Project Team

Ed Breitschwerdt PhD, Professor of medicine and infectious diseases at North Carolina State University College of Veterinary Medicine

Richard Maggi, PhD, Head of the Intracellular Pathogens Laboratory, North Carolina State University College of Veterinary Medicine

David Putrino, PhD, Director of Rehabilitation Innovation for the Mount Sinai HealthCare System. Nash Family Director, Cohen Center for Recovery from Complex Chronic Illness.

Amy Proal, PhD, President, PolyBio Research Foundation, Scientific Director, Cohen Center for Recovery from Complex Chronic Illness.

Project summary:

Project lead Dr. Ed Breitschwerdt

A project performed in concert with the Steve & Alexandra Cohen Foundation to determine the degree to which patients with long COVID, ME/CFS and hypermobile EDS diagnoses harbor tick-borne/vector-borne pathogens in blood. The project team recently developed, optimized, and validated a multiplex droplet digital PCR (ddPCR) assay for the simultaneous detection of tick-borne/vector-borne pathogens Babesia, Bartonella, and Borrelia in patient blood. This assay will be used on blood collected from patients at Mount Sinai’s Cohen Center for Recovery from Complex Chronic Illness. In samples from ~40% of study participants, culture methods will additionally be used to verify ddPCR results. 

Borrelia, Babesia and Bartonella have been associated with vascular problems, angiogenesis and inflammation. Thus, blood samples from each study participants will also undergo analysis for dozens of makers of vascular disease, angiogenesis, and inflammation-related analytes.  

Project background:

Infection with a pathogens such as SARS-CoV-2 can disable the host immune response in a manner that allows latent pathogens harbored by a person to reactivate and potentially drive new chronic symptoms. This trend of pathogen reactivation is being studied in long COVID with a focus on the herpesviruses. For example, multiple studies have documented Epstein Barr Virus reactivation in certain long COVID study participants. However, in addition to herpesviruses, many people can become latently infected with tick-borne/vector-borne pathogens that can also reactivate under conditions of immune dysregulation or stress. These tick-borne pathogens include Babesia, Bartonella, and Borrelia. Indeed a team recently reported the case of a long COVID patient that tested positive for Bartonella henselae DNA and RNA in a lymph node sample. Treatment with the antibiotic clarithromycin improved her symptoms.

Data from the project team showing simultaneous detection of Babesia(red and light (bluedots), Bartonella (blue dots) and Borrelia (green dots) DNA in blood

However, these tick-borne/vector-borne pathogens are extremely difficult to accurately identify via standard clinical tests, leaving many patients unaware that they are infected. The project team are experts in the study of vector-transmitted intracellular pathogens and their contributions to chronic disease in both humans and animals. They have developed a Quiagen’s Digital PCR (dPCR) assay capable of identifying Babesia, Bartonella, and Borrelia with far more accuracy that current clinical testing. For example in one study, the multiplex ddPCR assay was able to detect 31 Bartonella, 13 Borrelia, and 24 Babesia species. Sensitivity of 0.2-5 genome equivalent DNA copies per microliter was achieved for different members of the Bartonella and Borrelia genus, depending on the species or matrix type (water or spiked blood DNA) tested. The goal of the current project is to multiplex assay to identify the prevalence of tick-borne/vector-borne pathogens in blood collected from patients with diagnoses of long Covid, ME/CFS and hypermobile EDS.