One Health Archives

How education can bend the curve in the tick-borne disease epidemic

Kris Newby on May 11, 2023

There’s a dire shortage of health-care providers who are experienced in the diagnosis and treatment of tick- and other vector-borne diseases. This means many suffering patients must travel long distances and wait months for an initial appointment, leading to worse patient outcomes. [1]

There are immense insurance and logistical barriers that discourage providers from taking on patients with tick-borne diseases. Some of these were identified in a 2022 survey-study of 155 clinicians from 30 states who treat Lyme patients. They included complexity of care (79%), the cognitive impairment of patients (57%), and frequent patient calls between scheduled appointments (49%). [1]

This shortage of trained providers is getting worse as the incidence of vector-borne diseases rises. The Centers for Disease Control reports that:

Diseases spread by mosquitoes, ticks, & fleas tripled in the U.S., 2004-2016.
Since 2004, 9 new pathogens spread by mosquitoes & ticks have been discovered.
476,000 Americans are diagnosed with Lyme disease each year, in all 50 states.

Despite the alarming rise in these diseases, a 2023 study led by Cornell University, “Review of Continuing Medical Education in Tick-Borne Disease for Front-Line Providers,” found a “limited availability of continuing education for multiple life-threatening tick-borne diseases of increasing importance in the United States.” [2]

Invisible International is filling this educational gap by producing best-in-class Continuing Medical Education (CME) courses on vector-borne and environmental disease, available to anyone online for no cost. These courses cover prevention, diagnosis, and treatment of these disease.

What is CME?

Continuing Medical Education (CME) educational activities are classes, workshops, or conferences that increase the knowledge and skills of health-care providers, ensuring that they stay current on the latest medical research and best medical practices. Some states require that doctors, nurses, and other health professionals accrue a certain number of CME course credits each year to keep their medical licenses active.

What is unique about its CME offerings?

Invisible has one of the largest online CME collections of vector-borne diseases available. The courses are delivered by some of the most knowledgeable experts in their respective fields, featuring topics like persistent Lyme disease, the Bartonelloses, Lyme disease treatment, and neuropsychiatric symptoms of tick-borne diseases. Our courses incorporate the One Health concept, a recognition that the health of humans, pets, and the environment are all intertwined.

What is CME accreditation?

CME courses can be developed by medical societies, universities, companies, or nonprofits such as Invisible International. For these activities to be counted towards annual CME totals, they must be approved by independent accreditation organizations. This ensures that the educational activities are relevant, practice-based, effective, based on valid content, and independent of commercial influence.

Is Invisible’s CME accredited?

Invisible International’s Continuing Medical Education (CME) platform is accredited by two governing bodies:

The Accreditation Council for Continuing Medical Education (ACCME) sets course development guidelines to ensure accurate, balanced, scientifically justified clinical-practice recommendations, all free of commercial bias.
The American Academy of Family Physicians (AAFP) reviews individual courses to ensure that they:
- are relevant to family practice
- are evidence-based
- communicate the risks and benefits of clinical recommendations
- evaluate a learner’s grasp of the material.

Physicians taking AAFP-approved courses can receive reciprocal continuing education credits from the American Medical Association, (AMA), the American Osteopathic Association (AOA), the College of Family Physicians of Canada (CFPC), and other health professional organizations.

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 http://invisible.international/give.

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[1] Johnson LB, Maloney EL. Access to Care in Lyme Disease: Clinician Barriers to Providing Care. Healthcare. 2022; 10(10):1882. https://doi.org/10.3390/healthcare10101882

The authors of this study are Elizabeth L. Maloney, MD, a Minnesota family physician and Invisible’s education co-director; and Lorraine Johnson, JD, MBA, the Chief Executive Officer of LymeDisease.org and the principal investigator of its patient registry and research platform, MyLymeData.

[2] 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

New course on healthy cat ownership

Kris Newby on March 30, 2023

Invisible’s new continuing medical education course, “Zoonotic diseases and pet cats,” describes common diseases that can spread from cats to humans, along with some simple prevention tips. It’s taught by Erin Lashnits, MS, DVM, PhD, DACVIM, a clinical assistant professor in small animal internal medicine at University of Wisconsin’s School of Veterinary Medicine. Her pedigree as a veterinarian and a cat lover includes an MS degree in biology from Stanford University, a DVM from Cornell University, and a PhD in comparative biomedical sciences from North Carolina State University.

There are about 370M domestic cats and 600M unowned cats around the world, and they all come with a certain amount of disease risk. In this course, Dr. Lashnits provides an overview of these risks, as well as preventative measures to take when introducing a new cat into a home.

