Tick-Borne Disease Working Group
November 21, 2022 Virtual Meeting Summary
Back to November 21, 2022 TBDWG Meeting (online)
November 21st, 2022
Note: For context and clarity, speaker credentials will be included upon first mention in each meeting’s summary. Subsequently, individuals will be referenced by their first names to equalize expertise across the many diverse disciplines represented in this document. All perspectives and expertise, including patient-lived experience, are valued equally. Speaking on a first-name basis helps the Tick-Borne Disease Working Group ensure that all voices are heard and valued based on merit and without the bias of titles, eminence, or prestige.
James (Jim) Berger, MS, MT (ASCP), SBB, Designated Federal Officer, Tick-Borne Disease Working Group, Senior Blood and Tissue Policy Advisory, Office of Infectious Disease and HIV/AIDS Policy (OIDP), U.S. Department of Health and Human Services (HHS), opened the meeting by introducing Admiral Rachel Levine, Assistant Secretary for Health. Jim shared that ADM Levine is working to help the U.S. overcome the COVID-19 pandemic and build a stronger foundation for a healthier future, in which every American can attain their full health potential. Admiral Levine’s career began as a physician in academic medicine focused on the interaction of mental and physical health among children, adolescents, and young adults. Later, as Pennsylvania’s Secretary of Health, she focused on numerous public health challenges, including the COVID-19 pandemic and the opioid crisis.
Remarks by ADM Rachel Levine, MD, Assistant Secretary for Health
ADM Levine welcomed participants to the 25th and final meeting of the Tick-Borne Disease Working Group. She shared that she looks forward to working with colleagues at HHS, on Capitol Hill, at the White House, and across the federal government to implement the Working Group’s recommendations.
ADM Levine reviewed the efforts of the current and past Working Groups. Since its inception in 2017, the Working Group has succeeded in upholding the mandate of the 21st Century Cures Act, including support for epidemiological, basic, translational, and clinical research related to tick-borne diseases. Each iteration of the Working Group consisted of federal representatives and public members with diverse and unique perspectives who collaborated to provide a report to the Secretary of Health and Human Services, Congress, and the public at the end of each 2-year-cycle. During its tenure, the Working Group formed 21 subcommittees that identified and analyzed recent tick-borne disease research, assessed federal tick-borne disease funding and activities, solicited public feedback, and determined need in areas such as treatment, surveillance, tick ecology, access to care, diagnostics, and public health. The final Working Group spent eight months analyzing subcommittee findings to finalize recommendations and content for the third and final Report to Congress. This process incorporated written and verbal comments from numerous members of the public, including patients, family members, caretakers, advocates, scientists, and clinicians. This public feedback provided invaluable insight into the lived experience of people affected by tick-borne diseases and associated illnesses.
ADM Levine noted that HHS will continue to prioritize work on Lyme disease and other tick-associated illnesses and engage the public in these efforts, in part through an interagency effort to develop a National Public Health Strategy for the Prevention and Control of Vector-Borne Diseases in Humans. Development of the National Strategy will involve 17 Federal agencies and divisions, including both civilian agencies and the U.S. Department of Defense, and include five goals, 19 strategic priorities, 43 objectives, and 119 sub-objectives. HHS plans to deliver a National Strategy Report to Congress in December 2023.
As part of this effort, HHS published its second request for information (RFI) for public comment on November 21, 2022. This RFI, “Input on the National Public Health Strategy for the Prevention and Control of Vector-Borne Disease in Humans,” allows 30 days for public input, which will be incorporated into the report. The RFI contains a ten-page section entitled “HHS Tick-Borne Disease Working Group.” This report section merges the Working Group’s 2018 and 2020 Congressional report recommendations with the goals and strategic priorities of the draft national strategy. This section illustrates how the National Strategy goals and priorities advance the Working Group’s recommendations and how those recommendations are being implemented across HHS. Once the current Working Group’s recommendations are finalized and delivered to Congress, HHS will add them to this section as well. The Office for the Assistant Secretary of Health (OASH) plans to implement these recommendations publicly and proceed with ongoing, robust engagement with the patient community.
In addition to its work on the National Strategy, HHS is promoting collaboration opportunities, such as the LymeX Innovation Accelerator (LymeX) public-private partnership. LymeX recently announced its first ten LymeX diagnostic prize-winning teams, which each received $100,000. The accelerator expects to award an additional $9 million toward the development of diagnostics for Lyme disease.
