The US Centers for Disease Control and Prevention (CDC) has finally officially recognised the medical significance of persistent symptoms after acute Lyme disease, and has included these in the federal framework for Infection-Associated Chronic Conditions and Illnesses (IACCIs). This long-awaited acknowledgment validates the experience of those living with long-term symptoms following infection.
In its new Emerging Infectious Diseases supplement (Volume 31, Supplement – October 2025), the CDC states:
“Chronic sequalae considered IACCIs include various combinations of infection-associated organ damage, autoimmune conditions, and persistent unexplained systemic symptoms, such as debilitating fatigue, post-exertional malaise, cognitive impairment, musculoskeletal pain, and sleep disorders.“
“Suspected mechanisms include continued immune stimulation from antigens or continued infection in a sequestered body site that cannot be sampled, reactivation of latent viruses, autoimmune responses, microbiome dysbiosis, persistent tissue damage, disordered coagulation, and disrupted nerve signaling. IACCIs cause marked disruption to a patient’s ability to return to work or school or to resume their life as it was before the inciting infection.”
Read the supplement Progress Toward Understanding Infection-Associated Chronic Conditions and Illnesses – Anthony E. Fiore
Within this supplement the CDC cites a landmark Lyme IACCI report produced by the National Academies of Sciences, Engineering, and Medicine Committee. The report confirms the urgent need to draw on existing knowledge and pursue evidence-based interventions that relieve symptoms based on biological plausibility. It also clarifies the need for ongoing research to better understand underlying disease mechanisms, which may then help determine future drug targets and treatments.
- Listen to patient advocate Col. Nichole Malachowski discussing the Lyme IACCI report.