea are also common among Lyme sufferers. Joint and muscle pain is typical for many as is inflamed muscles, muscle cramps and loss of muscle tone (“Lyme Disease”).  Because of these broad and varied symptoms—of which the list above provides only a general overview of—and the medical community’s lack of adequate knowledge of Lyme disease, patients are often misdiagnosed.  Considering the disease’s scope of symptoms and severity, it should not be surprising that the International Lyme and Associated Diseases Society  (ILADS) states that “without proper treatment, chronic Lyme patients have a poorer quality of life than patients with diabetes or a heart condition” (“International Lyme and Associated Disease Society”).  How unfortunate it is, then, that it is exceedingly difficult for an infected patient to receive a proper diagnosis of Lyme disease; timely treatment is paramount yet diagnosis is oft delayed.

In addition to the fact that a low percentage of Lyme disease sufferers display the telltale “bulls eye rash,” it is also accepted that around 50% of Lyme infected individuals “don’t test positive for the disorder on standard diagnostic tests, which detect antibodies to the bacterium Borrelia burgdorferi…” and new research indicates this is because the “antibodies to the disease often completely bind to the antigens of B. burgdorferi and routine testing doesn’t detect them” (“Pinning Down the Lyme Disease Antibody”).  In addition to this finding by Patricia Coyle of the University of New York at Stony Brook, The Lyme Disease Foundation and the Lyme Alliance have posted an article entitled: Reasons for False Negative (Seronegative) Test Results in Lyme Disease where nine research-based explanations are given as to why the Bb antibodies may not be present or detectable in an infected person’s body. The causes range from laboratory error to a patient having so many spirochetes that there simply aren’t enough antibodies to be detected. This is why “some of the worst cases of Lyme disease test negative” (“Reasons for False Negatives”).  While the Centers for Disease Control recommends a tiered testing procedure, none of the three recommended tests (ELISA, IFA and Western Blot) are “useful in the diagnosis of early stages of Lyme disease since a primary serum immune response is just beginning” (“Lyme Disease Diagnosis”, “Borrelia Burgdorferi and Lyme Disease”).  Since early treatment is fundamentally necessary in minimizing Lyme disease’s affect the American Medical Association says, “tests should be used to support rather than supersede a physician’s judgment” and advises that “[t]he early use of antibiotics can prevent persistent, recurrent, and refractory Lyme disease (“The Journal of the American Medical Association”).  In treating Lyme disease, then, we come back to the old adage about an ounce of prevention; that is, it is better for a doctor to prescribe antibiotics if a person has symptoms after recently being at risk for contracting the disease than it is to “wait and see.”  Much of the population unwittingly puts themselves in jeopardy of picking up an infected tick and contracting the infection.

Truly, any place outdoors is a potential tick environment; Lyme.org states: “ticks can be anywhere—in the woods, by the seashore, or even in your backyard” (“Lyme Disease”).  Any place that birds, mice, chipmunks, shrews, or deer—common carriers of the spirochete—have reason to occupy there is the possibility of Bb infected ticks being present as well.  The University of Pennsylvania reported on a nearby woodland study led by one of its biologists and “[a]ccording to the study, white-footed mice account for about a quarter of infected ticks. Short-tailed shrews and masked shrews were responsible for a quarter each and chipmunks for as much as 13 percent” (“University of Pennsylvania Study Reveals Inconspicuous Hosts”).   A Yale Journal of Biology and Medicine articles reports “[d]eer are important hosts of adult ticks” and “deer and mice are reservoirs of the organism and thus are fundamental to the ecology of Lyme disease” (“Prevalence of the Lyme disease Spirochete”). Since the habitat of these host animals is often analogous to outdoor human habitat, by consequence so too is the habitat of the tick, regardless of life stage.

