November 29, 2018
CDC releases papers highlighting tick borne disease and the recently emerged tick species Haemaphysalis longicornis
OA Combatting the Increasing Threat of Vector-Borne Disease in the United States with a National Vector-Borne Disease Prevention and Control System
The American Journal of Tropical Medicine and Hygiene
Reported cases of vector-borne diseases in the United States have more than tripled since 2004, characterized by steadily increasing incidence of tick-borne diseases and sporadic outbreaks of domestic and invasive mosquito-borne diseases. An effective public health response to these trends relies on public health surveillance and laboratory systems, proven prevention and mitigation measures, scalable capacity to implement these measures, sensitive and specific diagnostics, and effective therapeutics. However, significant obstacles hinder successful implementation of these public health strategies. The recent emergence of Haemaphysalis longicornis, the first invasive tick to emerge in the United States in approximately 80 years, serves as the most recent example of the need for a coordinated public health response. Addressing the dual needs for innovation and discovery and for building state and local capacities may overcome current challenges in vector-borne disease prevention and control, but will require coordination across a national network of collaborators operating under a national strategy. Such an effort should reduce the impact of emerging vectors and could reverse the increasing trend of vector-borne disease incidence and associated morbidity and mortality.
Full paper available here
Multistate Infestation with the Exotic Disease–Vector Tick Haemaphysalis longicornis — United States, August 2017–September 2018
Morbidity and Mortality Weekly Report (MMWR)
C. Ben Beard, PhD1; James Occi, MA, MS2; Denise L. Bonilla, MS3; Andrea M. Egizi, PhD4; Dina M. Fonseca, PhD2; James W. Mertins, PhD3; Bryon P. Backenson, MS5; Waheed I. Bajwa, PhD6; Alexis M. Barbarin, PhD7; Matthew A. Bertone, PhD8; Justin Brown, DVM, PhD9; Neeta P. Connally, PhD10; Nancy D. Connell, PhD11; Rebecca J. Eisen, PhD1; Richard C. Falco, PhD5; Angela M. James, PhD3; Rayda K. Krell, PhD10; Kevin Lahmers, DVM, PhD12; Nicole Lewis, DVM13; Susan E. Little, DVM, PhD14; Michael Neault, DVM15; Adalberto A. Pérez de León, DVM, PhD16; Adam R. Randall, PhD17; Mark G. Ruder, DVM, PhD18; Meriam N. Saleh, PhD14; Brittany L. Schappach10; Betsy A. Schroeder, DVM19; Leslie L. Seraphin, DVM3; Morgan Wehtje, PhD3; Gary P. Wormser, MD20; Michael J. Yabsley, PhD21; William Halperin, MD, DrPH22
Full report available here
November 16, 2018
Check this out- Tick Check 1-2 (Lyme Disease Prevention Rap) Video
The Division of Environmental Health in Fairfax County, Virginia released a rap video earlier this year to help promote the importance of tick bite prevention and treatment in a fun and lighthearted way. The video features rapper and tick biologist Andy Lima, as MC Bugg-Z.
See the video and the entire Fairfax County tick prevention webpage here.
November 15, 2018
Tickborne Disease Working Group Releases 2018 Report to Congress
The U.S. Department of Health and Human Services' Tick-Borne Disease Working Group released its 2018 Report to Congress this week. The report highlights the growing public health threat of tick-borne disease nationally and recommends a multi-pronged response to the problem that includes surveillance, biological and clinical research, education, and health provider outreach.
A copy of the report's Executive Summary is provided here. The full report can be found here.
TICK-BORNE DISEASES have rapidly become a serious and growing threat to public health in the United States. Despite many scientific unknowns, experts agree that the incidence and distribution of tick-borne diseases are increasing. Over the past 25 years, reports of Lyme disease have increased steadily with estimated annual cases approximating 300,000 (Hinckley et al., 2014; Nelson et al., 2015). The number of U.S. counties now considered to be of high incidence for Lyme disease has increased by more than 300% in the Northeastern states and by approximately 250% in the North-Central states. The Centers for Disease Control and Prevention (CDC) currently recognizes 18 tick-borne pathogens in the United States. However, researchers and health care practitioners continue to discover emerging disease agents and new medical conditions associated with tick bites.