In 2023, OASH plans to host Lyme disease and tick-borne disease work groups, workshops, co-creation events, and possibly round tables. OASH recruited two U.S. digital core fellows this year, one of whom is developing open dashboards and digital scorecards to track HHS’s progress on implementation.
ADM Levine commended the efforts of current and past members of the Tick-Borne Disease Working Group, alternates, and subcommittee members. She expressed gratitude for the leadership of Working Group Co-Chairs Holiday Goodreau and Dr. Linden Hu, of Designated Federal Officer Jim Berger, and of Alternate Designated Federal Officer, Kaye Hayes. She also commended the work of OIDP staff, specifically, Dr. Chinedu Okeke, Lauren Overman, and Allison Petkoff.
Welcome and Roll Call
Jim conducted roll call (see Appendix 1: Tick-Borne Disease Working Group Members and HHS Support Staff). The meeting began with a quorum. Jim reiterated that the Working Group will submit their final report to Congress in December 2022.
Recap of Meeting 24 Goals and Timeline
Holiday Goodreau, Executive Director, LivLyme Foundation; Co-creator, TickTracker; Working Group Co-Chair, presented a recap of Meeting 24. The agenda was as follows:
Discussed Chapter Comments and Revisions
Voted on Remaining Chapters
Disease Prevention and Treatment
Access to Care and Education
Public Comment Chapter (except for Patient Profiles)
Executive Summary, Introduction, Conclusion, and Looking Forward
Linden Hu, MD, Tufts University School of Medicine, Professor Microbiology and Medicine; Vice Dean for Research; Working Group Co-Chair, presented the objectives for Meeting 25:
Review and Vote on Patient Stories
Final Vote on the Report to Congress
Overview of the Working Group’s Mission Statement, Vision Statement, and Values
Jim reviewed the Working Group’s Mission Statement, as follows:
The Tick-Borne Disease Working Group’s mission, as mandated through the 21st Century Cures Act, is to provide expertise and to review all efforts within the Department of Health and Human Services related to all tick-borne diseases, to help ensure inter-agency coordination and minimize overlap, and to examine research priorities. As part of this mandate, and to provide expertise, we will ensure that the membership of the Working Group represents a diversity of scientific disciplines and views and is comprised of both Federal and non-Federal representatives, including patients, and family members or caregivers, advocates of non-profit organizations in the interest of the patient with tick-borne illness, scientists, and researchers. A major responsibility of our mission will be to develop and regularly update the action of HHS from the past, present, and the future.
Jim then reviewed the Working Group’s Vision Statement, as follows:
SHARED VISION: A nation free of tick-borne diseases where new infections are prevented, and patients have access to affordable care that restores health.
Finally, Jim gave an overview of the Working Group’s Core Values, the complete versions of which are provided below.
RESPECT: Everyone is valued
We respect all people, treating them and their diverse experiences and perspectives with dignity, courtesy, and openness, and ask only that those we encounter in this mission return the same favor to us. Differing viewpoints are encouraged, always, with the underlying assumption that inclusivity and diversity of minority views will only strengthen and improve the quality of our collective efforts in the long term.
INNOVATION: Shifting the paradigm, finding a better way
We strive to have an open mind and think out of the box. We keep what works and change what doesn’t. We will transform outdated paradigms, when necessary, to improve the health and quality of life of every American.
HONESTY and INTEGRITY: Find the truth, tell the truth
We are honest, civil, and ethical in our conduct, speech, and interactions with our colleagues and collaborators. We expect our people to be humble, but not reticent, and to question the status quo whenever the data and the evidence support such questions, to not manipulate facts and data to a particular end or agenda, and to acknowledge and speak the truth where we find it.
EXCELLENCE: Quality, real-world evidence underlies decision-making
We seek out rigorous, evidence-based, data-driven, and human-centered insights and innovations—including physician and patient experiences—that we believe are essential for scientific and medical breakthroughs. We foster an environment of excellence that strives to achieve the highest ethical and professional standards, and which values the development of everyone’s skills, knowledge, and experience.
COMPASSION: Finding solutions to relieve suffering
We listen carefully with compassion and an open heart in order to find solutions which relieve the suffering of others. We promise to work tirelessly to serve the greater good until that goal is achieved.
