2014 Conference Speaker Summaries

Click on name to link to summary:

Brian A. Fallon, MD, MPH Jason A. Carlyon, PhD Marina Makous, MD 
Richard Marconi, PhD Charles Chiu, MD, PhD Thomas N Mather, PhD 
Nicole Baumgarth, DVM, PhD Joseph D. Forrester, MD, MSc Steven Schutzer, MD
John T. Belisle, PhD Emir Hodzic, DVM, PhD Shelia Statlender, PhD
Kenneth Bramwell, PhD Linden Hu, MD Travis Taylor, PhD 
Ahmet C. Burakgazi, MD
John Keilp, PhD Sam R. Telford III, ScD 
Michael L. Weinberger, MD  


Long-term Follow-up of Patients with Persistent Lyme Encephalopathy
Brian A. Fallon, MD, MPH (Conference Co-Director) / Chandra A.

Background. Prospective studies of patients with early Lyme disease followed over time suggest that approximately 10% develop long-term problems. The long-term status of those who present with post-treatment chronic symptoms after getting Lyme disease is not known. Retrospective studies indicate that a risk factor for poor long-term outcome is delayed onset of treatment. Although Four U.S. Randomized Clinical trials have been conducted of those with chronic symptoms (most of whom were first treated late in illness), none has yet followed patients over time to assess long-term outcome. This presentation first will review all studies that have followed patients prospectively over time, including those in the U.S. and in Europe. Secondly, this presentation will present results from a long-term follow-up of patients with post-treatment Lyme encephalopathy.

Methods. The patient sample was drawn from the Brain Imaging and Treatment Study of Post-treatment Lyme Encephalopathy at Columbia University which enrolled 18 healthy volunteers and 37 patients with well-documented prior Lyme disease previously treated with IV ceftriaxone and current objective cognitive impairment. As participants were enrolled between 2000 and 2004, the follow-up interval was 8-13 years later. Follow-up assessments included a structured telephone interview as well as self-report questionnaires. The structured telephone interviewed asked patients to rate themselves on global improvement, on specific improvement (pain, fatigue, and cognition), on current functional impairment, and the extent to which they feel currently impacted by the earlier Lyme infection. The self-report questionnaires matched questionnaires given to patients prior to initial study enrollment and after completing study treatment 10 years earlier. Enrollment in this follow-up study continues. This report will be a preliminary assessment of the initial cohort who have been reached – 24 Lyme patients and 11 controls. We anticipate additional subjects will be included in time for the Conference presentation.

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Marconi3New Advances in the Pursuit of a Combinatorial Human Vaccine for Lyme Disease & Anaplasmosis
Richard T. Marconi, PhD (Conference Co-Director)

Dr. Marconi’s presentation will focus on ongoing efforts in his laboratory to develop novel OspC-epitope based diagnostic antigens and vaccines for human Lyme disease. The presentation will cover the pros and cons of current preventive approaches. An overview of the biological importance and properties of the OspC protein will be provided as a means of establishing its potential utility in novel preventive and diagnostic strategies for use in humans. The presentation will then trace the work that has spanned the last 10 years that has led to the conceptualization and design of prototype chimeric OspC-epitope antigens. The potential of this technology to be used in the construction of single polypeptides that can protect against multiple tick borne diseases including Lyme and human anaplasmosis will be discussed. 

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BaumgarthImmune suppression during infection of mice with Borrelia burgdorferi
Nicole Baumgarth, DVM, PhD

The immune response to Borrelia burgdorferi (Bb), which causes Lyme disease, is an enigma. Acute infections induce many different antibodies, some of which are used in diagnostic tests. These antibody responses appear initially strong, but seem to rapidly diminish following antibiotic treatment. In addition, mice and humans do not seem to develop protective immunity following the infection, as reinfections can occur frequently in endemic areas and experimental settings. Based on these findings we hypothesize that infection with Bb may suppress or subvert the development of protective long-term antibodies.

Previously we showed that lymph nodes are an early target of Bb infection in mice. We can find Bb in these lymph nodes, which become enlarged and lose their normal structure. Normally in infections, structures called germinal centers form in lymph nodes to produce long-lived antibody-producing cells, but in these Borrelia-infected lymph nodes, germinal centers appear only briefly despite an ongoing infection. We have found that these germinal centers are structurally abnormal and produce neither long-lived antibody-producing cells nor memory B cells. By vaccinating Bb-infected mice with a usually strong antigen, we showed that the lack of long-term immune response to Bb is because the infection actively suppresses the immune response.

Together these studies show that Borrelia burgdorferi evades mammalian immune responses by affecting germinal centers. The data explain the lack of long-term protective immunity to Bb in both experimentally-infected mice and humans and suggest that acute Bb-infection causes a state of immune suppression.

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BelisleMetabolomics of Lyme Disease: A Novel Diagnostic Approach
John T. Belisle, PhD

The currently recommended method for diagnosing Lyme disease is a two-tiered serology-based test that is limited in its ability to differentiate active from previous infection, diagnose early LD, and is not standardized among laboratories. Moreover, the interpretation of test results is open to subjectivity. Thus, a fresh approach for improved diagnostic development is critical to the field. Studies applying the global evaluation of small molecule biomarkers, “metabolomics”, for the discovery of biosignatures and biomarkers for monitoring cancers and metabolic diseases have shown tremendous promise. Although this technology has not been widely applied for infectious diseases, it is recognized that infectious diseases are manifested based on alterations in the biochemistry of a biological system.

Over the past three years our laboratory in collaboration with the Centers for Disease Control and Prevention, and New York Medical College successfully developed a serum based metabolomics approach to identify a small molecule biosignatures that can differentiate early Lyme disease (localized and disseminated) patients from healthy individuals from both endemic and non-endemic regions in the United States, and from patients with diseases that have look-alike symptoms or that are cross-reactive with existing serology-based tests for Lyme disease. This biosignature was developed with well-characterized retrospective samples and has significantly enhanced sensitivity as compared to the two-tiered serology-based testing of the same samples. These analyses provide proof-of-concept that a Lyme disease multi-analyte small molecule diagnostic can be developed. Further validation of this model; structural identification of biosignature metabolites; and additional comparisons targeting early localized versus disseminated Lyme disease, baseline versus 1-month post-treatment, and early Lyme disease versus Lyme arthritis are being performed. These efforts not only hold potential for new Lyme diagnostic and prognostic tools, but will also provide new information about the biology of Lyme disease.

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Bramwell2Gene Variant Exacerbates Inflammatory Arthritis in Mice
Kenneth K.C. Bramwell, Ph.D.

Lyme Disease, caused by infection with the tick borne spirochete Borrelia burgdorferi, is a growing societal concern, especially in endemic regions of the United States and Europe. Part of the concern is rooted in the uncertainty surrounding pathological outcomes associated with B. burgdorferi infection. A large percentage (70%) of infected individuals develop the characteristic bulls-eye rash erythema migrans at the site of the infected tick bite, with progression to further clinical complications following dissemination of the spirochete. Lyme arthritis is the most common symptom, occurring in 30-60% of infected individuals. Part of the wide variation in Lyme disease symptoms and severity observed within the patient population is thought to be due to differences in heritable genetic risk factors.

To identify regulatory genes, we have used an unbiased forward genetic approach, based on the observation that genetic differences between inbred mouse strains lead to consistent differences in their Lyme arthritis severity. Early studies identified the location of large regulatory regions of the genome responsible for this effect, followed by a process of refinement through genetic mapping to identify candidate regulatory genes to be formally investigated.

We have recently reported our identification of the first naturally occurring gene polymorphism that regulates Lyme arthritis severity, in the lysosomal enzyme beta-Glucuronidase (Gusb). Our severely affected mouse strain carries a partial deficiency in this gene, which does not cause spontaneous disease but leads to a more severe inflammatory arthritis following infection with B. burgdorferi, consistent with a two-hit model. The Lyme arthritis severity of this strain was profoundly reduced after their partial Gusb deficiency was corrected through transgenic overexpression. We also found that partial Gusb deficiency increased the severity of rheumatoid arthritis in our mice, indicating a conserved role and a common mechanism. The human Gusb gene is polymorphic, and GUSB enzyme levels vary by more than 30-fold in the normal human population. Severe Gusb deficiencies are very rare and cause a congenital lysosomal storage disease called Sly syndrome, characterized by pathological accumulation of the natural substrates of the GUSB enzyme, glycosaminoglycans (GAGs). We observed a pronounced increase in the accumulation of GAGs in the inflamed joint tissues of B. burgdorferi infected mice with partial or severe Gusb deficiencies, which may represent a novel mechanism underlying the pathogenesis of disease in Lyme and rheumatoid arthritis.

