Claire Cummins Science Reviews - Biology, 2024, 3(3), 16-21
16
Recent Developments in Infectious Disease Research
Claire Cummins, MSc
University of Tours, Tours, France
https://orcid.org/0000-0002-4922-3470
https://doi.org/10.57098/SciRevs.Biology.3.3.2
Received September 25, 2024. Revised October 15, 2024. Accepted October 15, 2024
Abstract: The field of infectious disease research is rapidly evolving and advancing, driven by the demand to
address both current and emerging threats to global health. The recent COVID-19 pandemic underscored the
criticality of infectious disease outbreak preparedness and response, while factors such as climate change,
migration, and globalization continue to influence disease transmission dynamics. Innovative approaches to
infectious disease research are more essential than ever to prevent future pandemics and the spread of vector-
borne diseases.
This comprehensive review article investigates some recent pertinent developments in infectious disease
research, including the development of a novel serosurveillance platform, modeled after the one designed
during the COVID-19 pandemic, aimed at tackling the growing global threat of arboviruses. Also investigated
in this article is the repurposing and application of mRNA vaccine technology, initially developed during the
pandemic, to address the complex challenge of tick-borne Lyme disease. Finally, we outline several novel and
cutting-edge strategies aimed at tackling the ever-mounting crisis of antimicrobial resistance (AMR).
Each of these innovations marks a significant step forward in global health security and preparedness, offer-
ing promising solutions to the challenges of a rapidly evolving world, while drawing on the lessons learned
from past outbreaks and epidemics.
Arbovirus Serosurveillance Inspired by the
COVID-19 Pandemic
Serosurveillance involves testing blood samples
from the general population for the presence of anti-
bodies against a pathogen of interest, allowing estima-
tion of the number of people previously infected
and/or vaccinated against the pathogen. Serosurveil-
lance data is extremely important for informing public
health policy in aiding outbreak prediction, identifying
high-risk groups, estimating the burden of disease, and
planning future vaccination programs in a cost-effec-
tive manner (Wilson et al., 2012).
As of mid-2024, the COVID-19 pandemic has
resulted in more than 770 million confirmed cases
and over 6.9 million deaths worldwide, according
to the World Health Organization (WHO). The
unprecedented and rapidly developing nature of
this pandemic required rapid global public health
response and intervention, with an example of this
being ‘SeroTracker’, a custom-built online
dashboard, fulfilling a worldwide demand for a
unified resource for seroprevalence estimates. The
platform allows users to visualize seroprevalence
data on a world map so as to compare findings
between regions, population groups, and different
diagnostic testing modalities (Arora et al., 2020).
Building on the success and utilization of the
SeroTracker platform, the same approach is now being
applied to arboviruses- which include mosquito-borne
viruses such as dengue, yellow fever, and Zika, with
the development of 'ArboTracker.' This new multi-
pathogen dashboard is designed for arbovirus sero-
prevalence studies. Mosquito-borne viruses pose a sig-
nificant global health threat, and their transmission is
exacerbated by factors such as migration, globalization,
and climate change. Yet, many cases remain underre-
ported due to outdated surveillance systems and lim-
ited diagnostic resources. ArboTracker is an exciting
new tool that could address this gap, allowing re-
searchers and policymakers to explore and visualize
seroprevalence estimates via an interactive online map,
as well as download datasets for use in predictive dis-
ease modeling. Furthermore, the stacking of multiple
pathogens within the visualization platform has much
potential in future prevalence studies requiring the
Science Reviews - Biology, 2024, 3(3), 16-21 Claire Cummins
17
grouping of pathogens by family. This will enable the
platform to be adapted and customized for quickly as-
sessing and responding to future infectious disease
outbreaks (Whelan et al., 2024).
Thinking Outside the Box to Address the Ever-
Challenging Lyme Disease
Lyme disease, transmitted by tick-bite from
the genus Ixodes, is caused by various strains of the
spirochete bacteria Borrelia burgdorferi. It is one of
the most prevalent vector borne diseases in North
America and Europe, with its geographical range
continuing to expand. The infection, Lyme borreli-
osis (LB), poses a major challenge due to its biolog-
ical complexity, person-to-person variation in
symptoms, variability of the bacterial genospecies,
and diagnostic limitations. In fact, diagnosis of LB
is a contentious topic in the scientific community, as
it has been subject to much debate and controversy
due to its reliance on indirect serological methods.
These methods are of low sensitivity, thus making
accurate diagnosis, especially in early infection,
very challenging.
