Introducing docs.microsoft.com - <AUTHOR> https://docs.microsoft.com/teamblog/introducing-docs-microsoft-com/ <comment><USER5> From TFA:

"Shortened Article Length

Another common piece of feedback was that our content at times can be overwhelming because of its length and that long articles are more difficult to navigate and find what you're looking for. To address this, we've broken down many longer articles into smaller logical steps and provided Previous and Next buttons at the bottom of articles to navigate between steps in a multi- part tutorial as shown below."

Sounds like a race to the bottom. I very much prefer long single-page articles.

<comment><USER6> [Disclosure: I work for the team that built docs.microsoft.com]

Thanks for the feedback, and we went through a lot of customer feedback already on this. I'll try to be brief in a response

\- A good example on why - For our documentation we clearly saw customers jumping around content trying to find the part of the article that helps them. Depending on the article (see point #2) very few people read from beginning to end. A good example here is that instead of having separate articles on how to setup iOS, Android and Windows phone devices with Intune, the previous articles had that as part of a much later article. If an admin who's company has standardized on Android, they want just the Android content, they don't want to have to sift through iOS/Windows troubleshooting to get to the Android setup content. For SEO, it's also much more likely that they'll find the solution by Googling (with or without Bing) to something like "Setup Intune Android" and go directly to the page that takes care of just that task. For developers, we face the same problem where some articles include multiple langauges and code samples are duplicated. Instead of doing that, we would break the article into pieces by language.

\- Another key reason is not all content is built the same. We'd get feedback that many of our competitors have a much simpler "Getting Started" tutorial, while ours would be much longer and we'd get feedback that it seems more complex or overwhelming. When you are just starting off, "Hello World" is a lot better than War & Peace. It's about thinking about the right level of content for the task our customers are going through. In some cases, it's fine to have one long article.

\- We will also provide the option for customers to have all content together versus having content broken into separate pieces and made available for offline. Customers want both.

\- The reason we called this out is that the previous architecture _doesn 't not even have this as a capability_.

I hope this helps give some context on the decision and thanks for the feedback.

<comment><USER7> One thing I beg of you:

Don't break links to old versions of documents!

(I realise this requires building a redirect forest. But we're talking 20 years of MS documentation.)

<comment><USER8> [Also MS employee that works on the docs.microsoft.com team]

No, we will not break links. We are doing graceful redirects from MSDN/TechNet to the new site.

<comment><USER9> Thanks for that. I have come to expect all MSDN links to rot almost immediately, and it'll be nice to see that stop happening.

</comment></comment></comment></comment></comment><comment><USER10> Oh no. It pops up a quick menu when I select text, like Medium. The problem is that I'm constantly selecting the lines I'm reading. :(

Edit: Also, it's extremely narrow. On my 32" 4K display, 70% of the screen is empty. And the font is too think. And stuff keeps moving/jumping when I'm moving the mouse cursor.

I want 1998 back.

<comment><USER11> > The problem is that I'm constantly selecting the lines I'm reading

I'm glad to hear I'm not the only one! I compulsively select random blocks of text: select up, select down, repeat. I definitely get annoyed with the popup- menu-on-select feature of Medium, but I feel I can hardly blame Medium for my random, compulsive habit.

<comment><USER12> I share this "pain".

I have the unshakable habit of triple-clicking a paragraph to highlight it to serve as a mark of where I was at when i need to interrupt reading.

<comment><USER13> I also have the same ehabit. I a glad I am not the only one.

<comment><USER14> Me too, anyone know why this is a thing? Such a common twitch... does it help reading?

<comment><USER15> I do not have any data on it (1) but I think it's like moving a bookmark across the page as you are reading: it makes it easier to jump from the end of one line to the start of the next one.

(1) not even on the claim that that bookmark has that effect.

<comment><USER16> It's called meta-guiding

</comment></comment></comment></comment></comment></comment></comment><comment><USER17> I think the main issue with documentation for Microsoft products/APIs is that the content is spread out on a large number of different Microsoft domains which makes it inherently difficult to find something. I have also often found (after using google to find the relevant article) that the content is either out of date or not relevant anymore.

Adding yet another site to the list of sites which might or might not have up- to-date content is not going to fix that issue. What they need is a central, properly searchable and well-maintained repository that spans all of their products.

<comment><USER18> Depending on what you're looking for, there's usually only two you need: MSDN[0] and TechNet[1].

[0] [https://msdn.microsoft.com/library](https://msdn.microsoft.com/library) [1] [https://technet.microsoft.com/library/default.aspx](https://technet.microsoft.com/library/default.aspx)

<comment><USER19> You confirm the problem in your response:

"usually"

"only two"

That means that Google.com is still needed as the front-end to MS documentation. Ergo, it doesn't matter how many domains they use to host their documentation.

<comment><USER20> Not to mention search on MS sites essentially doesn't work (unless something has changed).

</comment></comment></comment></comment><comment><USER21> I thought biggest improvement to the MS website, MSDN and technet included, would be simply to disable the incessant demands for feedback on the webpage or surveys.

Would you like to take a short 25 minute survey? You visited this site 25,000 times previously and we have asked each of those times, but maybe this time you will change your mind and answer the survey.

<comment><USER8> [Disclosure: working on the team that built docs.microsoft.com]

We are fixing that. Thank you for the feedback!

<comment><USER22> Thank you, I sent this same feedback because on some configurations it would use almost 20% of the screen.

The login proxy (where it checks if you are a user or not and if you should login to track you) really sucked too, I would just use the docs in private browsing mode and it would be 10x faster.

Thanks for your hard work, the new docs look excellent.

</comment></comment></comment><comment><USER23> At $DAY_JOB we have various document (or rather, knowledge) repositories -- a mostly-abandoned-but-still-useful-often-enough-to-not-ignore wiki, the obligatory but overwhelming salesforce, personal (silo) collections of email lists/archives, a semi-public knowledge base, a half-hearted attempt at moving internal mail lists into yammer, various product guides (PDF's), a public- access user forum, an LMS, and probably a few others I don't know about. It is precisely as easy to search for information as you'd assume.

Last year we embraced Sharepoint - with expectations of replacing much of the above. (It didn't.)

Evidently no one uses Sharepoint as a way of presenting documentation to the world - let alone using the wiki-like features - not even Microsoft. What's the opposite of NIH syndrome?

<comment><USER24> Situation: There are 14 competing information stores.

14?! Ridiculous! We need to develop one universal store that covers everyone's use cases.

Situation: There are 15 competing information stores.

<comment><USER25> Solution: Move things over from one into the blessed solution, and then kill the other one. Repeat as necessary. Accept that nothing will cover 100%

Sometimes you have to push to fix the process

<comment><USER26> You always have to push to make changes like this. You have to allocate ressources to migrate, and while it may save money in the long run, not all management people understand or want to pay for it.

</comment></comment></comment></comment><comment><USER27> Ugh. I'm all for modernizing msdn, but those mouse-over comment bubbles cause a the text underneath to shift - that's just really, really annoying. Mousing over the text causes everything to jump around.

Also, the marked-text context menu: that only works within a single paragraph. Cross over to the next and it's not showing any more.

<comment><USER28> Agree, it's so irritating that I stopped reading the article and came back to hacker news to read the comments..

</comment></comment><comment><USER29> I am wondering how google (mentioned as an offset to bing) is going to handle the availability tweeking and facebooking feature. It will be interesting to see if my searches now reference some persons personal collection of data and take me away from page source. Search engines are all about recent/modified content and might go to the less official/slightly modified sources. The search engine communities are full of intelligent people, but I still can't get the same 5 pages from stack overflow showing up when I have a problem, no matter how I change the search terms. I usually end up going to the site and then going to the reference link in the answer.

</comment><comment><USER30> Livefyre sidenote feature breaks selection and copy/paste on iPhone - <USER2> from being completely useless in first place.

Sending snippets of docs via email and other means is key - and is so much easier than signing into a third party service, using some lame social share feature, and then trying to find your contact there instead.

Aside from that, new layout looks nice!

<comment><USER30> Replying to self: tables are completely broken on mobile too - <USER3> [https://docs.microsoft.com/en-us/multi-factor- authentication...](https://docs.microsoft.com/en-us/multi-factor- authentication/multi-factor-authentication-get-started-adfs-w2k12) and scroll to 'options' \- it's about 5 CHARACTERS wide on iPhone 6 :)

<comment><AUTHOR> Well it looks quite horrible on desktop as well

</comment></comment></comment><comment><USER31> I am glad to see they acknowledge MSDN is bad. I fear they will make it worse but well, we'll see. Microsoft has been surprising these times.

