In 1975, four months after starting his rheumatology fellowship at Yale University, he learned of a cluster of children who were thought to have juvenile rheumatoid arthritis in Lyme, Connecticut.
Steere called each affected family, representing 39 children in all, and he found an additional twelve adults suffering from what was thought to be juvenile rheumatoid arthritis.
[3][8] A quarter of the people Steere interviewed remembered getting a strange, spreading skin rash (erythema migrans) before experiencing any other symptoms.
A European doctor happened to be visiting Yale at the time, and he pointed out that the rash was similar to one frequently encountered in northern Europe and known to be associated with tick bites.
[citation needed] Steere then learned about the work of the Swedish dermatologist Arvid Afzelius, who in 1909 had described an expanding, ring-like lesion and speculated that it was caused by the bite of an Ixodes tick.
[3] Writing in the Journal of the American Medical Association (JAMA) in 1993, Steere and colleagues stated that Lyme disease had become "overdiagnosed" and overtreated.
However aside from the issue of terminology, some mainstream medical opinion goes as far as to say that some Lyme disease cases can become "difficult to treat" if not quickly diagnosed.
[21] Steere and his colleagues said that even patients with a positive serology for Borrelia infection and with symptoms resembling those of CFS or fibromyalgia, would not be helped by further antibiotics.
[23] As chief of the rheumatology and immunology department at Tufts School of Medicine, Steere led the research effort on Lymerix, the preventive Lyme vaccine by SmithKline Beecham, now GlaxoSmithKline (GSK), which first appeared on the market in January 1999.
[3][24] Lymerix works on the outer surface protein A (Osp-A) of Borrelia burgdorferi, the causative agent of Lyme disease.
Using a novel approach of proteomics and translational research, developed with Catherine Costello at Boston University, he and his colleagues have identified four novel autoantigens that are targets of immune responses in patients with post-infectious Lyme arthritis.
[29] He has developed an algorithm for the treatment of such patients: after oral and intravenous antibiotic therapy, they are given immunosuppressive medications, such as methotrexate or TNF inhibitors, as in rheumatoid arthritis.
With his colleagues Annalisa Pianta and Elise Drouin, he has reported a link between immune responses to a commensal microorganism in the gut microbiome, Prevotella copri, and two novel autoantigens (human proteins) that are highly expressed in joints of rheumatoid arthritis patients.
These findings, which have implications for the diagnosis and treatment of the disease in the future, were highlighted in recent articles in Arthritis and Rheumatology [34] and the Journal of Clinical Investigation.