Tag Archives: Long Point

Lyme Disease In Canada And USA Has Epidemic Potential- New Microbes Discovered

Spring means fresh flowers and sunny days, but it also brings seasonal health issues as the weather gets warmer: from Rosacea to Lyme disease.

Most likely, you or someone you know has been affected by Lyme disease, the most common tick-borne illness in North America with more than 300,000 cases diagnosed each year. In a timely new book, Conquering Lyme Disease(Columbia University Press), Columbia University Medical Center physicians Brian A. Fallon and Jennifer Sotsky reveal that despite the challenges to find a cure for this complex, debilitating disease, precision medicine and biotechnology are accelerating the discovery of new tools with which doctors will be able to diagnose it and treat patients.

“Through rapid genetic sequencing, scientists can identify many different strains of Borrelia burgdorferi as well as new tick-borne microbial infections, such as Borrelia miyamotoi, Borrelia mayonii, and the Heartland virus.”  — Brian Fallon 

Could groundbreaking technologies that rapidly increase our understanding and open up new pathways mean a cure for Lyme disease one day soon? The Global Search for Education is pleased to welcome Dr. Brian Fallon to find out how tech is tackling the ticks.

“Modern technology using Next-Generation Sequencing (NGS) allows one to discover with great rapidity all microbes that may be present within a sample of fluid.” — Brian Fallon

Brian, how has technology improved the research process for tick borne diseases?

Consider the difference in price of genome sequencing between 20 years ago and today. In 2003, it had taken the Human Genome Project about 4 years and costs estimated between $500 million to 1 billion…by 2006 the cost for sequencing a single human genome had dropped to 14 million……today a whole human genome can be sequenced within days for less than $1,000.   This is a tremendous advance.

Why is genome sequencing so important?  Let’s look at human tick-borne diseases.  When two different people are infected with Borrelia burgdorferi (the microbe that causes Lyme disease), one will resolve the disease quickly after a course of antibiotics while the other may develop a chronic relapsing remitting illness.  Why?  Because one person might have gotten a more persistent strain, while the other received  a less invasive strain that stays localized to the skin.  Additionally, the genetic differences in the human determines how the immune system responds to the invading microbe. Understanding the genetics of the infection and of the human host allows scientists to unravel the mysteries of tick-borne illnesses.

Through rapid genetic sequencing, scientists can identify many different strains of Borrelia burgdorferi as well as new tick-borne microbial infections, such as Borrelia miyamotoi, Borrelia mayonii, and the Heartland virus.  When the genome of a microbe is sequenced, it provides a starting point for the study of pathogenesis, vaccine development, and treatment.  Discovery of these new microbes inside ticks has been enormously helpful.  A patient who has had typical symptoms of Lyme disease after a tick bite but has tested negative on the blood tests for Lyme disease might puzzle clinicians. They may criticize the insensitivity of the Lyme disease tests.  However, when this same patient is tested for the newly discovered tick-borne infection, Borrelia miyamotoi, the diagnosis is then clear. Yes, the patient had a Lyme-like illness, but it wasn’t Lyme disease: it was Borrelia Miyamotoi disease.

Modern technology using Next-Generation Sequencing (NGS) allows one to discover with great rapidity all microbes that may be present within a sample of fluid.   This  “discovery based” approach using “unbiased next generation sequencing” enabled a 14 year old boy to be rescued from a fatal infection within 48 hours (Wilson et al, NEJM, 2014). This boy had endured 3 hospitalizations over 4 months, had over 100 diagnostic tests, spent 44 days in an ICU for encephalitis of unknown etiology, had a brain biopsy, and had to be put into a medically induced coma to prevent damage from his ongoing seizures.