<comment><USER32> Just try to get Google or Apple OSes documentation.

MSDN is the best documentation I ever seen from OS vendors.

Not to mention the mainframe, commercial UNIX and embedded real time OSes, even worse than those mentioned above.

<comment><USER33> redhat.com/docs and (back when Sun was a thing) docs.sun.com were great.

<comment><USER32> Where is the Red Hat documentation about the programming languages, respective libraries and IDEs delivered in a Red Hat ISO?

This one looks very poor versus MSDN content.

[https://access.redhat.com/documentation/en- US/Red_Hat_Enterp...](https://access.redhat.com/documentation/en- US/Red_Hat_Enterprise_Linux/7/html/Developer_Guide/index.html)

<comment><USER34> I'm pretty sure they rely on the respective upstreams to provide those.

Red Hat's OS docs are very good. I'm not sure it's their job to document what you're asking for.

<comment><USER32> If we are comparing them to MSDN quality, it is.

MSDN documents everything that Microsoft delivers to Windows developers, OS, programming languages, frameworks, IDEs, system administration,knowledge base, magazines and books.

</comment></comment></comment></comment></comment></comment><comment><USER35> Interesting choice of domain name. Coming from docs.google.com, I almost thought this was Office 365.

<comment><USER36> Also, docs.com. A Microsoft product.

</comment></comment><comment><USER37> I thought Microsoft Open Sourced their docs to Stack Overflow a long time ago?

<comment><USER38> Hard to believe I had to scroll this far down the comments to see this sentiment. I've been working with .NET since 2001, and I avoid MSDN because most "documentation" is nothing more than class definitions and member signatures pulled straight from the compiled code or XML documentation. There tends to be no _useful_ information like detailed samples, possible use cases, how the class interacts with other related classes, etc. If I just want to see signatures I can decompile the class with ReSharper. Make it more like Stack Overflow and they'll have some converts.

</comment></comment><comment><USER39> I would prefer if MS opened up their documentation and made it available for offline usage. The current options for that are hopelessly inadequate with (arbitrary) limits on the amount of data you can export. Now we get this crapscript laden fancy thing with only content from the marketing division. Not impressed.

<comment><USER40> All Documentations for Docs are available on Github. They are not all in the same repo, but grouped by topic.

Azure? git clone [https://github.com/Azure/azure- content.git](https://github.com/Azure/azure-content.git)

Azure RMS? git clone [https://github.com/Microsoft/Azure- RMSDocs.git](https://github.com/Microsoft/Azure-RMSDocs.git)

...

</comment></comment><comment><USER41> Maybe I'm just losing my eyesight, but does anyone else find that font impossible to read?

<comment><USER42> I also find it hard on my eyes. Looks like it's "Segoe UI" embedded via web fonts.

If you compare their screenshot: [https://docs.microsoft.com/teamblog/content/images/2016/05/D...](https://docs.microsoft.com/teamblog/content/images/2016/05/DocumentationExample.png)

To one of mine: [https://imgur.com/rFwTqUW](https://imgur.com/rFwTqUW)

It's not even close.

Edit: Seems the "blog" portion is very different than the actual docs: [https://imgur.com/YKvFxCh](https://imgur.com/YKvFxCh)

<comment><USER6> [Disclosure: I work for the team that built docs.microsoft.com]

Thanks folks, we had Segoe UI Light on the blog and have switched it to use the same font as our docs!

<comment><USER42> Awesome! It's very encouraging to see your comments here, reminds me there are humans in the tech ;)

docs.microsoft.com looks like it will be a very nice upgrade.

</comment></comment></comment></comment><comment><USER43> Some CSS tweaks that make it slightly more bearable (at least on my 1920px wide display)

      /* disable social sharing buttons */
      .lf-selection-popover,.lf-thread-btn{display:none;}
      aside#social{display:none;}

      /* make sidebar thinner and content wider */
      @media only screen and (min-width: 1024px){#sidebar{max-width:20%;}}
      @media only screen and (min-width: 1024px){div#main{max-width:80%;width:auto;margin:0;}}
      body>div.container{max-width:none;}

      /* make blog post wider */
      article.post{max-width:none;}

<comment><USER44> Are you sure making things wider actually makes it easier to read? Very long lines have make it hard for your eyes to track the start of the next line when you've reached the end of one. This is backed up by solid research, and is the main reason why books, magazines and a lot of websites have the width that they do.

<comment><USER45> Not all text is about maximum readability at the expense of everything else. If there is a long doc that I need to scan to find out where the useful bit of info is, I want to see more on the screen, even if it goes against some study saying I don't want to. If I'm reading every word of something, maybe the oft referenced studies are valid. In any case, I would certainly prefer that I had the choice to lay it out how I prefer. When making a doc platform like this, it doesn't seem like a ton of work to cater to different opinions, even if they think the customer is wrong.

</comment></comment></comment><comment><USER46> I like how they're boasting about how much effort it took them to figure out people want something simple and easy to use.

<comment><USER47> More like one person or group spent a lot of effort on convincing their boss that people wanted this.

</comment></comment><comment><USER48> Nice, I've always found msdn to be a bit hard to navigate through.

<comment><USER49> Yes! When the easiest way to something on a web site is to ask Google (or some other search engine) for it, something is very wrong.

<comment><USER50> Their search capability simply sucks. Unlike google, it seems knowledge from Bing doesn't seep to other parts of the company. Windows store search also sucks. It can't handle misspellings the way Youtube and Chrome store can.

<comment><USER49> It's not just the builtin search, the way the content is organized always seem be out of line with the way my brain works.

As a reference, take a look at (if you're not familiar with it already) at PostgreSQL's manual[1]. With Postgres, I don't need to search, I can (nearly always) find what I need by scanning the table of contents by eyeball. Also, I can download the whole thing as a PDF for offline reading (or printing if I wanted to).

This is an example of the standard Microsoft should aim for. And that's just the first example I can think of off the top of my hat. FreeBSD has a great manual, too, and last time I looked, the JDK also came with very good - <USER4> well-organized - documentation. I don't think it is _hard_ to do per se, just very tedious, but Microsoft certainly has the resources to do it if management makes it a priority.

I am sorry for ranting a little here, but the state of Microsoft's documentation is very disappointing in light of the resources they have; when I was a Linux newbie and made the mistake of asking a stupid question on a discussion board, I got flamed rather hard about not having read the documentation. I then replied - my second mistake, I guess - that apparently to Unix people, "user friendly" means "comes with more documentation than you'd ever want to read". One of the flamers replied - in a very matter of fact tone - that, yes, documentation is always good, because without documentation you're screwed eventually; with good documentation, no matter how complicated and nasty a program is, at least you have a chance. It took me many years to understand the wisdom in those words, but I think I only came to really appreciate them since I became a Windows admin.

[1][http://www.postgresql.org/docs/9.4/static/index.html](http://www.postgresql.org/docs/9.4/static/index.html)

<comment><USER51> Couldn't agree more. I've always considered PostgresQL's documentation the finest of _any_ software I've used, OSS or not. Many years' experience with all kinds of software convinces me it's nearly a law of nature: the quality of a project's documentation predicts the quality of the software itself.

However I'm pretty sure writing excellent documentation must be a very hard task, otherwise it wouldn't be such a rarity. Of course, Microsoft has the resources to do it, but the level of resources required to produce and maintain surely must be decidedly non-trivial. Reasonably, we could conclude they think it provides poor ROI.

We might well beg to differ on that point, and worth saying how much their inadequate documentation reflects the quality and utility of their products.

<comment><USER52> I think postgres' docs work quite well as a reference documentation. But in my opinion they're quite bad at introducing users to postgres/SQL/databases, including important operational tasks like backups.

<comment><USER51> In some respects that's true, though the docs do contain a lot of patient explanation at a pretty basic level.

I wouldn't exactly call it a tutorial but it did teach me a great deal about SQL when I started using the db > 15 years ago.

New standards and features have made the program more complicated over time, so periodically I need to study up on these topics. More than a few times, it's been really useful to have that "beginner level" info re: stuff that's new to me.

But like you say, not all subjects are covered that way, perhaps they haven't been considered to be basic. I bet if there are enough requests the project would improve the documentation in those areas.

</comment></comment></comment></comment></comment></comment></comment><comment><USER53> anyone here around when msdn would send out 70+ cdroms only to replace them 3 or 6 months later?

<comment><USER54> Yeah! I loved getting those MSDN discs in the mail and seeing what was new.

I have to say I miss the old VS6 MSDN days. It was so much simpler then with just a bunch of help files.

