Evaluation and Follow-up of People With Tick-borne Diseases

Study Overview
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Brief Summary
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Background: Lyme disease is the most common tick-borne disease in the United States, but other diseases transmitted by ticks have also been on the rise in recent years. Early symptoms of a tickborne disease include fever, headache, fatigue and possible rash. Researchers want to collect information and samples from people with Lyme disease and other tick-borne illnesses to better understand and diagnose these diseases. Objective: To evaluate and follow people with tick-borne diseases to help researchers learn more about these infections. Eligibility: People ages 18 and older who have or are suspected of having a tick-borne infection. Design: Participants will have an initial visit, and visits about 1, 6, and 12 months later. The visits can include a physical exam, blood tests, collection of blood, urine and saliva samples for research, and filling out health-related questionnaires. Participants who have the rash of Lyme disease may be invited to have up to 3 skin punch biopsies of the rash for research.

Detailed Description
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Lyme disease is a multisystem illness caused by the spirochete Borrelia burgdorferi and it is the most common vector-borne illness in the United States. Tick-borne disease cases reported to the Center for Disease Control and Prevention (CDC) have been on the rise with over 59,000 cases reported in 2017. This protocol is designed to collaborate with University of Maryland School of Medicine for the purpose of recruiting and enrolling patients with Lyme disease and other tickborne illnesses. This is a natural history study which has the objective of developing a rigorously defined population of patients with Lyme disease and other tick-borne illnesses, per CDC case definitions, to serve as the basis for research in multiple aspects of the infections. These research sub-projects have emphasis in exploring the biological markers of tick-borne infections, developing new diagnostic tests for these infections, assessing the clinical course and outcome of patients with these tick-borne infections, and defining the immunological response to the pathogens.

Official Title
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Evaluation and Follow-up of Patients With Tick-borne Diseases

Conditions
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Lyme Disease, Tick-Borne Disease

Participation Criteria
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Eligibility Criteria
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INCLUSION CRITERIA: Clinical diagnosis of suspected, confirmed, or probable LB or other TBD per CDC case definitions. Has not received antibiotic therapy for tick-borne disease for more than 2 weeks. Age >=18 years. Able to provide informed consent. Subjects must maintain a private physician for non-protocol related medical complaints and for emergency medical treatment required for these or other disorders. EXCLUSION CRITERIA: Post-treatment Lyme disease syndrome Women who report they are pregnant. Any other condition or history of unacceptably poor compliance that, in the opinion of the investigator, would make the patient unsuitable for enrollment or could interfere with the patient participating in and completing the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1<br>Persons with diagnosed or suspected tick-borne disease age >=18 years | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Define percentage of participants with suspected, probable, or confirmed TBD, as defined by the CDC case definitions and TBD testing, and measure clinical outcome using established assessment tools and questionnaires. | Identify type of tick-borne disease and clinical outcome. | Assessed annually. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Utilize current and future technologies to develop new direct and indirect tests and biomarkers for TBDs. These can include, but not limited to, antibody-based testing, antigen-based testing, molecular-based testing, culture. | Will use samples for developing novel diagnostic testing. | Ongoing | 
| Evaluation of the immune response to the pathogens. These can include, but are not limited to, cytokine testing, cellular response testing, antibody profile, metabolomics, proteomics, transcriptomics, and others. | Will use samples to explore human immune response to TBDs. | Ongoing | 
| Genomic-based testing for research on pathogen virulence and mutations. | Will use samples to explore pathogen. | Ongoing | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lyme, Borrelia, Anaplasma, Rickkettsia, Lone Star, Natural History