The Power of Plants in Tick Prevention

As we embrace the beauty of spring and the outdoor activities it brings, we also face the increased risk of tick encounters. Dr. Nev Zubcevik, Chief Medical Officer of Invisible International, and an avid gardener, shares insights on how gardeners can use specific plants to protect themselves from ticks and the diseases they carry, such as Lyme disease—a condition that affects 476,000 Americans annually.

Q: Dr. Zubcevik, why is it important for gardeners to consider tick-repelling plants?
A: With tick-borne diseases on the rise, it’s crucial we utilize every tool in our arsenal for prevention. Tick-repelling plants are a natural, aesthetic way to make our gardens less hospitable to ticks and the wildlife that carries them. This method complements other preventive measures, creating safer outdoor spaces for everyone.

Q: Lavender is popular in gardens. How does it deter ticks?
A: Lavender’s lovely fragrance, appealing to humans, is detestable to ticks. Its beautiful blooms add color and fragrance to your garden while acting as a natural line of defense against ticks.

Q: Can you tell us more about how rosemary helps repel ticks?
A: Absolutely. Rosemary emits a strong aroma that ticks find repulsive. It’s an excellent choice for gardeners because it’s not only effective against ticks but also enhances your garden’s aroma and is useful in the kitchen. Plus, it’s drought-resistant, making it a low-maintenance option for busy gardeners.

Q: What makes wormwood a good addition to a tick-preventive garden?
A: Wormwood contains absinthin, a bitter compound that’s unappealing to both ticks and their common hosts, like deer and mice. Its silver foliage adds beauty to your garden while serving as a natural pest deterrent.

Q: How does garlic contribute to tick prevention?
A: Garlic’s strong scent is a natural pest repellent, including ticks. Planting garlic around your garden can create a barrier that ticks are likely to avoid. It’s also a bonus for gardeners who love cooking with fresh herbs.

Q: Mint is known for its invasiveness. Is it still worth planting for tick prevention?
A: While mint does require careful management to prevent it from taking over, its strong scent is highly effective at repelling ticks. I recommend planting mint in containers to keep it contained while leveraging its tick-repelling properties. It is also a wonderful culinary herb that makes for a healthy and flavorful addition to dishes, sauces, and drinks.

Q: Geraniums are beautiful but toxic to pets. How do they fit into tick prevention?
A: Geraniums contain geraniol, which is effective against ticks. However, their toxicity to pets means they should be used with caution. If you have pets, consider placing geraniums in areas your pets don’t access or choosing other plants from this list.

Q: Marigolds are bright and cheerful. Do they repel ticks?
A: Yes, marigolds emit a fragrance that ticks dislike. They’re easy to grow and can add a protective and colorful edge to your garden.

Q: Can you explain how chrysanthemums contribute to tick prevention?
A: Chrysanthemums contain pyrethrin, a natural insecticide that repels ticks. Incorporating these flowers into your garden can provide a natural defense against ticks while adding beauty to your landscape.

Q: Lemongrass is often associated with citronella. How does this plant help in repelling ticks?
A: Lemongrass contains citronella oil, which is a well-known insect repellent. Planting lemongrass can help keep ticks at bay, and it offers the added benefit of being a delicious culinary herb. Its tasty tea is research-proven to help fight off infections and reduce cholesterol.


Q: Any final thoughts or advice for our readers?
A: While incorporating tick-repelling plants is a powerful strategy, it’s important to approach tick prevention holistically. This includes regular yard maintenance, using personal repellents, and conducting tick checks after outdoor activities. Additionally, I encourage everyone to gain in-depth knowledge by accessing the free, accredited Continuing Medical Education (CME) courses on vector-borne and environmental illnesses offered by the Invisible Education Initiative, funded by the Montecalvo Foundation. These resources are invaluable for both clinicians and the public in understanding and combating tick-borne diseases.

