Background Tick-borne infections cause significant morbidity and mortality around the world1-3. In the US, 400,000 new cases of Lyme borreliosis occur each year4-6. Eighteen tick-borne illnesses that occur in the US are listed in Table 1.
These are caused by bacterial, viral, and protozoal pathogens that have co-evolved with ticks and their vertebrate hosts. Recent ecosystem disruptions have been caused by climate change, farming, and industrialization. These disruptions have increased the frequency of human-tick encounters each year over the past 30 years.
In addition to ecosystem and climate changes, chemical changes in our food chain, air, and water have led to primed and dysregulated innate immune responses. We have called this a persistently activated cell danger response (CDR)7.
When the CDR fails to return to a normal baseline state, the process of healing is disrupted8, and many different kinds of chronic complex illness can result. Two of these that we have studied are autism spectrum disorder (ASD)9 and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)10.
About 10% of patients who have acute Lyme disease will go on to develop chronic symptoms of post-treatment Lyme disease syndrome (PTLDS, Box 1). Box 1 Diagnostic Criteria for Post-treatment Lyme disease syndrome (PTLDS)11 Documented Lyme disease by two-tier testing; 1) positive enzyme immunoassay (EIA) or indirect immunofluorescence assay (IFA), followed by 2) a positive Western blot, with or without the erythema migrans (EM) rash.
Treated with doxycycline for 4 weeks Life altering fatigue for at least 6 months after completing antibiotic treatment Three or more areas of musculoskeletal pain Brain fog, difficulty finding words, or difficulty with previously routine memory tasks Positive Western Blot Results—CDC Criteria IgM Positive: two of the following three bands are present: 24 kDa (OspC)*, 39 kDa (BmpA), and 41 kDa (Fla)12 IgG Positive: five of the following 10 bands are present: 18 kDa, 21 kDa (OspC)*, 28 kDa, 30 kDa, 39 kDa (BmpA), 41 kDa (Fla), 45 kDa, 58 kDa (not GroEL), 66 kDa, and 93 kDa13 *The apparent molecular mass of OspC is dependent on the strain of B. burgdorferi being tested. The 24 kDa and 21 kDa proteins referred to are the same