Symposium Explores Tick-Borne Diseases and Emerging Risks on Long Island

In Suffolk County, there are four tick species that are of public health importance and that are responsible for the transmission of a variety of tick-borne pathogens. On May 27, the Symposium on Tick-borne Diseases, co-sponsored by the Stony Brook University Renaissance School of Medicine (RSOM) Departments of Medicine and Microbiology and Immunology, brought together leading researchers and clinicians to discuss the latest advances in tick-borne illness research and care.

The day-long program addressed the growing prevalence of infections on Long Island — a hotspot for tick-borne diseases — as well as emerging threats and the increasing impact on local communities. It covered recent advances in research on tick-borne illnesses, including infections common on Long Island and the Alpha-gal meat allergy. 

“Today’s symposium reflects our institution’s longstanding track record of breakthrough research on tick-borne diseases, a history that stretches back more than four decades to 1982, when Jorge Benach of the Department of Microbiology and Immunology, in collaboration with colleagues at the Rocky Mountain Laboratories and New York State Department of Health, published an article in Science describing the association between a previously unknown spirochete and Lyme disease,” said Peter Igarashi, MD, dean of the Renaissance School of Medicine.

The symposium featured basic and clinical researchers from RSOM and Stony Brook Southampton Hospital who are leading important work not only in Lyme disease, but across the broad spectrum of tick-transmitted illnesses. “Their work is especially important here on Long Island, where Suffolk County has the highest density of tick-borne diseases in the nation,” Igarashi said.

Sessions addressed the significance of the tick problem on Long Island, pathogenesis research on tick-borne infections and clinical-translational research on tick-borne infections. Afterward, a clinical-translational research panel of experts offered insight on the latest research and prevention resources for Long Island residents.

Luis Marcos, MD, associate professor of clinical medicine in the Division of Infectious Diseases, discussed his research on tick-borne diseases, particularly Lyme disease, highlighting the post-treatment Lyme disease syndrome (chronic Lyme) and recurring symptoms like fatigue and joint pain. 

“When I came here, I started seeing patients coming in with symptoms like fatigue, headaches, neck stiffness and joint pain after a positive test for Lyme disease,” said Marcos, who had never seen a case of Lyme disease before. “Then the symptoms go away, and something happens with them, like a stress in life, a trauma, a long trip or another infection, and all the symptoms come back again. We give them antibiotics, thinking perhaps that will eradicate or eliminate the symptoms. Unfortunately, some of these patients have been on antibiotics for years, and they continue having symptoms. So it’s likely something else that we don’t know, and it’s not a bacteria. But this is something very real.”

Marcos mentioned a conversation he had in 2017 with Gary Wormser, a prominent infectious disease specialist affiliated with New York Medical College and Westchester Medical Center and a frequent collaborator with researchers from Stony Brook’s Division of Infectious Diseases. 

“I didn’t want to start from ground zero, I wanted to start with something that was important,” said Marcos. “He told me he would study the long-term symptoms of Lyme disease because nobody really knows what’s going on, but it’s important that we figure this out.”

Andrew Handel, MD, a board-certified pediatric infectious disease specialist at Stony Brook Medicine, discussed interdisciplinary approaches to studying tick-borne diseases in children. 

“There are moments where there are more common and less common episodes of Lyme disease and other control infections, but I see children in the hospital, in our clinic and in the Southampton Regional Tick-Borne Disease Center, with tick-borne disease concerns and diagnoses, and the problem is not slowing down,” he said.

Handel said the number of children diagnosed with Lyme disease through Stony Brook Medicine over the past three years ranges from about 30 to 70 per month. “These numbers don’t seem to be slowing down,” said Handel. “We really need to think about tick-borne diseases in children as a separate entity. In pediatrics, we often see that children are not small adults, and even though the pathogens are the same, the manifestations and implications can be quite different in children.”

Charles Vorkas, MD, an infectious diseases physician-scientist in the Department of Microbiology and Immunology, discussed his work in human tick-borne immunology, focusing on tuberculosis and tick-borne infections like Lyme disease and babesiosis. 

“My focus is on tuberculosis immunology, and we were really privileged to be able to apply the skill set to understand local immunologic problems within the tick-borne infection population, not only because we see these patients in our clinics, but because this represents a very complex ecology spanning multiple different organisms,” said Vorkas, who came to Stony Brook in 2021.

Vorkas said he was surprised to find that so little is known about the human immune response to these infections, despite the fact that the incidence in our region was so high. 

“We’ve learned a lot from mouse models, particularly how these pathogens get transmitted and the type of cells that they infect,” he said. “However, in order to understand interventions that can help biomedical vaccination and immune-mediated interventions, we need to study them in clinically relevant models, such as individuals who present acute Lyme disease or babesiosis.”

Congressman Nick LaLota received Stony Brook Medicine’s inaugural Healthcare Policy Leadership Award at the symposium. The award was presented by Stony Brook Medicine Executive Vice President William Wertheim, MD.

Congressman LaLota, who represents Suffolk County, New York, attended the symposium as part of his longstanding interest and engagement in issues related to tick-borne diseases. 

During his remarks, Wertheim highlighted the critical importance of the groundbreaking work being conducted across Stony Brook University and Stony Brook Medicine on tick-borne diseases.

“The work that our researchers are doing is vital to improving the education, prevention, diagnosis and treatment of vector-borne disease,” said Wertheim. “Given the impact of vector-borne disease on Long Island, we are pleased to have Congressman LaLota and his team here today to learn more about this important work.”

— Robert Emproto