For Further Reading and Resources:

By incorporating these tick-repelling plants into your garden, you can enjoy the outdoors with a little more peace of mind, knowing you’re taking steps to protect yourself and your loved ones from tick-borne illnesses.

Support Invisible International, a 501c3, and learn more about our educational programs.

New Course Alert: Lyme & Tick-borne Disease Webinar & Panel Discussion

Global Lyme Alliance and Invisible International teamed up to host a Lyme & Tick-borne Disease CME Webinar, which took place on April 6. The event video and accredited CME courses are now available to the public and clinicians online. Free CME credit for physicians and other frontline providers is available through the Invisible Education Initiative.

The CME content includes:

Long Lyme/Co-Infections and Long COVID | What do they have in common?, Instructor: John Lambert, MD. Available for 0.5 CME
Neuropsychiatric Symptoms with Lyme Disease & Tick-borne Illness, Instructor: Shannon Delaney, MD. Available for 0.75 CME
Panel discussion and Q&A with instructors, Moderated by Chris Green, MD, Education Co-Director, Invisible International. Available for 1.5 CME

More information:

Invisible International and Global Lyme Alliance are thrilled to introduce a cutting-edge Continuing Medical Education (CME) course titled “Long COVID/Long Lyme Expert Clinician Panel”. This course, generously sponsored by the Global Lyme Alliance, represents a fresh effort to equip clinicians with the latest insights and evidence-based strategies for managing two challenging conditions: long COVID and long Lyme disease.

This panel is moderated by Dr. Christine Green, Invisible International’s Co-Director of Education, and features Dr. Shannon Delaney, an adult and pediatric psychiatrist, and Dr. Jack Lambert, an adult and pediatric infectious disease specialist. Together, these experts dive deep into the nuances of long COVID and long Lyme disease, drawing upon clinical experience in the US and Ireland. Participants will gain a comprehensive understanding of the complexities surrounding these conditions, incorporating the latest evidence-based research and clinical experience of the featured experts.

The panel is structured to emphasize the significant mental health aspects associated with Lyme disease, guiding clinicians on how to effectively monitor for mental health sequelae, integrate mental health screening tools into their practice, and make informed referrals to mental health professionals. Furthermore, it offers a concise overview of Lyme disease persistence post-standard treatments, challenging the outdated notion that Lyme disease is always straightforward to treat.

Additionally, the “Long COVID/Long Lyme Expert Clinician Panel” CME course aims to draw parallels between the clinical manifestations of long COVID and long Lyme disease, shedding light on potential treatment options. This segment is particularly designed to enhance clinicians’ diagnostic and therapeutic approaches, potentially accelerating treatment decisions and saving lives.

The Invisible Education Initiative, funded by the Montecalvo Foundation, provides free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. All courses are available at no cost for AAFP Prescribed Credits.

New Course Alert: “Antibiotic Treatment of Bartonella Infections” by Dr. Monica Embers

Invisible is excited to announce a new course: “Antibiotic Treatment of Bartonella Infections.” This course is designed for medical professionals seeking to deepen their understanding of Bartonella treatment. It centers around the groundbreaking work conducted by Dr. Monica Embers, Director of Vector-Borne Disease Research at Tulane University. Here is a preview what she covers in the course:

Q1: What is the current standard of care for the treatment of Bartonella infections?

Dr. Embers: The treatment varies based on the specific Bartonella infection. For example, a combination of gentamicin and doxycycline is often used for endocarditis caused by Bartonella.

Q2: How do Bartonella’s different microenvironments affect antibiotic efficacy?

Dr. Embers: The bacteria can exist extracellularly, intracellularly, or within biofilms, each affecting its susceptibility to antibiotics and complicating treatment strategies.

Q3: Can you discuss the latest research efforts in treating Bartonelloses?

Dr. Embers: Combination therapy and novel small molecule inhibitors show promise against Bartonella henselae in vitro. However, we need more pre-clinical studies to determine antibiotic efficacy and establish specific treatment regimens.

Q4: What are some diseases caused by Bartonella spp.?