To illustrate, the American Lyme Disease Foundation states that:

larval and nymphal deer ticks often hide in shady, moist ground litter, but adults can often be found above the ground clinging to tall grass, brush, and shrubs. They also inhabit lawns and gardens, especially at the edges of woodlands and around old stonewalls where… the ticks’ preferred hosts thrive. (“American Lyme Disease Foundation”)

According to the Lyme Disease Research Database ticks can only move on their own in about a nine-foot circle; when they are ready to feed “they wait for a new host from the tips of grasses or shrubs and then transfer to people or animals that brush up against the vegetation. They do not fly or jump, and they are not found in trees” though they can be found on the trunks of trees (“Ticks Carrying Lyme Disease”).  The winged are carriers and distributors of the disease as well; birds’ role in the spread of Lyme disease should not be overlooked, either.

With this in mind, consider that  “[w]ild birds…carry emerging zoonotic pathogens…as a reservoir host or by dispersing infected arthropod vectors…” and “bird migration provides a mechanism for the establishment of new endemic foci of disease at great distances from where an infection was acquired” (“Birds, Migration and Emerging Zoonosis”). Dr. Kurt Reed and his colleagues report that “[t]he major role birds play in the geographic expansion of Lyme disease is as dispersers of B. burgdorferi-infected ticks” (“Birds, Migration and emerging Zoonosis”). Thus, while small mammals are frequent hosts for ticks and carriers of the disease, migratory birds can disperse infected ticks to broad ranges, exponentially increasing the number and prevalence of Lyme disease cases in geographic locations outside of initial “hot zones.” Increasing control of ground animal hosts is thus overlooking an important carrier of infected ticks. It is dully true that the difficulty in protecting against carriers of Lyme disease makes the best-laid plans go awry.

In spite of diligent precautions, it appears at least plausible that humans can contract Lyme disease without coming into direct contact with an infected tick.  As a result of inadequate research into alternative vectors for Lyme disease, it is not definitively known if Lyme disease can be spread by means aside from a direct tick bite.  However, a study carried out by R.B. Nadelman and his colleagues found that when “[d]ilutions of stock cultures of two strains of B. burgdorferi were inoculated into samples of citrated red cells (RBCs)” and refrigerated for 6 weeks it was “concluded that B. burgdorferi may survive storage under blood banking conditions and that transfusion-related Lyme disease is theoretically possible” (“Survival of Borrelia burgdorferi in Human Blood”).  This possibility has led to the American Red Cross implementing restrictions preventing a person afflicted with Chronic (Disseminated) Lyme Disease from being able to donate blood, but states that anyone “treated with antibiotics and completely recovered…can donate 12 months after the last dose of antibiotics was taken” (“Lyme & Babesiosis: Blood/Organ Donation”). The problem with this guideline is that ILADS states how “[c]urrently there is no reliable test to determine if someone…is cured of it [Lyme disease] (“International Lyme Disease and Associated Diseases Association”).  As a result, Lyme spirochetes could persist in the blood of a donor who has stopped treatment and shows no symptoms of Lyme; the Bb bacterium that remains living in stored blood could infect the recipient. As such, the USCF Blood Center is more stringent in its policies and lists Lyme disease as one of their “conditions [that] would permanently disqualify an individual as an allogenic or designated blood donor” (“Lyme & Babesiosis: Blood/Organ Donation”).  There are also some studies that have been conducted which yield findings to suggest the possibility of an infected person transmitting the disease to a partner via sexual contact, though findings are preliminary and unsubstantiated.

In particular, Dr. Gregory Bach, a contributor to The Canadian Lyme Disease Foundation, reported that “semen samples provided by male Lyme patients and the male sexual partner of a Lyme infected female patient were positive approximately 40% of the time” and that his “laboratory studies confirm the existence of Lyme spirochetes in semen/vaginal secretions” (“Recovery of Lyme Spirochetes”).  Similarly, Dr. Bach found among his patients that “sexually active couples seem to have a marked propensity for antibiotic failure raising the question of sexually active couples re-infecting themselves through intimate contact” (“Recovery of Lyme Spirochetes”). Other superficial support for this mode of transmission comes when one considers that both the Lyme disease spirochete and the spirochete that causes Syphilis are comparable.

