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Lyme Disease

Researchers from the joint Johns Hopkins University Bloomberg School of Public Health and Geisinger Environmental Health Institute, under the direction of Dr. Brian Schwartz and Dr. Annemarie Hirsch, are conducting a three-year study of Lyme disease in Pennsylvania, funded by The Steven & Alexandra Cohen Foundation. Pennsylvania has more reported Lyme disease cases than any other state, approaching 5,000 cases per year. Geisinger, an integrated health system, provides care to 1.6 million patients in 40 counties in the state, many of which reside in the highest risk areas in the state. Geisinger has had an electronic health record since 2001, allowing evaluation of Lyme disease risk as well as diagnosis and treatment patterns in a large, heterogeneous geography with urban and rural areas over many years. The objective of the study is to evaluate Lyme disease in Pennsylvania in relation to individual, population, and community vulnerabilities. We are using electronic health record data, patient interviews, and questionnaires to study the risk of Lyme disease as well as the risk of treatment delays in Lyme disease. Long-term, we hope to translate our findings into clinical care, through targeted screening of populations at risk, to reduce the burden of the disease in the region.

Publications

  • Moon KA, Pollak J, Hirsch AG, Aucott JN, Nordberg C, Heaney CD, Schwartz BS. Epidemiology of Lyme disease in Pennsylvania 2006–2014 using electronic health records. Ticks and Tick-borne Diseases. 2018 Oct 26.
  • Hirsch AG, Herman RJ, Rebman A, Moon KA, Aucott J, Heaney C, Schwartz BS. Obstacles to diagnosis and treatment of Lyme disease in the USA: a qualitative study. BMJ open. 2018 Jun 1;8(6):e021367.


Invited presentations

  • Schwartz BS. “Lyme disease: epidemiologic and clinical overview; and our research.” Lyme Symposium 2017, Lycoming College, Williamsport, PA, November 6, 2017.
    Moon KA. “Lyme disease epidemiology using electronic health records: Innovative case-finding & evaluation of individual, community, landscape, and climate risk factors.” Climate change and emerging infectious disease seminar. State University of New York at Albany School of Public Health. Albany, NY, October 18, 2018.
  • Schwartz BS. “Lyme Disease: Epidemiologic & Clinical Overview and Ongoing Research.” Johns Hopkins Occupational and Environmental Medicine Residency Seminar, Baltimore, MD, October 2018.

Scientific conference abstracts

  • Moon KA, Pollak J, Nordberg C, Heaney C, Hirsch AG, Schwartz BS. Individual, Community, and Landscape Risk Factors for Lyme Disease using Electronic Health Records. International Society of Environmental Epidemiology (ISEE). Sydney, Australia. September 2017.
  • Moon KA, Pollak J, Nordberg C, Heaney C, Hirsch AG, Schwartz BS. Epidemiology of Lyme Disease using Electronic Health Records. Lyme Disease in the Era of Precision Medicine Conference. Mount Sinai. October 2017.
  • Heaney C, Moon KA, Hirsch AG, Pollak J, DeWalle J, Schwartz BS. Landscape risk factors of Lyme disease and potential effect measure modification by climatic variability. Lyme Disease in the Era of Precision Medicine Conference. Mount Sinai. October 2017.
  • Moon KA, Pollak J, Nordberg C, Heaney CD, Hirsch AG, Schwartz BS. Individual and community-level risk factors of Lyme disease in Pennsylvania using electronic health records. Annual Meeting of the Society for Epidemiologic Research, Baltimore, MD, June 2018.
  • Pollak J, Moon KA, Hirsch AG, Schwartz BS. Risk factors for delayed diagnosis and treatment of Lyme disease, and the identification of Lyme diagnosis and treatment stages through electronic health records and free text analysis. Annual Meeting of the Society for Epidemiologic Research, Baltimore, MD, June 2018.
  • Pollak J, Moon KA, Hirsch AG, Schwartz BS. Identification of Lyme Disease Stages with Electronic Health Records and Free Text Analysis; and Evaluation of Risk Factors for Disseminated (vs. Early) Lyme Disease. Lyme Disease in the Era of Precision Medicine Conference, New York, NY, October 2018.


Other dissemination

  • Dr. Hirsch recorded a video on Lyme disease that was posted to YouTube and available to Geisinger patients internally, found here.
  • The Spring 2018 issue of the Geisinger Magazine included a story on our Lyme disease work (“Recognizing and treating Lyme disease quickly”); Dr. Hirsch was interviewed for the story. Geisinger Magazine is mailed to patients and is displayed in clinic waiting rooms.
  • We have been disseminating our work within Geisinger, from the CEO to Geisinger’s Innovations group. Forbes.com wrote a story about Geisinger CEO David Feinberg on November 10, 2018, in which Dr. Feinberg mentioned our work. Dr. Feinberg has now been recruited by Google to lead their health innovations group; he was explaining how big data can be used to battle disease, and was quoted as saying: “And we know, based on how close they live to the forest, the odds of them getting Lyme disease,” he said. “We can start thinking in advance what’s wrong with people, or what could become wrong with them, and prevent it.” This is based on our work and our meetings with Dr. Feinberg.