Eventually Dr. Charles Chiu at U.C.S.F. employed NGS analysis of more than 8 million sequences with a bioinformatics pipeline (SURPI) for the detection of all known pathogens. The cause of the boy’s meningoencephalitis was revealed as Leptospira santarosai. He had likely acquired it in Puerto Rico, as it is not present in the continental United States.  He received the appropriate antibiotics and was discharged 2 weeks later to rehab.  This same approach is especially useful for uncommon infections as they might not be suspected; for example, rare tick-borne viruses such as Powassan Virus or Heartland Virus can be rapidly  detected using this discovery approach.

DNA Double Helix
DNA Double Helix
How has big data impacted the way advocacy groups support research?

A patient-generated source of Big Data is LymeDisease.org.  This California based organization developed a survey called “My Lyme Data” that patients could fill out on the web about their clinical history and lab tests and treatments.  In a short period of time, they had data on 10,000 patients whom they track over time.  With this information, they provide a more comprehensive clinical view of the bulk of patients who are diagnosed with persistent symptoms despite treatment for Lyme Disease (aka Chronic Lyme Disease).

“In geographic areas where medical professionals are scarce, AI technologies will play an increasing role in improving patient care by allowing differential diagnoses to be generated and treatment options suggested through AI-based systems accessed through the internet.”  — Brian Fallon

Jobs in all professions are being automated. Do you believe AI technologies will only assist doctors or will they replace physicians in some tasks? What does this mean for doctors, nurses, and the future of medicine?
Borrelia transmission via Tick
Borrelia

While AI technologies will go a long way to assist health care providers to provide better care, its application to medical care is still just beginning.   One can anticipate, however,  that in geographic areas where medical professionals are scarce, AI technologies will play an increasing role in improving patient care by allowing differential diagnoses to be generated and treatment options suggested through AI-based systems accessed through the internet.

The general public has more access to information than ever before about Lyme disease from websites, medical organizations, articles and social media. Everyone can be their own “expert” or even their own “doctor.”  Can you speak about the pros and cons of online health data in the era of fake news?

This obviously is a huge area of concern. Individuals used to turn to their physician or to the medical information books, such as the Merck Manual. Now, they turn to the web.

In a recent survey of patients who used the web to obtain health information (Doherty-Torstrick 2016), we learned that more than half of the 730 patients reported they experienced increased distress as a result of checking the web.  We also learned from this survey that individuals who did not have a health education were more likely to spend more time on the web and were thus prone to develop more anxiety than those who were better educated from a health perspective.   While some of the information they find may be accurate, other information may be well-intentioned but ill-informed, misleading, and even harmful.

“Researchers can rapidly screen thousands of drugs to determine which agents have the strongest ability to kill Borrelia spirochetes.  This is possible because of the development of high throughput assays, which have proven more effective than the standard agents in eradicating both the stationary phase Borrelia and its more drug-tolerant persister-forms.” — Brian Fallon

Tick distribution Canada

Look into the future.  What are the technologies you are most excited about in terms of helping to find cures for Lyme disease and improve patients quality of life?

Researchers can rapidly screen thousands of drugs to determine which agents have the strongest ability to kill Borrelia spirochetes (Feng 2014).  This is possible because of the development of high throughput assays, which have identified new antibiotics that have proven more effective than the standard agents (doxycycline, amoxicillin) in eradicating both the stationary phase Borrelia and its more drug-tolerant persister-forms.  While it cannot be assumed that what is true in the lab setting will translate to efficacy in humans, biotechnology advances have enabled the identification of new therapeutic agents, offering  much hope for a wider array of treatment options for patients in the future.

Another major advance is “big data” conducted by biomedical information engineers trained in biostatistics and computer science.  Internet search engine queries are being monitored to predict outbreaks of infectious disease.  Unanticipated side effects of drugs and their interactions can be detected through analyzing millions of digital medical records from patients who have taken a particular drug.  One can examine whether patients given an antibiotic did better when treated for longer or shorter periods, or whether patients with a pre-existing autoimmune disease are more likely to develop complications from a new onset Tick-borne infection than those without a history of autoimmune problems.

