Abstract
Lyme disease (also known as Lyme borreliosis) is the most common vector-borne disease in the United States with an estimated 476,000 cases per year. While historically, the long-term impact of Lyme disease on patients has been controversial, mounting evidence supports the idea that a substantial number of patients experience persistent symptoms following treatment. The research community has largely lacked the necessary funding to properly advance the scientific and clinical understanding of the disease, or to develop and evaluate innovative approaches for prevention, diagnosis, and treatment. Given the many outstanding questions raised into the diagnosis, clinical presentation and treatment of Lyme disease, and the underlying molecular mechanisms that trigger persistent disease, there is an urgent need for more support. This review article summarizes progress over the past 5 years in our understanding of Lyme and tick-borne diseases in the United States and highlights remaining challenges.
Highlights
According to the Center for Disease Control and Prevention (CDC), the number of vector-borne diseases reported to the National Notifiable Diseases Surveillance System (NNDSS) between 2004 and 2016 reached a total of 642,602 cases
The annual NIH investment in Lyme disease (LD) research so far has been small compared to many other infectious diseases [6]
More research into the prevention, diagnosis and treatment of LD is needed in order to address the significant health risks posed by this tick-borne disease
Summary
According to the Center for Disease Control and Prevention (CDC), the number of vector-borne diseases reported to the National Notifiable Diseases Surveillance System (NNDSS) between 2004 and 2016 reached a total of 642,602 cases. Tick-borne diseases (TBDs) accounted for 77% (491,671 cases) of reported cases with the total number of cases doubling in 13 years. LD is caused by pathogenic species in the Borreliella genus (for the relationship with the Borrelia genus, see section Genomic Insights From Borreliaceae Lineages). These spirochetal bacteria are transmitted from vertebrate reservoirs to human hosts through bites from infected Ixodes spp. ticks. The causes of PTLD are not yet well-understood but are an active area of research due to their critical importance to advancing therapy development and effective treatment for this patient population. The annual NIH investment in LD research so far has been small compared to many other infectious diseases (see Table 1) [6]
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