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BurakgazipicLyme Disease – Induced Polyradiculopathy Mimicking Amyotrophic Lateral Sclerosis
Ahmet Z. Burakgazi, MD

Lyme disease, the leading arthropod-borne infection in the USA, can cause a wide spectrum of neurological conditions affecting central and peripheral nervous systems (PNS). Lyme disease related PNS manifestations include cranial neuropathy, polyradiculopathy, motor neuropathy, brachial plexopathy, lumbosacral plexopathy, and distal axonopathy. Lyme disease can cause severe, predominantly axonal polyradiculopathy, but it is less common than a chronic predominantly sensory polyradiculopathy. Furthermore, its diagnosis can be very challenging and it can mimic other neurological disorders such as Amyotrophic Lateral Sclerosis (ALS), or Guillain-Barre syndrome (GBS). Careful and detailed examination and investigation are required to confirm the diagnosis and to prevent misleading inaccurate diagnoses.

Herein, we report a unique case with an ALS-mimicking predominantly motor polyradiculopathy presentation caused by Lyme disease. A 64 year-old man presented with a one-month history of rapidly progressive weakness involving bulbar, upper limb and lower limb muscles. The physical examination showed widespread weakness, atrophy, fasciculation and brisk reflexes. The initial electrodiagnostic test showed widespread active and chronic denervation findings. The initial physical and electrodiagnostic findings were suggestive of ALS. However blood serology indicated possible Lyme disease. Thus, the patient was treated with doxycycline. The clinical and electrodiagnostic findings were resolved with the treatment.

The diagnosis of Lyme disease can be very challenging and it can mimic other neurological disorders such as ALS or GBS. Careful and detailed examination and investigation are required to confirm the diagnosis and to prevent misleading inaccurate diagnoses.

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CarlyonPromising Progress in Developing Protective and Therapeutic Approaches Against Anaplasma phagocytophilum Infection
Jason A. Carlyon, PhD

Human granulocytic anaplasmosis (HGA) is an emerging tick-borne disease in the United States, Europe, and Asia. The number of HGA cases reported to the U. S. Centers for Disease Control and Prevention rose nearly seven-fold between 2003 and 2012. Yet, seroprevalence data indicate that the infection is underreported in some endemic regions. HGA is an acute illness characterized by fever, chills, headache, malaise, leukopenia, thrombocytopenia, and elevated liver enzymes. Complications include shock, seizures, pneumonitis, rhabdomyolysis, hemorrhage, increased susceptibility to secondary infections, and death. Risk for complications and fatality is greater for the elderly, the immunocompromised, and when proper diagnosis and/or antibiotic therapy are delayed. The same ticks that transmit HGA also transmit Lyme disease, and coinfections do occur.

The causative agent of HGA is Anaplasma phagocytophilum, a bacterium that infects white blood cells called neutrophils. A. phagocytophilum is an “obligate intracellular” pathogen, which means that it cannot survive freely in the environment. Entry into host cells is therefore essential for its survival – a phenomenon that we are exploiting to develop effective preventative/therapeutic treatments against the disease.

A. phagocytophilum uses surface proteins called invasins to mediate entry into host cells. We identified three A. phagocytophilum invasins (OmpA, Asp14, and AipA) that are critical for infection. All are on the bacterium’s surface, which makes them accessible to blocking antibodies. We delineated the specific regions of OmpA, Asp14, and AipA that are necessary for cellular invasion. A combination of antibodies against the “invasion domains” of all three proteins blocked A. phagocytophilum infection of host cells in vitro. We are now poised to evaluate these targets’ protective efficacies in vivo. Moreover, we have an exciting collaboration with Dr. Rich Marconi’s laboratory to combine our HGA protective epitopes with protective epitopes of Lyme disease targets identified by his group to develop a chimeric vaccine that will protect against both HGA and Lyme disease. Given the potential severity of these diseases, the limited choices of antibiotics for treating them, and the lack of a vaccine against either, our work is highly relevant.

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ChiuTickChip Detection Microarray, Tickborne Viruses, STARI, and Transcriptome Profiling of Lyme Disease
Charles Chiu, MD, PhD

Lyme disease, a tickborne febrile illness caused by the bacterium Borrelia burgdorferi, is the most common vector-borne disease in the U.S, and incidence is increasing worldwide. An estimated 3.4 million commercial antibody-based tests are conducted annually in the U.S. for Lyme, yet these tests fail to diagnose up to 40% of acute Lyme disease cases. In addition, existing tests are unable to detect in a multiplexed fashion clinically significant co-pathogens in the tick vector, such as Babesia and Anaplasma. We will discuss the use of emerging genomic technologies – microarrays and deep sequencing – to address the urgent clinical need for improved Lyme diagnostics. First, a novel microarray platform called the TickChip has been developed and is able to detect all tickborne pathogens, including viruses, bacteria, and parasites from blood in a single assay. In preliminary data using spiked samples, we have shown that the TickChip has a sensitivity of detection of 1-10 genome copies of Borrelia burgdorferi or Babesia microti per milliliter of blood. Second, whole-exome transcriptome profiling of Lyme disease patients by deep sequencing has identified a specific and robust host response signature for acute Lyme that persists for at least one month duration. This transcriptome data is currently being leveraged to design a multiplexed host response-based assay for acute Lyme disease diagnosis. Finally, we will report the use of unbiased deep sequencing for the detection and discovery of novel viruses in the hunt for the etiologic agent of STARI (Southern Tick-Associated Rash Illness), a Lyme-like illness that is spread by the Amblyomma tick, a vector which also harbors the pathogenic Heartland virus. The rising incidence and morbidity of Lyme and associated tick- borne illnesses demand the development of new diagnostics with the sensitivity to broadly detect these tickborne disease agents, both known and novel. 

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ForresterSudden Cardiac Arrest Associated with Lyme Carditis
Joseph D. Forrester, MD, MSc

Lyme carditis is inflammation of the heart due to infection by Borrelia burgdorferi. It occurs uncommonly among patients with Lyme disease and is rarely fatal. In November 2012, a tissue bank pathologist detected pathology suspicious for Lyme carditis in tissues from a young adult who had died suddenly and unexpectedly. Seven months later, in July 2013, pathologists at a tissue bank and at CDC detected similar findings in heart tissues from two additional, unrelated young adults who had died suddenly. Medical records of the index cases were reviewed and specimens were tested for evidence of B. burdorferi infection.

The decedents, two males and one female aged 26-38 years, were residents of Connecticut, Massachusetts, and New York. All had serologic evidence of early disseminated LD, and spirochetes were detected in cardiac tissues by microscopy, immunohistochemistry, and polymerase chain reaction assays. Donated corneas from two decedents had been transplanted to three recipients before the diagnosis of Lyme disease was established, but no evidence of disease transmission was found.

Prompt recognition and early, appropriate therapy for Lyme disease is essential. Health-care providers should ask patients with suspected Lyme disease about cardiac symptoms and obtain an EKG if indicated. Conversely, they should ask patients with unexplained heart block about possible exposure to infected ticks. These three deaths underscore the need for better methods of primary prevention of Lyme disease and other tickborne diseases.

Disclaimer: The findings and conclusions in this summary are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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HodzicPost-Antibiotic Persistence and Resurgence of Attenuated Borrelia burgdorgeri
Emir Hodzic,DVM, PhD

Persistent infection with Borrelia burgdorferi, the agent of Lyme disease, is the rule, not the norm, in its many hosts. The ability to persist and evade host immune clearance poses a challenge to effective antibiotic treatment. There is growing experimental evidence in a variety of animal species that viable, non- cultivable spirochetes persist following treatment with several different antibiotics.

Our studies have undeniably found persisting spirochetes in mouse tissues 2, 4, 8 and 12 months after antibiotic treatment. The status of infection was evaluated based upon culture, qPCR, xenodiagnosis, and transplantation of allografts into naïve recipients. During the course of B. burgdorferi infection, an increasingly heterogeneous subpopulation of replicatively attenuated spirochetes arises that have lost small plasmids. These attenuated spirochetes remain viable, but divide slowly and are non-cultivable, thereby being tolerant to antibiotics. Treatment success is inversely correlated with spirochete populations, since spirochete burdens in mouse tissues are highest during early infection, when antibiotics work best. The persistence of non-cultivable spirochetes occurs following treatment with several different classes of antibiotics. The most recent studies indicated that low numbers of persisting, but non-cultivable spirochetes resurge 12 months after antibiotic treatment, with re-dissemination into multiple tissues.