While most Lyme disease patients who are diagnosed and treated early can fully recover, 10 to 20% of patients suffer from persistent symptoms, which for some are chronic and disabling. Studies indicate that Lyme disease costs approximately $1.3 billion each year in direct medical costs alone in the United States. A comprehensive understanding of the full economic and societal cost remains unknown. It is likely orders of magnitude higher and potentially a $50- to $100-billion-dollar problem for the United States, although more research is needed (Vanderhoof & Vanderhoof-Forschner, 1993; Zhang et al., 2006). Prompt diagnosis and treatment of tick-borne diseases are crucial to prevent long-term complications. Today, available diagnostic tests can be inaccurate and complex to interpret, especially during the earliest stage of infection when treatment is most effective. Unlike in other infectious disease settings, tests to directly measure the presence of the infecting organism, such as cultures or tissue biopsies, are not available for some tick-borne diseases such as Lyme disease. This leaves physicians without the tools needed to diagnose; and without an accurate diagnosis, it is challenging for physicians to provide early treatment.
Persistent symptoms after treatment of Lyme disease can be severe, yet their cause(s) remains unknown and debated. There are currently no uniformly accepted or validated treatment options for patients with these chronic symptoms. As a result, uncertainty surrounding appropriate clinical care has led to polarization within the medical community, and patients are often left suffering in limbo without a clear path to illness resolution or even symptom management (Rebman et al., 2017). The lack of a clear path for treatment of persistent symptoms in some patients with Lyme disease and other tick-borne diseases not only amplifies patient suffering but also significantly increases health care costs.
This report outlines an integrated, multipronged approach to the growing public health challenges posed by tick-borne diseases in the United States. It contains nine main chapters, including Background; Methods; Epidemiology and Ecology; Prevention; Diagnosis; Treatment; Access to Care, Patient Outcomes; Looking Forward; and Conclusion. The Background and Methods chapters explain how the report was developed. The other chapters present the main challenges, key issues, and recommendations specific to the broader topics.
To understand tick-borne diseases, we need to first understand tick ecology and how ticks transmit diseases. Due to the lack of a coordinated national surveillance program, currently there are significant gaps in information on local distribution of infection-causing ticks, especially in regions beyond the Northeast and Upper Midwest. Nationwide, standardized approaches for tick, animal, and human
surveillance are needed to understand the geographic distribution of infectious ticks in order to understand the spread of disease and predict where people are at risk. Advanced technologies and systematic studies are also needed to rapidly identify new disease agents that pose emergent risks to public health, including to the blood supply. Given that seven new tick-borne pathogens have been shown to infect people in the United States since 2004, this is a priority.
Effective prevention relies on multipronged strategies. To reduce exposure to ticks, we need a comprehensive understanding of the biological drivers behind the continued spread of tick-borne diseases, so that effective tick- and infection control methods can be identified and validated. Need also exists for the transparent development of a safe, effective human vaccine to prevent Lyme
disease, the most common of these illnesses. In the absence of effective strategies for controlling ticks and blocking the transmission of tick-borne pathogens, it is crucial to educate health care professionals and the public about tick-borne disease prevention, especially best practices for protection from tick bites. Outreach efforts to promote prevention and raise awareness among physicians and the public must be expanded at both the Federal and state level to ensure accurate, effective, and consistent messaging.
Clinical research priorities must include the development of new technologies and approaches to improve diagnosis of tick-borne diseases and monitor response to treatment. There is a critical need for sensitive and specific direct-pathogen detection strategies that are broad enough to cover multiple potential tickborne pathogens. Understanding the etiology and pathogenesis of ongoing symptoms after initial treatment should be a clinical research priority. Investigations are also needed into the potential roles of immunologic responses, bacterial persistence, and coinfecting pathogens in order to design and test new therapies and, ultimately, improve outcomes and care for patients with ongoing symptoms.