COLLABORATION: Work with citizens and patients as partners
The best results and outcomes won’t be created behind closed doors but will be co-created in the open with input of the American public working together with these core values as our guide. We actively listen to the patient experiences shared with us, respect the lived experiences of patients and their advocates, and learn from their experiences in our pursuit of objective truth. Across diverse audiences, we communicate effectively and collaborate extensively to identify shared goals and leverage resources for maximum public health impact.
ACCOUNTABILITY: The buck stops here
We, as diligent stewards of the public trust and the funds provided by our fellow citizens, pledge to be transparent in all of our proceedings and to honor our commitments to ourselves and others, while taking full responsibility for our actions in service to American people.
Objectives
Jim reviewed the Working Group’s objectives, which are to provide expertise and review all efforts within HHS related to all tick-borne diseases, to help ensure interagency coordination and minimize overlap, and to examine research priorities. He outlined the Working Group’s duties, as follows:
No later than two years after the date of enactment of the authorizing legislation, review a summary of:
Ongoing tick-borne disease research, including research related to causes, prevention, treatment, surveillance, diagnosis, diagnostics, duration of illness, and intervention;
Advances made pursuant to such research;
Federal activities related to tick-borne diseases, including (a) epidemiological activities related to tick-borne diseases and (b) basic, clinical, and translational tick-borne disease research related to the pathogenesis, prevention, diagnosis, and treatment of tick-borne diseases;
Gaps in tick-borne disease research described in clause 3b;
The Working Group’s meetings; and
The comments received by the Working Group.
Make recommendations to the Secretary regarding any appropriate changes or improvements to such activities and research.
Solicit input from States, localities, and non-governmental entities, including organizations representing patients, health care providers, researchers, and industry regarding scientific advances, research questions, surveillance activities, and emerging strains and species of pathogenic organisms.
Public Comment
Holiday welcomed public commenters and reminded the public of the three ways to engage with the Working Group: (a) providing oral public comments at public meetings, (b) submitting written public comments for a public meeting by email to tickbornedisease@hhs.gov, and (c) sending comments any time by email to tickbornedisease@hhs.gov. She expressed appreciation for all the members of the public who provided public comments over the past six years.
Mira Shapiro: Mira is a biostatistician who has chronic Lyme disease. She shared that it took more than 20 years for her to receive an accurate diagnosis of her Lyme disease and other co-infections. Prior to her diagnosis, her symptoms progressively worsened and adversely affected her career, her family life, and her overall quality of life. She expressed her belief that if she had not eventually received a diagnosis, she would have lost her ability to walk or passed away, as the disease had progressed to affect her central nervous system. She stated that she regrets not being diagnosed at an earlier stage, which she believes could have prevented many of her current symptoms. Mira noted that many patients are now receiving treatment from medical professionals with expertise in treating Lyme disease. She expressed that the Infectious Diseases Society of America (IDSA) has abandoned patients with chronic Lyme disease and urged the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) not to erect obstacles to patients receiving treatments.
Logan Wade: Logan is a 25-year-old Lyme disease patient and developer. At 23 years old, Logan experienced a stomach bug that was followed by multiple symptoms, including memory loss, chronic fatigue, multiple chemical sensitivities, gluten sensitivity, nerve pain, headaches, and sleep problems. He had no history of tick bites but experienced a bull’s-eye rash when he was 10 years old. His ELISA and Western blots for Lyme disease have all been negative. Eventually Logan received treatment from a Lyme disease specialist who found that he tested positive for Lyme C6 peptide and Bartonella and was IgG positive for exposure to Babesia duncani. He explained that he has paid significant funds to receive these tests and treatment but feels that he is now slowly improving. By comparing the amount of money he has spent on his own treatment, Logan underscored what he perceives as NIH’s underfunding of treatments for Lyme disease.
Olivia Goodreau: Olivia is founder of the LivLyme Foundation and inventor of a free global tick tracker app, as well as a free symptom tracking app. She explained that she provided comments at the first Working Group meeting when she was 12 years old. She shared her concern for the children who have lost their childhoods to tick-borne diseases. Her own diagnosis took 18 months, and she saw 51 doctors before she received a positive Lyme disease test. During that time, she experienced hundreds of blood draws, a liver biopsy, MRIs, CAT scans, and spinal taps. She was told both that she would die by age 40 and that she was fabricating symptoms for attention. She feels that Lyme disease robbed her of her childhood, her ability to play sports, and her friends. She highlighted that many children are being diagnosed with Lyme disease every day, and even more are living with undiagnosed illness. She stressed the need for better tests, better treatments, and increased awareness of tick-borne diseases. She urged Congress to swiftly implement the Working Group’s recommendations.