Tick
2005 James Gathany; William Nicholson
The blacklegged ticks, I. pacificus, (depicted here), and I. scapularis, are known vectors for the zoonotic spirochetal bacteria Borrelia burgdorferi, which is the pathogenic bacteria responsible for causing Lyme disease. The ticks, inoculated with the bacterium when they bite infected mice, squirrels and other small animals, subsequently pass the pathogens to their human victims when they obtain a blood meal.B. burgdorferi bacteria can infect several parts of the body, producing different symptoms at different times. Not all patients with Lyme disease will have all symptoms, and many of the symptoms can occur with other diseases as well. If you believe you may have Lyme disease, it is important that you consult your health care provider for proper diagnosis.
The first sign of infection is usually a circular rash called “erythema migrans”, or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite after a delay of 3-30 days. A distinctive feature of the rash is that it gradually expands over a period of several days, reaching up to 12 inches (30 cm) across. The center of the rash may clear as it enlarges, resulting in a bull’s-eye appearance. It may be warm but is not usually painful. Some patients develop additional EM lesions in other areas of the body after several days. Patients also experience symptoms of fatigue, chills, fever, headache, and muscle and joint aches, and swollen lymph nodes. In some cases, these may be the only symptoms of infection.

Our Lyme and Tick-borne Diseases Research Center, located at the Columbia University Irving Medical Center (CUIMC) in New York City, is right next door to an international data resource.  CUIMC is the coordinating center of a public health information initiative which includes medical records from approximately 400 million people drawn from eighty health-care organizations from around the world.  This represents a unique opportunity  to ask questions, generate hypotheses and get answers about Tick-borne diseases.  When discovery is optimized, medical care is enhanced.

For the Silo, David Wine/CM RubinWorld. 

Brian Fallon, MD, MPH is the Director of the Lyme and Tick-Borne Diseases Research Center at the Columbia University Irving Medical Center and the author with Jennifer Sotsky of Conquering Lyme Disease: Science Bridges the Great Divide, published in 2018 by Columbia University Press.

Ontario Can’t Afford To Not Win War On Phragmites

Phragmites is likely the largest invasive plant threat facing Ontario today. It has taken over our wetlands, invaded our ditches and can get a foothold just about anywhere. It’s the monster that keeps coming back – we can’t let our guard down.

Phragmites was first found locally in the Long Point wetlands 20 years ago.

Spraying of glysophate started at Long Point and Rondeau Provincial Parks in September 2016, and has proven 99.7 per cent successful. When the phragmites is dead, the seed bank of native species, like cattails, will reactivate. Although spraying works, it must be followed up by rolling or cutting and burning. On Long Point Bay, there is a combination of private, provincial and federal wetlands. Much of the private wetlands are in the hands of hunt clubs, most of which have been active in controlling phragmites.

The Crown Marsh and the Turkey Point beaches are provincial holdings.

The Canadian Wildlife Service land, which comprises most of the point itself and the Big Creek marsh, are federal. I recently attended the meeting of the Long Point Phragmites Action Alliance – a local group dedicated to fighting this invader. They donated $20,000 toward continuing spraying in the Long Point Crown Marsh last year. Their annual fundraiser, Rocking the Point, will be August 24th.

My office worked tirelessly to ensure phragmites were sprayed last fall at Turkey Point beach after several years of inaction by the previous government. This spring the dead plants were flattened and burned. The Ministry of Natural Resources and Forestry is working with a number of conservation partners to coordinate prevention, control, research and management activities to help address this serious threat in recognition of the importance of the prevention, early detection, early response and eradication of invasive species.

This year the Ontario government is investing over $2 million in invasive species programs and education, and will be investing $850,000 in the centre to support ongoing research and management. Based in Sault Ste. Marie, the centre brings together government, academia, industry and Indigenous communities and organizations to conduct research, response planning, management and habitat restoration.