It is crazy that today documentation is still such a weak point. I just want clean documentation that I can format how I want (user style sheets) with lots of solid example code.

</comment></comment><comment><USER55> My big problem reading Microsoft docs is the pattern (around Visual Basic docs?) where they put objects, properties, methods, functions, etc. in separate sections, making it hard to figure out what applies where. Are they planning to address the difficulty of getting information out of the structure at all, or are they just putting window dressing on it?

<comment><USER8> [PM on the docs.microsoft.com team]

Yes, we are planning to address content structure to make sure that all important reference and conceptual information is well-organized and accessible. If you have any particular concerns regarding this, feel free to shoot me an email: dendeli [at] microsoft

</comment></comment><comment><USER56> I have somewhat of an interest in UWP. I'm not actively pursuing it but everyone once in a while I take a look to see if something worth my time is going on.

Now the best method I've found for finding content on msdn is a google search. If this no longer works my UWP interest will probably not be worth the bother.

</comment><comment><USER57> An interesting thing here is the source repositories. Sources are Markdown + YAML frontmatter, as many of the static generators use nowadays, but particularly given the source repositories are hosted on GitHub it's hard not to notice the Jekyll similarities.

</comment><comment><USER58> Nice to see MSDN move to more modern design. But I don't see any search capability?

Shameless pug, We currently working on documentation hub for developers [https://www.docsapp.io/](https://www.docsapp.io/)

<comment><USER59> As someone searching for an enterprise grade replacement to our current system of using MS word -> pdf -> CD to publish and maintain 500+ user and install guides...

-what flavor of Markdown do you support (captions/TOC/auto-number figures and tables)

-can I paste images from the clipboard directly into the editor (like one can with github issues)?

-what's the advantages over setting up my own git repo and using something like gitbooks?

....

You _really_ should have a demo available for people to try out.

<comment><USER58> Here is link to demo published site [https://demo.docsapp.io/](https://demo.docsapp.io/)

\- We support Github Flavored Markdown

\- We dont have paste image from clipboard, but we will add the feature idea to roadmap.

\- We provide support for versioning, fulltext search, private internal documentation (soon)

</comment></comment></comment><comment><USER60> Yeah, a lot of Microsoft's Enterprise customers are also stuck with archaic software and deployment systems, both built following Microsoft's advice to use ASP.NET WebForms and Entity Framework for everything.

</comment><comment><USER61> It would be a nice start if the farce of searching for some obscure error, finding an even more obscure forum entry linking to some MSDN page, navigating to this page just to see that it does no longer exists.

</comment><comment><USER62> Are they going to fix the page load times? MSDN is _terrible_ for click-wait- scroll usage, especially if you're trying to use the left navigation drilldown.

<comment><USER63> From the article:

> Fundamentals like site performance are a key feature and something many > customers have asked us to improve on UserVoice. Page load time on > docs.microsoft.com are between 50-300% faster in terms of load time and we > are better geo-distributed than ever before. We've also built on an > architecture that is running 100% on Azure.

</comment></comment><comment><USER64> So, will I have to login into something to read the docs now?

<comment><USER65> Not from I've seen, but you can login with a variety of accounts to comment.

</comment></comment><comment><USER66> Yikes. Seems that almost no one designing websites bothers to study the more important parts of typography. Recently, typography has been bastardized to mean "an expensive looking sans serif font."

But there is really important knowledge out there regarding ease of reading, contrast, ideal formatting, etc.

Cant believe that they choose a font weight that is so light. That alone makes this redesign way worse than the original.

<comment><USER67> The blog portion uses a light font. The documentation part doesn't.

<comment><USER66> Well I jumped the gun then. I just _assumed_ they would use the chance to show off their new format with a post about their new format. Guess not.

Looking at the actual documentation site, its not bad on first glance.

</comment></comment></comment><comment><USER68> now all their links are going to be broken, then they'll change everything again in 2years. typical ms.

<comment><USER8> [PM on the docs.microsoft.com team]

Not at all. We do graceful 301 redirects, so for all content from MSDN/TechNet that gets moved, none of the references will break.

</comment></comment><comment><USER69> reminds me docs.google.com

I thought it as a canonical pointer for Office 365 docs.

</comment><comment><USER70> yes we live pastels and hipster fonts.

<comment><USER71> We've asked you before to stop posting uncivil and/or unsubstantive comments to Hacker News. If you keep doing it, we'll ban your account, so it would be much better if you would stop doing it.

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

[https://news.ycombinator.com/newswelcome.html](https://news.ycombinator.com/newswelcome.html)</comment></comment>


How are you preparing for black friday? - <AUTHOR> As customers and developers :) <comment><USER2> By ignoring the bullshit

</comment><comment><USER3> By refreshing the Google Store's Pixel 3 XL page hoping they are going to cut this ludicrous price.</comment>


Learn to code (but don't become a programmer) - <AUTHOR> http://jmduke.com/blog/2013/12/10/learn-how-to-code-but-dont-become-a-programmer

<comment><USER2> Learn how to learn, problem solve, and critical thinking skills instead and become whatever you want.</comment>


Ask HN: Proposal for a Learning area on HN - <AUTHOR> We are a very highly concentrated source of knowledge on HN.
I feel like we need a LEARN section on HN. It needs to be more categorized though - but there is a ton of information that we all know that should be shared.
I propose we create a section of HN that will help to educate people on literally anything germane to our community and industry.
@Dang - would you support this? <comment><USER2> How do you propose this would work? Its a very vague suggestion and to me it conjures the idea of something like wikipedia or stack overflow, not a news feed...

<comment><USER3> Or ELI5 on reddit, which does occasionally have very interesting questions so I'm not knocking it or anything, but it seems like what he's asking for is already done well in a lot of other places. No need to repeat it here.</comment></comment>


Time to Get Serious about Tick-Borne Diseases - <AUTHOR> https://blogs.scientificamerican.com/observations/its-time-to-get-serious-about-tick-borne-diseases/ <comment><USER2> Being someone who has this disease, I can say its much worse than even this article depicts. I was self-diagnosed after seeing over 10 doctors. First was told ahh its Lupus! Then it was certainly some kind of STD, then Rheumatoid Arthritis, then Gout, then reactive arthritis, it wasnt until I looked at my spreadsheet I had kept to look for commonalities that I noticed every one of them said they were "75% sure it wasnt Lymes". I immediately went to anylabtestnow and had a few tests done for common forms of borellia infection and took the results to my rheumatologist. You would think thats the end of it but no, after months of antibiotics I was still not well and still couldnt walk correctly, I ended up at a naturopath in Seattle. All said and done I lost 30lbs, couldnt get out of bed, pain everywhere, symptoms of amnesia, forgetting everything, scoriosis on my eyelids, and all kinds of other really terrible side affects that I wont get into here.

<comment><USER3> Sounds terrible. I hope you are better now.

I read here in a comment here about a person that went through years of antibiotics, to no avail. What finally helped? A 2 week fast. He said he found the idea on some forum and decided to give it a go, since he had nothing to lose at that point.

<comment><USER4> [http://www.smashcompany.com/philosophy/how-i-recovered- from-...](http://www.smashcompany.com/philosophy/how-i-recovered-from-lyme- disease)

<comment><USER5> Fasting to cure the Lyme disease sounds very strange. Almost as the infamous banana diet to cure celiac disease.

</comment></comment></comment></comment><comment><USER6> Lyme disease is no joke. My neighbor's son found out he had Lyme after being mis-diagnosed with (I think) MS. He was losing motor function, one eye started to go blind, and he was chronically tired. He made a full recovery after being diagnosed but that was several years taken from a person in their early 20s.

I believe I had some sort of tick-borne bacterial illness as well. I felt a scratch on my ankle and found a small tick. I didn't think anything about it and threw it in the toilet. A few days later I started losing concentration, almost feeling out of body. I'd find myself not remembering what I was doing or how I got there. I couldn't read. I would stop mid conversation unable to remember what I was saying. After a week I went to the doctor and Lyme came back negative. Another week passed and he gave me an antibiotic and it cleared up in a few days. It may have been psychosomatic but I have never experienced anything like it before or since. The mark on my ankle has taken almost three years to heal.

<comment><USER7> My girlfriend was recently possibly diagnosed with MS. I say possibly because the doctor isn't confident - he put it at about 75% likely it's MS - but has no other answers to her symptoms which include numbness that started in her feet and eventually went up to her thighs that lasted for ~2 weeks, as well Barber's Chair Syndrome, and Retinal Vasculitis.

All 3 symptoms have since faded away, and the MRI's weren't conclusive enough to say it was MS, so the doctor is at a loss and working to get her set up with more tests.

