Applications focused on TBDs and conditions prevalent in the United States (https://www.cdc.gov/ticks/data-summary/index.html), of concern to military personnel and their beneficiaries in the U.S. and overseas, and/or involving understudied patient populations, are encouraged. A summary of TBDs and Focus Areas previously funded by the TBDRP is available on the CDMRP website (https://cdmrp.army.mil/tbdrp/pdfs/TBDRP%20FY16-20%20Portfolio%20Pie%20Ch...).

Applications submitted to the FY21 TBDRP should be focused on Lyme disease and/or other tick-borne diseases/conditions with emphasis on reducing public health burden. It is recommended that applications respond to at least one of the following specific FY21 TBDRP Focus Areas, however applications may also propose research outside of these Focus Areas as long as strong justification and indication of overall impact on the burden of disease is provided.

Applicants are particularly encouraged to submit applications to topics listed under the Diagnosis and Treatment Focus Areas.

• Diagnosis ○ Development of direct detection diagnostic assay for agents of Lyme and/or other tickborne diseases. ○ Diagnostic biomarker panel for Lyme disease and/or other TBDs that distinguishes tickborne infection from other febrile illnesses. ○ Approaches capable of distinguishing active infection and previous exposure, and/or monitoring response to treatment. ○ Innovative approaches that provide diagnosis for a single or multiple tick-borne infections.
• Treatment ○ Novel therapeutic strategies for acute and persistent TBDs. ○ Potential treatments designed to mitigate development of long-term sequelae following infection with bacterial, parasitic, or viral TB agents. ○ Translational approaches that bridge basic biology to the development of potential treatments
• Prevention ○ Drugs, antibodies, vaccines, or other novel approaches that can be administered and/or utilized prophylactically to prevent human TBD. ○ Identification, validation, and/or improvement of tick- or reservoir-targeted prevention and control interventions that are safe and non-toxic to non-target species. ○ Understanding the ecology of understudied TBD vectors and reservoirs with emphasis on how it relates to human risk.
• Pathogenesis ○ Pathogenesis of persistent clinical manifestations associated with Lyme disease. ○ Immune evasion and/or tolerance of TB pathogens (Lyme and/or other TBDs). ○ Effects of tick sialome on human infection, immune response, disease progression, and pathogen dissemination. ○ TB infections and co-infections (simultaneous or sequential) and their effects on human disease severity, the local and systemic immune response, or pathogen synergy and competition. ○ Pathogenesis of mammalian meat allergy (allergic response to galactose-alpha-1,3- galactose [alpha-gal]). ○ Understanding the potential role of maternal-fetal transmission and the ability to prevent TBDs by this mode of transmission.