Assessment Of Patients With Borrelia Infection

National Institute Of Allergy And Infectious Diseases

Investigators

Linked publications, trials & patents

Abstract

Tickborne diseases are a serious health threat that has steadily risen, with reported cases more than doubling from 2004 to 2016. Lyme disease, or Lyme borreliosis, accounts for more than 80% of the reported cases of tickborne diseases in the US. It is estimated that over 476,000 cases of Lyme disease are diagnosed and treated per year in the US, and almost 130,000 cases are reported annually from European countries with surveillance for the infection. Our current work addresses the following areas in Lyme disease: development of new tests and biomarkers for infection, investigation of persistence of infection with B. burgdorferi in humans, and investigation of the role of immune response in Lyme disease and post treatment Lyme disease syndrome (PTLDS). We have three clinical protocols exploring diverse aspects of Lyme disease and tickborne infections that are currently open to recruitment. In these, and past clinical studies, we have evaluated more than 800 patients. Together with this large clinical database, we have assembled a large biorepository that has served to explore multiple avenues of research in Lyme borreliosis and tickborne diseases. In the past, we have published our collaborative study with Childrens National Research Institute, which showed that most parents of children diagnosed with Lyme disease reported that their kids recovered within six months of completing antibiotic treatment. The study collected survey responses from the parents of 102 children ages 5 to 18 years who had been diagnosed with Lyme disease between six months and 10 years before enrollment. Adolescents ages 10 to 18 years old were also invited to complete adolescent-specific questionnaires. According to these parent survey responses, 75% of children fully recovered within six months of completing treatment: 31% of all children recovered within one month; 30% recovered in one-to-three months; and 14% recovered in four-to-six months. Approximately 22% of children in the study experienced at least one symptom that persisted six or more months after completing treatment; of those, 9% had symptoms classified as post-treatment Lyme disease syndrome. Six percent of the children were not fully recovered at the time of the survey, with 1% experiencing symptoms significant enough to impair daily functioning. This study supports previous data showing an excellent overall prognosis for children with Lyme disease and can help clinicians manage families expectations about the varying post-treatment recovery times of pediatric Lyme disease patients. Post-treatment Lyme disease symptoms remains poorly understood in children and adults, and more research is needed to better understand these prolonged symptoms and identify treatment targets. We have also help study the serologic response to Anaplasma phagocytophilum and Babesia microti, two emerging tick-borne pathogens in the United States. Using a peptide array to select sets of linear peptides, we identified peptides that can be a useful tool for detection of antibody reactivity to both pathogens.