The phenomenon of persistence of non-cultivable spirochetes could be explained by antimicrobial tolerance, in which different classes of antibiotics fail to completely eliminate non-dividing or slowly dividing subpopulations of spirochetes. Plasmid loss is likely to occur during the course of infection and increase over time. The biological significance of attenuated spirochetes is probably insignificant, but the medical significance is another matter, and compels further investigation.

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HuXenodiagnosis of Lyme Disease in Humans
Linden Hu, MD

Background: Animal studies suggest that Borrelia burgdorferi, the agent of Lyme disease, may persist after antibiotic therapy and can be detected by various means including xenodiagnosis using the natural tick vector (Ixodes scapularis). No convincing evidence exists for the persistence of viable spirochetes after recommended courses of antibiotic therapy in humans. We determined the safety of using I. scapularis larva for the xenodiagnosis of B. burgdorferi infection in humans.

Methods: Laboratory-reared larval I. scapularis ticks were placed on 36 subjects and allowed to feed to repletion. Ticks were tested for B. burgdorferi by PCR, culture and/or isothermal amplification followed by PCR and electrospray ionization mass spectroscopy. In addition, attempts were made to infect immunodeficient mice by tick bite or inoculation of tick contents. Xenodiagnosis was repeated in seven individuals.

Results: Xenodiagnosis was well tolerated with no severe adverse events. The most common adverse event was mild itching at the tick attachment site. Xenodiagnosis was negative in 17 patients with post-treatment Lyme
disease syndrome (PTLDS) and/or high C6 antibody levels and in 5 patients after completing antibiotic therapy for erythema migrans. Xenodiagnosis was positive for B. burgdorferi DNA in a patient with erythema migrans early during therapy and in a patient with PTLDS. There is insufficient evidence, however, to conclude that viable spirochetes were present in either patient.

Conclusions: Xenodiagnosis using Ixodes scapularis larva was safe and well tolerated. Further studies are needed to determine the sensitivity of xenodiagnosis in patients with Lyme disease and the significance of a positive result.

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Keilp“Understanding suicidal behavior risk in Lyme Disease: Perspectives from studies of suicidal behavior in depression.”
John G. Keilp, Ph.D.

Rates of both depression and suicidal behavior are elevated in chronic illnesses. It is well-known, in turn, that rates of depression are elevated in post-treatment Lyme disease syndrome (PTLDS). However, there is very little systematic research on suicidal behavior in PTLDS.

In our own work, we have found that PTLDS patients exhibit levels of depression that are intermediate between healthy individuals and those with true major depressions. Despite their generally mild symptoms, a subgroup of PTLDS patients report suicidal thoughts. Outside of occasional case reports, though, little is known about the association of this thinking with actual suicidal behavior.

In addition, cognitive impairments in the context of depression are associated with increased risk for suicidal behavior, and a number of the cognitive impairments typically found in PTLDS are those associated with risk. These include impairments in memory and language fluency. While some components of attention are associated with risk for suicidal behavior in depression, and these components of attention are typically intact in PTLDS, those PTLDS patients who exhibit impairment in attention may be at elevated risk.

This talk will describe findings from our earlier study of PTLDS with memory impairment, findings from studies of risk factors for suicidal behavior in major depression, and propose recommendations for the evaluation of suicidal behavior in PTLDS. Standard clinical procedures for the assessment of suicidal behavior risk, as well as factors that may be unique to PTLDS, will be emphasized.

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MatherMore than Lyme: Progress towards a tick-borne disease protective vaccine
Thomas N. Mather, PhD & Wendy Coy Shattuck

Worldwide, ticks can transmit more than 20 pathogens that impact human and animal health. In North America, just one tick vector, Ixodes scapularis, transmits at least 5 pathogens capable of causing significant disease. Costs to develop an effective and safe human vaccine targeting any one of these tick-transmitted pathogens are estimated to be more than $100 million. Discovery of a broad-spectrum vaccine that targets ticks but effectively suppresses pathogen transmission and host infection by multiple tick-borne pathogens would represent a major milestone for improving public health. A strategy for inducing acquired resistance to the tick itself instead of to each individual pathogen they transmit represents a conceptually-sound and novel strategy for interrupting pathogen transmission and preventing a myriad of tick-borne diseases; empirical data in animal models and epidemiological data in humans strongly suggests that such a strategy can work. This presentation will discuss progress being made to develop a broadly-protective anti-tick vaccine.

While most vaccines are designed to promote antibody responses, a cellular immune response, particularly CD4+ (T helper) T-cell activity is required for vaccine efficacy. T-cells themselves are stimulated by a very limited number of highly specific antigenic determinants (epitopes) derived from the intruding organism’s proteins. Algorithms that accurately model the MHC-peptide interface have been central to the prediction of T-cell epitopes. With the availability of complete sequences of tick-secreted proteins (tick salivome), our studies to date have followed a path marked by milestones that include detecting and characterizing the nature of anti-tick immunity, identifying immune correlates of protection, critical antigen discovery and validation, and development of a novel animal model for accelerating translation into clinical studies. A total of 52 potentially antigenic candidate vaccine peptides have been identified and synthesized from over 150 tick salivary proteins. These are being used to construct prototype vaccines for proof of concept studies.

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MakousCase Presentation of a Suicidal Patient: Lyme or Depression?
Marina Makous, MD

A case will be presented that highlights key questions in the evaluation of the patient with treatment-resistant depression, suicidal thoughts, and possible Lyme disease. Identifying material has been changed to preserve patient confidentiality, but the doctor’s deliberations, clinical history, laboratory results and outcome remain intact.

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SchutzerAtypical EM & PCR in Lyme Disease
Steven E. Schutzer, MD

Atypical Erythema Migrans has been observed in many suspected cases of Lyme disease in the past. Lyme disease was confirmed by CDC criteria of seroconversion in those cases. We applied a more direct confirmation by the use of a PCR-based assay. In the past estimates of atypical EM were on the order of 30%. Our recent data shows in a select population the cases approached 70%. Regardless of whether the number is 30% or 70% it is wise to consider that atypical, non bull’s-eye lesions, are not uncommon and may be first sign that an infection with Borrelia burgdorferi has occurred.

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Statlender“The Impact of Lyme Disease on the Brain: Implications for Diagnosis, Treatment and Recovery”
Sheila M. Statlender, Ph.D.

This presentation will address the impact of tick borne diseases on the brain, and the critical role of mental health professionals in the diagnosis and treatment of the neuropsychiatric and neurocognitive symptoms that reflect brain involvement.

Hundreds of peer-reviewed studies have noted the ability of the Lyme disease bacterium to invade the central nervous system (neuroborreliosis), yet associated symptoms are often not acknowledged or adequately addressed. This may be compounded by an unfortunate tendency to attribute poorly understood or controversial medical illnesses to “stress,” “malingering,” or primary psychiatric disorders, ignoring the underlying medical etiology. Mental health practitioners with expertise in tick borne diseases understand the full range of associated neuropsychiatric and neurocognitive symptoms, and play a vital role in: 1) screening for symptoms and relevant history as part of the psychotherapeutic assessment and treatment planning process, 2) making referrals for medical evaluation when indicated; 3) evaluating and identifying the presence of cognitive, sensory and other neuropsychological sequelae, “invisible” symptoms which could otherwise be overlooked; 4) providing supportive counseling and coping techniques; 5) facilitating appropriate communication between patients and their medical practitioners; and 6) participating in the development of safety plans for patients whose symptoms place them at risk for self-harm behaviors. The impact of Lyme disease on the brain must be identified and addressed in the overall treatment plan, in order to achieve optimal outcomes for these patients.

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TaylorPowassan & Tick-Borne Encephalitis
Travis Taylor, PhD

Vector-borne flaviviruses, including West Nile virus, dengue virus and tick-borne encephalitis virus serocomplex (TBEV) greatly impact global health and cause millions of infections per year. These viruses are responsible for millions of infections annually, with symptoms ranging from severe encephalitis to hemorrhagic fever with mortality rates exceeding 30%. Currently, treatment is limited to supportive care and few vaccines are available. Powassan virus (a TBEV member) is endemic to North America and can share both vector (Ixodes scapularis) and reservoir host (Peromyscus) with Borrelia burgdorferi.

Despite severe disease in humans, infection of the natural vector and host has little noticeable effect. Based upon our previous work that revealed virus-specific antiviral genes in a TBEV-murine model, we predict that the coevolution of flaviviruses with their respective hosts has resulted in potent antiviral factors that suppress virus replication and protect the host from lethal infection, thus ensuring viruspersistence.

This seminar will provide clinical information on diagnosis and treatment for Powassan virus and provide a background comparison to other flaviviruses. Current work to understand the host antiviral response to these viruses, as well as future therapeutic options will be discussed.