What's interesting is she found a tick on her about a year ago, but the Lyme results came back negative. It may be MS but the doctor seems to have enough doubt that I've often wondered if it might be Lyme or something else.

<comment><USER8> There is currently no reliable Lyme test. The most commonly used test has an accuracy and sensitivity of 50 %. Worthless. A tick bite + weird symptoms = very high change it's caused by a tickborne disease.

[https://globallymealliance.org/about- lyme/diagnosis/testing/](https://globallymealliance.org/about- lyme/diagnosis/testing/)

<comment><USER9> The CDC says, "When performed and interpreted in accordance with current guidelines, 2-tiered serologic analysis has a sensitivity of ≈70%–100% and a specificity >95% for disseminated Lyme disease." [[https://wwwnc.cdc.gov/eid/syn/en/article/22/7/15-1694.htm](https://wwwnc.cdc.gov/eid/syn/en/article/22/7/15-1694.htm)]

</comment></comment></comment></comment><comment><USER10> The testing and treatment of tick borne pathogens is a fine line between politics, science and empathy is because many people have been treated poorly by the medical industry. The majority of the symptoms are ignored by physicians or misdiagnosed. In many cases, co-infections or existing immuno- suppressive conditions are ignored by physicians. That's happened to a number of people I know.

It is very common for most practitioners to be ignorant of: HLA DR gene types (can accumulate metals, mycotoxins, lyme toxins, etc), the nature of the Lyme bacteria strains: spirochtte (reproductive, doxycycline susceptible), round bound starvation form (resistant to most antiobiotics), and the nature of biofilm colonies (antibiotic resistant) that exist in nature and our bodies. Furthermore, most physicians do not know what labs and tests to apply to a patient: Igenex and Galaxy labs for Lyme, Bartonella, Babesia, etc testing; c3a, c4a, tgf-b1, mmp-9, inflammation markers.

In short, each human phenotype, genetic expression, and immune context are all highly unique ... which means that every case is different. Inflammation from our immune response is the primary driver of symptoms and is very, very often mis-diagnosed as something else like MS or dementia (happened to a number of people I know). We need a lot more data to finally help educate physicians and bring the vast majority them out of the stone age. We need to educate everyone on complex systems, nutrition, and biology instead of just authority.

<comment><USER11> Just reading up about this issue. Root cause for the controversy seems to be difficulty of diagnosis. What prevents development of a "smoking gun" detector for lyme, finding the actual lyme causing bacteria _in vivo_ in humans with symptoms?

<comment><USER12> There isn't a "smoking gun" detector for Lyme in much the same way that there isn't a "smoking gun" detector for cancer. Diagnosing Lyme with blood tests is only one tiny piece of the controversy around Lyme.

<comment><USER11> For cancer, you can do a biopsy and know for sure. The equivalent would seem to be presence of the bacterial infection in the body.

<comment><USER13> Right, but if you could do it for Lyme couldn't you do it for every bacteria? Blood testing would be our best bet, and we already do that with Lyme antibody testing and Lyme DNA testing. The main problem is that they are very expensive tests (usually a couple hundred dollars, and not always covered by insurance) and thus you need enough clinical suspicion to make the call to get something like that. How do you further increase your suspicion when you have a disease that mimics a lot of other diseases, without breaking the bank?

<comment><USER11> Antibody testing seems to have wiggle room, which causes people to assume they have Lyme whatever the result. If they believe chronic Lyme is ruining their lives, and long term antibiotics will help, why not take a conclusive test that actually finds the bacteria and know for sure? What's missing from all these anecdotes is that they go from not being sure of the diagnosis, to trying a fringe treatment against the recommendation of multiple medical bodies.

<comment><USER12> You say all of these things, as a probably-not-100-year-old-human, about a genus of highly advanced shapeshifting spirochete bacteria that have spent the past (perhaps) 500 million years living in the bloodstreams and bodily tissues -- and evading the immune systems -- of billions of mammals and reptiles (and everything between) across the globe.

We only found out about these spirochetes in 1981. That's 38 years ago. You're probably older than that.

Yet you have cited precisely zero sources, arguing by shooting holes in straw men. For the love of <God>, and all that is holy, Sooheon: please base your opinions on evidence.

<comment><USER11> Not sure what rubbed you the wrong way, these are just questions I have as I read about this topic for the first time, trying to understand the controversy here. I'm not going to have reams of citations for you. If you have citations to throw at me feel free, but from what I can see, reliable medical bodies consider this to be a misdiagnosis at best.

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER14> Hmmm; Is the Scientific American's "Observations" section equivalent to newspapers' "Opinions" or "Editorial"?

Because while I agree with overall message ("Let's get serious about battling ticks and diseases they spread"), there is a strange mix of scientific/data- based; political/opinion-based; and just plain emotional imploring. It brings up the _highly_ controversial Chronic Lyme topic right front and centre, but then attempts to steer itself ambiguously away from it (essentially, "Whatever the case, we need to fight it"). Can the author really be unaware of the immediate guard that will go up on every side of that thorny issue?

<comment><USER15> I'm a neurologist, which means I specialize in diseases of the brain, spinal cord, and nerves.

The clinical entity of chronic lyme disease which is undiagnosable by conventional medicine and require months and months of antibiotics is pseudoscience. There is a large industry built to pedal treatments to purported sufferers. I don't want to be disrespectful of the people who report being helped by these treatments, but this is exactly the same situation as vaccinations causing autism: people being convinced by "obvious facts" that are ultimately supported by anecdotes but not science.

The medical community can be wrong, for sure (h. pylori is a great example), but we notice treatments that help our patients, even when unconventional (the FDA approval of cannabis to treat epilepsy is the most recent example).

This will eventually reach the same conclusion as the vaccination debate; hopefully with a lower price tag of dollars and lives.

<comment><USER16> I guess those of us who were bitten by ticks and have been sick ever since are just imagining our illnesses? Why is it that the medical establishment is fine with TB requiring 6 months of antibiotics, but because you can't believe that tick-borne diseases may take months to treat?

It's time for the medical field to actually consider the possibility that prolonged tick-borne illnesses might be real. Is months of antibiotics the best treatment? I don't know, but it's the only treatment option I've been given. It sure beats an army of doctors (2 PCPs, 2 neurologists, rheumatologist, immunologist, and more) trying to convince me there's absolutely nothing wrong with me. Tell my wife, kids and friends that everything's fine - I'm exhausted from the time I get up to the time I go to bed, brain fog, working memory issues, etc. The only test that came back positive was rocky mountain spotted fever (4 months ago) and I've been feeling ill for almost 3 years. But you're right chronic tick-borne illnesses don't exist.

For the record, I would likely believe it was quackery too if I wasn't living proof that it's real.

<comment><USER17> > But you're right chronic tick-borne illnesses don't exist.

Why the snarky sarcasm? My comment is hidden now, but I thought I said they _do_ exist, and that the pseudoscience is in the chronic, longterm antibiotic treatments.

But your reaction is exactly what parents of kids with autism said: I saw my child get autism after a vaccination. I am it. It happened to me.

Tick diseases do exist, and they have great (conventional) treatments. It can be _very_ difficult to get the right diagnosis, and for your doctor to make the diagnosis.

There are a lot of people out there selling very expensive and completely inappropriate treatments, and it has created endless confusion on the part of the patients who are suffering. It's unconscionable, and when the patients/victims are so convinced that they campaign for it, it's downright tragic.

Just consider how exhalted Andrew Wakefield was by his patients in the day.

Regardless: I'm sincerely happy that you're getting much better.

<comment><USER16> [https://news.tulane.edu/pr/study-finds-lyme-bacteria-can- sur...](https://news.tulane.edu/pr/study-finds-lyme-bacteria-can-survive- after-antibiotic-treatment-months-after-infection)

<comment><USER15> Your link makes my point perfectly: doctors are open-minded, and have conducted rigorous investigations using meaningful clinical endpoints, and cannot substantiate the anecdotal reports of improvement in spite of a very diligent search. It states:

      Posttreatment LD remains a poorly understood syndrome,
      occurring in an estimated 10% to 20% of humans treated
      under current IDSA guidelines.30 Multiple randomized,
      placebo-controlled studies that evaluated sustained
      antimicrobial therapy concluded that there is no benefit
      in alleviating patients' symptoms and indicated that long-
      term antibiotic therapy may even be detrimental to
      patients because of potential associated complications
      (ie, catheter infection and/or clostridial colitis).31,
      32, 33

Where the references are:

Berende, A., ter Hofstede, H.J., Vos, F.J., van Middendorp, H., Vogelaar, M.L., Tromp, M., van den Hoogen, F.H., Donders, A.R., Evers, A.W., and Kullberg, B.J. Randomized trial of longer-term therapy for symptoms attributed to Lyme disease. N Engl J Med. 2016; 374: 1209–1220

Kaplan, R.F., Trevino, R.P., Johnson, G.M., Levy, L., Dornbush, R., Hu, L.T., Evans, J., Weinstein, A., Schmid, C.H., and Klempner, M.S. Cognitive function in post-treatment Lyme disease: do additional antibiotics help?. Neurology. 2003; 60: 1916–1922

Klempner, M.S., Hu, L.T., Evans, J., Schmid, C.H., Johnson, G.M., Trevino, R.P., Norton, D., Levy, L., Wall, D., McCall, J., Kosinski, M., and Weinstein, A. Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. N Engl J Med. 2001; 345: 85–92

<comment><USER16> I tracked down those studies and the treatments tested were from 30 days to 12 weeks - hardly what I would consider 'long term therapy' that's currently advocated/practiced by LLMDs.

