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Patricia V. Smith, BA

President, Lyme Disease Association, Inc.
Advisory Board, Columbia University Lyme & Tick-Borne Diseases Research Center
Jackson, NJ

Welcome, Remarks/Brief Overview of LDA, Lyme & Tick-Borne Diseases

Pat Smith is in her 25th year as LDA President and has been a Lyme advocate for 37 years. After helping to write and pass legislation to establish the HHS Tick-Borne Disease Working Group, she served 4 years as a member, co-authoring two reports to Congress and co-chairing two subcommittees, and also served 4 years on the Congressionally Directed Medical Research Program (CDMRP) Programmatic Panel, having worked with Congress to get tick-borne diseases included in this Department of Defense program. Pat also testified before two Congressional Subcommittees on Lyme disease. In 2021, Pat worked with Congressman Chris Smith to get the CHILD Act 2021 introduced, amending the Individuals with Disabilities Education Act (IDEA) to include Lyme and other tick-borne diseases as examples of disabilities−recognizing more clearly that the education of children is affected by Lyme disease to ensure they receive related services. She has briefed committees in both Houses of Congress over time, and spoken before the Women in Government conference.

Pat is former Chair, (NJ) Governor’s Lyme Disease Advisory Council and former president of the Wall Board of Education—also acted as an advocate in the schools for children with Lyme. She was Environmental Protection Agency’s PESP 2011 Lyme prevention conference session co-chair with CDC. In 2011 she presented a Lyme session to the New Jersey Education Association’s Annual Meeting. She is a founding member & former officer of ILADS, International Lyme & Associated Diseases Society, a professional medical and research organization. She served on the on-line journal Contagion Infectious Disease Today, Chronic Lyme Expert Panel video.

She has led LDA in its funding effort of 122 research grants, research which has appeared in 56 journals to date, and of many small educational grants helping other organizations with their programs. She worked with author Amy Tan to develop LDA’s LymeAid 4 Kids, supplying medical grants for financially disadvantaged families and developed LDA’s brochures: LymeR Primer; ABCs of Lyme Disease, for parents & educators; and Tick ID Card. She has published many articles on Lyme and tick-borne diseases, including co-authoring one read into the Congressional Record and has received recognition from Congress, and testified in many states on Lyme legislation.




Ricardo G. Maggi, PhD

Research Professor, Internal Medicine
College of Veterinary Medicine
North Carolina State University
Raleigh, NC

Simultaneous detection and absolute quantification of Babesia, Bartonella and Borrelia by droplet digital PCR

Dr. Ricardo G. Maggi received his Licentiate degree in Chemistry at Universidad Nacional de Cordoba, Argentina in 1988, his MS, working on environmental chemistry, at University of Puerto Rico in 1993, and his Ph.D., characterizing the molecular mechanisms of microbial adaptation in extreme environments in 2001. During 1995 to 2002, he served as Adjunct professor at the Inter-American University of Puerto Rico in San German, PR teaching and mentoring MS students in environmental chemistry and microbiology. After a year as a Chief Researcher at BioPolo, Italy, Dr. Maggi joined North Carolina State University in 2003. Since 2004, first as Assistant Professor at the College of Veterinary Medicine and now as full Research Professor, he focused his work on vector-borne and zoonotic pathogens diseases. From 2009 to 20014 he served also as Co-Director of the Vector Borne Diseases Diagnostic Laboratory and since 2009 as co-director of the Intracellular Pathogens Research Laboratory, CVM-NCSU (position that he still holds).
During the past 17 years, Dr. Maggi’s laboratory has focused on the development of new and enhanced serological, molecular and microbiological methods for the detection and characterization of Anaplasma, Babesia, Borrelia, Ehrlichia, Mycoplasma, and Rickettsia infections in animals and humans. These efforts have resulted in new diagnostic modalities, such as the Bartonella-Alpha Proteobacteria Culture Medium (BAPGM) platform, a Babesia-Bartonella-Borrelia multiplex Droplet Digital PCR (ddPCR) assay, and the development of in-vitro non-tumorigenic epithelial human cell line model systems to gain mechanistic insights to altered cellular pathways leading to angiogenesis, cancer induction, and inflammation.
Dr. Maggi has published 142 peer-reviewed clinical and research journal articles, 4 book chapters published in two languages in three countries, and was invited to over 50 lectures at national and international research and clinical forums.