In Dr. Lashnits’ experience, she sees cat bites as a concerning risk. There are an estimated 400,000 cat bites a year, and a high percentage of these may lead to deep infections.

“Cat bites are much more likely to get infected than dog bites,” said Dr. Lashnits. “So taking care to play safely with cats and kittens is super important – use toys, not fingers.”

Fleas are also a major concern, since they can transmit, bartonelloses, plague, and rickettsial diseases. Toxoplasmosis and various types of worms can also be transmitted from cat feces. To avoid these diseases and others she recommends daily cleaning of litter boxes and year-round flea, tick, and heartworm medicine.

It’s also important to note that humans can transmit COVID to their cats, and this risk goes up if cats share a bed with humans.

Dr. Lashnits also provides a checklist for new cat owners:

Make sure your new cat is vaccinated, dewormed, and treated for fleas and ticks before taking it home.
Keep your cat quarantined for at least a week before giving it the run of the house, to minimize stress and look for signs of disease.
Discourage children from letting kittens bite their hands during play.
Avoid feeding your cat raw food to prevent food-borne diseases.
Take your cat for routine veterinarian checkups.
Provide your cat with year-round flea, tick, and heartworm protection.
Get into a routine of cleaning litter boxes daily.

Watch here: https://learn.invisible.international/courses/zoonotic-disease-and-pet-cats/

New course on healthy dog ownership

Kris Newby on February 7, 2023

Invisible’s new continuing medical education course, “Zoonotic diseases and pet dogs,” discusses common diseases that can spread from dogs to humans, along with some simple prevention tips. It’s taught by Erin Lashnits, MS, DVM, PhD, DACVIM, a clinical assistant professor in small animal internal medicine at University of Wisconsin’s School of Veterinary Medicine. Her pedigree as a veterinarian and a dog lover includes an MS degree in biology from Stanford University, a DVM from Cornell University, and a PhD in comparative biomedical sciences from North Carolina State University.

It’s estimated nearly half of all U.S. households own one or more dogs (80 to 90 million total), and along with cohabitation comes additional disease risks. In this course, Dr. Lashnits covers diseases that can be transmitted from dogs, advice on how to safely import dogs from abroad, and preventative measures when introducing a new dog into a home.

Dr. Lashnits’ new dog checklist:

Make sure your dog is vaccinated, dewormed, and treated for fleas and ticks before taking it home.
Before letting a new dog roam free with other dogs, keep it separated for about a week, observing for any signs of disease.
Avoid feeding your dog raw food to prevent food-borne diseases.
Take your dog for routine veterinarian checkups.
Provide your dog with year-round flea, tick, and heartworm.
Review the CDC guidelines on importing dogs from abroad.

In Dr. Lashnits’ practice, she sees dog bites and flea- and tick-borne diseases as major disease risks. Fleas can carry Bartonella, plague, and rickettsia species. Ticks can transmit Lyme disease, Rocky Mountain spotted fever, several deadly viruses, and a host of other pathogens.

She also offers a warning about dog kisses: “Try to train your dog not to lick you on the mouth, and if it does, wash your hands and face,” said Dr. Lashnits.

Dr. Lashnits goes on to explain how dogs can serve as sentinels for human disease, citing the use of dogs for tracking the alarming spread of invasive Asian longhorned ticks across the middle Atlantic states.

Watch here: https://learn.invisible.international/courses/zoonotic-disease-and-pet-dogs/

Join our One Health Innovation Hackathon on Nov. 5th

Kris Newby on October 18, 2022

Bridging the Knowledge Gap Between Human and Animal Clinicians

Register: https://tinyurl.com/y3285t6m

When: Nov. 5, 2022
—9am to 12:30pm: Lightning Talks on One Health Challenges
—12:30 to 4pm: Med-Vet Innovation Hackathon

What: Learn about the One Health challenges faced by animal and human clinicians in addressing tick- and vector-borne diseases, which have worsened with climate change, ecosystem imbalances, and public health funding inequities. An afternoon innovation hackathon will follow the presentations.

Where: This is a free online event. Zoom info will be sent prior to the event.

Who: Animal and human health professionals, students, hackers, creators and others invested in One Health are welcome. For the afternoon hackathon, participants are invited to form teams of up to 4 people. If you don’t have a team, you can find collaborators during the hackathon.

Awards: Four winning teams will be awarded $1,000 each. Winning teams will be eligible for future solution implementation funding.

Award criteria: Awards will go to four teams with the best pitch deck solution proposals for enhancing communication between animal and human clinicians, improving health for all.