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TelfordBorrelia miyamotoi
Sam R. Telford III, ScD

Borrelia miyamotoi disease (BMD) has recently been described from febrile patients in the northeastern U.S. The agent has been known as a commensal of Ixodes persulcatus species complex ticks globally and may infect 1-5% of host seeking ticks in Lyme disease endemic sites. B. miyamotoi is likely maintained by transovarial transmission in ticks, although deer are reservoir competent as are white-footed mice. Chronic infection in immunodeficient mice causes spectacular hepatosplenomegaly with microabscesses and accumulations of spirochetes. Human cases have presented with meningoencephalitis or a flu-like illness confused with human granulocytic ehrlichiosis; elevated liver function tests and leukopenia were also seen in these patients. B. miyamotoi from North America may genetically differ from those in Eurasia, and unlike the prototypic Japanese strain, cannot be cultivated in vitro. The clinical spectrum and public health burden remain to be described. BMD is the 5th zoonotic infection transmitted by deer ticks in the northeastern U.S.

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WeinbergerPain Management
Michael L. Weinberger, MD

In my talk I will discuss current and evolving issues in pain medicine and their relevance to lyme disease including the use of ketamine and opioids for chronic pain.





2014 Conference Power Point Slide Shows

Please Click on the Following Speakers to Download their Power Point Presentations

Pat Smith

Dr. Fallon – Video on Upcoming Conference

LDA/Columbia Lyme Conference Early Discount Registration Prices Expire on April 5

  • 15th Annual Lyme & Tick-Borne Diseases:
  • Medical, Neuropsychiatric & Public Health Implications
  • May 3 & 4, 2014 Downtown Marriott, Providence, RI
  • CME (physician) & CE (social workers & psychologists) credits offered. Public also invited to register
  • Early conference registration expires April 5
  • Special Room Block prices for sleeping rooms expires April 10 (if rooms still available in block)

By reporting recently that there are approximately 300,000 new Lyme disease diagnoses made annually in the U.S. and that unrecognized Lyme has led to sudden cardiac death, the Centers for Disease Control & Prevention (CDC) has acknowledged that Lyme & other tick-borne diseases (TBD) are “a tremendous public health problem.” Columbia University and the national Lyme Disease Association are sponsoring a scientific and medical conference on Lyme and other emerging tick-borne diseases, offering CME credits for physicians and CE credits for social workers and psychologists, and general registration for the public. A networking reception is included so that attendees can interact with doctors and researchers.

The conference faculty from across the US and Germany will address vaccines, therapeutic approaches to Lyme and other TBD, and novel diagnostics (microarray analysis of tick-borne pathogens, transcriptome profiling to identify markers of Lyme, and metabolite profiles), since current ones, the standard for 20 years, identify less than 50% of cases of early Lyme. Doctors often rely upon the EM (bull’s eye rash), but an expert will discuss the many atypical rashes (or no rash) which occur with Lyme. Several diagnostic techniques under development will be presented, including a first ever study using xenodiagnosis (allowing disease-free ticks to bite humans to detect the Lyme bacteria), which may lend credence to possible persistence of the Lyme bacteria in humans, and a study in mice showing the resurgence of persisting Lyme bacteria following antibiotic treatment.

The clinical implications from this research will include presentations of various treatment modalities, such as the use of IVIG in autoimmune neurologic diseases, IV antibiotic treatment for Lyme, corticosteroids in arthritic children with Lyme, pain management, and an entire session devoted to mental health implications-impact of Lyme on the brain─ including suicidal behavior. Case studies of Lyme mimicking ALS and three sudden deaths due to Lyme carditis will be presented. Immune suppression and genes which may signify a predisposition to Lyme arthritis will also be covered.

Also addressed will be other TBD, especially those caused by viruses. These TBD often lack approved diagnostics or treatment protocols, including one on the rise in the Northeast, Powassan virus, which kills 10% of patients, and Tick-Borne Encephalitis Virus, which can produce long-lasting or permanent neuropsychiatric sequelae in 10-20% of infected patients. Additionally, two other new bacterial TBD which are problematic but not well understood, Borrelia miyamotoi and STARI, southern tick-associated rash illness (infectious organism unknown), both producing Lyme-like disease, will be examined as will therapeutic approaches against anaplasmosis.

Conference Flyer

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2014 Conference Speaker Biographies

Click on name to link to bio: 

Brian A. Fallon, MD, MPH Joseph D. Forrester, MD, MSc Shelia Statlender, PhD 
Richard Marconi, PhD Emir Hodzic, DVM, PhD  Travis Taylor, PhD 
Nicole Baumgarth, DVM, PhD Linden Hu, MD   Sam R. Telford III, ScD 
John T. Belisle, PhD John Keilp, PhD  Michael L. Weinberger, MD
Kenneth Bramwell, PhD Marina Makous, MD  David Younger, MD
Ahmet C. Burakgazi, MD  Thomas N Mather, PhD   
Jason A. Carlyon, PhD  Susanne Nimmrich, MD  Elizabeth Maloney, MD
Charles Chiu, MD, PhD
Steven Schutzer, MD
Patricia V. Smith, BA


FallonBrian A. Fallon, MD, MPH (Conference Co-Director)
Professor of Psychiatry
Director, Lyme and Tick-Borne Diseases Research Center
Columbia University Medical Center
Director, Center for the Study of Neuroinflammatory Disorders & Biobehavioral Medicine, New York State Psychiatric Institute
New York, NY
Lyme and Tick-Borne Diseases Research Center 

Ten Year Follow-up after IV treatment for Lyme Encephalopathy – what happened?

Brian A. Fallon, MD, MPH. Dr. Fallon is director of the Lyme & Tick-borne Diseases Research Center at Columbia University Medical Center where he leads a team focused on biomarkers, diagnostics and treatment of chronic Lyme symptoms. His team’s recent work has included the testing of novel diagnostic assays in a large community study, with the net result of the identification of a more sensitive Lyme Western blot. His team’s work on Lyme encephalopathy led to the discovery of hundreds of unique proteins present in the CSF of Lyme patients but not in the CSF of patients with chronic fatigue syndrome or healthy controls. His team’s current focus is on clarifying the immunologic profile and neural circuitry of patients with persistent symptoms. His team is also investigating the CNS metabolic effects of intravenous ceftriaxone using MR Spectroscopy to probe glutamatergic transmission. Dr. Dwork in his Center is examining the neuropathologic findings in post-mortem studies of patients with chronic Lyme symptoms. Dr. Moeller in his Center is examining the interaction between peripheral immunologic markers, central immune markers, and brain neurocircuitry among patients with chronic symptoms with the goal of identifying of biomarkers to help guide treatment recommendations.

Dr. Fallon serves on the editorial and review board of three journals, has lectured and published widely, and most recently has led an international team for the American Psychiatric Association’s revision of DSM-5 to clarify the prevalence of illness anxiety in the general population.

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Marconi3Richard T. Marconi, PhD (Conference Co-Director)

Professor of Microbiology & Immunology
School of Medicine
Virginia Commonwealth University, Richmond, VA

New Advances in the Pursuit of a Combinatorial Human Vaccine for Lyme Disease & Anaplasmosis

Dr. Marconi is a Professor in the School of Medicine at Virginia Commonwealth University. He earned his Ph.D. at the University of Montana where he studied the functional role of ribosomal RNA and its interactions with antibiotics and transfer RNA. He conducted his post-doctoral training at The Roche Institute of Molecular Biology and the Rocky Mountain Laboratories (NIAID, NIH). At Roche, Dr. Marconi’s research efforts were focused on the study of the molecular regulation of methionine biosynthesis in Escherichia coli. Dr. Marconi then accepted an Intramural Research Training Award with the NIH to study the pathogenesis of Lyme disease and other spirochetal infections at Rocky Mountain Laboratories. Dr. Marconi now has ~25 years of experience in the study of pathogenic spirochetes. His current research interests are diverse and include the study of molecular mechanisms of pathogenesis of Lyme disease, tick borne relapsing fever and periodontal disease. A considerable focus of the Marconi lab has been translational with an emphasis on the development of novel therapeutic strategies, diagnostic assays and vaccines for these important human infections. Dr. Marconi has demonstrated experience in product development and has developed and patented a novel and innovative vaccine for canine Lyme disease. Research is now under way in his laboratory to develop a multi-valent vaccine for use in humans that protects against multiple tick borne pathogens. Dr. Marconi is well recognized for his vaccine related research and has lectured worldwide. He has published over 85 papers, reviews and book chapters.