 


Conference Lecture Summary

This presentation describes the development, optimization, and validation of a ddPCR assay for the simultaneous detection of Babesia, Bartonella, and Borrelia spp. DNA from several sample matrices, including clinical blood samples from animals and patients, vectors (ticks, fleas, sandflies), as well as samples from human and animal cell lines and tissues from animal models (infected with Bartonella and/or B. burgdorferi). The multiplex ddPCR assay (BBB ddPCR), developed based upon a recently published a Bartonella ddPCR assay using the QX200 system from Bio-Rad, is able to detect 31 Bartonella spp. (including 8 previously uncharacterized species), 8 Borrelia spp, and 24 Babesia spp. (including 8 previously uncharacterized species). The assay is also able to detect 2 Theilaria spp. (T. equi and T. cervi) and well as C. felis from naturally infected wildlife species. The BBB ddPCR assay, based on the QX One ddPCR system from Bio-Rad, showed to be able to perform the simultaneous detection and absolute quantification of multiple vector-borne pathogens (such as Babesia, Bartonella and Borrelia) from clinical samples.




Kenneth B. Liegner, MD

Private Practice
Pawling, New York

Disulfiram in the Treatment of Lyme disease: Promise & Perils

Dr. Kenneth Liegner is a Board Certified Internist with additional training in Pathology and Critical Care Medicine, practicing in Pawling, New York. He has been actively involved in diagnosis and treatment of Lyme disease and related disorders since 1988. He has published articles on Lyme disease in peer-reviewed scientific journals and has presented poster abstracts and talks at national and international conferences on Lyme disease and other tick borne diseases. He has cared for many persons seriously ill with chronic and neurologic Lyme disease. His work has focused on the serious morbidity and (occasional) mortality that can eventuate from this aspect of the illness. He has emphasized the urgent need for widespread clinical availability of improved methods of diagnostic testing and for development of improved methods of treatment for Lyme disease in all its stages. He holds the first United States patent issued proposing application of acaricide to deer for area-wide control of deer-tick populations as a means of reducing the incidence of Lyme disease. He has authored In the Crucible of Chronic Lyme Disease – Collected Writings & Associated Materials, a documentational history of the struggle to characterize the nature of Lyme disease in the late 20th and early 21st centuries, published November 2015 (www.inthecrucibleofchroniclymedisease.com).

He served two terms on the Board of Directors of The International Lyme and Associated Diseases Society (www.ilads.org), is on the Scientific Advisory Board of the Lyme Disease Association (www.lymediseaseassociation.org), and is a member of the American Medical Association (www.ama-assn.org), the Westchester County Medical Society (www,wcms.org), the Medical Society of the State of New York (www.mssny.org) and The American Association of Physicians and Surgeons (www.aapsonline.org). He is on the staff of Northern Westchester Hospital Center in Mount Kisco, New York (Northwell Health System) and the Sharon Hospital in Sharon, Connecticut (Nuvance Health System).

He was the first physician to apply disulfiram in the treatment of Lyme disease and published his experience with his first three patients in the peer-reviewed journal Antibiotics, May 2019 (https://www.mdpi.com/2079-6382/8/2/72) and reported his first 3 years’ experience with the drug in December 2020 (Antibiotics 2020, 9(12), 868; https://doi.org/10.3390/antibiotics9120868) He was co-author on a landmark pathologic study of tissues from a person with chronic Lyme disease (https://www.mdpi.com/2079-6382/8/4/183) and co-author of the ILADS evidence-based definition of chronic Lyme disease (https://www.mdpi.com/2079-6382/8/4/269). .