Early detection is especially important because once invasive species become established it is extremely difficult to remove them, potentially causing long-lasting damage to our environment.

For federal lands, thanks to the actions of MP Diane Finley, the Nature Conservancy of Canada (NCC) will receive $375,000 over the next three years to aid in the removal and prevention of phragmites growth in sensitive ecosystems. Recently, we saw another win for the ongoing control of phragmites with the Ontario Trillium Foundation’s significant contribution of $90,000 to NCC to purchase a boat to control this invasive. Now in its fourth year, the partners have effectively controlled phragmites in over half the coastal wetlands at Long Point and Turkey Point.

With the help of the Ontario Trillium Foundation funds, NCC will be able to continue monitoring the shorelines for phragmites – catching remnant populations before they spiral out of control. Early detection and constant monitoring and control are key to successfully eradicating those devastating invaders and returning the marshes and shorelines to havens for turtles, birds and waterfowl. Although $2 million has been spent on phragmites control in the area, we must be vigilant as the monster will return. For the Silo, Toby Barrett MPP for Haldimand-Norfolk.

Supplemental- The Ontario Phragmites Working Group.

Featured image- Phragmites Great Lakes region photo by Janice Gilbert 2007

Ontario Beach Zoomorph Profiled In Mexico City University Of Art Publication

Artist Jarrod Barker, was recently invited to take part in MUCA-Roma’s Ala Afuera project. Based in the Roma district of Mexico City, MUCA is a University Museum of science and art. What made this project doubly exciting was the opportunity to show case a part of Barker’s home internationally.

The curators asked for a submission of 3 images and accompanying explanatory write-ups that “from your perspective, show a form of relationship between humans and the rest of nature.” This topic aka- Umwelt is not foreign to Barker who installed an exhibition of that name in 2010 at the Norfolk (nee Lynnwood) Arts Center in Simcoe,Ontario.

 

Long Point Seal Tamer Concept- J. Barker
Location: Long Point, Norfolk County, Ontario, Canada
Long Point is a world biosphere. I know this because the United Nations has told me so. But for several months of the year Long Point is transformed. Under certain winter conditions, Long Point looks less like a marshy, swampy bird watchers paradise and more like an arctic shore. At least on the South West side. When I visit Long Point during these times, I react to the environmental changes. I see things differently. I feel things differently. A sun bleached tree stump becomes a seal. A marsh reed becomes a baton. A flint pebble becomes a ball. Natural transformation through the changes of the seasons is a holistic experience.

 

After the selection process, if successful- one of the artist submitted images and write-ups was selected for transformation into a postcard and incorporated with the other artist submissions. The goal was for the Ala Afuera team to mail out the postcards to other international Museums of art and science and Contemporary Art institutions as a connective gesture to highlight MUCA and the work of the artists involved in this project and to bring awareness to our human/nature relationships.

 

“The objective of the project Allá Afuera (Out There) is to gather a mosaic of images that represent
ways of understanding the relationship we humans have with the rest of nature. From bucolic or
passionate points of view to other more threatening myths and taboos, amazement, fear, the absurd,
and maybe even indifference. We do not intend to cover all possibilities, but through images as a direct
reading form, show that there are multiple ways of looking at this Bond.

Three times a year we will present a collection of postcards, with 18 images each, gathered in a
biombo format. After two years we will complete the edition of six collections, with a total of 108 ways
of understanding, 108 points of view, and 108 forms of defining our relationship with what is out there. “

Ala Afuera which translated mean’s “Out there” began mailing out the works a few weeks ago.  For the Silo, Stephanie Bordega. 

For more information and to request postcards please contact-
Allá Afuera (Out there) project Gonzalo Ortega and Jeronimo Hagerman
MUCA ROMA MUSEUM (University museum of science and art, Roma district, Mexico City)
allaafueramucaroma@gmail.com

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