I don't have any definitive answers. All I can tell you is, if you felt as lousy as I feel, you'd be willing to try it given the lack of any meaningful treatment options from the current mainstream medicine that has managed to extract a shitload of my money in exchange for mostly blank stares & shoulder shrugs (or my favorite, passing me onto another specialty, resulting in another 2 month wait.)

<comment><USER15> > the treatments tested were from 30 days to 12 weeks - hardly what I would > consider 'long term therapy' that's currently advocated/practiced by LLMDs

ahh! there is something here. I't subtle but I think it's a really important process you've described:

Conventional medical experts took the anecdotes and lyme theories, and decided to test "long term" therapy that was being advocated by less-conventional but still well-meaning providers at the time. These were the results: they showed there was no benefit.

So conventional thinking moved on, and the now-fringe thinkers simply moved the goalposts. Any scientist is going to be open-minded about the possibility of something being effective, even if they don't understand it. But at this point there are far better places (meaning "likely to show efficacy") to invest research resources.

And the question we're all asking ourselves is: if the alt-medicine community is so convinced that there is a benefit, why on earth won't they perform a randomized, placebo-controlled, clinical trial. We already did several, and published them. If the alt-lyme community still wants to continue making claims and expect to be listened to, they are going to need evidence.

That seems like it should be uncontroversial to me, but here we are.

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER18> Prevention is worth a lot here. I've been aware of Lyme for 30 years now probably? (I have lived most of my life not that far from Lyme, CT where it was first noticed.) Because I've been aware of it so long it would get brought up to the doctor immediately if something happened. It would also be very unlikely I would get bit and not notice.

Taking the usual recommended precautions and checking yourself carefully goes a really long way.

Be careful around tall grass. Don't hang around in areas that make it easy for a tick to get on you. Wear clothes that reduce risk.

I've been a very active hiker/mountain biker for many years now. I've pulled a few ticks (<10) off me but I have always found them before they bit me.

Biggest factor I've noticed in the people I know who have gotten Lyme is dog ownership. I would be really interested if someone did a study. It seems Dogs in the house raise the risk significantly. Dogs on a walk behave in the most risky way possible hanging out in tall grass and going everywhere (they're dogs, can't blame them) and they have a nice furry coat that is easy to grab onto for the ticks. Then you need to check the dog and remove the ticks, bringing yourself into contact with the ticks. Or you miss them and now the ticks are crawling around in your house.

Dog owners also seem to wear more casual clothes going for a walk with the dog. The dog drags them into areas they might not have gone on their own. The casual clothes provide more surface to grab onto vs dedicated clothes an outdoor enthusiast is wearing. (Most feel compelled to wear appropriate clothes and at that point you can adjust for tick prevention)

Unfortunately I've known multiple dog owners who have gotten Lyme multiple times.

Check kids really carefully, they're too young to know any better.

</comment><comment><USER19> Several years ago I went on a hike/hammock camping trip. This was in an `old- growth` state forest and had practically no underbrush. The ground around the campfire area was bare dirt, and I sat/reclined on a ground-sheet and a 'sit- pad'. (two layers between me & the ground).

2-days into the camping I started to feel like I was having a reaction to a bug bite, assumed it was mosquitoes and ignored it.

I got home after 4-days, went to climb in the shower and my wife pointed out that I had several ticks attached to my back. So I grabbed my knife, pulled them off, and watched the area for a few days. (I had my wife circle the red- welts with a sharpie to make sure it didn't spread.)

I was ofcourse concerned about Lyme. Turns out nothing happened, and the redness went down. But I took precautions against getting made a meal of, and I still failed. It was a sobering incident, and I know I was lucky.

<comment><USER20> Did you use any insect repellent?

<comment><USER19> Yes, (basic DEET spray, and 'Muskoil')but this was before I learned about Permethrin. I now use that religiously.

</comment></comment></comment><comment><USER21> Disclaimer: I am not a doctor.

If you live in a lyme-tick area, you should have antibiotics on hand at all times.

If you find a tick that's already been on you long enough to cause a red irritation spot, the clock is ticking.

Any time spent on finding a doctor to see, waiting for test results, seeing if symptoms develop, etc. is wasted time.

The sooner you make your body an unfriendly environment to the bacteria, the less time they have to grow and spread.

This means not only antibiotics, but also not eating anything calorie dense, eating fresh garlic and other natural antibacterials, and getting a lot of sleep, when your immune system works best. If you are a weed smoker and it makes you crave food, it may help to take a tolerance break. Coffee will not help you in this situation.

This is a protocol I've learned about from several people for whom antibiotics do not work. I think there's a book about it.

Doctors have told me that a 3-day course is enough to prevent a system-wide infection if you catch it early. Once an infection settles in, a longer course is needed, typically 14 days, which will do major damage to your biome.

<comment><USER22> > If you live in a lyme-tick area

So, continental US, excluding maybe Nevada and New Mexico (because desert).

> you should have antibiotics on hand at all times.

So, here is a problem: in US, antibiotics are prescription-only. And no doctor would prescribe antibiotics preventively. They will prescribe antibiotics after a tick bite, but you need an office visit (or online office visit). The only way to get antibiotics preventively is to stash some after a tick bite, or simulate symptoms over a video call.

TL/DR: if you are in US, you're fucked.

<comment><USER23> The desert certainly doesn't stop the suckers, speaking as a New Mexico resident. Ticks abound, Lyme equally so.

<comment><USER24> Really? The CDC [0] shows a total of 4 cases of Lyme in NM from 2012-2017. Looking at that map, it appears to me that the desert does seem to stop the suckers.

[0] [https://www.cdc.gov/lyme/stats/maps.html](https://www.cdc.gov/lyme/stats/maps.html)

<comment><USER25> Not to mention:

> Each dot represents one case of Lyme disease and is placed randomly in the > patient's county of residence. The presence of a dot in a state does not > necessarily mean that Lyme disease was acquired in that state. People travel > between states, and the place of residence is sometimes different from the > place where the patient became infected.

</comment></comment></comment></comment></comment><comment><USER26> Lyme has a great young hacker: there's a kid who got Lyme, and she learned how to build an app, connect doctors, start a foundation, and create a self- reporting network of hikers, campers, and outdoors people. Very inspiring!

[https://ticktracker.com/](https://ticktracker.com/)

[https://livlymefoundation.org/](https://livlymefoundation.org/)

<comment><USER27> While the goal seems laudable not sure I follow the purpose of the app. Is it to track ticks in areas where people don't expect them? Where I grew up you'd be reporting them every other day

<comment><USER28> I imagine so, since the affected areas are expanding.

</comment></comment></comment><comment> wes-k I live in TN which fortunately doesn't have Lyme carrying ticks but other bad things like Rocky Mountain spotted fever and alpha gal (allergy to meat thanks to the lone star tick).

There are several precautions we take every time we go camping or hiking during tick season:

1\. Spray permethrin on shoes and ankles.

2\. Tuck pants into socks.

3\. Leg tick checks during + full body check when we get home and for next two days.

4\. Toss all clothes in the drier. The heat kills them. Do not wash first!

5\. Shower with T/gel. Still not fully tested but we heard this will kill them!

So far I've had a few cases of an attached tick but nothing longer than half a day of exposure. Bleh!!

<comment><USER29> Do you find permethrin to be more effective than DEET? Or do you do it because it's safer.

<comment><USER30> Permethrin is vastly more effective than deet. It lasts for weeks, even across washes and kills basically any insect that touches the sprayed areas. Its so harmless to mammals(1) that ranchers spray it directly on cattle.

It is extremely toxic to marine life and indiscriminately kills insects including beneficial pollinating insects. Use with care.

