05.23.24

Senator Collins Questions Top Health Officials on Tick-Borne Diseases

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Washington, D.C. – At an Appropriations hearing to review the Fiscal Year 2025 budget request for the National Institutes of Health (NIH), U.S. Senator Susan Collins questioned Director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr. Jeanne Marrazzo on the progress made in Lyme and tick-borne disease prevention and treatment.

In February, the U.S. Department of Health and Human Services (HHS) released the National Public Health Strategy to Prevent and Control Vector-Borne Diseases in People.  This national strategy was required as part of the Kay Hagan Tick Act that was authored by Senators Collins and Tina Smith (D-MN) and signed into law in December 2019.

Last year, Maine CDC reported a record 2,904 confirmed Lyme disease cases and the Maine Tick Lab found that deer ticks are expanding their range farther north and Down East.

Below is the full transcript of their exchange.

Sen. Collins said:

HHS recently released the National Public Health Strategy to Prevent and Control Vector-Borne diseases in people.  This was required as part of the Kay Hagan Tick Act, which I authored with Senator Murray, and others, and it builds on the NIH strategic plan for tick-borne illnesses. 

This is increasingly a problem in the State of Maine.  Twenty years ago, we didn't have ticks in Maine that transmitted these kinds of diseases like Lyme disease.  Increasingly, it's all over the State of Maine, they're all over the United States.  And it creates real problems.  Maine to hit a record high number of Lyme disease cases in 2023, and as ticks continue to expand, those cases are likely to increase. 

I was pleased to see the specific goal of reducing the number of Lyme disease cases by 25 percent by the year 2035.

Could you briefly update us on the progress made in Lyme and tick-borne disease diagnostics, treatments, and potential vaccines?  Because one problem is there has been a real dispute in the medical community on how to treat Lyme disease.

Dr. Marrazo responded:

Senator Collins, as someone who did my residency in Connecticut and worked in Old Lyme for a summer where I think I saw every manifestation of Lyme disease, and recently coming from Alabama where we saw tons of tick-borne illness, your comments could not resonate with me more.  It's a really challenging infection, and you highlight the fact that we still 25 years after, or however many, we still don't even have a really good diagnostic test that we can use.  The serology is very frustrating, it leads to a lot of misinterpretation.

So, let me just say that we released our strategic plan, as you know, for tick-borne disease in 2019.  And the support from this Committee in this area has been critical in advancing advances for both the basic the diagnostic and the vaccine and the treatment areas.  So, in the basic area, one of the more exciting things is that we finished, with both intramural and extramural scientists, sequencing, the Ixodes scapularis genome, which is very exciting because you can now go in and be more specific about genetic targets, to try to develop some of these vaccines and figure out what are the antigenic components.  What's stimulating this immune response that probably frankly, informs post treatment syndrome, what was previously called chronic Lyme disease, but it's clearly a post treatment inflammatory syndrome. 

I'll jump ahead to that and just note that in 2021, we actually had a proposal out for work specifically on post treatment conditions and awarded seven big grants to look at that to try to figure out, is that pathogen really persisting in these areas?  And how can we best to address it?  With the diagnosis, we're really looking carefully at a number of new serology approaches some point of care diagnostics, which will help people a lot in the field, especially since people come to emergency rooms in the summer with these infections all the time. 

And then the last thing I'll mention is the vaccines.  We have a pretty successful vaccine for dogs, right there is a canine vaccine.  We are figuring out why that vaccine is actually working and we're trying to learn from that analogy to develop and refine the approaches to human vaccines, which has been really challenging.

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As the Vice Chair of the Appropriations Committee and a member of the Health Committee, Senator Collins secured an increase of $2 million for the CDC Lyme disease and vector-borne diseases programs in Fiscal Year 2024, which support the programs authorized under the Kay Hagan Tick Act she authored.  The legislation also included $100 million for research into Lyme and other Tick-Borne diseases at the NIH.

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