Namely, John Scythes, director of Toronto’s Community Initiative for AIDS Research (CIFAR) says that syphilis is a “closely-related member” of the same “spirochete family” as Lyme’s Borrelia burgdorferi and that the Bb bacterium looks “like Syphilis under a microscope” (“Lyme Disease Discovery Raises New Concerns”, “Under Our Skin”).  However, according to an excerpt published by the National Center for Biotechnology Information (NCBI) Syphilis “is similar to B. burgdorferi in that it is a spirochete with a relatively small genome and requires a host to survive; however, at the genomic level, the two organisms are not very closely related to each other at all” (“What do Lyme disease and Syphilis Have in Common?”).  Thus, the question remains over whether coitus can spread the Lyme-causing bacterium.

In explicit opposition to the idea of Lyme Disease being sexually transmitted, The Centers for Disease Control’s Division of Vector-borne Infectious Diseases reports that person to person transmission is not possible, stating: “[t]here is no evidence that Lyme disease is transmitted from person-to-person. For example, a person cannot get infected from touching, kissing or having sex with a person who has Lyme disease” (“Lyme Disease Transmission”).  Additionally, and despite his findings, Dr. Bach concluded in his study of spirochetes in sex fluids that “[w]hether or not further clinical studies with a larger statistical group will support the hypothesis of sexual transmission remains to be seen (“Recovery of Lyme Spirochetes”).  A contributor to anapsid.org, Matthew Gross, explained that the spirochetes found in semen samples were not distinguished as being living or dead. He argues “as bacteria are killed by antibiotics or the immune system, the dead cells are broken up and filtered out through the kidneys and passed in urine through the urethra, the same path used by semen” (“Is It Sexually Transmitted?”).  While the questions over Lyme disease being sexually transmitted continues, in vitro infection is one mode of transmission that is well documented and not questioned.

Specifically, the Centers for Disease Control’s Division of Vector-borne Infectious Diseases says, “Lyme disease acquired during pregnancy may lead to infection of the placenta and possible stillbirth…” (“Lyme Disease Transmission”). The documentary “Under Our Skin” recounted a woman who served as a case study for this fact; she had experienced miscarriages and stillbirths four separate times before finally giving birth to a surviving son who tested positive for Lyme disease (“Under Our Skin”).  In vitro infection is a mode of transmission that has been thoroughly documented and recognized by the small medical sub-community that accepts Lyme as a serious disease when compared to the ignorance that surrounds sexual transmission.  Lyme.org corroborates in vitro infection as a means of infection, first saying, “Congenital LD has been described in medical literature” and then explaining that the Borrelia burgdorferi bacterium can “pass from mother to fetus across the placenta, resulting in congenitally acquired LD” (“Lyme Disease”).  Even though it is clear that fetal infection in vitro is possible in an untreated mother, it is still unclear whether an infected mother can pass on the disease to her child in any other way.

While the CDC and Lyme Disease Foundation are in agreement that there is not a documented case of Lyme disease being transmitted through human milk, Dr. Bach has recovered spirochetal DNA from umbilical cord as well as breast milk samples (“Recovery of Lyme Disease Spirochetes”).  Similarly, Lyme.org reports “[a]nimal studies have demonstrated that ingestion of Bb can result in infection” so clearly more research needs to be done into this possible means of transmission (“Lyme Disease”).   Since the exact modes of transmission for Lyme disease’s Borrelia burgdorferi bacterium is not universally known or understood, it should come as no surprise that it is difficult for the general public to defend themselves from the disease by all means possible.  Because Lyme disease may be transmitted via unknown means to humans and from human to human, the problem of Lyme disease cases being under-reported is magnified exponentially.