Symptoms can vary depending on the person
as well as the genotype of the infective bacteria, and
include erythema migrans, headaches, arthralgia,
and myalgia (Fig. 1). However, especially in cases
that go untreated due to inaccurate diagnosis, the
strong and chronic antibody response that fails to
clear the infection long-term can cause much more
serious and chronic symptoms such as arthritis (Fig.
1), profound fatigue, and cognitive impairment
(Guérin et al., 2023).
Figure 1: Phases and symptoms of Lyme Disease. (Created with BioRender.com)
Suboptimal diagnosis inevitably leads to
suboptimal treatment of Lyme disease, with the
symptoms often being mistaken for viral infection,
leading to unnecessary treatments such as steroids,
which can actually worsen the condition, or utiliza-
tion of inappropriate antibiotics that are ineffective
against Borrelia burgdorferi. Inadequate treatment of
Lyme disease with non-recommended antibiotics
can lead to serious complications. Therefore,
though effective treatment exists for early stage dis-
ease, delayed diagnosis can make treatment more
challenging as the bacteria may have disseminated
throughout the body before treatment was initiated
(Aucott et al., 2009).
The complex challenges that Lyme disease
presents have led researchers to explore the
alternative of a preventative vaccine, with the first
candidate receiving FDA approval in 1998 being
Claire Cummins Science Reviews - Biology, 2024, 3(3), 16-21
18
LYMErix, developed by GlaxoSmithKline, a
recombinant vaccine targeting the outer surface
protein (OspA) of Borrelia burgdorferi, which
demonstrated 76% efficacy after three doses (Steere
et al., 1998). However, only four years later, the
vaccine was withdrawn due to low demand and
public concerns over the safety of the vaccine
(Poland, 2011).
Nevertheless, due to the rising incidence of
Lyme disease today, renewed efforts have been
made to develop an effective vaccine, with Valneva
and Pfizer collaborating to make the VLA15 vaccine,
which as of 2024 is in Phase 3 clinical trials with
promising results in terms of safety and efficacy.
The vaccine, like LYMErix, targets the OspA protein,
but trumps LYMErix due to its wider protection,
covering the six serotypes of bacteria that are the
most common in the US and Europe (Cornstedt et
al., 2017).
In 2023, the companies behind the successful
mRNA COVID-19 vaccine , Pfizer and BioNTech,
announced plans to develop a mRNA-based Lyme
disease vaccine, which is in early preclinical stages
as of 2024. As was seen during the COVID-19 pan-
demic, mRNA technology offers excellent flexibility
due to quicker design and manufacturing than tra-
ditional vaccines. Additionally, production of
mRNA vaccines is more efficient, since they are de-
signed to simply encode instructions for the im-
mune system to create the target protein (Fig. 2) and
don’t require the large-scale production of proteins
or inactive pathogens as is the case for conventional
vaccines (Pine et al., 2023).
Figure 2: Schematic overview of the mRNA-based Lyme disease vaccine. (Created with BioRender.com)
These positive aspects of mRNA vaccines of-
fer much potential for Lyme disease prevention, al-
lowing the targeting of multiple bacterial strains in
one vaccine, which can be more easily customized
to target different Borrelia burgdorferi strains based
on regional prevalence.
Antimicrobial Resistance: Moving Beyond
Antibiotics?
Antimicrobial resistance (AMR) has been a
problem plaguing global health security for dec-
ades, and in 2024, remains one of the most pressing
health challenges facing our population. Over the
next 25 years, an estimated 39 million people are ex-
pected to die from drug-resistant pathogens alone
(Barron, 2024). For decades after AMR first emerged,
the problem was remedied by the introduction of
newer classes of antibiotics (Martinez, 2014); how-
ever, in recent years, this development has slowed
down, leading to the exponential growth of re-
sistant organisms.
Additionally, misuse and excessive
prescribing of antibiotics in health and agricultural
environments has exacerbated the spread. The
Science Reviews - Biology, 2024, 3(3), 16-21 Claire Cummins
19
mechanisms of how AMR develops are varied and
include undergoing genetic mutations in response
to environmental pressures or threats either via
horizontal gene transfer or spontaneous genomic
rearrangement. In this way, bacteria continuously
evolve and develop resistance strategies each time
new antibiotics are employed (Berger and Loewy,
2024).
With both the continuous rise of AMR and the
reduced capacity to develop new antibiotics, the
pursuit of novel alternative treatments is a pertinent
medical need currently. One approach is to use
combination therapy, i.e.: utilizing two or more
antibiotics to promote an enhanced response, which
is currently used to effectively treat Mycobacterium
tuberculosis whereby a four-drug regimen targets
different pathways for survival, providing more
protection if the bacteria gains resistance to one
target pathway.
