Targeted Call for Research into Debilitating Symptom Complexes Attributed to Ticks – Scientific Progress reports

As of November 2022 

GNT1169827 Developing Treatment for Debilitating Symptom Complexes attributed to Ticks

CIA Richard Kanaan, University of Melbourne 

• The study experienced a number of significant delays due to the COVID-19 pandemic, though these issues have been addressed and the study is operating efficiently now, leaving the project perhaps 18 months behind schedule.  To date a number of milestones and achievements have been realised. 
• A review of all cases of suspected DSCATT that were assessed by the infectious disease department at Austin Health has been completed. Overall the majority of cases’ symptoms could be potentially explained by other diagnoses, and almost all could be at least partly explained by other diagnoses.  
• The symptom profiles of over 100 surveyed patients with DSCATT found that their symptoms tended to form three clusters, one cluster being typical of infection. The majority of patients had pronounced fatigue.  This will be reflected in our case definition and in our DSCATT scale. 
• Patients with DSCATT were interviewed on their medical journeys and experiences, and their attitudes towards psychotherapy.  Patients reported the impact of their symptoms was exacerbated by a medical system experienced as delegitimising their illness. Though there was considerable variation, there was wide support for the potential value of psychotherapy in principle, tempered by the view that this is unlikely to be of benefit, and may be seen as dismissing DSCATT unless accompanied by biological treatment.  
• Developed and manualised a tailored therapy for adults with DSCATT. The therapy has been piloted, and revised for testing in a randomised controlled trial. 

Publications/presentations 

Schnall J, Oliver G, Braat S, Macdonell R, Gibney KB, Kanaan RA. Characterising DSCATT: A case series of Australian patients with debilitating symptom complexes attributed to ticks. Aust N Z J 

For more information see University of Melbourne, Developing a treatment for DSCATT https://blogs.unimelb.edu.au/dscatt/  

GNT 1169949 Troublesome Ticks: Determining the aetiology of DSCATT in Australia

CIA Professor Peter Irwin, Murdoch University 

This research project is currently in the third year of tick season. Patient enrolments to this clinical research project have been impacted by the COVID-19 pandemic, consequently the number of patients (and controls) included in the study to date are below our original targets, though more than 200 tick-bitten participants, and controls, have been enrolled to date. The recent east coast deluges have resulted in a high level of tick activity in the environment and thus elevated recruitment. The spring and summer of 2022/2023 is the final season for the research. We have maximised patient enrolments through proactive postings on social media, presentations to medical personnel, and media commentary. 

A biobank of samples from patients and controls has been established, and biological specimens have been archived for analysis. Comprehensive laboratory testing and analysis will continue through 2023. Data from real time laboratory tests including pathologies, selected serologies, microbial cultures, and psychometric analyses are complete and/or in process. 

For more information about this study please see https://tickstudy.murdoch.edu.au/  

Publications

Two peer-reviewed manuscripts have been published to date: 

1. Barbosa et al. (2022) The Troublesome Ticks Research Protocol: Developing a Comprehensive, Multidiscipline Research Plan for Investigating Human Tick-Associated Disease in Australia. Pathogens 2022 Nov 3;11(11):1290. https://doi.org/10.3390/pathogens11111290  
2. Lee et al. (2023) A systems biology approach to better understand human tick-borne diseases. Trends Parasitol 2023 Jan;39(1):53-69. doi. 10.1016/j.pt.2022.10.006. Epub 2022 Nov 16