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BaumgartNicole Baumgarth, DVM, PhD
Professor, Pathology, Microbiology, Immunology
Center for Comparative Medicine
University of California, Davis
Davis, CA



Immune Suppression During Infection of Mice with Borrelia burgdorferi

Nicole Baumgarth is a DVM, PhD and Professor of Immunology at the Center for Comparative Medicine, University of California, Davis. She is also the Chair of the Graduate Group in Immunology there. Dr. Baumgarth’s research encompasses studies on the regulation of immune responses to infections and B cell biology. Much of her recent work has focused on the regulation of B cell responses and B cell subset responses using mouse models to two very different pathogens and immune responses: Acute influenza virus infection, an infection that fully resolves and induces highly protective and long-lived B cell-mediated immunity, and B cell responses to Borrelia burgdorferi, a bacterial spirochete and the causative agent of Lyme disease. Infections with B. burgdorferi induce strong B cell responses, however, those responses to not result in clearance of the infection. By contrasting a successful with a not-successful B cell response her group hopes to uncover important immune regulatory mechanisms that shape the quality of the B cell response.

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BelisleJohn T. Belisle, PhD
Dept of Microbiology, Immunology, Pathology
College of Veterinary Medicine & Biomedical Sciences
Colorado State University  Fort Collins, Colorado



Metabolomics of Lyme Disease: A Novel Diagnostic Approach 

Bacterial Genetics and Physiology

There are two primary foci of our laboratory group: The provision of reagents and collaborations with other researchers through the Tubculosis Research Materials and Vaccine Testing Contract (NO1-AI-75320) The study of mycobacterial physiology and genetics. 

The recent completion of the genome sequences of Mycobacterium tuberculosis and Mycobacterium aviumprovides a unique opportunity to study the proteomes of these organisms using high throughput methodologies, such as 2-D PAGE and LC-MS-MS. We are currently using such approaches to address several aspects of the M. tuberculosis proteome: (1) study the glycoproteins of M. tuberculosis and define the implications of post-translational modifications on immunogenicity and bacterial physiology; (2) elucidate the molecular mechanism of growth regulation and glycolipid biosynthesis in Mycobacterium spp.; and (3) define and characterize proteins of M. tuberculosis that are primary targets of the host immune response and involved in pathogenesis. The overall goal of this work is to provide a better understanding of the physiology of Mycobacterium spp., and to apply this knowledge to the development of improved diagnostics, vaccines and anti-mycobacterial drugs. 

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Bramwell2Kenneth Bramwell, PhD
Post-Doctoral Fellow
Department of Pathology
University of Utah
Salt Lake City, Utah

Gene Variant Exacerbates Inflammatory Arthritis in Mice

Dr. Kenneth K.C. Bramwell is a Postdoctoral Fellow in the lab of Janis Weis in the Department of Pathology at the University of Utah. He earned his Ph.D. in Cell and Molecular Biology from Baylor College of Medicine in 2009. Using a mouse model of Lyme arthritis, his work has focused on the identification of host genetic risk factors that are responsible for the wide spectrum of disease severity reported among Lyme patients. Through this approach, he has recently identified the lysosomal enzyme beta-Glucuronidase (Gusb) as a key regulator of Lyme and rheumatoid arthritis severity. Over the past several year he has received numerous travel awards and invitations to present his work at conferences focused on genetics, infectious disease, technical advances, membrane trafficking, and immunology. Dr. Bramwell is a recipient of the Arthritis Foundation Postdoctoral Fellowship.

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BurakgazipicAhmet C. Burakgazi, MD Neurologic
Asst. Professor
Department of Internal Medicine
Virginia Tech Carilion School of Medicine and Research Institute
Roanoke, VA 24016


Neurologic Lyme & Case of Polyradiculopathy Mimicking ALS

Dr. Ahmet Burakgazi has begun his medical practice as neurologist and assistant professor at Virginia Tech Carilion School of Medicine. He is also the director of Muscular Dystrophy Association/Amyotrophic Lateral Sclerosis at Carilion Clinic. He received his medical degree from Hacettepe University, Ankara, Turkey; he completed his neurology residency & clinical neurophysiology fellowship (focusing on EMG/NCS and neuromuscular diseases) at George Washington University, where he also served as a chief resident. His clinical interests include electrodiagnostic medicine, neuromuscular diseases, and botulinum toxin injections for neurological disorders. He has authored many articles in respected journals.

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CarlyonJason A. Carlyon, PhD
Associate Professor
Microbiology and Immunology
Virginia Commonwealth University
Richmond, VA


Promising progress in developing protective and therapeutic approaches against Anaplasma phagocytophilum infection?

Intracellular pathogens are fascinating organisms for study and present wonderful opportunities to examine the complexities of the pathogen-host interface. Residing within mammalian host cells affords intracellular pathogens with distinct survival advantages. They are sequestered from antibody- andcomplement-mediated attack while being privy to a nutrient-rich environment. My laboratory studies adhesion, invasion, and intracellular survival strategies of the obligate intracellular bacterium Anaplasma phagocytophilum, the causative agent of human granulocytic anaplasmosis (HGA; formerly human granulocytic ehrlichiosis). HGA is an emerging and potentially fatal infectious disease that is gaining increased recognition in the United States, Europe, and Asia and is the second most common tick-transmitted disease in the U. S. A. phagocytophilum is unique in that it persists within its mammalian host by colonizing neutrophils. Neutrophils are key effectors in innate immunity that eradicate microbial invaders by ingesting and subjecting them to powerful oxidative and proteolytic killing mechanisms. A. phagocytophilum invasion of the primary effector cell of microbial killing presents a striking paradox and raises questions as to why it chooses such aformidable host cell and how it evades and subverts neutrophil killing pathways. We are seeking to answer these questions through multiple research projects.

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ChiuCharles Chiu, MD, PhD
Assistant Professor
Department of Laboratory Medicine
Biomedical Sciences Graduate Program
Division: Infectious Diseases
University of California, San Francisco School of Medicine
San Francisco, CA

TickChip detection microarray, STARI, and transcriptome profiling of Lyme disease

Charles Chiu, M.D./Ph.D. is Assistant Professor of Laboratory Medicine and Medicine / Infectious Diseases at UCSF, Director of the UCSF-Abbott Viral Diagnostics and Discovery Center (VDDC), and Associate Director of the UCSF Clinical Microbiology Laboratory. He completed his M.D. and Ph.D. from the University of California, Los Angeles in Biophysics and completed internal medicine residency, infectious disease fellowship, and postdoctoral training at UCSF. Dr. Chiu is an expert in development and implementation of advanced genomic technologies – microarrays and next-generation sequencing (NGS) – for pathogen discovery and clinical assay validation in the microbiology laboratory, with over 50 patents and peer-reviewed publications on these topics. His current research interests include (1) pathogen discovery in hepatitis, encephalitis, and infectious disease outbreaks, (2) development of novel pathogen and host transcriptome-based diagnostics for Lyme disease and Southern tick-associated rash illness (STARI), and (3) implementation of NGS-based assays and cloud-based bioinformatics analysis pipelines for infectious disease diagnosis. His work in Lyme disease and “Lyme-like” illnesses includes the development of a TickChip microarray array for diagnosis of tickborne pathogens in clinical samples, transcriptome profiling of acute and chronic Lyme disease for identification of diagnostic markers, and the use of unbiased NGS to search for the etiologic agent of Southern tick-associated rash illness (STARI). He has spoken at numerous national and international conferences on these topics, and is on an FDA task force on bloodborne pathogen screening for ensuring transfusion safety. His research is currently supported by an NIH R01 grant and a 7-year UCSF-Abbott Pathogen Discovery Award.

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ForresterJoseph D. Forrester, MD, MSc
Epidemic Intelligence Service Officer
Division of Vector-Borne Diseases
Centers for Disease Control & Prevention
Ft. Collins, CO


Sudden Cardiac Arrest Associated with Lyme Carditis

Joe Forrester MD MSc is a medical epidemiologist in the CDC’s Epidemic Intelligence Service and a categorical general surgery resident at Stanford University. After growing up in Colorado, Dr. Forrester attended the University of Virginia where he received his MD. During his medical training, he also received his MSc in Infectious Disease from the London School of Hygiene and Tropical Medicine. He is currently at the vector-borne bacterial diseases branch of CDC as an Epidemic Intelligence Service officer for his two years of dedicated surgery residency research.

Dr. Forrester was the lead investigator for the recent CDC investigation into three sudden cardiac deaths that were associated with Lyme carditis, and continues to investigate the epidemiology of Lyme carditis and risk factors for cardiac arrest. As an Epidemic Intelligence Service officer, Dr. Forrester is also responsible for investigating outbreaks of plague and tularemia. He volunteers as a copy editor for Accidents in North American Mountaineering and as an ad-hoc reviewer for several medical journals; in 2012 he was received the Wilderness and Environmental Medicine Excellence in Peer Review award.

