Annual progress reports

Developing Treatment for Debilitating Symptom Complexes attributed to Ticks (1169827)

  • Professor Richard Kanaan (Chief Investigator A)
  • University of Melbourne
  • Budget: $1,055,766.00
  • Funding period: 2019 to 2024

Project Synopsis

Chronic Lyme Disease is an unexplained condition. The causative organisms for Lyme Disease have long been identified and typically respond well to simple antibiotics, but many patients continue to report symptoms. Though in some cases this reflects inadequate treatment, there is a “post-Lyme disease syndrome” whose aetiology has not been established and which remains controversial. This is even clearer in the Australian context, where no Lyme-causative organisms have been found. With analogous conditions, such as chronic fatigue syndrome, mechanistic models and effective therapies have been developed that focus on symptom management and graded activity to improve functioning and quality of life. These approaches adopt the principle of aetiological neutrality, with moderate success. This project would extend this approach to the Australian Chronic Lyme Disease variant, DSCATT (Debilitating Symptom Complexes attributed to Ticks). We plan to:

  1. review the many cases that have presented to our services to determine a case definition and a set of diagnostic requirements
  2. adapt the treatment approach for unexplained syndromes to the specifics of DSCATT
  3. conduct a feasibility randomised controlled trial to confirm the suitability of the therapeutic method to the population as well as assess the feasibility of a future trial using a priori parameters.

Progress report April 2023

The preparatory phases of the project have all now been completed. The case definition was established by a modified Delphi process involving consumers, clinicians and researchers, supplemented by statistical analysis of consumer survey data. This case definition has been included in the trial protocol and will be published in due course. The DSCATT symptom scale was completed following statistical analysis and has been included in the trial protocol, to be published in due course. The intervention was piloted and found to be acceptable and with evidence of efficacy; it has been modified following feedback from the pilot, and the patient manual included in the trial protocol. The pilot intervention's outcomes have been analysed and are also being written up for publication. The main project protocol has been submitted to ethics and received provisional approval now. We will publish the final trial protocol and commence the trial. 

Publications and other resources

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


Troublesome Ticks: Determining the aetiology of DSCATT in Australia (1169949)

  • Professor Peter Irwin (Chief Investigator A)
  • Murdoch University
  • Budget: $1,934,788
  • Funding period: 2019- 2024

Project Synopsis

A four-year longitudinal study of patients with tick bite will be conducted in order to provide a scientifically valid, evidence-based understanding of the cause(s) of debilitating symptom complexes attributed to ticks (DSCATT). With current uncertainty about the aetiology of DSCATT, the proposal will encompass clinical, psychological and laboratory assessment of tick bite patients, and matched controls, to better define the illness and to determine if infectious organism(s) are contributing to the symptom complexes. Utilising advanced molecular testing, immune profiling and routine pathology together with clinical and psychometric testing at the time of tick bite, and at subsequent occasions up to 12 months, physical and psychological correlates, and laboratory markers associated with DSCATT will be identified. This study builds upon recognised research and is informed by a national team with expertise in medicine, psychology, epidemiology, microbiology, immunology and infectious disease and, crucially, Australia-wide access to samples. The team is therefore uniquely placed to analyse ticks, blood and skin biopsies from people bitten by ticks (n=900), and from controls (n=1,800) living in the same geographical locations.

Progress report November 2022

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 Troublesome Ticks.

Publications and other resources 

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.   

Lee et al. (2023) A systems biology approach to better understand human tick-borne diseases. Trends Parasitol 2023 Jan;39(1):53-69. Epub 2022 Nov 16