 _(1) With some important exceptions, thanks to rileyphone for the reminder._

<comment><USER31> Please note that permethrin is still toxic to cats.

<comment><USER30> Indeed, so much so that if you have both a cat and a dog, you should not use the standard topical flea treatment on your dog (which contains permethrin) as enough may transfer to your cat to cause serious issues.

</comment></comment></comment></comment></comment><comment><USER27> Coming from a place with an endemic Lyme disease problem, I whole heartedly agree with the thrust of the article. I'd add however that in addition to funding and research into tick-borne diseases, there needs to be significant research and funding directed at reducing tick populations in an environmentally safe manner (current methods mostly involve spraying your lawn with chemicals, or applying permethrin to rodents and deer in some ridiculous fashion)

<comment><USER32> Agreed. I vote to reintroduce wolves.

<comment><USER33> Or some other means of controlling deer populations, like, say, hunting.

</comment></comment></comment><comment><USER34> Lyme is essentially the poster child for an emerging disease related to climate change and human activity. It's an old organism in an ancient tick that had a happy lifecycle of tick-mouse-tick-mouse-tick-deer-tick. Humans took the forest and the predators out of the picture and now the ticks and the deer proliferate at hugely increased rates, and now we're part of the lifecycle of this tick and the Borrelia organism.

<comment><USER35> Are deer much more dense than in the past?

And as bad as Lyme is, if we kept predators like wolves in the civilization- adjacent forests, would it be better or worse --- today's Lyme rate vs the counterfactual wolf attack rate if they stayed?

<comment><USER34> I think it is hard to know before the appearance of people who might count, but the loss of the forest means that the deer are browsing suburban areas more and the ticks are becoming more prevalent. Clearly there are no longer any wolves or cougars in the Northeast and that affects predation.

I'm not sure the counterfactual is really relevant. I'm just saying Lyme is the poster child for this kind of problem. My preference would be for more risk from wolves and more diverse ecology, with less suburbia and more forest. If your preference is for whatever causes the least number of deaths then you're going to have to also integrate driving, pollution, carcinogens, etc., into your model.

<comment><USER36> > more risk from wolves

Just to be clear, there is essentially zero risk to humans from wolves. Wolves present a risk to livestock, and that's the reason humans eradicated them from most of the places they used to roam.

</comment></comment></comment></comment><comment><USER37> _> Yet when patients blame failed tests and treatments for their persistent symptoms, when they seek additional care for Lyme disease, they are often told they suffer from anxiety or chronic fatigue syndrome. They are derided, called anti-science, denied insurance reimbursement.

> They are dismissed in ways comparable to those experienced by their AIDS- > afflicted brethren._

The Atlantic just published a good article about this: [https://www.theatlantic.com/magazine/archive/2019/09/life- wi...](https://www.theatlantic.com/magazine/archive/2019/09/life-with- lyme/594736/)

</comment><comment><USER38> In the Alps you can't even go into a mid altitude wood without finding a tick or 2 walking on your dog. Hiking over 1600m is the only way to avoid them. I'm lucky to have a dog with white fur, so I can see them before they bite but it's a constant battle.

I wonder:

1\. if we always had them. Probably not, I can't remember seeing that many in my childhood 2\. if there's a way to get rid of those or we're forced to have this problem forever.

Has anyone here ever thought of building an army of tick-detector robots powered by solar panels that can go around and grab as many ticks as possible?

<comment><USER12> 1\. Yes, Otzi had Lyme: [https://www.nature.com/articles/ncomms1701](https://www.nature.com/articles/ncomms1701). However, it's possible tick populations were lower 50-100 years ago.

2\. Yes. The main issue is that nobody wants to pay for the robots, although they're extremely effective: [https://www.cnet.com/news/military-robot- deploys-co2-to-lure...](https://www.cnet.com/news/military-robot-deploys- co2-to-lure-ticks-to-their-doom/), [https://ieeexplore.ieee.org/document/1594003/?arnumber=15940...](https://ieeexplore.ieee.org/document/1594003/?arnumber=1594003)

</comment></comment><comment><USER39> I agree it's serious (I've had Lyme disease and so have family members), and there are problems with positively identifying symptoms, but I don't get what this article is asking for?

The author herself quotes:

> _For ticks, "proven and scalable control measures do not exist," wrote three > officials from the U.S. Centers for Disease Control and Prevention in 2018._

She ends with "Prevention efforts have failed. Do the work on ticks."

But do _what_ work? She just admitted measures don't exist.

Is she asking for an order of magnitude more funding? New research approaches? _Are_ there even any promising solutions we haven't tried? Or is she just asking for magic?

For someone demanding change, it feels disingenuous to not even give a cursory description of what the current obstacles are or potential avenues for addressing them.

<comment><USER11> Does it really need to be spelled out? :p

1\. Incite outrage, 2. generate clicks and discussion, 3. profit!

E: revisiting this because pure snark adds nothing. I think the heart of the issue is that the tests are inconclusive -- why can't people who care enough look for the _B. burgdorferi_ virus itself live in the blood for a clear-cut diagnosis?

</comment></comment><comment><USER40> Aside from Lyme disease, I'm also personally concerned about Chronic Wasting Disease. We have deer on our property all the time and all they do is shit and piss everywhere.

This appears to be the deer-form of Mad Cow Disease and apparently the prions in the feces can be spread even after it goes into the ground and in the plants that grow from it afterwards.

<comment><USER25> There is no case of a human contracting CWD. While CWD can be an issue for the local deer population, it is not something to be worried about. Avoid eating brains, spinal cords, and lymph nodes of deer as a precaution.

</comment></comment><comment><USER41> My Lyme story is probably one of the less dramatic posted here, but it is telling that I feel like I was relatively taken good care of compared to many others here and elsewhere. My first symptom was the classic erythema migrans (bullseye rash), which was painful on its own, but given that this was during summertime in southern Italy it got unbearable at times. I saw a doctor who told me I had probably been bitten by a spider or lizard, but nothing to worry about. I asked him about Lyme but he insisted there were no ticks in Italy (!)... Eventually I got low fever and terrible upper joint pains, as well as deformed nails and fingers (the second stage of Lyme). This was still not enough for the doc as again, there are no ticks in Italy... After a short time Bell's palsy kicked in (severe facial paralysis and a drastic change in taste in my case) and then I knew that I was 100% dealing with Lyme. So off we go to Italy's main institution for infectious diseases where they tap me for an insane amount of blood to analize, and tell me I will stay at the hospital for maybe a week. Tests came back and Lyme was positive, even though there are no ticks in Italy... I ended up staying at the hospital almost two months with antibiotics pumped intravenously multiple times a day for hours. After recovering I had to go to the hospital for health controls every 2-3 months or so for a around a year.

And I was lucky enough to go through this during a time where antibiotics are still effective at fighting bacterias. One of my biggest fears is entering a post-antibiotic era, where bacterias grow resistant at a faster rate than we are discovering new antibiotics. If we keep misusing them, to erroneously treat ourselves, to feed livestock, pumping the rest products into rivers, this might not be such a far fetched scenario.

</comment><comment><USER42> If you're interested in the intersection between Lyme disease and investigations into it being a bioweapons program gone wrong there's a recent book on the subject.

<[https://www.amazon.com/Bitten-History-Disease-Biological- Wea...](https://www.amazon.com/Bitten-History-Disease-Biological- Weapons/dp/006289627X/>)

I haven't read it, but I heard an interview with the author and the book sounds well researched. It doesn't reach a definitive conclusion that Lyme came from a bioweapons program gone wrong, but it does talk about other bioweapons programs similar to Lyme.

</comment><comment><USER43> Can gene drive be used against ticks? Mosquitos get many defenders who claim they are important as food for other species, but even that argument can't be used against eliminating ticks.

<comment><USER44> David Sinclair mentions a CRISPR tech to kill ticks here: [https://youtu.be/o9Fg-usoBHc?t=410](https://youtu.be/o9Fg-usoBHc?t=410)

</comment></comment><comment><USER45> Borrelia burgdorferi (the pathogen that causes Lyme) was named after Willy Burgdorfer. Burgdorfer claimed that the disease was the result of a biological weapons program that went awry. This is an interesting read: [https://www.amazon.com/Bitten-History-Disease-Biological- Wea...](https://www.amazon.com/Bitten-History-Disease-Biological- Weapons/dp/006289627X)

<comment><USER46> That's a discredited conspiracy theory: [https://www.aldf.com/did-lyme- disease-originate-in-the-easte...](https://www.aldf.com/did-lyme-disease- originate-in-the-eastern-u-s-from-borrelia-burgdorferi-infected-ticks-that- escaped-from-a-laboratory-at-the-plum-island-animal-disease-center-where- scientists-were-conducting-top-sec/)

<comment><USER47> >Some claim that Lyme disease was introduced into the northeastern region of the U.S. by a man-made strain of Borrelia burgdorferi that escaped from a high containment biological warfare laboratory on Plum Island. However, there is ample evidence to indicate that both Ixodes ticks and B. burgdorferi were present in the U.S. well before the Plum Island facility was ever established.