In his free time, Dr. Forrester is a rock-climber, mountaineer and expedition kayaker. In 2009, he completed a 3,600 mile solo-kayak descent of the Missouri and Mississippi Rivers to raise more than $20,000 for Parkinson’s disease research.

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HodzicEmir Hodzic, DVM, PhD
Director, Research & Diagnostic Core Facility
Center for Comparative Medicine, UC Davis
Davis, CA

Resurgence of Persisting Non-Cultivable Borrelia burgdorferi Following Antibiotic Treatment in Mice

Dr. Hodzic has a wide range of knowledge to foster creativity of new ideas, a broader professional vision, leadership, and an insight into the areas of microbiology and molecular biology.  His research focused on investigating the interaction of Borrelia burgdoferi with tick vectors and mammalian hosts, using animal models.  His special interest has been on the kinetics of infection, immune responses, and clearance patterns after treatment, and persistence.  Dr. Hodzic has been involved in a groundbreaking research that has shown evidence of B. burgdorferi persistence after antibiotic therapy.

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HuLinden Hu, MD
Tufts Medical Center
Geographic Medicine & Infectious Diseases
Boston, MA



Xenodiagnosis of Lyme Disease in Humans

Dr. Linden Hu is Professor of Medicine at Tufts University School of Medicine and Vice Chairman for Faculty Development in the Dept. of Medicine at Tufts Medical Center. He received his A.B. in Human Biology and M.D. from Brown University. He did his residency in Internal Medicine at St. Elizabeth’s Medical Center in Boston and a fellowship in Infectious Diseases at Tufts Medical Center.

Dr. Hu is involved in both clinical and laboratory based research into Lyme disease. His focus is on the mechanisms by which the spirochete adapts to its various natural hosts and evades the host immune responses. His laboratory is also developing reservoir-targeted vaccines to reduce transmission of tick borne diseases in the wild.

Dr. Hu has been a member or Chairman of numerous peer review committees for the NIH and the National Research Fund for Tick-borne Diseases. He has received a Daland Fellowship from the American Philosophical Society and the Maxwell Finland Award from the Massachusetts Infectious Disease Society and is a Fellow of the Infectious Disease Society of America. In 2010, he was elected to the American Society for Clinical Investigation. Dr. Hu teaches at Tufts Medical School and at the Sackler School of Graduate Biomedical Studies where he is training faculty in the Programs in Microbiology and in Immunology.

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KeilpJohn Keilp, PhD
Assistant Professor of Clinical Psychology
Columbia University, College of Physicians & Surgeons, NY
Research Scientist IV
Head of Neuropsychology Laboratory
Division of Molecular Imaging and Neuropathology
New York State Psychiatric Institute, New York, NY
Licensed Psychologist, New York State

Understanding suicidal behavior risk in Lyme Disease: Perspectives from studies of suicidal behavior in depression

John G. Keilp, Ph.D. is a Neuropsychologist, a Research Scientist at the New York State Psychiatric Institute, and an Assistant Professor of Clinical Psychology in Psychiatry at the Columbia University College of Physicians and Surgeons. Dr. Keilp’s work has focused on neuropsychological features of depression and its relationship to suicidal behavior, as well as on the neuropsychological consequences of Lyme disease. He is Head of the Neuropsychology Laboratory in the Department of Molecular Imaging and Neuropathology at the New York State Psychiatric Institute, a member of the scientific advisory board of the Columbia Lyme Disease Research Center, and a consultant neuropsychologist to the Lyme Evaluation Service at Columbia.

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MakousMarina Makous, MD
Board Certified Family Physician
Post-Doctoral Research Fellow
Psychiatry/Family Medicine
Columbia Lyme and Tick-Borne Diseases Research Center
New York, NY

Case Presentation of a Suicidal Patient: Lyme or Depression?

Dr. Makous is a Post-Doctoral Research Fellow in the Departments of Psychiatry and Family Medicine at Columbia University. She evaluates and offers treatment recommendations for patients with suspected neuropsychiatric sequelae of Lyme and other tick-borne diseases.

Currently,she is conducting a study to assess the validity of a short neurocognitive test in identifying specific cognitive deficits in patients with suspected Lyme disease. In addition, she is a collaborator in several other ongoing studies at the Lyme Disease Research Center.

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MatherThomas N Mather, PhD
Professor of Public Health Entomology
Director URI Center for Vector-Borne Disease
University of Rhode Island
Kingston, RI

More than Lyme: Progress towards a Tick-borne disease protective vaccine

Dr. Mather (a.k.a. the TickGuy) came to URI in 1992 from the Harvard School of Public Health, and now serves as director of URI’s Center for Vector-Borne Disease and its TickEncounter Resource Center. His research focus is on tick ecology, area-wide tick control strategies, tick-bite protection, and tick-borne disease prevention. His research and outreach programs are diverse, including anti-tick vaccine discovery projects, evaluations of targeted tick control strategies, tick-borne disease risk prediction, as well as development of tick-bite protection decision support tools and social networking strategies for tick-borne disease prevention. His work has received local, national, and even international recognition and has attracted more than $13 million from a wide variety of sources, including the National Centers for Disease Control, the US Department of Agriculture, the National Science Foundation, the Environmental Protection Agency, the US Agency for International Development, and the National Institutes of Health.

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Susanne Nimmrich, Dr. med (pending)
Resident/ Assistant physician, research associate
Asklepios Childrens Hospital Sankt Augustin
Department of Paediatrics and Neonatology
53757 Sankt Augustin

Intraarticular Corticosteroids in Refractory Childhood Lyme Arthritis

Susanne Nimmrich is a physician from Germany specializing in paediatrics. Following her studies at the Ernst-Moritz-Arndt-University Greifswald and Christian-Albrechts-University of Kiel she is working as a resident and research associate in the Asklepios Childrens Hospital Sankt Augustin since february 2012. A significant specialization of the department of paediatrics is rheumatology and different types of arthritis. The department takes part in the BiKer register as a large register of the paediatric rheumatology. Research subjects especially include rheumatic diseases, different types of arthritis, autoinflammatory diseases and especially new treatment options with biologics.

Additionally Susanne is working as a doctoral candidate at the Department of Neurology of the University of Kiel.


SchutzerSteven E. Schutzer, MD
Professor of Medicine
New Jersey Medical School, Rutgers University,
Newark, NJ

Atypical EM & PCR in Lyme Disease

Steven Schutzer, MD is a physician-scientist who trained and was on the faculty at Cornell University Medical College, New York Hospital, and Rockefeller University, before joining New Jersey Medical School. His research has focused on the interface of the immune system and microbes. Particular areas of research interest are Lyme and Tick diseases, neuroimmunology, and immunology. Dr. Schutzer is board certified in Internal Medicine, Allergy and Clinical Immunology, and Clinical Laboratory Immunology and is Professor of Medicine at UMDNJ, Rutgers.
Dr. Schutzer’s research is funded by the National Institutes of Health and other organizations.

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StatlenderSheila M. Statlender, PhD
Clinical Psychologist, Private Practice
Newton Center, MA

The Impact of Lyme Disease on the Brain: Implications for Diagnosis, Treatment and Recovery

Sheila M. Statlender, Ph.D., is a clinical psychologist in practice in Newton, Massachusetts for more than 25 years. She is a member of the American Psychological Association, the Massachusetts Psychological Association, the National Register of Health Providers in Psychology, and the International Lyme and Associated Diseases Society. Dr. Statlender specializes in the impact of chronic illness, including academic, vocational and personal adjustment issues, and provides individual and family counseling to many patients diagnosed with tick borne disease. Dr. Statlender has presented at a number of professional conferences and workshops, participated in the Boston Bar Association Task Force on Professional Challenges and Family Needs, and was a governor-appointed member of the Commission to Conduct an Investigation and Study of the Incidence and Impacts of Lyme Disease in the Commonwealth of Massachusetts.

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TaylorTravis Taylor, PhD
Asst. Professor
Virologist, Flavivirus Innate Immunity
College of Medicine and Life Sciences
University of Toledo
Toledo, OH

Powassan & Tick-Borne Encephalitis

Currently Dr. Taylor’s research focuses on the arthropod-transmitted members of the Flaviviridae family. Flaviviruses are globally significant human pathogens including dengue virus (DENV), West Nile virus (WNV) and the TBEV serocomplex of viruses. Select members of the TBEV serocomplex includes the highly pathogenic TBEV-Sofjin and Powassan virus (POWV) and require biosafety level (BSL)-4 and 3 facilities respectively…

Dr. Taylor received his Ph.D. degree at the University of Texas Southwestern Medical Center at Dallas under the mentorship of Dr. Wade Bresnahan. He then completed his postdoctoral training at the NIH Rocky Mountain Laboratories where he studied the biosafety level (BSL)-4 tick-borne flaviviruses in the laboratories of Drs. Marshall Bloom and Sonja Best. Dr. Taylor joined the Department of Medical Microbiology and Immunology in August of 2012.