Dr. Embers: Bartonella spp. bacteria cause diseases like Cat Scratch Disease, Carrion’s Disease, and Trench Fever, with Cat Scratch Disease being the most common.

Q5: What complications can arise from Bartonella infections in immune-compromised individuals?

Dr. Embers: Severe conditions like bacillary angiomatosis, bacillary peliosis, and blood-culture-negative endocarditis can develop, requiring aggressive treatment.

Q6: What are the challenges in diagnosing Bartonella infections?

Dr. Embers: The elusive nature of the bacteria makes diagnosis difficult. We need direct and reliable diagnostic tests, as current measures have several limitations.

Q7: Could you elaborate on Bartonella’s immune evasion strategies?

Dr. Embers: Bartonella employs sophisticated mechanisms to evade the host’s immune system: 1) Intracellular Location: Residing within host cells, like endothelial cells and erythrocytes, protects them from immune responses and certain antibiotics. 2) Biofilm Formation: Bartonella can form biofilms, complex bacterial communities that are resistant to immune responses and antibiotics. 3) Immune Suppression: Bartonella may suppress the host’s immune response, reducing the effectiveness of the host’s defense mechanisms. 4) Evasion of Phagocytosis: Bartonella has mechanisms to avoid being engulfed by phagocytes. 4) Subversion of Host Cell Functions: Manipulating host cell functions, such as altering apoptosis pathways, aids in Bartonella’s survival and proliferation.

Q8: What do you believe is the future of Bartonella treatment?

Dr. Embers: The future lies in further research and clinical trials, especially focusing on combination therapy and understanding the bacteria’s behavior in different host environments.

Thank you, Dr. Embers, for your insightful answers and for your dedication to vector-borne disease research. Your work offers hope and a new direction in the fight against these challenging diseases.

Watch the Course Here

The Invisible Education Initiative, funded by the Montecalvo Foundation, provides free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. These courses are available to clinicians and the public. To donate to this initiative and to learn about Invisible International, please go here.

Insights into Borrelia Miyamotoi: New CME Course from Dr. Shannon Delaney

In Invisible’s latest CME, titled “Borrelia miyamotoi Serology in a Clinical Population With Persistent Symptoms and Suspected Tick-Borne Illness,” medical professionals will be provided with important clinical knowledge about Borrelia miyamotoi. Taught by Dr. Shannon Delaney, a Columbia-trained psychiatrist, the course draws from her extensive experience and recent publication on this topic.

We asked Dr. Delaney to answer key questions about her study on Borellia miyamotoi. Read on to learn more!

Dr. Delaney, could you briefly explain what Borrelia miyamotoi is?

Dr. Delaney: Borrelia miyamotoi is a spirochetal bacterium causing relapsing fever, first identified in Japan in 1994. It’s transmitted by Ixodes ticks, the same vectors for Lyme disease. Clinically, it’s similar to Lyme disease but has distinct differences, like the absence of the erythema migrans rash common in Lyme disease.

What motivated you to conduct this study?

Dr. Delaney: Our goal was to investigate the prevalence of Borrelia miyamotoi in patients with persistent symptoms often linked to tick-borne diseases. There was a lack of substantial research in this area, and we aimed to fill that gap.

Can you describe the study’s design and methodology?

Dr. Delaney: We examined 82 patients from the Columbia University Irving Medical Center, and screened for Borrelia miyamotoi and Borrelia burgdorferi antibodies. Our methods included comprehensive assessments, serologic testing, and various questionnaires. The serology was based on the GlpQ gene of B. miyamotoi.

What were the key findings of your study?

Dr. Delaney: A significant finding was that 26% of our patients tested positive for B. miyamotoi. This is higher than previous reports in the literature. We also noticed that B. miyamotoi-positive patients reported more sleepiness and pain compared to those with Lyme disease.

Were there any surprising aspects in your research?

