CHRONIC

A doctor and his former patient explore what they posit is the pathogen-spread rise of autoimmune illnesses, with millions of victims.

Diseases such as multiple sclerosis, lupus, rheumatoid arthritis, and fibromyalgia are not single illnesses as such but instead clusters of symptoms with many points in common. Because their etiology is hard to pin down, many sufferers are often dismissed with the simple notation that the illness is psychosomatic. Yet, writes Phillips, “maybe you were referred to a psychiatrist or prescribed an antidepressant by your general practitioner.” For various reasons, he and Parish write, pathogens are on the rise and ever more ubiquitous as a result of climate change; these pathogens include viruses, parasites such as protozoa, and bacteria. By 2050, they project, 12% of the U.S. population will be affected by a kind of “Lyme+” disease, costing billions annually in medical expenses and lost productivity. The list of vector-borne ailments is long, and too often our understanding of them is incomplete. The authors write, for instance, that bartonellosis is not strictly a tick-borne disease but can be transmitted by fleas, lice, and even ants. Apart from the fact that a spirochete is involved, everything else about Lyme is “bitterly debated,” with no agreed-upon treatment regimen. What’s worse, the range of illnesses that may be hidden by Lyme-like symptoms can include cancer, hepatitis, and tuberculosis. Phillips and Parish suggest a range of treatments, from anxiety-reducing exercises to herbal remedies such as oregano oil, cinnamon bark, and cumin seeds that have been shown to have “strong killing activity against ‘persister’ forms of the Lyme bacterium”—though none of those proposed treatments is definitive.

An informative guide to what the authors call “the pandemic in plain sight,” urgent without undue alarmism.