 


Conference Lecture Summary

Some 4 years have elapsed since disulfiram was first knowingly applied in the treatment of persons with Lyme disease. Experience with the agent thus far, in one medical practice, is reviewed.




Brandon L Jutras, PhD

Assistant Professor
Fralin Life Sciences Institute
Department of Biochemistry
Virginia Tech
Blacksburg, VA

Not just another brick in the wall: The unusual peptidoglycan of Borrelia burgdorferi

Brandon Jutras (PhD) has been studying the biology and pathogenesis of Lyme disease for 13 years and authored more than 25 peer-reviewed articles, many of which have been published in the top-tier journals. His career began as a graduate student in the laboratory of Dr. Brian Stevenson at the University of Kentucky where he focused on deciphering the mechanisms of gene regulation in the spirochete Borrelia burgdorferi. After gaining a deep appreciation for unusual biological features of spirochetes, Dr. Jutras took his molecular skills and passion to the lab of Dr. Christine Jacobs-Wagner at Yale University, a world-renowned bacterial cell biologist. As a Howard Hughes Medical Institute Postdoctoral Fellow Brandon began to study the peptidoglycan sacculus of B. burgdorferi and uncovered several peculiarities about its’ synthesis and roles in pathogenesis. The Jutras lab at Virginia Tech has extended these studies to use peptidoglycan as a bio-tool to understand the cell cycle, morphogenesis, pathogenesis, and antibiotic susceptibility of B. burgdorferi. These principal components form the fundamental basis for understanding, diagnosing, treating, and preventing Lyme disease.

 


Conference Lecture Summary

The peptidoglycan sacculus is a mesh-like bag that protects bacterial cells from bursting. Virtually all bacteria have similar peptidoglycan structure. Borrelia burgdorferi—the Lyme disease agent— produces peptidoglycan with extremely unusual chemical features. Further, during growth, peptidoglycan is shed and is capable of causing arthritis. Here we will discuss how the Jutras lab is exploiting the unusual properties of B. burgdorferi peptidoglycan to understand and diagnose Lyme disease.




Marna E. Ericson, PhD

T Lab, Inc.- Director of Research
Hormel Institute, University of Minnesota, Medical Research Center- Adjunct Faculty
Austin, MN

Bartonella henselae Detected in Malignant Melanoma

Our goal is to understand the mechanism(s) of infection and persistence of vector-borne infectious diseases by investigating disease pathology, disease progression and co-morbidities in individuals infected with vector-borne pathogens such as Borrelia, Bartonella and Babesia. These pathogens are under-diagnosed due to their unique mechanisms of sequestration (biofilms) in tissues and blood, their fastidious and unique growth characteristics in vitro and their dynamic growth properties within the host. Formerly Marna was director of the Cutaneous Imaging Lab in the Department of Dermatology at the University of Minnesota, assistant professor for 20 years. Currently, she is a fellow at Fellow at Think, Lead & Innovate Foundation, an Adjunct Faculty member at the Hormel Institute, University of Minnesota and serves as the Director of Research at TLAB, Inc., in Gaithersburg, MD. TLAB is a medical diagnostic lab using molecular microscopy to identify the presence of vector-borne pathogens in blood and skin. Dr. Ericson specializes in advanced microscopy imaging techniques including multi-photon laser scanning microscopy, second harmonic generation, correlative microscopy, TEM and SEM, live imaging, and super-resolution microscopy.
These techniques have afforded unprecedented views, literally, of the wide range of tissues in which these pathogens can be detected. Recognition of the dermis as being a niche for Bartonella spp., in biofilms, has advanced our understanding of mechanisms of persistence and presents new opportunities for new treatment modalities. Collaboration with colleagues who have expertise in molecular biology, microbiology, dermatology, oncology, infectious diseases and nanotechnology has yielded invaluable new insights on the importance of biofilms in skin and other organs as well as the vascular system including both blood and lymphatic vessels. The multi-pronged approaches provide new insights and improved methods for detection and diagnosis for vector-borne diseases and life-altering co-morbidities.