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TelfordSam R. Telford III, ScD
Professor, Infections Diseases and Global Health Medicine
Tufts Cummings School of Veterinary Medicine
Grafton, MA


Borrelia miyamotoi

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WeinbergerMichael L. Weinberger, MD
Assoc. Professor of Anesthesiology
Pain Medicines, Anesthesiology, Internal Medicine
New York, NY



Pain Management

Dr. Weinberger graduated from Clark University with a BA in biology. He earned his MD in 1983 from the College of Physicians and Surgeons at Columbia University. He then completed an internship and residency in internal medicine at the St. Vincent’s Hospital and Medical Center, followed by a residency in anesthesiology at NewYork-Presbyterian Hospital/Columbia University Medical Center and a fellowship in pain medicine at Memorial Sloan Kettering Cancer Center.

Dr. Weinberger is the division chief of pain medicine. He is director of the Pain Management Center and program director for the pain medicine fellowship. An associate professor of anesthesiology at CUMC, he has been with the department since 2001. He practices all aspects of pain medicine and has a special interest in the spine, cancer pain, palliative medicine, and chronic regional pain syndrome (CRPS).

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YoungDavid Younger, MD
Clinical Associate Professor of Neurology
NYU School of Medicine
New York, NY


IVIG & Its Use in Autoimmune Neurologic Diseases


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MaloneyElizabeth Maloney, MD
Board certified in Family Medicine

President, Partnership for Health & Healing (accredited CME program provider)
Wyoming, MN



Organizing Committee/ Session Facilitator

Elizabeth L. Maloney, MD, is board-certified in family medicine and president of Partnership for Healing and Health, a company providing accredited CME programs on Lyme disease for physicians and other health professionals as well as Lyme disease education and training programs for private organizations and government agencies. She has published on Lyme disease in peer-reviewed journals and frequently lectures on Lyme disease at hospitals and medical conferences.

In addition to her clinical work, Dr. Maloney has held several physician leadership roles. She served as Chief of Staff at District Memorial Hospital and on the Board of Directors of Allina Medical Clinics, a multi-specialty healthcare system. Dr. Maloney is a member of the American Academy of Family Physicians, the Minnesota Academy of Family Physicians and the International Lyme and Associated Diseases Society.

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SmithPatbPatricia V. Smith
President, Lyme Disease Association, Inc. (LDA)
PO Box 1438 Jackson, NJ 08527

Conference Planner / Organizing Committee

Patricia V. Smith, a Monmouth University graduate, is completing her 17 th year as President of the volunteer-run national non-profit Lyme Disease Association. A member of Columbia University’s Lyme & Tick-Borne Diseases Research Center Advisory Committee, member of the Food & Drug Administration’s (FDA) PESP Partnership to promote avoidance of tick exposure, and Advisor to Lyme Research Alliance, CT, she is also former Chair of the (NJ) Governor’s Lyme Disease Advisory Council, former President/12-year member of the Wall NJ Board of Education and was FDA’s 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. Ms. Smith, a 30 year Lyme advocate, has raised funds for researchers nationally─research acknowledged in 33 scientific journals.

Besides speaking, publishing, TV/radio appearances and organizing 13 CME accredited Lyme scientific conferences for doctors, she’s testified for and secured passage of state and federal bills for Lyme research and physician’s right to treat. Working with author Amy Tan, she created LDA’s LymeAid 4 Kids, a fund for children with no health coverage for Lyme.

Chosen Jackson NJ’s Chamber of Commerce 2008 Woman of the Year, she has also received a certificate of Special Congressional Recognition from RI Congressman James Langevin, and had a flag flown over the US Capitol by request of NJ Congressman Christopher Smith in honor of her work on Lyme. In 2012, she was an invited to testify before the Foreign Affairs Committee, Africa, Global Health & Human Rights Health Subcommittee in Washington, DC. In 2013, she was invited to testify before the US House of representatives Energy & Commerce Health Subcommittee on HR 610 (Smith-NJ), a bill to establish a federal Lyme & Tick-Borne Dsieases Advisory Committee. 

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2014 LDA Conf. Online Regular Registration Form

 15th Annual Lyme & Other Tick-Borne Diseases:

Medical, Neuropsychiatric & Public Health Implications  

2-Day Conference Jointly Sponsored by:

Lyme Disease Association & Columbia University College of Physicians & Surgeons


Regular Registration: General public/others who do not need Continuing Medical Ed credits 

Fees: Early Registration $199 (by 04/05/14); $220 (after 04/05/14); $230 (if space available, at door) 

For CE registration – (Continuing education)  Register using regular registration (above) and be prepared to pay an additional $30 in cash or check at the door (check payable to Lyme Disease Association, Inc). You must register through regular registration online or by mail for the conference to be guaranteed entrance at the door, when you will then pay the additional fee. Check to see if you need verification for credits (below).

Social Workers  12.5 CE credits for RI social workers authorized from NASW RI Chapter,Authorization # RI-5570. Social workers in other states, contact your professional organization for reciprocity.     Psychologists: All psychologists from all states contact your professional organization for reciprocity.   LDA makes no guarantees for out of state social workers or any psychologist that your professional organization will accept CE credits. You yourself must verify reciprocity and acceptance with your professional organization. 

Saturday, May 3, 2014    7:15 a.m.- 5:30 p.m.  Reception 5:45 p.m.-7:00 p.m.

Sunday, May 4, 2014      7:30 a.m.-1:30 p.m.

  • One form per registrant 
  • Fee includes Sat. breakfast, lunch, breaks, reception, scientific lectures, exhibits; Sun. break, scientific lectures, exhibits; program.
  • Credit Card Registrations: Online Only    (No Phone or Fax Registrations) 
  • Cancellation: Written cancellation notice must be received by LDA by 4/10/14 for refund.  NO exceptions.  Email cancellation notice to treasurer@LymeDiseaseAssociation.org or fax 732-938-7215

(note: Paypal has known issues with google chrome.  If you have trouble with your submission please try using another browser such as internet explorer, firefox or safari)

{rsform 49}


Registration is a 2 step process: 

1) After you click the submit button you will have completed the LDA portion of the registration.  An email confirm will be sent by LDA, check your SPAM box if you do not receive it. 

2) Next you will be sent to the PayPal page to input your credit card information and finish registration.  An email confirm will also be sent by PayPal which you need to bring to the conference.  If you have registered and do not receive a PayPal confirm within 24 hours of your online payment, please email treasurer@LymeDiseaseAssociation.org 











2014 LDA Conf. Online CME Registration Form

 15th Annual Lyme & Other Tick-Borne Diseases:

Medical, Neuropsychiatric & Public Health Implications 

2-Day Conference Jointly Sponsored by:

Lyme Disease Association & Columbia University College of Physicians & Surgeons


Accreditation Statement This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the College of Physicians and Surgeons of Columbia University and the Lyme Disease Association. The College of Physicians and Surgeons of Columbia University is accredited by the ACCME to provide continuing medical education for physicians.  

AMA Credit Designation Statement  The College of Physicians and Surgeons designates this live activity for a maximum of 13.0 AMA PRA Category 1 Credits TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Fees: Early Registration $310 (by 04/05/14); $340 (after 04/05/14); $370 (if space available, at door) 

Saturday, May 3, 2014    7:15 a.m.- 5:30 p.m.  Reception 5:45 p.m.-7:00 p.m.

Sunday, May 4, 2014      7:30 a.m.- 1:30 p.m.

  • One form per registrant 
  • Fee includes Sat. breakfast, lunch, breaks, reception, scientific lectures, exhibits; Sun. break, scientific lectures, exhibits; program.
  • Credit Card Registrations: Online Only    (No Phone or Fax Registrations) 
  • Cancellation: Written cancellation notice must be received by LDA by 4/10/14 for refund.  NO exceptions.  Email cancellation notice to treasurer@LymeDiseaseAssociation.org or fax 732-938-7215
(note: Paypal has known issues with google chrome.  If you have trouble with your submission please try using another browser such as internet explorer, firefox or safari)
{rsform 50}


Registration is a 2 step process: 

1) After you click the submit button you will have completed the LDA portion of the registration.  An email confirm will be sent by LDA, check your SPAM box if you do not receive it. 