There are several reasons why Lyme disease is so vastly under-reported in America and it is the under-reporting that makes this serious and prevalent disease a silent epidemic.  In the first place, the testing and diagnosis for a “reportable case” of Lyme disease is fundamentally flawed.  The CDC requires “a physician-diagnosed erythema migrans 5cm in diameter or (2) at least one objective late manifestation (i.e., musculoskeletal, cardiovascular, or neurological) with laboratory evidence of infection with B. burgdorferi in a person with possible exposure to infected ticks” for a “reportable case” of Lyme disease (“The Journal of the American Medical Association”).  The problem in these overly-rigid guidelines lies in the aforementioned facts that less than fifty percent of people infected with Lyme Borrelia display an erythema migrans and this same figure is true for people that receive a “false negative” when tested for Lyme disease. The problem is so acute that while the CDC documents an average of 27,000 new “reportable cases” each year, “because of inaccurate tests and under-reporting the actual numbers may be up to 12 times higher, according to the CDC” themselves (“Lyme Disease Epidemic Causing Healthcare Crisis”).  Lyme.org and Lyme disease documentary creator Andy Abrahams Wilson both use a “conservative estimate that only one in 10 cases of Lyme disease is actually reported to the CDC” (“Lyme Disease”, “Under Our Skin”). This means that in actuality there are at least 270,000 new cases each year!  The Centers for Disease Control has recorded 343,505 cases of Lyme disease from 1980 to the present; yet using conservative and agreed upon estimates for unreported cases, that means that there have been at least 3.44 million cases of Lyme disease in the last 3 decades (“Lyme Disease”).

Put into perspective, the hysteria surrounding West Nile Virus is based on just over 1,000 cases being reported annually; this number is based on a high degree of false-positive tests as well, according to the CDC (“False Positive Results”).  The Center’s Division of Vector-borne Infectious Disease also goes on to say this for 2008 cases of West Nile Virus: “[o]f the 1338 cases, 674 (50%) were reported as West Nile meningitis or encephalitis (neuroinvasive disease), 624 (47%) were reported as West Nile fever (milder disease), and 40 (3%) were clinically unspecified at this time” (“Statistics, Surveillance and Control”).  A further comparison can be made with the number of AIDS-infected persons in America that stands at under a half million. The CDC and avert.org both report that 468,578 people in America have AIDS (“Aids in America”).   Thus, while such diseases receive high profiles and medical attention for their incidents of infection, Lyme disease—that has significantly higher rates of infection and greater ignorance surrounding it—remains a lesser-known and even slighted disease.

In closing, with the severe and potentially life-threatening symptoms that come from a poorly known disease spread by an arthropod the size of a poppy seed it should be clear that the amount of medical research and insight into this disease is disproportionately low when compared to other infectious diseases.  By sheer numbers of new cases the medical community is doing a disservice to its citizens by letting this epidemic expand unchecked, and the number of sufferers increase without adequate knowledge, diagnosis, or treatment for the disease.  Lyme disease is many times more rampant than other diseases that have been labeled “epidemics” by the medical community—yet Lyme disease is still cloaked in a cloud of ignorance and obscurity, assuring that things will only get worse before they get better.  How dark must things get for those suffering with Lyme disease before the first glimmers of dawn emerge on the edge of the horizon and those affected by this disease can bask in the light of knowledge and understanding?   How long before the millions of Lyme sufferers can revel in the warmth of adequate testing, diagnostic, and treatment practices that enable them to live a more fulfilling life?  Epidemics do not go away from being ignored, and the first step towards adequate realization over the severity of Lyme disease is admitting it has reached an epidemic proportion and is a serious health crisis.  Dr. Richard Horowitz called the Lyme epidemic a “process of ecological change capable of invading people’s bodies”; with the current and popular initiative to restore a healthy ecosystem, Lyme disease should be a prime motivator for change for those in the environmental fields (“Under Our Skin”).  And because of the agony it causes its sufferers and the millions of dollars it costs to treat each year, Lyme disease should be an affliction kept in the front of the minds of those in health fields instead of a silent epidemic that is pushed into the recesses and forgotten.

Works Cited

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