 


Bartonella henselae Detected in Malignant Melanoma, a Preliminary Study

Bartonella bacilliformis (B. bacilliformis), Bartonella henselae (B. henselae), and Bartonella quintana (B. quintana) are bacteria known to cause verruga peruana or bacillary angiomatosis, vascular endothelial growth factor (VEGF)‐dependent cutaneous lesions in humans. Given the bacteria’s association with the dermal niche and clinical suspicion of occult infection by a dermatologist, we determined if patients with melanoma had evidence of Bartonella spp. infection. Within a one‐month period, eight patients previously diagnosed with melanoma volunteered to be tested for evidence of Bartonella spp. exposure/infection. Subsequently, confocal immunohistochemistry and PCR for Bartonella spp. were used to study melanoma tissues from two patients. Blood from seven of the eight patients was either seroreactive, PCR positive, or positive by both modalities for Bartonella spp. exposure. Subsequently, Bartonella organisms that co‐localized with VEGFC immunoreactivity were visualized using multi‐immunostaining confocal microscopy of thick skin sections from two patients. Using a co‐culture model, B. henselae was observed to enter melanoma cell cytoplasm and resulted in increased vascular endothelial growth factor C (VEGFC) and interleukin 8 (IL‐8) production. Additionally, the two tissues also were found to have BRAF mutations, an oncogene expressed in up to 70% of melanomas. Findings from this small number of patients support the need for future investigations to determine the extent to which Bartonella spp. are a component of the melanoma pathobiome. Being at the frontier of understanding the role of the microbiome in cancer, we will discuss some new papers on this topic and future research plans.




Catherine A. Brissette, PhD

Associate Professor
University of North Dakota School of Medicine and Health Sciences
Grand Forks, ND

Borrelia colonization of the dura mater induces inflammation in the CNS

Catherine (Cat) Brissette received her B.S. in Zoology from Louisiana State University, her M.S. with Dr. Paula Fives-Taylor at the University of Vermont, and her Ph.D. on interactions of oral spirochetes with the gingival epithelium from the University of Washington with Dr. Sheila Lukehart. She continued work with spirochetes as a postdoc with Dr. Brian Stevenson at the University of Kentucky, with a focus on outer surface adhesins and regulation of virulence factors in the Lyme disease spirochete Borrelia burgdorferi. Cat is now an Associate Professor at the University of North Dakota School of Medicine and Health Sciences where she continues work with pathogenic Borrelia species. Cat’s lab is broadly interested in bacterial-host interactions, and is particularly interested in those bacterial and host factors that impact colonization and immune responses in the central nervous system during infection with Lyme and relapsing fever spirochetes.

 


Conference Lecture Summary

Lyme disease, which is caused by infection with Borrelia burgdorferi, can lead to inflammatory pathologies affecting the joints, heart, and nervous systems including the central nervous system (CNS). Laboratory mice have been used to define the kinetics of B. burgdorferi infection and host immune responses in other tissues, but similar studies are lacking for the CNS of these animals. Previously, we reported the ability of B. burgdorferi to colonize the dura mater of mice during late disseminated infection. We now show acute and persistent extravascular B. burgdorferi colonization of the dura mater after both needle inoculation and tick transmission, accompanied by increases in expression of inflammatory cytokines. These increases in inflammatory gene expression are similar to what is observed with B. burgdorferi stimulation of human astrocytes, microglia, brain endothelial cells, and choroid plexus epithelial cells in vitro. In addition, we observe a robust interferon response in the dura mater. Dura colonization is associated with perivascular leukocyte infiltration and meningitis, demonstrating for the first time that B. burgdorferi-infected mice can develop meningitis. We also observe an increase in interferon-stimulated genes in both the cortex and hippocampus of infected mice, despite a lack of detectable bacteria in the brain parenchyma. Combined with the increases in inflammatory gene expression and downregulation of genes involved in maintenance of blood-brain and blood-CSF barriers in both mice and human cell culture models, these results could provide insights into the mechanism of B. burgdorferi dissemination into the CNS and the damage associated with this pathogen.




