Pharmacist initiation of postexposure doxycycline for Lyme disease prophylaxis

In an article published by Jackson, et al. it is reported that a community pharmacy has begun to successfully develop a program to dispense doxycyline to patients who have come into contact with the tick species known to carry Lyme disease. The pharmacy, which is located in Rhode Island, is independently run and wanted to increase the ability of patients to access this treatment for Lyme disease. Patients were asked to report any symptoms of the disease and to assess the performance of the pharmacy. Overall, the project was deemed a great success and was expanded to more pharmacies. It is also being used as a benchmark for treatment of Lyme disease in areas with high infection rates.

I feel that this article is important to pharmacy for a few reasons. First, an independent pharmacy was able to identify a problem in their community and develop a plan to solve it. Second, they successfully executed their plan and have plans for expansion. Third, they have shown the importance of not only independent pharmacists, but the importance of pharmacists in general. This is a great example of collaborative practice. I’m sure that PA, a state that has a fair amount of Lyme disease diagnoses, could benefit from similar programs. What do you think about this program?

Link to the article

Jackson, Anita N., K. Kelly Orr, Jeffrey P. Bratberg, and Frederic Silverblatt. “Pharmacist Initiation of Postexposure Doxycycline for Lyme Disease Prophylaxis.” Journal of the American Pharmacists Association 54.1 (2014): 69-73. Web.

Genome of the tick that transmits Lyme disease sequenced

Tick-borne illnesses cause thousands of deaths per year after ticks infect their host. The host, animals or humans, is infected with the tick’s saliva as the tick ingests their blood. It is estimated that the actual number of cases of Lyme disease per year in the United States is over 300,000. The actual number of reported cases is significantly less than this because many cases are either not reported or they are misdiagnosed.

Researchers from Purdue University have sequenced the genome of the tick, Ixodes scapularis, that transmits Lyme disease after a decade-long project. Researchers say that the sequenced genome is a valuable tool that can be used to control ticks and to understand how they transmit the disease. Most importantly, this may be used as a means of discovering of how to interfere with the transmission of the disease. The researchers say they may be able to do this because they know what proteins the tick is making so they may be able to control the tick by controlling the proteins they express.

The researchers found that tick saliva contains thousands of compounds which allows ticks to have a large range of hosts. In addition, the researchers faced challenges because nearly 70% of the tick genome is repetitive DNA. Many of the genes have mutated and show that two copies may be associated with different functions, therefore giving the tick an evolutionary advantage.

I think this article was interesting because it shows another example of how we can use genomic sequencing to benefit humans. My question for the class is: Can you think of any other examples in which it would be beneficial to sequence the DNA of another insect or animal?

 

Reference:

Monika Gulia-Nuss, Andrew B. Nuss, Jason M. Meyer et al.Genomic insights into the Ixodes scapularis tick vector of Lyme diseaseNature Communications, 2016; 7: 10507 DOI:10.1038/ncomms10507