William (Bill) Fitzgerald: Bill commented that he first developed strange symptoms after a soccer-related trip to Connecticut, including light and sound sensitivity, a swollen, inflexible knee, low blood pressure, fatigue, night sweats, and fainting spells. He was told he might have Parkinson’s disease, lupus, fibromyalgia, chronic fatigue, and even male menopause. Twice over the course of two years, he tested negative for Lyme disease on the recommended two-tier ELISA tests. His doctor then recommended a new test, which came back positive for Lyme disease, babesiosis, and bartonellosis. He located a specialist who treated him with multiple antibiotics and malarial drugs. Over the course of five grueling years of treatment, he slowly recovered. He advocated for acknowledgement that chronic Lyme disease is a real and serious condition, for a robust public awareness program for Lyme disease and other tick-associated illnesses, for required tick-borne disease education in medical schools, and for continuing medical education to enhance recognition of the myriad symptoms these diseases can cause and to facilitate early diagnoses. He also expressed that the current two-tiered ELISA approach to diagnosis is flawed, and that patients need access to more sophisticated and sensitive diagnostics.
Janice Sutton: Janice Sutton shared that her daughter was treated by the late Dr. Charles Ray Jones after a year of illness, and only after chronic illness had set in. She expressed concern that in Rhode Island, she knows of only one clinician appropriately trained and educated about tick-borne diseases. She suggested that, like the neurological effects associated with long COVID, people with chronic Lyme disease experience neuronal loss and that this loss increases their risk of autism, Alzheimer’s disease, and Parkinson’s disease. She then asserted that the insurance companies are denying the existence of chronic Lyme disease in order to deny coverage for treatments.
Britta Cruz: Britta, who lives in Virginia, contracted a tick-borne illness in 2019. It took two and half years and consultations with numerous doctors before she received a diagnosis of Alpha-gal Syndrome (AGS). She expressed her belief that this delay in diagnosis led to her development of mast cell activation syndrome. She noted that her daughter also contracted a tick-borne illness in 2021, but she was diagnosed just one month later because Britta was aware of the risks associated with ticks. Her daughter has not developed complications, a fact which Britta attributes to her daughter’s prompt diagnosis. Britta advocated for better medical training about tick-borne diseases and associated illnesses, food labeling for people with AGS, and dedicated resources and funding for tick-borne disease patients, especially for those with more than one infection or illness. She highlighted the lack of sufficient research on the long-term effects of tick-borne diseases and associated illnesses.
Paul Owen: Paul is a patient advocate, software executive, and U.S. army veteran living inOhio. During basic training at Fort Dix, New Jersey, he received three tick bites, and then received several more tick bites while serving in the army in Missouri. He did not experience any symptoms until shortly after shoulder surgery in 2015. Over the following seven years, his symptoms progressed, and currently include a constant, severe headache, tremors, extreme fatigue, memory loss, localized seizures, hearing loss, and constant joint pain. He has spent tens of thousands of dollars on treatments. He stressed that tick-borne diseases are enormously costly to the affected individuals, their families, and the economy, and that insurance company denials exacerbate these financial challenges. He noted that military personnel are at particular risk for tick-borne diseases because of the environments to which they are exposed.
Julia Wagner: Julia is the president emeritus of the PA Lyme Resource Network and the mother of a 19-year-old seriously affected by tick-borne diseases. She explained that she wants to see more action based on the Working Group’s findings. She advocated for a red team approach to reviewing the CDC website and continuing medical education content. She also argued for changing the term Post-Treatment Lyme Disease Syndrome (PTLDS), which, in her view, is a misnomer that perpetuates misconceptions about tick-borne diseases. She asked for the following changes to CDC’s tick-borne disease web pages: update of the treatment section that includes information on IV antibiotics and their safety; acknowledgment of possible false negative test results; removal of the statements that tick bites do not confer disease until 36 hours after the initial bite and that there is no evidence of persistent infection; modification of the section on cognitive effects to note that cognitive symptoms can range from mild to severe and to include additional studies on Lyme disease-associated dementia; and an explicit allowance for treatment in the presence of symptoms despite negative test results. She would also like the CDC website to stress that clinicians have flexibility in responding to patients’ symptoms and clinical presentation. Over the past 5 years, her son has recovered from being bed bound, relearned to walk, and is now at college studying neuroscience. Julia expressed concern that the treatments that helped her son are not currently available to others suffering from tick-borne diseases due to outdated information and doctrinal rigidity. She emphasized the need for rapid implementation of the Working Group’s recommendations.