Ed Breitschwerdt, DVM

Professor of Medicine and Infectious Disease
North Carolina State University College of Veterinary Medicine
Raleigh, NC

Bartonella Bacteremia and Neuropsychiatric Illnesses

Dr. Edward B. Breitschwerdt is a professor of medicine and infectious diseases at North Carolina State University College of Veterinary Medicine. He is also an adjunct professor of medicine at Duke University Medical Center, and a Diplomate, American College of Veterinary Internal Medicine (ACVIM). Dr. Breitschwerdt directs the Intracellular Pathogens Research Laboratory in the Comparative Medicine Institute at North Carolina State University. He also co-directs the Vector Borne Diseases Diagnostic Laboratory and is the director of the NCSU-CVM Biosafety Level 3 Laboratory.

A graduate of the University of Georgia, Breitschwerdt completed an internship and residency in Internal Medicine at the University of Missouri between 1974 and 1977. He has served as president of the Specialty of Internal Medicine and as chairperson of the ACVIM Board of Regents. He is a former associate editor for the Journal of Veterinary Internal Medicine and was a founding member of the ACVIM Foundation.

Breitschwerdt’s clinical interests include infectious diseases, immunology, and nephrology. For over 30 years, his research has emphasized vector-transmitted, intracellular pathogens. Most recently, his research group has contributed to cutting-edge research in the areas of animal and human bartonellosis. In addition to authoring numerous book chapters and proceedings, Dr. Breitschwerdt’s research group has published more than 450 manuscripts in peer-reviewed scientific journals. In 2012, he received the North Carolina State University Alumni Association Outstanding Research Award and in 2013, he received the Holladay Medal, the highest award bestowed on a faculty member at North Carolina State University. In 2017, Dr. Breitschwerdt received the American Association of Veterinary Medical Colleges Outstanding Research Award and the American Canine Health Foundation Excellence in Research Award. In 2018, he was named the Melanie S. Steele Distinguished Professor of Medicine at North Carolina State College of Veterinary Medicine.

 


Conference Lecture Summary

In the past two decades, numerous (over 40) Bartonella species have been discovered, many of which have been implicated in association with a spectrum of disease in animals and human patients. The extent to which, or the mechanisms by which Bartonella infection contributes to neuropsychiatric illnesses has not been systematically studied. However, microbiological detection of Bartonella spp. DNA in blood supports a potential role for these bacteria in neuropsychiatric diseases such as Pediatric Acute Onset Neuropsychiatric Syndrome (PANS) and schizophrenia. The objective of this lecture will be to summarize our experiences with Bartonella species and neuropsychiatric illnesses.




Adrian Baranchuk, MD, FACC, FRCPC, FCCS, FSIAC

Professor of Medicine
Queen’s University
Editor-in-Chief, Journal of Electrocardiology
Vice President, International Society of Electrocardiology (ISHNE)
President Elect, Interamerican Society of Cardiology (SIAC)
Kingston, Ontario, Canada

All you need to know about Lyme carditis…and more!

Dr. Adrian Baranchuk, a native of Buenos Aires, Argentina, obtained his MD from the University of Buenos Aires in 1990. After qualifying in Internal Medicine and Cardiology (1995), he completed a Clinical Fellowship in Cardiac Electrophysiology (1997). In 2002 he immigrated to Spain for a Research Fellow. Dr. Baranchuk was appointed as a Clinical Fellow in Electrophysiology at McMaster University in September 2003.

Dr. Baranchuk was appointed as an Assistant Professor of Medicine at Queen’s University (2006), promoted to Associate Professor in 2010 and to Full Professor in 2016 (with Tenure). He has founded the EP Training Program in 2007.

He is a member of numerous editorial boards (Europace, Annals of Noninvasive Electrocardiology, etc) and reviewer of several journals. He is currently the Editor-in-Chief of the Journal of Electrocardiology and Deputy Editor for JACC in Spanish.