Dr. Delaney: The high seropositivity rate was indeed surprising. It suggests that B. miyamotoi might be more common than previously thought, especially in patients with symptoms suggestive of tick-borne diseases.

How does B. miyamotoi transmission differ from Lyme disease?

Dr. Delaney: Unlike B. burgdorferiB. miyamotoi can be transmitted directly from adult ticks to their offspring, meaning even larval ticks can be infectious. Plus, B. miyamotoi transmission to humans can occur quicker, within 24 hours of tick attachment.

What implications do your study’s findings have for public health?

Dr. Delaney: Our study highlights the need for increased awareness and testing for B. miyamotoi, particularly in patients presenting with multisystem symptoms similar to Lyme disease. Early diagnosis and treatment are crucial to prevent prolonged symptoms.

In this new Invisible CME, Dr. Delaney teaches learners about B. miyamotoi and findings from this recent study. Her course opens new pathways in understanding and managing tick-borne diseases, particularly Borrelia miyamotoi. The findings underscore the importance of considering B. miyamotoi in differential diagnoses for Lyme-like symptoms and the need for broader public health strategies to address tick-borne diseases.

Watch the Course Here.

The Invisible Education Initiative, funded by the Montecalvo Foundation, provides free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. These courses are available to clinicians and the public. To donate to this initiative and to learn about Invisible International, please go here.

Microbes & Mental Health: A historical review of 400+ journal articles

It’s long been recognized that infectious diseases can play a role in driving mental illness, but gathering evidence to support patient diagnoses can be time-consuming. To help healthcare providers quickly evaluate root-cause triggers, three medical experts — two in psychiatry and one in infectious disease — have reviewed, categorized, and cited hundreds of peer-reviewed journal articles that link specific microbes to common mental illnesses. The authors believe this is the first comprehensive review of associations between microbes and mental illness published in almost 30 years, and it is now available in the December issue of Healthcare.

“If we can catch these drivers of mental illness early in the disease process, many of the most serious cases can be prevented — before the afflicted end up in psychiatric hospitals, unhoused, or incarcerated,” said first author Robert C. Bransfield, MD, a Clinical Associate Professor at Rutgers-Robert Wood Johnson Medical School.

Bransfield and his coauthors, Charlotte Mao, MD, who serves as Invisible’s Curriculum Director and is a pediatric infectious disease physician trained at Harvard Medical School and Boston Children’s Hospital, and Rosalie Greenberg, MD, an adult/child/adolescent psychiatrist trained at Columbia University, spent over a year and a half gathering and evaluating hundreds of peer-reviewed journal articles, then organizing them in two quick-reference tables.

The authors believe that the link between microbes and mental illness can sometimes be missed because of the educational narrowing that happens when medical students transition to specialty fields.

“Psychiatrists end up with limited knowledge of infectious diseases and infectious disease specialists don’t get much exposure to psychiatric diseases,” said Mao. “To facilitate medical specialty collaboration, our article provides potential mechanistic explanations for how microbes might be associated with mental illness and a quick reference to relevant peer-reviewed studies, case reports, and case series.”

The authors began their research with a search of the medical literature for the five mental illnesses with the greatest psychiatric disability — autism spectrum disorders, schizophrenia, bipolar disorders, depressive disorders, and anxiety disorders. It also covered two behaviors of particular concern to both patients and physicians — suicidality and violent behavior. They also conducted a focused review of five infectious diseases commonly associated with mental illness: syphilis; toxoplasmosis; COVID-19; Lyme borreliosis; and group A streptococcal infections, which can cause Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).

Greenberg, who practices psychiatry in the New York Metropolitan area, sees a lot of mentally disturbed children with undiagnosed chronic Lyme borreliosis or the sequelae of undiagnosed strep infections, conditions that could be prevented with earlier diagnosis and proper treatment.

“What I often say to parents is, trust your instincts if you see abrupt personality changes in your child — things like obsessive-compulsive behaviors or unusual rages. It could be triggered by an infectious disease,” said Greenberg.

