A Canberra infectious diseases expert has decided to directly challenge the growing power of advocates who say Lyme disease has come to Australia.
Professor Frank Bowden from the Australian National University medical school says the bacteria has not been detected in Australia, despite being widespread in other countries.
"Throughout the world there are people who have thought they had Lyme disease but have another diagnosis," he told Fairfax Media.
"But unfortunately a large number of people who believe they have Lyme disease in Australia have symptoms which are not consistent with any Lyme disease that we see overseas.
"I've treated many people with Lyme disease acquired overseas and they follow a particular pattern, there are certain things that occur with Lyme disease that are typical of it."
Professor Bowden is publishing a book this week, Infectious, said to be a doctor's "eye-opening insights" into contagious diseases.
In one chapter under the heading "Lyme is the new black", he writes the current absence of Lyme Borrelia does not mean the disease is not here.
"But each time we look and don't find it, the argument for its presence weakens," he says.
"There is no microbiological evidence of it existing in Australia.
"Yet, excluding the cases picked up in these places, each year hundreds of Australians believe they have acquired Lyme disease locally.
"Most suffer from a variety of non-specific complaints, none of which is consistent with Lyme disease as it is seen anywhere else, and many look for a doctor who will prescribe months or even years of intravenous antibiotics."
The internet has made it easy for people to share their symptoms with people all over the world and the self-diagnosis of infectious diseases has become a "widespread and disturbing distraction", he says.
"Confirmation bias is the very human trait of being swayed towards your pre-existing beliefs and only paying attention to information that agrees with them," Professor Bowden says
"Medical people do it all the time but social media have turned popular opinions about Lyme disease into what amounts to a collective international delusion."
The federal Health Department says there is no conclusive evidence Lyme disease exists in Australia but it is monitoring the situation.
"Some patients and their healthcare practitioners believe this chronic debilitating illness is similar to Lyme disease which is found endemically in North America, parts of Europe and parts of Asia. Many of these patients have not travelled overseas to endemic areas," the department says.
The website of the Lyme Disease Association of Australia contains a map of the location of individuals with "an officially confirmed case".
Professor Bowden acknowledged he could face a backlash, particularly on social media, for his outspoken comments.
"Some of my colleagues have even questioned my sanity for writing this chapter in the first place," he says.
He wanted to make clear he was not making a judgment about people who are advocating for recognition of Lyme disease in Australia.
"I respect their need for hearing and attention," he said.
"My concern though is that we have to make sure we're not treating something that isn't there, we have to make sure we're treating the actual cause.
"The problem with true Lyme disease is that a small group of people who have it then go on to develop non-specific symptoms – tiredness, pain, lack of concentration, brain fog, change in mood, sleeplessness – these people would often fit into a diagnosis of what's called chronic fatigue syndrome."
Professor Bowden said if Lyme disease was found to exist in Australia, he would be the first person to acknowledge it.
"It's possible it could … we've got ticks but everybody has looked and we haven't been able to find Lyme disease ... it seems highly unlikely," he said.
"I'll go one step further. Let's just say that tomorrow we discover Lyme disease in Australia – I don't believe we will but let's say we did – it's been shown across the world that a standard course of antibiotics works.
"After six months, almost everybody will be better but for a small group of people who go on after true Lyme disease to become sick with chronic fatigue-like syndrome."