Fighting the Uptick in Lyme Disease

Lyme disease poses a serious and growing threat to public health. The U.S. Centers for Disease Control and Prevention estimates that more than 476,000 people contract Lyme disease each year. At this rate, one in 10 people in the U.S. is expected to contract the disease within their lifetime.  

First discovered in children in Lyme, Conn., in the 1970s, Lyme disease is transmitted via a bite from an infected black-legged tick. In early stages of infection, Lyme can present as flu-like symptoms. Left untreated, however, it can lead to severe health issues, including inflammation of the brain and spinal cord, arthritis, heart palpitations, facial palsy and nerve pain.  

Brandon Jutras, associate professor of microbiology-immunology at the Feinberg School of Medicine, has been studying Borrelia burgdorferi — the bacterium that causes Lyme disease — for over a decade. 

Lyme has been uniquely difficult to track, diagnose, prevent and treat, he says. Current testing methods for infection are unreliable, which means many cases go unreported. And milder winters due to climate change have allowed tick populations to expand their range far beyond the New England states notorious for the disease. 

Jutras, however, is decidedly optimistic about the future — and with good reason. His research, including two pivotal studies published just last year, is changing the outlook of Lyme disease diagnostics and treatment. 

The Trickiest Bacterium 

Jutras has spent his career studying arthropods — invertebrates, such as ticks, that have exoskeletons and segmented bodies. “Even as an undergrad and during my master’s research … I was always interested in bugs,” he says. “I did research on how spiders produce silk and the biophysical properties of that silk. And then I became more interested in the bugs that are inside the bugs. I started thinking about understanding infectious diseases not from a vector standpoint but from the microbe that’s actually causing the disease.” 

A vector is an organism such as a mosquito, flea or tick that carries and transmits a pathogen between hosts. In North America and Europe, Lyme disease is the most prevalent vector-borne infection in humans. It is also one of the most insidious — in large part because B. burgdorferi is “a highly unusual bacterium,” Jutras says.  

While most other bacteria are rod- or ball-shaped, B. burgdorferi are “serpent-like bacteria that are … faster than our fastest immune cells — so they can outrun just about any cell. 

“These bacteria coexist in several animals native to the U.S. and many other countries in the Northern Hemisphere,” Jutras adds, noting that B. burgdorferi is commonly found in perfectly healthy white-footed mice. “The real issue is when they get inside of us. We’re not the natural reservoir or host of Lyme disease. So the bacterium doesn’t know what to do inside us, and conversely, our immune system doesn’t know how to handle it.”  

The current standard of care is to administer a high dose of doxycycline, a powerful antibiotic that kills B. burgdorferi. This treatment has its drawbacks though: For one, it wipes out healthy gut bacteria. “It can make you feel quite sick,” says Jutras. What’s more, studies have shown that up to 20% of patients treated for Lyme disease continue to suffer from arthritis, fatigue, cognitive issues and pain, even after the bacterium is seemingly destroyed — a condition called post-acute infection syndrome (PAIS). Until recently, the exact cause of PAIS in people treated for Lyme disease was unknown.

Turning the Tide on Lyme

In 2025 Jutras and his team made two discoveries. In one study, his team provided evidence that PAIS can occur when the immune system continues to respond to remnants of dead bacterial cells. That “debris,” says Jutras, is peptidoglycan, a molecule found in the bacterial cell wall.

“Virtually all bacteria cells have peptidoglycan,” he says, and most people clear it from their systems without issue. Because of its unusual chemical and physical properties, though, B. burgdorferi’s peptidoglycan sticks around, accumulating in the liver and in knee joint fluids. Jutras suspects that there may be an at-risk population with a certain genetic mutation that causes their immune system to continue responding to the peptidoglycan as if the infection were ongoing.

Jutras says those patients may benefit from alternative treatments.

“One … is monoclonal antibody therapy,” he says. “We have monoclonal antibodies that can bind to the peptidoglycan. … So we can either mask the molecule so your immune system stops responding to it … or we can weaponize the antibodies to target and destroy the molecule.”

In another study, Jutras’ team identified an alternative antibiotic to treat Lyme disease with far fewer side effects than doxycycline. In mouse models, the federally approved antibiotic piperacillin was highly effective in killing B. burgdorferi at a dose 100 times less than the standard dose of doxycycline.

“Imagine you get bit by a tick. You go to the doctor, and they confirm it’s the Lyme disease–carrying tick,” he says. Rather than wait for symptoms to begin or taking a massive dose of doxycycline, a patient could receive “a single shot of piperacillin at a concentration that will not affect you whatsoever.”

Beyond treatment options, Jutras’ research also focuses on improving diagnostics. Current blood tests for Lyme disease take weeks to process, and they cannot distinguish between an active infection or previous exposure because they only look for antibodies, which may not always be detectable. “It’s an indirect test, meaning you’re not actually detecting the organism,” says Jutras. As a result, tracking the disease has been a challenge, as many cases go unreported.

“Not having good survey data … puts the public at risk of not knowing the overarching threat,” he says. If doctors do not know whether Lyme is prevalent in their area, for instance, they may not think to test patients for the disease.

Jutras has an answer for that problem too. His lab is developing an acute diagnostic test that can reliably identify Lyme disease within one to three days of infection. “During the initial stages of infection, B. burgdorferi releases tiny little pieces of peptidoglycan when it replicates,” he says. “So we’re using those pieces as a biomarker to say, ‘You have an active infection.’”

Jutras has a commercial partner and hopes to see these tests available in drugstores in the near future. In the meantime, if you’re heading outdoors, pack your insect repellent.