Lyme Disease Cases Triple in the US

Lyme disease has been strongly concentrated in the North American Midwest and Northeastern regions, where ticks and contact with ticks are common. According to a 2015 CDC report within the past 20 years, the incidence of Lyme disease has tripled and become the most commonly reported vector borne illness within the United States. In 2015, Lyme disease rose to the sixth most common Nationally Notifiable disease (7, 9). According to Mam Kilpatrick, a professor of ecology and evolutionary biology at UC Santa Cruz, there are a “number of promising strategies for controlling the disease that have not been widely implemented”, these control strategies will become more important as disease incidence continues to rise (9).

Lyme disease is still a relatively new disease diagnosis that was first recognized in 1977 (10). The difficulty in developing a treatment for Lyme disease is due to the complexity of Lyme disease itself. Lyme disease can be caused by 300 different strains of bacteria worldwide and over 100 different strains of bacteria within the United States (1). Humans can come into contact with an infected tick in a multitude of ways, such as through their pets. Borrelia burgdorferi has 5 subspecies of bacteria and is a common Lyme disease bacteria affecting humans; therefore, it is helpful to illustrate the complexity of Lyme disease (1). When the bacteria are within the tick, the protein OspA is on the surface of the bacterium; however; as the tick feeds and throughout early infection, the surface proteins become OspC. With persistent infection, the protein VisE is presented on the surface of the bacterium (4, 11). Therefore, when creating a vaccine, it is essential to target one of the many surface proteins at only a certain window of infection time. Lyme disease can affect multiple systems within the body: dermatologic, rheumatologic, neurologic, and cardiac. Typical symptoms include: pain in the muscles, whole body fatigue, fever, malaise, stiffness, swelling in the joints, or headache. The most recognizable sign is the bull’s-eye rash, which should be immediately reported to a physician (8).

In 1998, the pharmaceutical company GlaxoSmithKline Beecham responded to the growing public health concern by creating the vaccine LYMErix to prevent Borrelia burgdorferi infection in humans; however, in 2002, LYMErix was removed from the market with no hopes of a new drug to replace it (10). The case for LYMErix removal was the claim that the vaccine caused arthritis. However, a retrospective study illustrated that subjects with arthritis had statistically similar incidences between the control group and the vaccinated group. The vaccine was still removed from the market not due to safety concerns, but public opinion and poor sales (3). Public opinion has been such a hindrance to the development of a vaccine that it wasn’t until 2017 that the FDA approved a new vaccine clinical trial (2). Yet, the failure of LYMErix has caused the majority of North American laboratories to focus on improving diagnosis tests, not vaccine development.

In early June of this year, the University of Guelph, in Ontario received a grant to create a laboratory to find new prevention and treatment methods for Lyme disease. The purpose of this lab is to improve diagnostic testing so that it can detect Lyme disease in its earlier stages, and directly prevent long-term suffering that has become characteristic of the disease. This will be Canada’s first vector-borne research center to identify disease biomarkers and prognostic indicators (5).

Global Lyme Diagnostics (GLD) also made strides in combating Lyme disease. GLD developed a new test for detection aptly named the GLD Test. The GLD Test is based on research by Dr. Richard Marconi, a professor of microbiology and immunology in the School of Medicine at Virginia Commonwealth University in Richmond, Virginia. What is novel about the GLD test is that it utilizes the chimeritope technology, which is designed to identify the appropriate diagnostic antigen, allowing for earlier detection. Compared to current Lyme disease detection tests that test for Lyme disease antibodies, which may still been within the blood long after the infection is gone. Chimeritope technology uses constructed diagnostic antigens that are designed for the purpose of detecting Lyme disease strains regardless of the geographical origin, which has been an inhibiting factor in the past. Another essential element in the GLD Test, is that it is still a simple test for clinicians to use because it only requires a blood draw (6).

Even as incidence of Lyme disease rises, promising prevention and intervention methods are being developed. Today the simplest and most effective prevention methods are to cover up or avoid wooded areas where deer ticks live. The earlier the detection and treatment of the disease the better the outcome. While waiting for a vaccine to reach its final stages of development, it is essential to recognize the signs of Lyme disease and take proactive steps to prevent infection.

References

1. "Basic Information about Lyme Disease." ILADS. N.p., n.d. Web. 10 July 2017. <http://www.ilads.org/lyme/about-lyme.php>
2. La Vigne, Patrice, and Barbara Loe Fisher. "FDA Gives Green Light to Test Lyme Disease Vaccine on Humans." The Vaccine Reaction. N.p., 30 Jan. 2017. Web. 26 June 2017. <http://www.thevaccinereaction.org/2017/01/fda-gives-green-light-to-test-lyme-disease-vaccine-on-humans/>.
3. Lathrop, Sarah, Robert Balld, Penina Haber, and Gina Mootrey. "Adverse Event Reports following Vaccination for Lyme Disease: December 1998–July 2000."Science Direct. Elsevier, 22 Feb. 2002. Web. 26 June 2017 <http://ac.els-cdn.com/S0264410X0100500X/1-s2.0-S0264410X0100500X-main.pdf?_tid=fe984594-09c9-11e7-a899-00000aacb35f&acdnat=1489615062_7b2c1a3e74382ed7f7b1d3326ecb6020>.
4. Little, Susan, Stephanie Heise, Byron Blagburn, and Steven Callister. "Lyme Borreliosis in Dogs and Humans in the USA." Trends in Parasitology. N.p., Apr. 2010. Web. 26 June 2017 <http://www.cell.com/trends/parasitology/fulltext/S1471-4922(10)00018-8>.
5. "Lyme Disease: University of Guelph Receives Grant to Create Lab." Outbreak News Today. Outbreak News, 15 June 2017. Web. 26 June 2017. < http://outbreaknewstoday.com/lyme-disease-university-guelph-receives-grant-create-lab-55183/>.
6. "Lyme Disease: Global Lyme Diagnostics Announces New Test Is Available." Outbreak News Today. Outbreak News, 05 June 2017. Web. 26 June 2017. <http://outbreaknewstoday.com/lyme-disease-global-lyme-diagnostics-announces-new-test-available-46554/>.
7. "Lyme Disease." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 19 Dec. 2016. Web. 26 June 2017. <https://www.cdc.gov/lyme/stats/ >.
8. "Lyme Disease (Borrelia Burgdorferi)2017 Case Definition." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, n.d. Web. 26 June 2017. <https://wwwn.cdc.gov/nndss/conditions/lyme-disease/case-definition/2017/>.
9. "Lyme Disease: Promising Prevention and Control Measures Are Available but Underutilized." Outbreak News Today. Outbreak News, 25 Apr. 2017. Web. 26 June 2017. <http://outbreaknewstoday.com/lyme-disease-promising-prevention-control-measures-available-underutilized-52176/>.
10. Poland, Gregory A. "Vaccines against Lyme Disease: What Happened and What Lessons Can We Learn?" Clinical Infectious Diseases. Oxford University Press, 01 Feb. 2011. Web. 26 June 2017. <https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciq116>.
11. Tilly, Kit, Patricia A. Rosa, and Philip E. Stewart. "Biology of Infection with Borrelia Burgdorferi." Infectious Disease Clinics of North America. U.S. National Library of Medicine, June 2008. Web. 26 June 2017. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440571/>.