The recipient of several teaching awards (Outstanding Contribution in the Core Internal Medicine Program 2009) and in 2014 with the prestigious “Faculty of Health Sciences Education Award”. Dr Baranchuk was awarded with the “Golden Caliper Award” from the SOLAECE (Latin American Society of Pacing and Electrophysiology) for his outstanding contributions to science in 2014 and with the “ISHNE Junior Investigator Award” in April 2015. In 2016 he was distinguished with the “10 Most Influential Hispanic-Canadian Award” from the Hispanic business.ca and TD Bank. He was awarded with the “David Ginsburg Mentorship Award” in December 2017 and the “Faculty of Health Sciences Recognition Award” in 2018. He was recently awarded with the “Employment Equity Award” in recognition to his contributions to Gender Equity in Cardiology. In 2019 he also received the prestigious “2019 Ron Wigle Mentorship Award” by the Faculty of Health Sciences at Queen’s University and the “Consulting Service Teacher of the Year Award”, from the Department of Emergency Medicine at Queen’s University. He has received the “2020 Magdy Basta Award” from the Canadian Heart Rhythm Society in recognition to help advancing research of fellows and colleagues from all around the country.

His first book, Atlas of Advanced ECG Interpretation (REMEDICA, UK) represents a big collaboration effort from well-recognized electrophysiologists of all around the world. His second book Left Septal Fascicular Block was released by SPRINGER in 2016 and his iBook “Electrocardiogrpahy in Pracitice: What to do?” has been number 1 in iTunes for several weeks and downloaded more than 1100 times in about 6 months (2016). The following book was “Interatrial Block and Supraventricular Arrhythmias: Clinical Implications of Bayes’ Syndrome” was released in January 2017 by CARDIOTEXT. “Clinical Arrhythmology 2nd Edition” was released in July 2017 by Willey. His next book, “Brugada Phenocopy: The Art of Recognizing the Brugada ECG Pattern” was released by ELSEVIER in April 2018. In 2019 he released “Texto de Cardiología” the first ever book completely written by Spanish speakers covering all aspects of Cardiology (DISTRIBUNA) and his first fiction book titled “Charlas de Hospital” (“Hospital chit chat”).

He has published more than 725 articles in well-recognized international journals (623 in Pubmed), 54 book chapters and presented more than 255 abstracts. He was the President of the International Society of Electrocardiology (ISE) for the period 2017-2019. He also served as Canadian Vice President of the Interamerican Society of Cardiology (IASC) (2017-2019) and now is serving as IASC Secretary (2019-2021). He was elected Vice President of the International Society of Holter and Non-invasive Electrocardiology (ISHNE) for the period 2019-2021

He has mentored more than 110 students and residents and his publications usually include a Med Student or resident as first author. He has served as Member of the Electrophysiology Section Leadership Council of the American College of Cardiology (2017-2020). He is Co-Director of ECG University, a free website to learn ECG interpretation with more than 67K followers around the world.

He is in charge of organizing the ECG module for the trainee day and the ECG Workshops during the Canadian Cardiovascular Congress and the “A day for ECG lovers” for the World Heart Federation. He chaired the Annual Cardiovascular Symposium at Queen’s University and he chaired “Therapeutics 2020” at Queen’s University.
He lives in Kingston, Ontario, Canada with his wife Barbara and his daughter, Gala.

 


Conference Lecture Summary

Lyme disease (LD) is a tick-born bacterial infection caused by Borrelia burgdorferi. It is the most reported vector-born disease in North America, and its incidence has risen dramatically in recent years. In up to 10% of cases, bacterial dissemination of LD may lead to cardiac tissue inflammation and early disseminated Lyme carditis. The most common clinical presentation of LC is high-degree atrioventricular block (AVB) which can progress rapidly over minutes, hours, or days. Most AVB in LC resolve with appropriate antibiotic treatment without requirement of a permanent pacemaker. We will discuss the most recent findings on patients treated for early disseminated Lyme carditis without implant of a pacemaker and their clinical long-term follow-up.




