Months after a U.S. Congress–mandated working group sounded the alarm about tickborne illnesses and urged more federal action and money, the National Institutes of Health (NIH) is readying a strategic plan for these diseases. Last week it also, serendipitously, issued a rare solicitation for prevention proposals in tickborne diseases. The new pot of money, $6 million in 2020, represents a significant boost; NIH spent $23 million last year on Lyme disease, by far the most common tickborne illness, within $56 million devoted to tickborne diseases overall.
"I'm happy for anything" new going toward research, says John Aucott, director of the Johns Hopkins Lyme Disease Clinical Research Center in Baltimore, Maryland, who chaired the group that wrote the 2018 report. Strategies that may garner support include vaccines that target multiple pathogens carried by ticks or that kill the ticks themselves.
Aucott's panel included academic and government scientists as well as patient advocates; it formed as a result of the 2016 21st Century Cures Act. The group's report described tickborne diseases as a "serious and growing threat." About 30,000 confirmed Lyme disease cases were reported last year to the Centers for Disease Control and Prevention (CDC), but the agency believes the real number to be more than 300,000. Cases of Lyme disease have roughly tripled since the 1990s as ticks carrying Borrelia burgdorferi, the causative bacterium, have spread in response to climate change, neighborhoods encroaching on animal habitats, and other ecologic shifts.
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The Lyme disease field has for years been mired in controversy—researchers receive hate mail from angry and desperate patients, and scientific disputes can be vitriolic. That may have left government agencies reluctant to wade too deep into the fray. "I think the discussion is starting to shift," says Monica Embers, a microbiologist at Tulane University in New Orleans, Louisiana. She and others still hope for additional money from NIH and CDC for diagnostics and treatment research. CDC's budget for Lyme disease grew this year from $10.7 million to $12 million—the first increase in 5 years, albeit a modest one. "Preventing infection is going to go a long way if we can do it," Embers says.
Symptoms of Lyme disease vary but can include a rash at the site of the tick bite, fever, fatigue, and swollen lymph nodes. After a course of antibiotics, 10% to 20% of those infected remain sick, and the question is why: Some scientists believe the bacterium can persist in the body, but others dismiss the idea. This dispute, combined with patients whom doctors often can't help, has created a fractious field unlike almost any other.
Wikipedia entry for Borrelia burgdorferi [wikipedia.org].