Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a systemic chronic disease classified as a neurological disorder by the WHO.

Reports of individuals worldwide experiencing symptoms similar to ME/CFS or Fibromyalgia（FM） after COVID-19 infection have emerged.

Similar symptoms can also occur after co-infection with Lyme disease, a tick-borne disease.

Cases occurring after treatment are termed "post-treatment Lyme disease syndrome," while those that become chronic without diagnosis are termed "chronic Lyme disease" cases.

• ME/CFS is characterized by Post-Exertional Malaise (PEM), where severe weakness and worsening of symptoms occurs after physical or intellectual activities in daily life. Unlike normal fatigue or tiredness that recovers with sleep or rest, PEM can occur immediately after activity, or with a delay of several hours or days, and the depletion of the neuroimmune system can last for several days, weeks, or sometimes even longer.

• Symptoms can affect the entire body which include cognitive impairment, sleep disorders, pain, immune disorders, flu-like symptoms, orthostatic intolerance (inability to maintain a sitting or standing position for extended periods), hypersensitivity to sound, light, smells, chemicals, temperature intolerance, muscle weakness, and ataxia.

•  In Japan there are approximately 100,000 patients, 30% of whom are bedridden or in a near-bedridden state.

• Less than 6% of people recover to their pre-illness physical function.

• Recent studies have revealed encephalitis and immune abnormalities as potential causes.

• Biomarkers  and treatments have not yet been establshed.
• Because of the lack of doctors and other medical specialists treating these conditions, and not being included in the national health system's disease classifications, even severely ill patients who require home nursing care, tube feeding, or excretion assistance, or who are forced to use electric wheelchairs or stretchers for mobility, cannot easily obtain disability certificates or welfare services.

• Patients frequently have a severe financial burden of symptomatic treatment and out-of-pocket medical treatments.

• Patients often face a lack of understanding and prejudice from those around them, being told things like "they're just being spoiled", "they're lazy", or "it's a mental issue".
• On relatively good days, when meeting people, these patients are expected to perform at the same level as a healthy person, but then suffer from post exertional malaise and can become bedridden for days or even weeks.

• To conserve energy, understanding and cooperation from the workplace and school are essential, but at the same time, the patient themselves need the courage to say " No !"
• In childhood chronic fatigue syndrome, even when children complain about their symptoms, their parents and schools often don't believe them and dismiss it as a mental health issue, and they don't receive appropriate treatment, leading to a worsening of their symptoms.

Many people probably learned about Lyme disease when Justin Bieber and Avril Lavigne were diagnosed with it, and it received some media attention.

Recently, EXILE's ATSUSHI revealed that he has Lyme disease.

There are significant differences between "acute Lyme disease," "post-treatment Lyme disease syndrome," and "chronic Lyme disease," as they are known in the medical community.

Lyme disease (Borrelia), a tick-borne disease, and co-infections (such as Babesia, Bartonella, Anaplasma, and Ehrlichia) are generally recognized in the medical community as diseases that can be cured relatively easily with short-term antibiotics.

However, in 10-20% of patients who are infected by ticks or other routes of transmission, chronic symptoms persist even after short-term antibiotic treatment.

This is called "Post-Treatment Lyme Disease Syndrome."

 It is thought that Lyme disease triggers an overreaction of the immune system and reactivation of bacteria in biofilms , leading to a condition similar to myalgic encephalomyelitis/chronic fatigue syndrome. 

Furthermore, Lyme disease may progress undiagnosed and be misdiagnosed as neurological disorders such as myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, multiple sclerosis, and ALS, or psychiatric illnesses such as depression and schizophrenia.

Lyme disease specialists (LLMDs) and patient groups overseas refer to this as "Chronic Lyme," but it is not yet recognized by the general medical community, either globally or in Japan.

As a result, patients who can improve or recover with right Lyme treatment are being left behind by the medical community and society.

CDC standard tests are not  accurate and there are cases of false negatives, while expensive 

PCR or antibody tests are available but there are a shortage of Lyme Literate Medical Doctors in Japan, and it is very difficult to diagnose and treat chronic lyme disease and coinfections.