To read this open-source article, go here. For free medical education courses on diagnosing and treating microbe-driven mental health conditions such as Lyme neuroborreliosis or bartonellosis, visit the Invisible Education Initiative website, funded by the Montecalvo Foundation.

New Course Alert: “Combination Antibiotic Therapy for Treatment of Lyme disease”

We are excited to announce our new course, “Combination Antibiotic Therapy for Treatment of Lyme Disease.” This course is designed for medical professionals seeking to deepen their understanding of Lyme disease treatment. It centers around the groundbreaking study conducted by Dr. Monica Embers, Director of Vector-Borne Disease Research at Tulane University. To provide a comprehensive overview, we invited Dr. Embers to answer key questions about her study on combination antibiotic therapy.

Q: Dr. Embers, could you explain the main goals of your study?
Dr. Embers: Certainly! Our primary goals were to distinguish between antibiotic tolerance and resistance in Lyme disease, demonstrate persistence via tolerance by the Lyme disease spirochete, and evaluate the efficacy of combination therapy versus monotherapy in both animal models and humans.

Q: What are the key findings regarding antibiotic tolerance and resistance?
Dr. Embers: We found that Lyme disease bacteria, Borrelia burgdorferi, can become tolerant to antibiotics, meaning they can survive prolonged exposure without developing resistance. This tolerance contributes to the persistence of infection despite standard antibiotic treatment.

Q: How effective is combination therapy compared to monotherapy?
Dr. Embers: Our study showed that combination therapy – using multiple antibiotics – is more effective in targeting different forms of the Lyme disease bacterium, including dormant forms. This approach seems more successful in eradicating the infection compared to monotherapy.

Q: Can you discuss the prevalence of Post-Treatment Lyme Disease (PTLD) and its causes?
Dr. Embers: Yes, PTLD is a condition where symptoms persist even after antibiotic treatment. Our study suggests that the prevalence of PTLD might be higher than previously estimated. The causes could include inflammatory responses triggered by remnants of the bacteria, ongoing infection, or autoimmune responses.

Q: What insights did your research provide regarding the standard treatment guidelines for Lyme disease?
Dr. Embers: We found discrepancies between different guidelines, such as those from IDSA and ILADS, particularly concerning the duration and choice of antibiotics. Our research suggests that extended and combination therapies might be more effective, especially for patients with persistent symptoms.

Q: How do you see the future of Lyme disease treatment evolving based on your study?
Dr. Embers: Our study paves the way for more comprehensive treatment approaches, emphasizing the need for combination therapy. Future clinical trials should focus on these approaches to develop more effective and sustained treatments for Lyme disease, especially for those with PTLD.

Q: Lastly, what message do you have for patients currently struggling with Lyme disease?
Dr. Embers: It’s important to advocate for your health. If you’re experiencing persistent symptoms, seek medical advice and discuss the possibility of extended or combination antibiotic therapy. Stay informed and involved in your treatment process.

Thank you, Dr. Embers, for your insightful answers and for your dedication to Lyme disease research. Your study offers hope and a new direction in the fight against this challenging disease.

Watch the Course Here
The Invisible Education Initiative, funded by the Montecalvo Foundation, provides free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. These courses are available to clinicians and the public. To donate to this initiative and to learn about Invisible International, please go here.

Alruwaili, Y., Jacobs, M. B., Hasenkampf, N. R., Tardo, A. C., McDaniel, C. E., & Embers, M. E. (2023). Superior efficacy of combination antibiotic therapy versus monotherapy in a mouse model of Lyme disease. Frontiers in Microbiology, 14, 1293300.

Invisible’s New CME Course on Leptospirosis: The World’s Most Common Zoonotic Disease

Invisible’s newest CME course, “Leptospirosis: A Clinical Perspective,” provides medical professionals with comprehensive knowledge about diagnosing and managing leptospirosis. Leptospirosis is the world’s most common zoonotic disease, which is a category defined by infections that are spread between people and animals. It is often transmitted to humans through contaminated water. Taught by Dr. D. Scott Smith, a Stanford-trained infectious disease physician, the course draws from his extensive field experience. Dr. Smith has served as the Chief of Infectious Disease and Geographic Medicine at Kaiser Redwood City in California and is a current co-chair on the Professional Education Committee in the International Society of Travel Medicine.

