A Lyme-Fighting Power Duo

School Historian Karen Kruse Thomas recently spoke with Bloomberg Distinguished Professor Nicole Baumgarth, DVM, PhD, director of the Johns Hopkins Lyme and Tickborne Diseases Research and Education Institute, and Karen Peetz, Bus ’81 (MS), a Johns Hopkins trustee who provided funding that was matched by the University to establish the Peetz Family Professorship in the W. Harry Feinstone Department of Molecular Microbiology and Immunology. Nicole is the first to hold the Peetz Family Professorship, stepping into the position in September 2023. Nicole studies host responses to Borrelia burgdorferi, the bacterium that causes Lyme disease.

The following conversation has been edited for length and clarity.

Nicole, you hold doctorates in both veterinary medicine and human immunology. How did you become interested in tickborne diseases?

NB:   I started working on B. burgdorferi because I was fascinated by the way in which the pathogen evaded immunity. But the most important reason I study Lyme is because when I talk to patients and their families, it’s heartbreaking. Lyme won’t kill you but it’s a life-changing chronic disease that often goes undiagnosed, is difficult to treat, and isn’t curable.

What are some of the biggest challenges with tickborne diseases?

NB: It’s just not on the radar of medicine or public health. Malaria is the most well-researched and well-funded vector-borne disease, whereas Lyme and other tickborne diseases are very understudied. In the U.S., Lyme is the elephant in the room—by far the most common vector-borne disease, with 475,000 new cases every year. By contrast, in 2022, the number of new cases of the most common mosquito-borne diseases, West Nile virus and dengue, was 1,108 combined. There are neither vaccines for any of the tickborne diseases nor any easy way to reduce the tick population. You can’t use vector control on ticks the way you can kill mosquitos to prevent malaria. So, prevention is key, particularly through educating health professionals and the public about how to reduce tick exposure and recognize symptoms early.

You previously worked at a school of medicine. What attracted you to Johns Hopkins and to the Bloomberg School specifically?

NB: As a veterinarian, I’m aware that the public health term “herd immunity” originated from animals. I was interested in public health strategies because they can achieve broad results against Lyme. A place like Hopkins can put that disease, with its huge public health impact, on the map. But I was unsure about leaving my previous position since Bloomberg School faculty raise most of their salary through external grants. Holding the Peetz Family Professorship not only provided that assurance of stable funding, it empowers me to really take challenges head on.

Karen, you’re a former chief administrative officer at Citibank and a board member of the Global Lyme Alliance. Why did you establish the Peetz Family Professorship?

KP: I recognized the need for swift and comprehensive solutions to the urgent public health issue of Lyme and other tickborne diseases. Our son had such a struggle with babesia (a malaria-like illness transmitted by the same tick that transmits Lyme). I went to a gala to raise money for Global Lyme Alliance, where I met the GLA-funded researchers and other donors. Dave Nolan, a JHU trustee emeritus, was there and it turned out his son had a terrible case of Lyme disease. At that dinner, Ying Zhang, a former MMI faculty member and noted Lyme researcher, sat next to me and said, “Hopkins ought to tackle this.” Dean Emeritus Mike Klag suggested talking to Arturo Casadevall, MMI department chair, and that’s how the idea for the Lyme Institute and the Peetz Professorship was born.

What happened next?

KP: From the first meeting Dave and I had with Arturo in New York, we dreamed big. And to get something going, we knew someone had to write a check—we had to plant the seed money to find a great director. From the day we mentioned it to JHU President Ron Daniels, he was all about it, and Senior Vice President of Development and Alumni Relations Fritz Schroeder worked to obtain a $1 million matching gift from Bloomberg Philanthropies. The provost and the deans of the schools of medicine and public health were instrumental. We talked about what could be, and the various pieces fell into place. That’s what’s totally cool about it, that Hopkins had that mindset of “let’s do this!” It’s the epitome of a One University moment.

And how did Nicole become the first director of the Johns Hopkins Lyme and Tickborne Diseases Research and Education Institute?

KP: Nicole herself is just a remarkable person. She made a big life decision, moving from California to a new place and institution. Very early on she said to me, “at a state university, you get satisfied and talk about why you can’t do things, and at Hopkins we talk about why we can.” She took the plunge to come to Hopkins because that was true: with collaborators at the Bloomberg School and the School of Medicine, you get the best of both worlds. The Bloomberg School’s experience with vector-borne disease was also a big selling point for her, especially the resources of the Johns Hopkins Malaria Research Institute. There are tickborne researchers at other institutions, but no one is doing research, prevention, and treatment together the way Hopkins is.

There are already a lot of patient advocacy organizations raising money for Lyme research. What does the Lyme Institute at Hopkins have to offer that they don’t?

KP: People are getting sick every day, and all the Lyme advocacy groups work hard to create a lot of urgency. They emphasize patient stories and get lots of small donations, but there’s no long-term plan. The integrity of the Hopkins institutional brand can attract resources that the grassroots groups can’t. It’s so important to raise public awareness—but you also must move the needle for people to understand Lyme as a public health problem, in order to get the attention of the CDC, NIH, State of Maryland, Bloomberg Philanthropies, and other major players. We needed to be the one-stop shop for these kinds of organizations.

What do you see for the Lyme Institute in the future?

KP: I really appreciate the longevity of Hopkins—they’ll be here in another hundred years. This Institute can be the catalyst for cures. It wasn’t going to happen with the previous disintermediated model.

Nicole, what are you most excited about now that the Lyme Institute is up and running?

NB: Our studies in deer mice, the primary natural reservoir for Lyme, are very important to understanding human infection and immunity processes. The mouse immune system fights B. burgdorferi enough to keep the host from getting sick but doesn’t completely eliminate it. Mice are at the bottom of the food chain, so they are ideal for transmitting Lyme to larger species that carry the ticks where they can latch onto humans. By studying the way B. burgdorferi suppresses the immune system in mice, we may be able to identify targets for drug development.

We are also looking for ways to produce host immunity to not just Lyme but all tickborne diseases. That’s not possible with mosquito-transmitted diseases since mosquitoes feed quickly and leave. Since ticks must latch on for at least 48 hours to infect their host, anything that can prevent the tick from consuming blood or otherwise staying latched on could block transmission of infection.

These are examples of how we need to have the question of “and then what?” at the front and center of what we’re doing. It requires a different approach to basic science to ensure the knowledge is immediately applied to solve problems.

Karen Kruse Thomas is a writer for the Office of External Affairs at the Bloomberg School. To learn more about how to support the Institute’s work, please contact Heath Elliott, associate dean for development and alumni relations, at helliot2@jhu.edu.

N.B. The School's annual Lyme and Tickborne Diseases Symposium takes place May 1 – 2, 2024,  at the Bloomberg School's Wolfe Street campus. The symposium includes many Bloomberg School faculty, colleagues, and other experts in the biology of ticks, the pathogens tick carry, and the diagnosis and prevention of tick-transmitted diseases. The program includes breakout sessions during which participants will tackle broad questions about identifying the most pressing unanswered research questions and their applications for advancing public health. See the event program and register to attend.