2) Next you will be sent to the PayPal page to input your credit card information and finish registration.  An email confirm will also be sent by PayPal which you need to bring to the conference.  If you have registered and do not receive a PayPal confirm within 24 hours of your online payment, please email treasurer@LymeDiseaseAssociation.org 











2014 LDA/Columbia Conference Agenda

Saturday Agenda     Sunday Agenda     Registration



7:15 – 8:00 AM

Registration/Exhibits/Continental Breakfast

8:00 – 8:15 AM

Patricia V. Smith, BA, Conference Planner, Conference Organizing Committee, President, Lyme Disease Association, Inc.
Welcome,Remarks/Brief Overview of Lyme Spread/Introduction of CoDirector

Brian A. Fallon, MD, MPH Conference Co-Director, Mid-Morning Faclitator, Conference Organizing Committee


Joseph Breen, PhD National Institutes of Health (NIH) Morning Facilitator

8:15 – 8:55 AM

Richard T. Marconi, PhD – Keynote Speaker, Conference Co-Director
New Advances in the Pursuit of a Combinatorial Human Vaccine for Lyme Disease & Anaplasmosis

Professor of Microbiology & Immunology, Medical College of Virginia, Virginia Commonwealth University, VA

8:55 – 9:30 AM

John T. Belisle, PhD
Metabolomics of Lyme Disease: A Novel Diagnostic Approach

Professor, Dept of Microbiology, Immunology, Pathology, Colorado State University, CO

9:30 – 10:05 AM

Joseph D. Forrester, MD, MSc
Sudden Cardiac Arrest Associated with Lyme Carditis

Epidemic Intelligence Service Officer, Centers for Disease Control & Prevention

10:05-10:40 AM

Nicole Baumgarth, DVM, PhD
Immune Suppression During Infection of Mice with Borrelia burgdorferi

Professor, Pathology, Microbiology, Immunology, UC Davis, CA

10:40-10:55 AM

Morning Coffee Break

Brian A. Fallon, MD, MPH  Mid-Morning Facilitator

10:55-11:10 AM

Morning Discussion Panel

11:10-11:45 PM

Kenneth K.C. Bramwell, PhD
Gene Variant Exacerbates Inflammatory Arthritis in Mice

Post-Doctoral Fellow, University of Utah, UT

11:45-12:20 PM

Susanne Nimmrich, Dr. Med. (Pending)
Intraarticular Corticosteroids in Refractory Childhood Lyme Arthritis

Resident/Assistant physician, research associate, Asklepios Childrens Hospital Sankt Augustin, Germany

12:20-12:45 PM

Thomas N. Mather, PhD
More than Lyme: Progress towards a Tick-borne disease protective vaccine

Professor of Public Health Entomology, Director URI Center for Vector-Borne Disease, University of Rhode Island, RI

12:45–1:45 PM

Lunch Break


Richard T. Marconi, PhD – Saturday Afternoon Facilitator, Conference Co-Director, Conference Organizing Committee

1:45 – 2:00 PM

Late Morning Discussion Panel

2:00 – 2:35 PM

Travis Taylor, PhD

Host-Specific Antiviral Responses to the TickBorne Flaviviruses,
Powassan & TBEV

Asst. Professor, University of Toledo, College of Medicine, OH

2:35 – 3:10 PM

Charles Chiu, MD, PhD
TickChip detection microarray, STARI, and transcriptome profiling of Lyme disease

Asst. Professor, University of California, San Francisco School of Medicine, CA

3:10 – 3:25 PM

Afternoon Coffee Break

3:25 – 4:00 PM

Emir Hodzic, DVM, PhD
Resurgence of Persisting Non-Cultivable Borrelia burgdorferi Following Antibiotic Treatment in Mice

Director, Research & Diagnostic Core Facility, Center for Comparative Medicine, UC Davis, CA

4:00 – 4:35 PM

Jason A. Carlyon, PhD
Promising Progress in Developing pProtective and Therapeutic Approaches against Anaplasma phagocytophilum Infection

Assoc. Professor of Microbiology & Immunology, Virginia Commonwealth University, VA

4:35 − 5:10 PM

Linden T. Hu, MD
Xenodiagnosis of Lyme Disease in Humans

Professor, Tufts University School of Medicine, MA

5:10 − 5:30 PM

Afternoon Discussion Panel

5:45 – 7:45 PM





(Breakfast on your own)

7:30 – 8:00 AM



Elizabeth Maloney, MD – Sunday Facilitator, Conference Organizing Committee

8:00 – 8:30 AM

Sheila M. Statlender, PhD 
The Impact of Lyme Disease on the Brain: Implications for Diagnosis, Treatment and Recovery

Clinical Psychologist, Private Practice, Newton Center, MA

8:30 – 8:45 AM

Marina Makous, MD
Case Presentation of a Suicidal Patient: Lyme or Depression?

Board Certified Family Physician/Post-Doctoral Research Fellow, Columbia Lyme & Tick-Borne Diseases Research Center, NY

8:45 – 9:15 AM

John Keilp, PhD
Understanding suicidal behavior risk in Lyme Disease: Perspectives from studies of suicidal behavior in depression.

Assistant Professor of Clinical Psychology, Columbia University, College of P & S, NY

9:15–9:45 AM

Brian A. Fallon, MD, MPH, Conference Co-Director
Ten Year Follow-up after IV treatment for Lyme Encephalopathy – what happened?

Professor of Psychiatry, Columbia University, College of P & S, NY
Director, Lyme and Tick-Borne Diseases Research Center, NY

9:45–10:15 AM


Steven Schutzer, MD
Atypical EM & PCR in Lyme Disease


Professor of Medicine, New Jersey Medical School, Rutgers University, NJ

10:15–10:40 AM

Morning Coffee Break

10:40–10:55 AM

Morning Discussion Panel Mental Health

10:55–11:30 AM

Michael L. Weinberger, MD
Pain Management

Assoc. Professor of Anesthesiology, Columbia University, College of P & S, NY

11:30-12:05 PM

David S. Younger, MD
IVIG & Its Use in Autoimmune Neurologic Diseases

Clinical Associate Professor of Neurology, NYU School of Medicine, NY

12:05–12:40 PM

Ahmet C. Burakgazi, MD
Neurologic Lyme & Case of Polyradiculopathy Mimicking ALS

Asst. Professor, Internal Medicine, Virginia Tech Carilion School of Medicine, VA

12:40–1:15 PM

Sam R. Telford III, ScD
Borrelia miyamotoi

Professor, Infections Diseases, Tufts School of Veterinary Medicine, MA

1:15–1:30 PM

Afternoon Discussion Panel



Organizing Committee, Planner, & Staff

The individuals listed below planned, organized, and carried out conference preparation to ensure the conference meets the needs of the accreditation agency and of the attendees.

Conference Organizing Committee


Brian Fallon MD, MPH
Professor of Clinical Psychiatry
Director, Neuropsychiatry
Director, Lyme & Tick-Borne Diseases Research Center
Columbia University College of Physicians & Surgeons
New York, New York

(Conference Co-Director, Conference Organizing Committee)


Richard Marconi, PhD
Professor of Microbiology & Immunology
School of Medicine
Virginia Commonwealth University
Richmond, Virginia

(Conference Co-Director, Conference Organizing Committee)


Elizabeth Maloney, MD
Board certified in Family Medicine
President, Partnership for Health & Healing, accredited CME program provider
Wyoming, Minnesota

(Conference Organizing Committee)


Patricia V. Smith, BA
President, Lyme Disease Association, Inc. (LDA)

Wall, Township, New Jersey

(Conference Organizing Committee, Conference Planner)


LDA All Volunteer Staff 


Pam Lampe
LDA Board of Directors
Executive Vice President & Treasurer

New Jersey


Corey Lakin, BS
LDA Board of Directors
2nd Vice President, Technical Support

New Jersey


Ruth Waddington, RN
LDA Board of Directors
Corresponding Secretary

New Jersey

Richard Smith

Richard H. Smith, BA
LDA Board of Directors Member

New Jersey

Ira Auerbach

Ira Auerbach, BME, MSIA
Hudson Valley Lyme Disease Association Board Member

New York

Tom Rolin


Tom Rolin, BA
Lyme Disease Association Rhode Island Chapter, Board Member


Rhode, Island




2014 LDA Conference Exhibitors

The Lyme Disease Association has hosted 14 prior scientific conferences and each has provided opportunities for exhibitors to showcase their products to doctors, researchers, patients, and advocates. If your company is interested in purchasing an exhibit table, please print out the exhibitor package and email treasurer@Lymediseaseassociation.org to see if there is space left.

Click here for exhibitor package