John Aucott, MD

Director, Lyme Disease Research Center
Associate Professor of Medicine, Johns Hopkins University School of Medicine
Baltimore, MD
hopkinslyme.org

Long Haulers: Lessons from Lyme Disease, ME/CFS, and COVID-19

Dr. Aucott is an Associate Professor of Medicine in the Division of Rheumatology at Johns Hopkins University Medical School and the Director of the Johns Hopkins Lyme Disease Research Center. He is principal investigator for the SLICE studies of acute Lyme disease and chronic post-treatment Lyme disease. His research interests center on the pathophysiology, diagnosis and treatment of persistent illness after initial antibiotic treatment of Lyme disease and has resulted in over 30 peer reviewed publications. Dr. Aucott is an internationally recognized authority on Lyme disease and has served on groups sponsored by the Institute of Medicine, the Canadian Institutes of Health Research, and the U.S. Department of Health and Human Services. He is the past chair of the HHS Tick-Borne Disease Working Group.

 


Conference Lecture Summary

The COVID 19 pandemic has drawn attention to the varied outcomes that may follow acute infectious diseases. COVID Long Haulers present another example of a patient group that fails to recover their normal health after the initial phase of infection has passed. Long Haulers in COVID 19 and Lyme disease share many clinical features including life altering fatigue, cognitive difficulties and poorly explained pain. The current COVID 19 pandemic may present insights and research discoveries that help understand the underlying mechanisms involved in these hard to understand persisting symptoms. Understanding the cause of these chronic illnesses is the first step to future treatments and recovery.




Brian A. Fallon, MD, MPH (Moderator)

Professor of Clinical Psychiatry, Columbia University Vagelos College of Physicians and Surgeons Director, Lyme & Tick-Borne Diseases Clinical and Research Centers at Columbia University Irving Medical Center New York, NY Depression, Suicidal Behaviors, and Lyme: Results from a Nationwide Study in Denmark Dr. Fallon is the Director of the Lyme and Tick-Borne Diseases Clinical and Research Centers at the Columbia University Irving Medical Center. A graduate of Harvard College, he obtained his MD degree from the Columbia University College of Physicians and Surgeons, as well as a master’s degree in public health epidemiology from Columbia University. He did his research training and an NIH fellowship in biological psychiatry at Columbia Presbyterian Medical Center and the New York State Psychiatric Institute. Dr. Fallon’s research has focused on neuropsychiatry — the discipline that studies the behavioral and mood effects of diseases that affect the brain. His particular areas of research focus in Lyme disease include phenomenology, diagnostics, neuroimaging, biomarker, and treatment studies. Dr Fallon has lectured on Lyme disease nationally and internationally and was the lead investigator of one of the NIH-funded U.S. Clinical Trials of Post-Treatment Lyme Disease (PTLD). Dr. Fallon has published over 100 peer-reviewed articles, review papers, and book chapters and he has served as a reviewer for many journals, including JAMA, Journal of Infectious Disease, Clinical Infectious Disease, and the American Journal of Psychiatry. Most recently, Dr. Fallon and Dr. Jennifer Sotsky published “Conquering Lyme Disease: Science Bridges the Great Divide” (Columbia University Press).  


Conference Lecture Summary This presentation will review the results of our recent U.S.- Denmark collaboration to determine whether in fact mental disorders and suicidal behaviors are increased after the diagnosis of Lyme disease. Although cases reports, small series, and office-based practice chart reviews have been published suggesting an association, these studies all had methodological limitations which left these questions unanswered. Using a nationwide sample of people living in Denmark between 1994 and 2016 (n=6,945,837) and data from the Danish registries of hospital-based diagnoses, we investigated whether the rates of mental disorders, affective disorders, suicide attempts, and suicide were each higher after a hospital diagnosis of Lyme borreliosis compared to the rest of the Danish population without a registered diagnosis of Lyme Borreliosis. We examined whether temporal proximity to the diagnosis and number of episodes increased the rates of these adverse mental health outcomes. The results and implications of the study results will be discussed.