Faculty Bibliography

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. According to the Centers for Disease Control and Prevention, it is the most commonly reported vector-borne illness and the fifth most common disease in the National Notifiable Diseases Surveillance System. If left untreated, infection disseminates to the nervous system. The nonhuman primate model of Lyme disease of the nervous system, or Lyme neuroborreliosis, accurately mimics the aspects of the human illness. There is general recognition for the potential of infectious-related autoimmune inflammatory processes contributing to disease progression and clinical manifestations.

Medical science is just now realizing the full importance of the microbial world. Thanks to developments such as low-cost high-throughput sequencing of microbial communities comprising the human microbiome, the identity and function of unculturable microbes are being unveiled. Public health officials and neuroepidemiology researchers will be called on to guide the understanding of I-Cubed illnesses and the implications of the human microbiome for communicable and noncommunicable diseases, as the natural history is appreciated and the responsiveness of given medical and neurologic disorders to a variety of medical approaches, including strong antibiotics and immune-modulatory therapy is established.

Headache disorders cause significant disability. The public and most health professionals tend to perceive migraine as a minor or trivial complaint. In the past decade, important epidemiologic studies enjoining extensive surveys, pathophysiologic and genetic insights, and revised headache classification paradigms have produced clear evidence of the public health importance of headache disorders. The Global Campaign to reduce the burden of headache worldwide known as "Lifting the Burden" was launched in 2004 by the World Health Organization, the International Headache Society, the World Headache Alliance, and the European Headache Federation. This paper reviews salient progress in the neuroepidemiology of migraine headaches.

The South African health care system is embedded in a background of racial subordination and sexual violence against girls and women and of hierarchical male authority from youth to adulthood. Low wages, unemployment, urban overcrowding, inadequate sanitation, malnutrition, crime, and violence have contributed to economic and health inequality. With more health-insured whites than blacks and the proportion of gross national product spent on health care slowly increasing, two-thirds of health expenditures have been consumed by the private sector at a time when the cost of health insurance has risen to more than 3 times the rate of the consumer price index.

Zika virus is an arbovirus belonging to the Flaviviridae family known to cause mild clinical symptoms similar to those of dengue and chikungunya. Zika is transmitted by different species of Aedes mosquitoes. Nonhuman primates and possibly rodents play a role as reservoirs. Direct interhuman transmission has also been reported. Human cases have been reported in Africa and Asia, Easter Island, the insular Pacific region, and Brazil. Its clinical profile is that of a dengue-like febrile illness, but recently associated Guillain-Barre syndrome and microcephaly have appeared. There is neither a vaccine nor prophylactic medications available to prevent Zika virus infection.

Vasculitis is a spectrum of clinicopathologic disorders defined by inflammation of arteries of veins of varying caliber with variable tissue injury. Headache may be an important clue to vasculitic involvement of central nervous system (CNS) vessels. CNS vasculitis may be primary, in which only intracranial vessels are involved in the inflammatory process, or secondary to another known disorder with overlapping systemic involvement. A suspicion of vasculitis based on the history, clinical examination, or laboratory studies warrants prompt evaluation and treatment to forestall progression and avert cerebral ischemia or infarction.