Dr. Smith highlights the critical nature of leptospirosis. “Prompt recognition and appropriate management of this disease are crucial for clinicians, as it can be life-saving,” he notes, emphasizing the importance of timely and accurate response to potential cases (1).

The course addresses leptospirosis as a global threat that frequently mimics diseases like Lyme disease. It is designed to improve healthcare providers’ ability to identify the often non-specific symptoms of leptospirosis, which often pose a challenge in its early detection.

A key component of the course is the One Health approach, which melds human, animal, and environmental health considerations. This is crucial for the comprehensive understanding and management of leptospirosis.

Participants will delve into the diagnostic challenges of leptospirosis and explore the limitations of current testing methods. Treatment and prevention protocols, focusing on antibiotics such as doxycycline and penicillin, are covered. Strategies for avoiding exposure to contaminated environments such as stagnant bodies of water and lakes, and the use of appropriate protective gear are emphasized to limit the spread of leptospirosis. Under Dr. Smith’s guidance, this course aims to equip healthcare professionals with essential insights and practical skills to effectively confront leptospirosis, enhancing their capacity to address this significant global health challenge

Anyone can view the course here.

The Invisible Education Initiative, funded by the Montecalvo Foundation, provides free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. These courses are available to clinicians and the public. To donate to this initiative and to learn about Invisible International, please go here

  1. National Center for Biotechnology Information: Leptospirosis Overview. (Link)

Invisible works so that no patient is left behind

Dear Friend of Invisible,

Invisible is dedicated to ensuring that no Lyme+ patient is left behind. We focus on educating physicians about vector-borne diseases, and our efforts are entirely fueled by the generous support of donors like you.

Your contribution can help us expand our reach to more doctors and develop new educational courses.

Thank you for your commitment to helping us make a difference.

Together, we can make the invisible visible.

Support us today

Please support education that makes an impact this Giving Tuesday

Dear Friends and Supporters,

As we approach Giving Tuesday, a day dedicated to generosity and philanthropy, I urge you to consider the critical work of Invisible International. The shortage of trained providers in this field is worsening, a concern highlighted by the alarming statistics reported by the Centers for Disease Control:

  • Diseases spread by mosquitoes, ticks, and fleas tripled in the U.S. from 2004 to 2016.
  • Nine new pathogens spread by these vectors have been discovered since 2004.
  • Annually, 476,000 Americans are diagnosed with Lyme disease across all 50 states.

Despite these daunting figures, a 2023 study led by Cornell University revealed a stark reality: there is a limited availability of continuing education for life-threatening tick-borne diseases in the United States. (1) Another study revealed that the biggest barrier to patient access to treatment for Lyme disease is lack of physician education. (2)

Invisible International stands at the forefront of addressing this educational gap. We have created 40 CME courses for physicians, impacted over 100 institutions, delivered medical education presentations at 5 conferences, developed 3 clinical guides, and through our educational efforts, we have reached physicians who deliver vector-borne disease awareness to over 1,500,000 patient visits. Our courses, accredited by the Accreditation Council for Continuing Medical Education (ACCME) and reviewed by the American Academy of Family Physicians (AAFP), cover crucial aspects such as prevention, diagnosis, and treatment. These courses are available at no cost online, ensuring accessibility for all who need them.

Our initiative is further strengthened by the support of the Montecalvo Foundation, enabling us to offer these vital resources freely. However, to continue and expand our work, we rely on the generosity of individuals like you. Your donations empower us to educate more healthcare providers, enhance disease awareness, and ultimately save lives.

