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1986: Allen Steere forms the basis for the 1990 case definition.


Here, in 1986, Steere not only says you only need band 41 for diagnosis, but he says treatment fails in half the cases. 


This was the source of the first, 1990, CDC surveillance criteria - just do repeat Western Blots to look for new IgM bands, because that meant the bug was still alive after treatment.

"In contrast, among six patients with prolonged illness, the IgM response to the 41-kD protein sometimes persisted for months to years, and late in the illness during arthritis, a new IgM response sometimes developed to a 34-kD component of the organism. The IgG response in these patients appeared in a characteristic sequential pattern over months to years to as many as 11 spirochetes antigens. The appearance of a new IgM response and the expansion of the IgG response late in the illness, and the lack of such responses in patients with early disease alone, suggest that B. burgdorferi remains alive throughout the illness. "

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