Diana Nadler: Diana is a biostatistician with expertise in health care economics and outcomes research and the mother of an eight-year-old girl who received a tick bite in April 2021. She developed a fever and received amoxicillin for a week but did not receive follow-up testing. The next month, she developed a full body rash, fever, headache, and became agitated and anxious. Diana took her to urgent care, where a doctor ran labs for Lyme disease and anaplasmosis. Her daughter’s pediatrician ran blood tests, which showed low white blood cell and platelet counts but were negative for Lyme disease. Her daughter began experiencing urinary incontinence and reported experiencing intense anxiety, intrusive thoughts, and auditory hallucinations. Diana took her to see over 15 health care providers (including at Boston Children’s Hospital), who prescribed her daughter an antidepressant and did not conduct follow-up testing. After seeing a clinician with experience treating complex tick-borne disease, her daughter was diagnosed with Lyme disease, Mycoplasma infection, and bartonellosis. Diana advocated for updating the guidelines on testing and treatments.
Patricia Parker: Patricia is a business owner and farmer living in North Carolina. Her family of four were diagnosed with AGS this year; however, she believes that she, her husband, and her 10-year-old son have had AGS for the past eight years. Her son had breathing issues that necessitated multiple emergency room visits. She eventually removed hot dogs and bacon from his diet, after which his breathing issues resolved. Her husband periodically lost the ability to move his arms and legs. He is now taking antihistamines and avoiding meat, and his symptoms have resolved. Their diagnosis was precipitated by her daughter receiving a tick bite and experiencing classic AGS symptoms, including gastrointestinal problems and skin rashes. Patricia requested to have her daughter tested for AGS, and the test came back positive. Since she was diagnosed, Patricia’s thyroid problems, hair loss, and chest and abdominal pain have resolved. Patricia advocated for better food labelling, noting that despite all her family’s current dietary precaution, her daughter recently had an allergic reaction to raisins, which contained glycerin. She also stressed the need for more patient and provider education on AGS.
Holiday thanked the commenters for sharing their stories and reminded the public that they have until December 13th, 2022, to send public comments to HHS and the Working Group by emailing tickbornedisease@hhs.gov.
Review and Vote on Patient Stories
Linden reviewed the patient story placements in the final report to Congress.
Votes
Jennifer Platt, MSPH, DrPH, Co-founder, Tick-borne Conditions United, proposed a motion to approve the patient stories as presented. Holiday seconded the motion. Thirteen members voted yes; one member was absent. The motion passed.
Comments
Cat Thomson, Rose Li and Associates contractor, stated that patients and their families had reviewed the profiles and granted permission for their inclusion in the final report. Jennifer commented that the patient stories represented a wide range of different illnesses and people of different ages and backgrounds. Monica E. Embers, PhD, Associate Professor and Director of Vector-borne Disease Research, Tulane National Primate Research Center, asked to review the language of Senator Kay Hagan’s patient story. Monica then confirmed that it contained the appropriate language regarding the TICK Act and regional centers for excellence.
Final Vote on Report to Congress
The Working Group voted to approve the final report as written.
Votes
Elizabeth (Betty) Maloney, MD, President, Partnership for Tick-borne Diseases Education, proposed a motion to accept the report as written. Jennifer seconded the motion. Thirteen members voted yes; one member was absent. The motion passed.
Comments
Betty asked for confirmation that the minority report would be included in the report’s concluding chapter, and Holiday confirmed that it would.
Closing Remarks
Holiday expressed gratitude for the public speakers and members of the public who provided written comments. She thanked the Working Group’s past co-chairs, members, and subcommittees for their work on the previous two reports to Congress. She also thanked the Working Group’s current federal and public members, OIDP and RLA staff, and her Co-Chair Linden, for their efforts. She shared that as the mother of a daughter who has been struggling with tick-borne diseases for 11 years, she understands the pressing need for improved diagnostics, treatment, and education. She noted that although the Working Group is sunsetting, the efforts to address tick-borne diseases will continue.