On this Giving Tuesday, I ask you to join us in this trailblazing mission, ensuring no patient is left behind. Your contribution will directly impact the fight against vector-borne diseases and support healthcare professionals in providing the best possible care to those affected.

To donate and learn more about our impactful work, please visit Invisible International.

On behalf of all of us at Invisible,
with gratitude,


Dr. Nev Zubcevik
Chief Medical Officer
Invisible International



  1. Malkowski AC, Smith RP, MacQueen D, Mader EM. Review of Continuing Medical Education in Tick-Borne Disease for Front-Line Providers. PRiMER. 2023;7:497812. Published 2023 Feb 2. (doi:10.22454/PRiMER.2023.497812)
  2. Johnson LB, Maloney EL. Access to Care in Lyme Disease: Clinician Barriers to Providing Care. Healthcare. 2022; 10(10):1882. (



Our team in action


Invisible’s New Course on how to diagnose and treat babesiosis

In our new course, “An Introduction to Human Babesiosis,” you’ll learn how to diagnose and treat infections caused by babesia, a malaria-like protozoan parasite that can be transmitted through tick bites, blood transfusions, and organ transplants, or congenitally from mother to fetus. The course is taught by Elizabeth Maloney, MD, the Education Co-director at Invisible, a Minnesota family physician, and the founder/president of Partnership for Tick-borne Diseases Education, a nonprofit providing evidence-based education on tick-borne diseases.

The disease parasite babesia, called babesiosis, lives in red blood cells. It was originally found only in cattle. It crossed over to humans in Croatia in 1956 and in Colorado and Massachusetts in the late 1960s. [1] Recent studies show that this parasite is more prevalent than previously thought, with Babesia microti being found in 1-in-10 of the ticks in southern New England and up to 15% of ticks in Suffolk County (Long Island), New York. [2]  

When ticks transmit both Lyme disease and babesia simultaneously, patients are sicker and the resulting disease is harder to treat. [3] Coinfected patients are more likely to have fatigue, headaches, sweats, chills, anorexia, emotional lability, nausea, conjunctivitis, and splenomegaly more frequently than those with Lyme disease alone. The disease can be fatal for patients with damaged or missing spleens.

The course also discusses the global distribution of babesia and a new species of babesia, B. odocoilei, which may be causing unrecognized disease.

Babesiosis is an emerging infectious disease yet many clinicians have had no or very little training about it. This can lead to missed diagnoses and increased morbidity for patients.” said Dr. Maloney, “unrecognized cases of babesiosis in blood donors have produced transfusion-transmitted cases which carry a significant mortality risk. Informing clinicians about the infection will ultimately improve patient care. The primary goal of this CME offering is for clinicians to include  babesiosis in their differential diagnosis, when clinically appropriate.” 

Watch the course here.

The Invisible Education Initiative, funded by the Montecalvo Foundation, provides free, accredited Continuing Medical Education (CME) courses that focus on vector-borne and environmental illness within a One Health framework. These courses are available to clinicians and the public. To donate to this initiative and to learn about Invisible International, please go here


  1. Hildebrandt A, Zintl A, Montero E, Hunfeld KP, Gray J. Human Babesiosis in Europe. Pathogens. 2021 Sep 9;10(9):1165. doi: 10.3390/pathogens10091165. PMID: 34578196; PMCID: PMC8468516.
  2. Sanchez-Vicente S, Tagliafierro T, Coleman JL, Benach JL, Tokarz R. Polymicrobial Nature of Tick-Borne Diseases. mBio. 2019 Sep 10;10(5):e02055-19. doi: 10.1128/mBio.02055-19. PMID: 31506314; PMCID: PMC6737246.
  3. Krause PJ, Telford SR 3rd, Spielman A, Sikand V, Ryan R, Christianson D, Burke G, Brassard P, Pollack R, Peck J, Persing DH. Concurrent Lyme disease and babesiosis. Evidence for increased severity and duration of illness. JAMA. 1996 Jun 5;275(21):1657-60. PMID: 8637139.