The concept of "illusory truth" refers to the phenomenon where repeated exposure to a statement increases the likelihood of the statement being perceived as true, regardless of its actual veracity. This effect occurs because repetition enhances the fluency with which information is processed. When a statement is familiar, it is processed more smoothly, which the brain interprets as a signal of truthfulness. This cognitive bias highlights how easily our perception of reality can be manipulated through mere repetition. This understanding is crucial in addressing misinformation about diseases like persistent tick-borne diseases (TBDs). The illusory truth effect impacts both laypeople and health professionals who believe health misinformation. Some examples of the TBD narrative that need correction are both obvious and evasive, necessitating thorough clarification.

Persistent tick-borne diseases (TBDs) are often surrounded by illusory truths that can mislead the public. Some examples of these misconceptions include the belief that there are 100 different strains of Borrelia in the USA and 300 worldwide, and the distinction between American and European strains of Borrelia. Additionally, it is falsely believed that Borrelia can form cyst or cell wall-deficient forms. Another common misconception is that the risk of infection is very low if the tick is removed within 24–48 hours, leading to a sense of complacency. The idea that Borrelia infection is uncommon is also misleading. Furthermore, it is incorrectly stated that there is no vertical transmission of Borrelia from mother to fetus. The recognition of chronic Lyme disease by the CDC is another misconception, along with the belief that Lyme disease does not cause fatalities. The accuracy of Lyme disease tests is often questioned, as they are considered notoriously inaccurate, and there is a mistrust towards laboratory test results from foreign laboratories. These examples highlight the pervasive nature of illusory truths in the discourse surrounding TBDs.To combat the illusory truth effect, it is essential to promote media literacy and critical thinking skills. By being aware of this cognitive bias, individuals can take proactive steps to verify information before accepting it as true. Additionally, fact-checking organizations and transparent algorithms can help reduce the spread of misinformation by identifying and correcting false statements.In conclusion, the illusory truth effect is a powerful demonstration of how repetition can shape our beliefs and perceptions of truth. Its implications are far-reaching, affecting various aspects of society from personal beliefs to political opinions. Understanding and mitigating this effect is crucial in fostering a well-informed and critically thinking populace. By correcting the narrative surrounding persistent tick-borne diseases, we can provide better patient care and improve public health outcomes.

Learning points include that students will be able to appreciate: 

1. The need for better guidelines  

2. The need for better diagnostics 

3. Multiple microbe testing is not the exception but the must 

Garg, K., Jokiranta, S., Filén, S., and Gilbert L. 2021. Assessing the Need for Multiplex and Multifunctional Tick-Borne Disease Test in Routine Clinical Laboratory Samples from Lyme Disease and Febrile Patients with a History of a Tick Bite. Trop Med Infect Dis. 2021 Mar 17;6(1):38. doi: 10.3390/tropicalmed6010038. 

Johnson, T. L., Graham, C. B., Maes, S. E., Hojgaard, A., Fleshman, A., Boegler, K. A., ... & Eisen, R. J. (2021). Co-occurrence and genetic diversity of tick-borne pathogens in nymphal Ixodes scapularis from 2 regions in Minnesota, USA. Journal of Medical Entomology, 58(1), 8-20. 

Khatchikian, C. E., Prusinski, M. A., Stone, M., Backenson, P. B., Wang, I. N., & Levy, M. Z. (2015). Recent and rapid population growth and range expansion of the Lyme disease tick vector, Ixodes scapularis, in North America. Evolutionary Applications, 8(11), 1042-1057.