What a lazy "debunking". Of course creating a strain of bacteria would require the original bacteria to already exist.

</comment></comment></comment><comment><USER48> There's some healthy doubt to be cast on concepts like "Chronic Lyme." Consider, for one example, the data here: [https://lymescience.org/washington/](https://lymescience.org/washington/)

In this thread a poster claims that multiple doctors couldn't save them until a "doctor" with "natural remedies" put them on a fast.

Now, I support skepticism all around; it is very healthy to get second and third opinions when you know your body doesn't feel right. But it's also extremely important to trust actual expertise over self-diagnosis, Facebook groups, and so-called medicinal practitioners who hawk herbs and starving oneself as panacea.

</comment><comment><USER49> this summer, I got a tick bite. I immediately went to go get a prophylactic antibiotic (doxycycline). You'd think that the pharmacist could just give me some over the counter, but I had to go to a clinic and get a prescription – felt kinda absurd. I wonder how much Lyme disease is attributable to the inconvenience of the process, especially in USA where American are scared of obscure + outrageous medical fees.

<comment><USER50> We don't want 99 people taking antibiotics for every one who gets cured (about the rate most tick bites have of giving Lyme disease), so maybe a bit of gatekeeping is appropriate here. At least to ask "Has it been on you for 36 hours?"

Antibiotics have a major effect on your gut flora and I don't take them lightly.

<comment><USER51> That sounds bad, but what's the 'false negative' penalty? (Not getting antibiotics when you needed to). Pretty high - getting Lyme disease. If it was your kid, I'm thinking we'd all do it.

</comment></comment></comment><comment><USER52> Related : Accelerated phenology of blacklegged ticks under climate warming (ticks can survive in more areas and breed faster)

[https://royalsocietypublishing.org/doi/full/10.1098/rstb.201...](https://royalsocietypublishing.org/doi/full/10.1098/rstb.2013.0556?/=)

Ticks (and tick-borne diseases) will become widespread as the world is warming.

</comment><comment><USER53> One thing I must have messed from the article is: why are we not already serious about it? There was this comparison to AIDS, but AIDS had the whole horrible "moral" stigma against diagnosing and treating it. What ax to grind do people have with Lyme disease? Why are doctors misdiagnosing or deliberately ignoring it? What are the incentives? I don't understand.

<comment><USER54> Your confusion is understandable. What the article fails to mention is that, although Lyme disease is very real and is increasing, the disease referred to as "chronic Lyme disease" is not recognized by physicians as either Lyme disease or as an infection, but is more commonly classified alongside things like chronic fatigue syndrome and fibromyalgia as legitimate suffering from an unknown or poorly-understood cause (but not from infection). Other people, like the author of the linked article, disagree, and think that doctors are mistreating these patients. So there's some controversy.

<comment><USER11> I'm curious why there isn't a "smoking gun", i.e. the actual Lyme causing bacteria being found _in vivo_ rather than these inconclusive diagnostic tests and questionnaires. Seems like the first step to Getting Serious.

<comment><USER12> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195970/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195970/)

You can detect Lyme in the bloodstream, but it's much easier and hundreds of times cheaper to look for the human immune response - IgG and IgM - with a Western Blot or ELISA. The actual Bb spirochete is so dilute in the blood that a PCR test (costing upwards of $5k) is typically the only thing that will definitively detect it.

The "getting serious" bit is a policy request: why is the federal or state government paying so little attention to an issue that affects and injures hundreds of thousands of people per year?

<comment><USER11> There's all these linked stories of people suffering for years not knowing definitively what they have, a 5k test to diagnose for sure seems like a bargain. I don't understand why the CDC says chronic lyme doesn't exist and suffers claim they think it does but they don't know for sure. Why not settle it with a real test?

<comment><USER12> $5k is hardly a bargain when your insurer refuses to cover it. For some people, $5k is about the cost of replacing their car 10 times.

</comment></comment></comment></comment></comment></comment><comment><USER55> Just some observations:

\- In my country, Lithuania, tick-born diseases have been increasingly becoming a major problem. We had them for some time, but I think the problem has been amplified by the climate change in the last few decades. At least, the summers got hotter and the winters certainly start later than they used to in my childhood.

\- Ironically, cleaner environment and stricter EU regulations on the use of pesticides and other chemical compounds also played a role: tick population is flourishing. The government doesn't have or at least cannot come up with some means to control it. Spraying forests with some chemical compounds would certainly produce serious side effects and would do more harm than good (unless something new gets invented). There have been some discussions in the parliament to raise the issue at the EU level.

\- There are essentially two main diseases: tick-borne encephalitis (TBE) and Lyme disease. They are both very nasty. There is a vaccine from TBE. Unfortunately, vaccination is not universally funded or compensated by the government. Only for certain groups (forest rangers, members of the armed forces, etc). Nevertheless, a lot of people (including myself) get vaccinated and it's one of the most popular vaccines.

\- Apparently, there is also a vaccine from the Lyme disease: [https://en.wikipedia.org/wiki/Lyme_disease#Vaccination](https://en.wikipedia.org/wiki/Lyme_disease#Vaccination) . In 2000s, it was tried in the US, but then subsequently pulled out from the market. It is unclear whether the vaccine really had side effects or it was due to anti-vaxxers.

IMO, more effort should be put on: 1) large scale vaccination 2) research on possibilities to control the tick populations.

<comment><USER56> In 2016, the US FDA approved a canine Lyme vaccine called VANGUARD crLyme [1], and the principal investigator behind its development (Richard Marconi) is working toward a human vaccine [2], so there's hope; availability is still probably years away.

[1] [https://www.zoetisus.com/products/dogs/vanguard- crlyme/](https://www.zoetisus.com/products/dogs/vanguard-crlyme/)

[2] [https://news.vcu.edu/article/VCU_researcher_develops_Lyme_di...](https://news.vcu.edu/article/VCU_researcher_develops_Lyme_disease_diagnostic_and_comes_closer)

</comment></comment><comment><USER57> Most of the comments here are about Lyme's disease in deer ticks, but what really terrifies me is the Lone Star tick. This alpha-gal syndrome epidemic appeared out of the blue in the 2000's and gives you a lifelong allergy to red meat.

</comment><comment><AUTHOR> New Hampshire Public Radio and Outside/In just spun off a podcast on Lyme disease, Patient Zero:

[https://www.patientzeropodcast.com/](https://www.patientzeropodcast.com/)

I've been really impressed with the quality of journalism from Taylor Quimby, Sam Evans-Brown, and that team on other stories. They've had stories where they mention openly that they changed their view halfway through, or have a reasonable debate among the reporters. I find that really refreshing.

[http://outsideinradio.org/](http://outsideinradio.org/)

</comment><comment><USER58> If you get the signature bull's eye, you are lucky. My kid got it and we were able to recognize the textbook bite signature, in addition to her high temps and fever symptoms. They were able to test for Lymes and then aggressively do the IV antibiotics regiment.

As an avid camper, I treat all my clothing gear with Permethrin. In addition to keeping the flying bugs off you... they also keep the ticks off. I treat the tick 'entrances' and socks, which makes a huge difference for the normal ticks.

<comment> marble-drink Do you get irritation from the Permethrin?

<comment><USER58> It goes on clothing, not skin. I'm not pestered by it.

</comment></comment></comment><comment><USER59> I know people are concerned about using gene drives on native species, but why don't we use it against invasive species. Lantern flies in PA seem like a good example.

</comment><comment><USER60> I am close to someone with Lyme disease, and it's far more serious than I realized in terms of impact on day to day life. What I've learned is that it doesn't get the kind of funding or research as other debilitating diseases because it's relatively rare and hard to diagnose, so there's simply fewer people who go into medicine with a personal connection to it.

</comment><comment><USER61> I have noticed that certain family members are somehow attractive to ticks. On the same forest walk , my mom would always be blessed with a tick while me, my dad and brother never. Off course this is a very small sample size but consistent for literally my whole life growing up across Europe.

<comment><USER62> Even walking style might make a difference.

I tend to fairly carefully but rapidly pick my way along a trail. My wife and kids do not. I'd imagine this varies the rate of exposure to things like foliage on the edges of the trail.

