Deer Tick
Discovery of the Cause of Lyme Disease
Lyme disease is the leading
arthropod (tick) borne illness in the U.S., with over 125,000 cases
reported since 1982. Diagnosis at an early stage enables treatment
with a simple course of antibiotics that usually, though not always,
leads to a complete cure; left untreated, Lyme can result in much more
severe symptoms including painful arthritis, especially of the knee
joints, and irreparable damage to the heart and nervous system. Identifying
its cause required two discoveries. Jorge Benach, then of the New York
State Department of Health and the Department of Pathology and currently
Director of the Center for Infectious Diseases and a member of Microbiology
and Molecular Genetics, played a major role in both. He coauthored
the Science publication (New Series,
Vol. 216, No. 4552 (June 18, 1982) 1317-1319) that showed that a bacterium
isolated from a deer tick was the likely causative agent. The second
step required showing that the bacterium was actually present in human
beings showing the symptoms of Lyme disease and Prof. Benach was principal
author on the New England Journal of Medicine publication
( Volume 308:740-742, March 31, 1983, Number 13) the following
year reporting that finding.* The bacterium, a spirochete, was designated Borrelia
burgdorferi in honor of the principal author of the Science paper,
Willy Burgdorfer of Rocky Mountain Laboratories, a research component
of NIH.
The disease was first identified at Lyme, Connecticut; 90% of the cases are reported in the Northeast/Mid-Atlantic region and the Upper Midwest. Some 10,000 cases were reported in 1991, growing over the last decade to more than 20,000 annually, despite the difficulty of distinguishing a condition whose symptoms include fevers, chills, headaches, nausea, and/or joint pain and swelling, and whose characteristic “bull’s eye” rash does not always appear.
Stony Brook researchers have been at the forefront of efforts to improve Lyme diagnostics, which have a disappointingly high rate of false negatives, especially at the early stages of the disease. Prof. Benach and Pathology colleague Marc Golightly developed the critical laboratory test to detect the presence of antibodies to B. burgdorferi, an ELISA test (a very sensitive measurement of the interaction of antibodies with their specific antigen, in this case B. burgdorferi) that became the original “gold standard” for Lyme diagnosis. The first diagnostic to use recombinant DNA technology, able to provide results in an hour at the point of care, was also developed at Stony Brook.
*Gail S. Habicht, then as now a member of Pathology, also coauthored this article.