Vet/MD student honorariums: $300 will be awarded to each of the first 10 veterinary and 10 medical students who register and participate in the hackathon. Eligibility is based on date of registration, all-day participation, and proof of enrollment as a vet or medical student.

Speakers: One Health leaders from MassGen/Harvard Medical School, HHS, One Health Commission, University College Dublin School of Medicine, Tulane University School of Medicine, University of Wisconsin School of Veterinary Medicine, North Carolina State College of Veterinary Medicine/Duke University, and more.

Register at https://tinyurl.com/y3285t6m

ABOUT
One Health is a problem-solving framework that strives to improve the health of all living things on the planet through collaborations between animal, plant, environmental, and human health experts.

During this event, participants will learn about and brainstorm on ways to reduce the impact of tick- and vector-borne diseases, which have worsened with climate change, ecosystem imbalances, and public health funding inequities.

The morning will include lightning talks that inform and define the challenges in tackling these problems. The afternoon will feature a hackathon where participant-deﬁned teams and challenge topics will be organized. Teams will hold initial meetings to discuss how they will tackle their hacks and present them to judges later in the year. Awards will be based on solutions presented in team pitch decks at the end of the day.

AGENDA (Subject to change)

9:00am WELCOME REMARKS
Nev Zubcevik DO
Chief Medical Officer, Invisible International

Laura Lott, MBA
Chief Executive Officer, Invisible International

9:15am LIGHTNING TALKS: Why One Health is Important

Kristen Honey, PhD*
Chief Data Scientist and LymeX Co-Founder, Office of the Assist. Secretary for Health,
US Dept of Health & Human Services *Invited, not confirmed
“The Importance of One Health InnovationX to HHS”
Cheryl Stroud, PhD, DVM
Exec. Director, One Health Commission
“One Health for Human & Animal Clinicians”
John Lambert, MD, PhD
Consultant in Infectious Diseases and Genitourinary Medicine at Mater Misericordiae University Hospital; Full Clinical Professor at University College Dublin School of Medicine; Advisory Board Member, Invisible International
“Call for international collaboration and data sharing from the clinical trenches”
Elizabeth Lee-Lewandrowski, PhD, MPH
Assist. Professor of Pathology, Harvard Medical School; Research Faculty and Clinical Laboratory Scientist, Massachusetts General Hospital, Department of Pathology; Research Director, Invisible International
“Why You Should Care about Zoonotic Diseases”

10:00am LIGHTNING TALKS: Diagnostic & Treatment Challenges and Solutions

Monica Embers, PhD
Assoc. Professor of Microbiology and Immunology, Tulane University School of Medicine
“Diagnostic Challenges”
Elizabeth Maloney, MD
Education Co-director, Invisible International
“Barriers to human treatment: Results from a survey of clinicians”
Erin Lashnits, DVM, PhD, MS, DACVIM
Clinical Assist. Professor, Univ. of Wisconsin School of Veterinary Medicine
“One Health Clinical Model”

10:45am PANEL: Fostering Animal & Human Health Collaborations
Moderator: Christine Green MD, Education Co-director, Invisible International

Edward Breitschwerdt, DVM, DACVIM
Professor of Medicine and Infectious Diseases, North Carolina State University College of Veterinary Medicine; Adjunct Professor of Medicine at Duke University Medical Center
Steven Phillips, MD
Internal Medicine; Private Practice, author of bestselling book, CHRONIC
Charlotte Mao, MD, MPH
Curriculum Director, Invisible International
Pediatric Infectious Disease, formerly Dean Center for Tickborne Illness, Spaulding Rehabilitation Hospital; Pediatric Infectious Disease Division, Massachusetts General Hospital
Elizabeth Lee-Lewandrowski, PhD, MPH
Assist. Professor of Pathology, Harvard Medical School; Research Faculty and Clinical Laboratory Scientist, Massachusetts General Hospital
Research Director, Invisible International
11:30am – 12:30pm Live Q&A

12:30-1:00pm HACKATHON: Idea Pitches

1:00-3:00pm Med-Vet Innovation Hackathon breakout sessions

3:00pm Presentations

3:30-4:00pm Concluding Remarks/Judging/Awards

THANK YOU

Sponsors
The Lovell Family Foundation, The Montecalvo Foundation, The Xefos Family, The Hewson Family

Collaborators
One Health Commission, Louisiana One Health in Action, Galaxy Advanced Microbial Diagnostics

Faculty Affiliations
MassGen/Harvard Medical School, University College Dublin School of Medicine/Mater Misericordiae University Hospital, Tulane University School of Medicine, University of Wisconsin School of Veterinary Medicine, North Carolina State College of Veterinary Medicine/Duke University

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