<comment><USER63> I do the same. I live within 200 feet of trailheads and hike all the time. I watch for areas of trails with overhanging plants, and avoid touching them as I walk by.

I have also started treating my hiking boots, hiking pants, and shirt with Premethrin. If you are careful, getting Premethrin into the general environment can be avoided.

</comment></comment></comment><comment><USER13> Serious question: do you think more could be done to help bring awareness to patients to encourage earlier screening for Lyme disease and other tick borne diseases? I remember being told that if I ever saw a tick on my skin or if I had a target sign rash on my body that I should 1) take the tick with me, and 2) go to the doctor.

At least then you have a record of potential Lyme exposure in your record and it can be brought into the differential diagnosis as a reason for your symptoms in the future.

Like a public health campaign where you had some ads especially in wooded areas that are Lyme endemic areas.

I think back to things like the BE FAST mnemonic (balance, eyes, face, arm, speech, time) for stroke awareness, and feel like many people don't even know that.

</comment><comment><USER64> > It's Time to Get Serious about Tick-Borne Diseases

I was diagnosed with Lyme disease two years after a tick bite in Nth Germany. A strong course of antibiotics cured me of the disease. At the time I got to learn of the chronic Lyme community (typically self diagnosed) and what the specialist doctors are saying.

It seemed to me that the range of possible symptoms of this disease, and the difficulty in diagnosing it, make it a nice excuse for other problems somebody might be experiencing.

Ultimately, the best evidence I saw - the people in the hospital diagnosed with Lyme disease tended to have identifiable symptoms, e.g arthritic joints, while the self diagnosed complained of feeling unsociable and not motivated to continue with working.

</comment><comment><USER65> It was vanquished. We pulled the vaccine off the market.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870557/#idm140...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870557/#idm140034452980864title)

<comment><USER10> How about the French pharmaceutical company that shelved their vaccine before GlaxoSmithKline's? I will try and find the article, but as I remember it, their vaccine worked on the OSPa protein and had a number of proven and harmful side effects. It turns out that the Lyme bacteria is hard to vaccinate for since it can change its outer surface proteins to evade the antibodis pretty easily -- in the end, the immune system is much better on its own than relying on a vaccine.

<comment><USER66> American vaccine was 90% effective with side effects on par with non- vaccinated population. It was pulled thanks to the antivax crowd:

[https://www.vox.com/science-and- health/2018/5/7/17314716/lym...](https://www.vox.com/science-and- health/2018/5/7/17314716/lyme-disease-vaccine-history-effectiveness)

</comment></comment></comment><comment><USER67> It looks like it's getting worse [https://www.cdc.gov/lyme/stats/maps.html](https://www.cdc.gov/lyme/stats/maps.html)

Either this means more diagnoses or more people being infected

</comment><comment><USER68> For whom it may concern, regarding specifically a Bb infection: [https://clinicaltrials.gov/ct2/show/NCT03891667](https://clinicaltrials.gov/ct2/show/NCT03891667)

</comment><comment><USER69> We would already have a vaccine against lyme, anaplasmosis, etc if they were diseases that affected rich people. But since it's mostly poor people living out in the woods that get Lyme disease, nobody cares. Nobody important anyway.

</comment><comment><USER70> I'm a deer hunter. I'm out in the woods scouting a few times in the late summer, then I'm out there every day in the fall for about two months.

I treat everything with permethrine: clothes, socks, boots, hats, orange vest, backpack, ground blind, even the tripod chair I sit on in the blind. Permethrine, derived from the chrysanthemum flower, kills ticks (as well as ants and bees). If one lands on your pants or shirt, it will quickly die. But permethrine is considered harmless to mammals once it's dry. It also doesn't hurt to spray some deet on your exposed skin (face, hands etc.). Permethrine survives several washings.

As soon as I come back from a hunt, I strip and take a hot scrub shower. This is probably the best way to rid them from your body before they latch on, which usually takes a few hours up to 24 or so before they settle in a desirable spot.

Reducing the deer population is an excellent way to reduce the adult tick vector; deer can travel quite far and spread tick populations quickly.

The nymph phase of the tick life cycle is slightly different; they are on mice and other rodents until they reach a certain size. You can actually reduce this population by putting out tick tubes everywhere in your yard, under brush, under wood piles, wherever rodents might tend to go. The tubes contain cotton or dryer lint sprayed with permethrine; the rodents take bits of the material back to line their nests, and it kills the baby ticks. I do this every spring, in the hopes it will rid the vicinity of many ticks.

Lyme is serious business and once you get it, it can take years if not forever to get rid of. Lymerix was a vaccine developed in the 1990s that was about 80% effective, but unfortunately an anti-vaccine group sued the company successfully and they pulled it off the market. The CDC subsequently determined there was no validity to the plaintiff's claims, but by then the deed was done. Probably hundreds of thousands of people suffer from Lyme today because of this lawsuit.

There are new vaccines in the pipeline that sound very promising; they target common proteins among the family of Lyme bacteria (there are about a dozen known species of borrelia bacteria) so that one shot should protect you. Of course, promising doesn't mean guaranteed, so we'll just have to wait and hope this thing can be beaten.

In the meantime, we can focus on attacking the vectors: reduce the overpopulation of deer and rodents that carry the ticks, encourage more use of permethrine and other insecticides. Monhegan Island, off the Maine coast, had 25% prevalence of the disease until they eradicated the deer population (originally brought there in the 1950s-60s as a tourist attraction) and new cases of Lyme went down to almost nil.

We can encourage more predators like hawks and owls and snakes, all of which work to keep the rodent population in check. Flocks of birds eat ticks, but bird populations have greatly decreased in recent decades, so we might think about ways to bring them back, perhaps through reforestation and limiting exurban development that removes habitat.

</comment><comment><USER71> My roommate recently fell asleep in a hammock and woke up covered in currently feeding ticks and tick bites from ones that had their fill and left. It's been about 3 weeks since then and he doesn't seem to have any forgone symptoms. It seems odd to me that... is he just lucky?

<comment><USER72> Over the course of my life (I am in my mid 30s), I have gotten probably 75+ tick bites.

When I was a kid I lived in the country, about 20 minutes from the nearest town and would have a tick-check every time I returned from being outside during the times when ticks are more prevalent.

Many times you would have ticks but they didn't get a chance to bite yet (Thankfully my parents did these tick-checks all the time, I hated it at the time but looking back I understand their concern).

I usually get at least one a year (tick that actually bites me), and although recently (Age 30+) I have been getting them checked out/monitor them more closely than when I was a younger, I've been lucky myself to not get this disease or any other ones related to ticks yet.

If anyone is curious as to this location, I live in the Upper Peninsula of Michigan.

</comment></comment><comment><USER73> Throw away account here. Writing on mobile so excuse the short sentences. Been dealing with Lyme disease since 2011. Main symptoms have been fatigue (both mental and physical), brain fog, headaches, migraines, cold extremities.

Anyone reading this dealing with Lyme has I'm sure heard of many different treatment protocols to get better. In fact, I've got a list of over 50 treatments from doctors and patients I've saved in a spreadsheet.

To keep it short, I've tried many different treatments and have been very skeptical of most of them and most have not had any meaningful improvement.

Talked with a contractor who was doing work for me who had to close his business because of chronic Lyme. He tried all different doctors and protocols and he found a solution that cured him. It's going to sound crazy and I'm sure it will get downvoted but I'd rather get the information at least out there for anyone to consider. The contractor mentioned this guy called the Medical Medium. This medical medium guy says science actually is wrong about Lyme being bacterial, but is actually viral. I know it sounds crazy. I know there is no science behind it. Try to keep an open mind. I eventually read the theory behind it, tried the protocol, and am now 5 months into it. Best I've ever been in terms of symptoms.

Again, I'm a guy who only follows science. I don't try to get into stuff that is considered out there, but I was desperate enough to at least consider it and try it. Maybe read it and consider it. And please don't say I'm spreading unscientific information. I know that I am but for people who have an illness without a defined solution, I think it's sometime good to being open to considering an unconventional approach.

[https://www.medicalmedium.com/blog/herpes- viruses](https://www.medicalmedium.com/blog/herpes-viruses)

<comment><USER74> Medical Medium is bullshit. Dude claims a spirit from the future psychically communicates advanced medical knowledge to him alone... garbage like celery water curing autoimmune diseases.

His website has an extensive legal medical disclaimer that basically says "none of this is medical advice, if you listen to me it's all on you"</comment></comment>


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<comment><USER2> Nokia makes great hardware, can't wait to see what they have in the pipeline.</comment>