Report on the Neuropsychiatric Impact of Vector-Borne Infections and Their Relation to Sustainable Development Goals (SDGs)

Introduction

For over fifty years, psychiatrist Dr. Robert C. Bransfield has treated patients with complex psychiatric conditions, many of whom were unresponsive to conventional therapies. A significant pattern emerged linking these psychiatric symptoms to a history of infectious diseases, particularly Lyme disease and other vector-borne infections. This observation challenges traditional paradigms in psychiatry and infectious disease medicine, emphasizing the importance of integrated health approaches aligned with the Sustainable Development Goals (SDGs), especially SDG 3: Good Health and Well-being.

Vector-Borne Infections and Neuropsychiatric Effects

Dr. Bransfield’s research highlights Bartonella, a vector-borne bacterium increasingly recognized for its neuropsychiatric impact. He compares Bartonella infections to opportunistic infections in immunocompromised patients, such as those with HIV. In healthy individuals, immune systems may suppress Bartonella; however, co-infections like Lyme disease can weaken immunity, allowing latent Bartonella to manifest clinically.

Key points include:

1. Bartonella’s transmission pathways remain under debate, but its interaction with Lyme disease is critical.
2. Co-infections demonstrate complex, interactive infections where symptoms often arise from immune responses rather than direct pathogen presence.

This understanding supports SDG 3 by promoting comprehensive disease management and improved mental health outcomes.

Infection and Brain Function: A Complex Relationship

Dr. Bransfield stresses the need to move beyond conventional infectious disease models to understand how infections affect psychiatric function. The brain’s complexity requires monitoring immune and gene activity over time to fully grasp these effects.

• Patients may improve with treatment but relapse upon medication withdrawal due to gene regulation changes.
• Neural communication involves neurotransmitters and immune transmitters, the latter often overlooked but essential.
• Psychiatric treatments influence long-term genetic and immune signaling pathways, explaining delayed therapeutic effects.

This approach aligns with SDG 3 by advancing mental health research and treatment strategies that consider immune-genetic interactions.

Three Mechanisms by Which Infections Affect Brain Function

Dr. Bransfield identifies three primary mechanisms:

1. Peripheral Immune Response: Body infections trigger immune signaling molecules impacting brain function.
2. Vascular Effects: Certain infections cause damage or inflammation in brain blood vessels.
3. Direct Brain Infection: Less common but includes infections like neuroborreliosis (neuro-Lyme) invading brain tissue.

While direct brain infections are rare, most cases involve immune signaling affecting brain function, underscoring the importance of integrated infectious disease and psychiatric care, contributing to SDG 3 and SDG 17: Partnerships for the Goals.

Autoimmunity and Sudden Neuropsychiatric Symptoms

Infection-triggered autoimmunity presents serious neuropsychiatric risks. Dr. Bransfield notes:

• In some cases, the immune system attacks nerve tissue without adaptive resolution.
• Conditions such as PANS and PANDAS, initially linked to strep infections, are now associated with various pathogens.
• Autoimmune reactions can cause sudden-onset OCD, motor tics, aggression, confusion, or delirium.
• Effective treatment can restore normal function, highlighting the critical role of immune regulation in mental health.

This emphasizes the need for improved healthcare systems and research (SDG 3 and SDG 9: Industry, Innovation, and Infrastructure) to address immune-related brain disorders.

Call for Cross-Disciplinary Awareness and Integrated Approaches

Dr. Bransfield advocates bridging psychiatry and infectious disease disciplines to enhance understanding of immune-brain interactions underlying treatment-resistant psychiatric symptoms. His findings call for:

• Increased awareness among healthcare providers of infection-related psychiatric conditions.
• Development of integrated diagnostic and therapeutic strategies.
• Promotion of collaborative research efforts to elucidate immune and genetic mechanisms.

Such integrated approaches support SDG 3 by improving mental health care and SDG 17 by fostering global partnerships in health research and practice.

Conclusion

Dr. Bransfield’s work underscores the complex interplay between vector-borne infections, immune responses, and psychiatric symptoms. Addressing these challenges requires a multidisciplinary approach aligned with the Sustainable Development Goals, particularly SDG 3, to ensure good health and well-being through innovative, inclusive, and integrated healthcare solutions.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article focuses on complex psychiatric conditions linked to infectious diseases, highlighting the intersection of mental health and infectious disease management.
   • It emphasizes treatment-resistant psychiatric symptoms and the role of infections, immune response, and autoimmunity, all central to improving health outcomes.
2. SDG 4: Quality Education
   • By advocating for cross-disciplinary awareness and integrated approaches between psychiatry and infectious disease medicine, the article indirectly supports education and knowledge dissemination among healthcare professionals.
3. SDG 17: Partnerships for the Goals
   • The call for integrated, cross-disciplinary collaboration between psychiatry and infectious disease fields aligns with SDG 17’s focus on partnerships to achieve sustainable development.

2. Specific Targets Under Those SDGs

1. SDG 3: Good Health and Well-being
   • Target 3.3: By 2030, end the epidemics of communicable diseases including vector-borne diseases such as Lyme disease and Bartonella infections.
   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment, and promote mental health and well-being.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
2. SDG 4: Quality Education
   • Target 4.7: By 2030, ensure that all learners acquire knowledge and skills needed to promote sustainable development, including health education and cross-disciplinary awareness.
3. SDG 17: Partnerships for the Goals
   • Target 17.16: Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology, and financial resources.

3. Indicators Mentioned or Implied to Measure Progress

1. SDG 3 Indicators
   • Indicator 3.3.3: Malaria incidence per 1,000 population (analogous for vector-borne diseases like Lyme disease and Bartonella infections).
   • Indicator 3.4.2: Suicide mortality rate (related to mental health outcomes and psychiatric conditions).
   • Indicator 3.8.1: Coverage of essential health services, including mental health and infectious disease treatment.
   • Implied indicators related to treatment efficacy and relapse rates in psychiatric patients with infectious disease history, as discussed in the article.
2. SDG 4 Indicators
   • Indicator 4.7.1: Extent to which education for sustainable development is mainstreamed at all levels.
   • Implied measurement of cross-disciplinary awareness and training among healthcare professionals.
3. SDG 17 Indicators
   • Indicator 17.16.1: Number of countries reporting progress in multi-stakeholder partnerships.
   • Implied indicators on collaboration between psychiatry and infectious disease fields.

4. Table of SDGs, Targets, and Indicators

Source: contagionlive.com