Drug-adjuvant combinations are also being
used to combat AMR, because adjuvants enhance
the activity of an antibiotic such as Augmentin – a
combination of the antimicrobial amoxicillin and
the adjuvant clavulanic acid (Konwar et al., 2022).
Antimicrobial peptides (AMPs) are short,
positively charged peptides that are involved in the
innate immune systems of various prokaryotes, in-
sects, plants, and animals. They have gained trac-
tion in recent years as an alternative to traditional
antibiotics, as they demonstrate broad-spectrum ac-
tivities against bacteria, viruses, and fungi. Their
positive charge allows them to target the negatively
charged components in the bacterial cell mem-
branes (Fig. 3), which means they are effective
against both Gram-positive and Gram-negative
bacteria. Some AMPs have already been FDA-ap-
proved, and they offer much potential as they are
predicted to have a low risk for resistance develop-
ment due to their diverse mechanisms of action
(Berger and Loewy, 2024).
Figure 3: Antimicrobial peptides disrupt bacterial membrane integrity. (Created with BioRender.com)
Monoclonal antibodies (MABs) that selec-
tively target antigens have been an area of interest
for AMR alternative treatments due to their high
specificity and favorable side effect profile (Lu et al.,
2020), with only three currently approved by the
FDA for the treatment of bacterial infections. These
MABs work by neutralizing bacterial secretory tox-
ins (Berger and Loewy, 2024), which again may
pose a low risk for resistance development as the
treatment targets external mechanisms of the bacte-
ria.
Bacteriophages are naturally-occurring vi-
ruses that specifically target and invade bacteria
and were researched and used in the clinical setting
in the 20th century, however, with the advent of an-
tibiotics, their use declined. However, due to the
challenge that AMR poses today, bacteriophage re-
search is of renewed interest with ongoing global
Claire Cummins Science Reviews - Biology, 2024, 3(3), 16-21
20
studies aimed at developing optimized phage ther-
apies for clinical use (Konwar et al., 2022). Some
bacteriophages produce endolysins, which can de-
stroy bacteria by breaking down their cell walls. An
example of this is the endolysin that has been devel-
oped into the drug SAL200, which is effective
against methicillin-susceptible (MSSA) and methi-
cillin resistant Staphylococcus aureus (MRSA). It is
also effective against destroying difficult biofilms,
which is a huge challenge for conventional antimi-
crobials (Jun et al., 2017).
Another alternative route from traditional an-
tibiotics is the use of nanomaterials to treat drug-re-
sistant infections, which act as carriers to deliver an-
tibiotics directly to bacterial cells. This innovative
mechanism allows the precise targeting of antibiot-
ics to infection sites, reducing the required dosing
and thus reducing the capacity for the bacteria to
develop resistance. Studies show the effectiveness
of nanoparticles against a wide range of problem-
atic multidrug resistant bacteria, including Staphy-
lococcus aureus, Escherichia coli, carbapenem-re-
sistant Acinetobacter baumannii, and Pseudomonas ae-
ruginosa (Berger and Loewy, 2024).
Conclusion
In conclusion, the rapidly evolving landscape
of infectious disease research reflects the growing
need for innovative solutions to address global
health threats. The examples of ArboTracker for ar-
bovirus surveillance, the repurposing of mRNA
vaccine technology for complex diseases like Lyme,
and the pursuit of alternative treatments to combat
antimicrobial resistance, display this innovation.
These developments are a testament to how science
is rising to meet the challenges of a world increas-
ingly shaped by factors like climate change, migra-
tion, and globalization.
Each of these breakthroughs represents a step
forward in global health security, providing us with
tools not only to address current issues, but also to
prepare for future infectious disease threats.
By leveraging new technologies and interdis-
ciplinary approaches to global health, we can better
predict, prevent, and respond to infectious diseases,
ultimately improving health outcomes and
strengthening our preparedness for pandemics yet
to come.