Linden expressed his gratitude for the committee and subcommittee members and their efforts to improve the health of people with tick-borne diseases.
Adjournment
Jim adjourned the meeting at 11:15 am EST.
Appendix 1: Tick-Borne Disease Working Group Members and HHS Support Staff
Tick-borne Disease Working Group
In alphabetical order:
Co-Chair
Holiday Goodreau, Executive Director, LivLyme Foundation, Co-creator, TickTracker (Present)
Co-Chair
Linden Hu, MD, Professor of Microbiology and Medicine, Vice Dean for Research, Tufts University School of Medicine (Present)
Charles Benjamin (Ben) Beard, PhD, Deputy Director, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services (Present)
CAPT Rebecca Bunnell, MPAS, PA-C, Senior Advisor, Learning and Diffusion Group, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services (Not Present)
Dennis Dixon, PhD, Chief, Bacteriology and Mycology Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, U.S. Department of Health and Human Services (Present)
Monica E. Embers, PhD, Associate Professor and Director of Vector-borne Disease Research, Tulane National Primate Research Center (Present)
Elizabeth Maloney, MD, President, Partnership for Tick-borne Diseases Education (Present)
Robert J. Miller, PhD, National Program Leader, Agricultural Research Service, U.S. Department of Agriculture (Present)
CDR Todd Myers, PhD, HCLD (ABB), MB (ASCP), Office of Counterterrorism and Emerging Threats, Office of the Chief Scientist, Office of the Commissioner, U.S. Food and Drug Administration, U.S. Department of Health and Human Services (Present)
Jennifer Platt, DrPH, Co-founder, Tick-borne Conditions United (Present)
Sunil K. Sood, MD, Chair of Pediatrics, South Shore University Hospital, Attending Physician, Infectious Diseases, Cohen Children’s Medical Center, Professor of Pediatrics at Hofstra/Northwell (Present)
Kirby C. Stafford III, PhD, Chief Scientist and State Entomologist, Department of Entomology, Center for Vector Biology & Zoonotic Diseases, The Connecticut Agricultural Experiment Station (Present)
Leith Jason States, MD, MPH (FMF), Deputy Chief Medical Officer, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services (Present)
Gabriella Zollner (Romero), PhD, Program Manager, Deployed Warfighter Protection Program, U.S. Department of Defense (Present)
Alternative Federal Representatives
In alphabetical order:
Kristen Honey, PhD, PMP Executive Director of InnovationX, U.S. Department of Health and Human Services (Present)
RADM Estella Jones, DVM, U.S. Public Health Service, Deputy Director, OCTET U.S. Food and Drug Administration (Not Present)
Andrew Y. Li, PhD, Research Entomologist, Invasive Insect Biocontrol & Behavior Laboratory, U.S. Department of Agriculture (Not Present)
Samuel S. Perdue, PhD, Chief, Basic Sciences, Bacteriology and Mycology Branch at National Institutes of Health (Present)
CDR Monica Reed-Asante, PharmD, USPHS, Pharmacist, Senior Health Insurance Specialist for Centers for Medicare and Medicaid Services (Not Present)
LTC Michelle Colacicco-Mayhugh, PhD, PMP, Deputy Medical Entomology Consultant to the U.S. Army Surgeon General (Not Present)
HHS Support Staff
In alphabetical order:
James (Jim) Berger, MS, MT (ASCP), SBB, Designated Federal Officer, Tick-Borne Disease Working Group, Senior Blood and Tissue Policy Advisory, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services
B. Kaye Hayes, MPA, Alternate Designated Federal Officer, Tick-Borne Disease Working Group, Deputy Assistant Secretary, Office of Infectious Disease and HIV/AIDS Policy, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services
Chinedu Okeke, MD, MPH-TM, MPA, Senior Policy Advisor, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services
Lauren Overman, MPH, CPH, Public Health Analyst, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services
Allison Petkoff, Public Health Analyst, Office of Infectious Disease and HIV/AIDS Policy, U.S. Department of Health and Human Services
Content created by Assistant Secretary for Health (ASH)
Content last reviewed March 30, 2023