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:

• Centers for Disease Control and Prevention (CDC): Tick-borne Diseases
• Gardening Know How: Using Plants for Natural Pest Control
  
• Finally, don’t forget to do your tick checks!

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.

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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.

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.

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. burgdorferi, B. 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.

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.