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Paper short abstract

Poland’s "Lyme Wars" reveal a crisis of expertise. By framing post-infectious states as active chronic illness, "Lyme-literate" communities challenge official EBM. This paper analyzes diagnostic inflation and commodification of medical uncertainty to propose a resilient, inclusive future of care.

Paper long abstract

Borreliosis is a well-defined bacterial infection. However, the emergence of the "Chronic Lyme Disease" (CLD) narrative has led to the development of a parallel medical market. This approach reconfigures Borreliosis as an enigma-disease, systematically deconstructing evidence-based consensus in all aspects, but its tick-borne causes.

The medical landscape is divided by a sharp medical, legal and professional conflict between the official and state-sanctioned guidelines and the proliferation of non-standardized treatment protocols, primarily the ILADS method. At the heart of this schism is the ontological status of persistent symptoms (e.g. fatigue, muscle pain, "brain fog"). Those symptoms are treated as a post-infectious immunological state by institutionalised medicine, or an active infection by the alternative approach. This distinction entails two conflicting therapies, including a long-lasting, health-damaging and extremely costly alternative protocol.

Poland constitutes a compelling case study of this epistemic friction. There is a very active „Lyme-literate” alternative community, which offers a narrative of hope to patients left alone with a diagnosis of persistent syndromes of a completed therapy. This facilitates the marketing of financially ruining therapies and increases the over-diagnosis of Lyme disease, which currently reaches as high as 90%. The proliferation of the alternative approach has sprinkled heavy criticism from the medical circles and state institutions, which may still not fully address the spreading convictions and misinformation. Addressing the vulnerabilities of patients caught in this "epistemic war" of a contested disease is a foundation for building a resilient future of care, which balances scientific rigor with patient-centered empathy.