References
1. Arora, R. K., Joseph, A., Wyk, J. V., Rocco, S., Atmaja, A., May, E., Yan, T., Bobrovitz, N., Chevrier,
J., Cheng, M. P., Williamson, T., & Buckeridge, D. L. (2020). SeroTracker: a global SARS-CoV-2
seroprevalence dashboard. The Lancet Infectious Diseases, 0(0). https://doi.org/10.1016/S1473-
3099(20)30631-9
2. Aucott, J., Morrison, C., Munoz, B. et al. Diagnostic challenges of early Lyme disease: Lessons
from a community case series. BMC Infect Dis 9, 79 (2009). https://doi.org/10.1186/1471-2334-9-79
3. Barron M. The Antimicrobial Resistance Pandemic: Breaking the Silence | ASM.org. ASM.org. Pub-
lished 2024. Accessed October 8, 2024. https://asm.org/Articles/2024/October/Antimicrobial-Re-
sistance-Pandemic-Breaking-Silence
4. Berger I, Loewy ZG. Antimicrobial Resistance and Novel Alternative Approaches to Conventional
Antibiotics. Bacteria. 2024;3(3):171-182. https://doi.org/10.3390/bacteria3030012
5. Comstedt, P., Schüler, W., Meinke, A., & Lundberg, U. (2017). The novel Lyme borreliosis vaccine
VLA15 shows broad protection against Borrelia species expressing six different OspA serotypes. PloS
one, 12(9), e0184357. https://doi.org/10.1371/journal.pone.0184357
6. Guérin, M., Shawky, M., Zedan, A. et al. Lyme borreliosis diagnosis: state of the art of
improvements and innovations. BMC Microbiol 23, 204 (2023). https://doi.org/10.1186/s12866-
023-02935-5
7. Jun, S. Y., Jang, I. J., Yoon, S., Jang, K., Yu, K. S., Cho, J. Y., Seong, M. W., Jung, G. M., Yoon, S. J., &
Kang, S. H. (2017). Pharmacokinetics and Tolerance of the Phage Endolysin-Based Candidate Drug
SAL200 after a Single Intravenous Administration among Healthy Volunteers. Antimicrobial agents
and chemotherapy, 61(6), e02629-16. https://doi.org/10.1128/AAC.02629-16
Science Reviews - Biology, 2024, 3(3), 16-21 Claire Cummins
21
8. Konwar, A. N., Hazarika, S. N., Bharadwaj, P., & Thakur, D. (2022). Emerging non-traditional
approaches to combat antibiotic resistance. Current Microbiology, 79(11), 330.
9. Lu RM, Hwang YC, Liu I-Ju, et al. Development of Therapeutic Antibodies for the Treatment of Diseases.
Journal of Biomedical Science. 2020;27(1):1-30. doi:https://doi.org/10.1186/s12929-019-0592-z
10. Martinez JL. General Principles of Antibiotic Resistance in Bacteria. Drug Discovery Today:
Technologies. 2014;11(1740-6749):33-39. doi:https://doi.org/10.1016/j.ddtec.2014.02.001
11. Pine M, Arora G, Hart TM, Bettini E, Gaudette BT, Muramatsu H, Tombácz I, Kambayashi T, Tam
YK, Brisson D, Allman D, Locci M, Weissman D, Fikrig E, Pardi N. Development of an mRNA-lipid
nanoparticle vaccine against Lyme disease. Mol Ther. 2023 Sep 6;31(9):2702-2714. doi:
10.1016/j.ymthe.2023.07.022.
12. Poland GA. Vaccines against Lyme Disease: What Happened and What Lessons Can We Learn?
Clinical Infectious Diseases. 2011;52(suppl_3):s253-s258. doi:https://doi.org/10.1093/cid/ciq116
13. Steere AC, Sikand VK, Meurice F, et al. Vaccination against Lyme Disease with
RecombinantBorrelia burgdorferiOuter-Surface Lipoprotein A with Adjuvant. New England Journal of
Medicine. 1998;339(4):209-215. doi:https://doi.org/10.1056/nejm199807233390401
14. Whelan, M. G., Ware, H., Himanshu Ranka, Kenny, S., Shaikh, S., Roell, Y., Akter, S., Selemon,
A., Toews, E., Chu, M., Niklas Bobrovitz, Arora, R. K., & Jaenisch, T. (2024). ArboTracker: a
multipathogen dashboard and data platform for arbovirus seroprevalence studies. The Lancet
Infectious Diseases. https://doi.org/10.1016/s1473-3099(24)00585-1
15. Wilson, S. E., Deeks, S. L., Hatchette, T. F., & Crowcroft, N. S. (2012). The role of seroepidemiology
in the comprehensive surveillance of vaccine-preventable diseases. CMAJ : Canadian Medical Asso-
ciation journal = journal de l'Association medicale canadienne, 184(1), E70–E76.
https://doi.org/10.1503/cmaj.110506
