Special Issue "Lyme Disease: The Role of Big Data, Companion Diagnostics and Precision Medicine"

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 June 2018

Special Issue Editor

Guest Editor
Dr. Raphael B. Stricker

Union Square Medical Associates, San Francisco, CA, United States
Website | E-Mail
Interests: tickborne diseases; immunodeficiency diseases; immunological infertility

Special Issue Information

Dear Colleagues,

Lyme disease, caused by the spirochete Borrelia burgdorferi, has become a major worldwide epidemic. Studies based on Big Data registries show that >300,000 people are diagnosed with Lyme disease each year in the USA alone, and up to two-thirds of individuals infected with B. burgdorferi will fail conventional 30-year-old antibiotic therapy. Recent studies have highlighted metabolic and molecular persistence mechanisms that allow the Lyme spirochete to survive in the face of immunological and antibiotic challenges. Consequently, improved companion diagnostic tests and novel treatment approaches for Lyme disease are urgently needed to combat the epidemic. In particular, therapies based on the principles of precision medicine could be modeled on successful “designer drug” treatment for other diseases. This Special Issue of Healthcare examines the use of Big Data registries, companion diagnostics and precision medicine that will revolutionize the diagnosis and treatment of Lyme disease in the coming years.

Dr. Raphael B. Stricker
Guest Editor

Manuscript Submission Information

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Keywords

  • Lyme disease
  • Borrelia burgdorferi
  • tickborne diseases
  • persistent infection

Published Papers (3 papers)

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Research

Open AccessArticle Human Babesiosis Caused by Babesia duncani Has Widespread Distribution across Canada
Received: 6 February 2018 / Revised: 14 May 2018 / Accepted: 15 May 2018 / Published: 17 May 2018
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Abstract
Human babesiosis caused by Babesia duncani is an emerging infectious disease in Canada. This malaria-like illness is brought about by a protozoan parasite infecting red blood cells. Currently, controversy surrounds which tick species are vectors of B. duncani. Since the availability of a
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Human babesiosis caused by Babesia duncani is an emerging infectious disease in Canada. This malaria-like illness is brought about by a protozoan parasite infecting red blood cells. Currently, controversy surrounds which tick species are vectors of B. duncani. Since the availability of a serological or molecular test in Canada for B. duncani has been limited, we conducted a seven-year surveillance study (2011–2017) to ascertain the occurrence and geographic distribution of B. duncani infection country-wide. Surveillance case data for human B. duncani infections were collected by contacting physicians and naturopathic physicians in the United States and Canada who specialize in tick-borne diseases. During the seven-year period, 1119 cases were identified. The presence of B. duncani infections was widespread across Canada, with the highest occurrence in the Pacific coast region. Patients with human babesiosis may be asymptomatic, but as this parasitemia progresses, symptoms range from mild to fatal. Donors of blood, plasma, living tissues, and organs may unknowingly be infected with this piroplasm and are contributing to the spread of this zoonosis. Our data show that greater awareness of human babesiosis is needed in Canada, and the imminent threat to the security of the Canadian blood supply warrants further investigation. Based on our epidemiological findings, human babesiosis should be a nationally notifiable disease in Canada. Whenever a patient has a tick bite, health practitioners must watch for B. duncani infections, and include human babesiosis in their differential diagnosis. Full article
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Open AccessArticle Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease
Received: 7 March 2018 / Revised: 27 March 2018 / Accepted: 11 April 2018 / Published: 14 April 2018
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Abstract
Introduction: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, in patients who have been treated with recommended
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Introduction: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. Methods: In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Results: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined. Full article
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Open AccessArticle Citizen Science and Community Engagement in Tick Surveillance—A Canadian Case Study
Received: 14 January 2018 / Revised: 22 February 2018 / Accepted: 27 February 2018 / Published: 2 March 2018
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Abstract
Lyme disease is the most common tick-borne disease in North America and Europe, and on-going surveillance is required to monitor the spread of the tick vectors as their populations expand under the influence of climate change. Active surveillance involves teams of researchers collecting
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Lyme disease is the most common tick-borne disease in North America and Europe, and on-going surveillance is required to monitor the spread of the tick vectors as their populations expand under the influence of climate change. Active surveillance involves teams of researchers collecting ticks from field locations with the potential to be sites of establishing tick populations. This process is labor- and time-intensive, limiting the number of sites monitored and the frequency of monitoring. Citizen science initiatives are ideally suited to address this logistical problem and generate high-density and complex data from sites of community importance. In 2014, the same region was monitored by academic researchers, public health workers, and citizen scientists, allowing a comparison of the strengths and weaknesses of each type of surveillance effort. Four community members persisted with tick collections over several years, collectively recovering several hundred ticks. Although deviations from standard surveillance protocols and the choice of tick surveillance sites makes the incorporation of community-generated data into conventional surveillance analyses more complex, this citizen science data remains useful in providing high-density longitudinal tick surveillance of a small area in which detailed ecological observations can be made. Most importantly, partnership between community members and researchers has proven a powerful tool in educating communities about of the risk of tick-vectored diseases and in encouraging tick bite prevention. Full article
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