Americans need help, yet progress has been hampered by a lack of attention at the Federal level and by divisions within the field. The recommendations in this 2018 report of the TickBorne Disease Working Group represent a longterm investment in tackling the rise of tick-borne diseases in this country. However, immediate changes are also required to help patients already suffering from tick-borne diseases; to protect them from discrimination; and to address the inflexible, inconsistent, and often unaffordable care that patients frequently encounter in the current health care system.
Increased Federal funding, prioritization, and leadership are needed to reverse the alarming trends associated with tick-borne diseases.
Despite several decades of research, prevention, and educational activities, Federal funding for tick-borne diseases is less per new surveillance case than that of other diseases. The U.S. National Institutes of Health (NIH) and CDC spend $77,355 and $20,293, respectively, per new surveillance case of HIV/AIDS, and $36,063 and $11,459 per new case of hepatitis C virus, yet only $768 and
$302 for each new case of Lyme disease. Federal funding for tick-borne diseases today is orders of magnitude lower, compared to other public health threats, and it has failed to increase as the problem has grown.
It is also essential that funding and resources be allocated to support a comprehensive, interagency program to address the mounting
challenges identified in this report. All research, prevention, and education initiatives should be inclusive of special populations such as children, who suffer disproportionately from tick-borne diseases. Patients whose lives continue to be disrupted by the lasting effects of these illnesses are counting on emerging scientific research, evidence-based policy, and the health care establishment—including the Federal Government with Congressional and Executive leadership—to provide solutions. We must act now.
November 6, 2018
TickApp featured on ASTMH Annual Meeting Blog
A New App that Allows Researchers to Study Lyme Disease Risks also Documents the Great American Lawn Mowing Divide
By Matthew Davis
ASTMH Annual Meeting 2018 Blog
In their efforts to understand behavioral differences between people in the Northeast and Midwest that can expose them to tick-borne diseases, a team of tick experts from the University of Wisconsin and Columbia University identified one risk factor that doubles as a revealing cultural divide: 60 percent of Wisconsin residents who signed up for their innovative Tick App survey tool reported mowing their own lawn. Only 25 percent of those from New York state identified as self-mowers.
“The lawn mowing difference is still staggering to me,” said Gebbiena Bron, who presented findings Tuesday at TropMed18 of a study that is using the Tick App to look at risk factors influencing human-tick encounters in Lyme disease-endemic areas of the two regions. Thus far, the app has been downloaded by 663 people in the Midwest and 366 people in the Northeast. Users consent to allowing researchers to regularly track their movements. Many also keep a diary and post pictures of ticks they may find on themselves or their pets.
In all seriousness, Bron noted that lawn work may be an under-appreciated risk factor for Lyme disease. She said most people associate tick encounters with being in the woods, but there is increasing evidence of ticks “in your yard.” For example, of the 460 reports of tick encounters fielded thus far, 41 percent of app users from the Midwest and 56 percent from the Northeast believed the encounter occurred in their own yards.
Bron said she and her colleagues from Columbia came up with the idea of the Tick App to address the challenges of observing how human behavior can affect the prevalence of Lyme disease. “We are very difficult animals to study,” she said. But smartphone apps, she said, are proving to be excellent tools for following Homo sapiens.
Thus far, the data collected form the app indicate tick encounter risks are generally higher for people in the Midwest. The app revealed that, in addition to the lawn-moving divide, the Midwestern cohort was more likely to spend time outdoors gardening, camping, hunting and fishing. At the same time, she said the Midwesterners were more likely to do things to reduce the risk of Lyme disease, like wearing protective clothing and regularly checking themselves for ticks.
To translate that finding for a lay audience, Bron said: “The Packers beat the Jets.”
Going forward, Bron said researchers are looking for ways to gather data that can assess the risk level of individual tick encounters “because not all tick encounters are created equal.” For example, researchers would like to know how many involve black-legged ticks, which carry Lyme, or another type, like lone star ticks, which do not.
November 5, 2018
Confirmed human case of St. Louis encephalitis virus reported in a resident of Dane County, Wisconsin
Rare virus unseen in state for 37 years confirmed in Dane County, health officials say
SLEV spread by mosquitoes, DHS says
WISC-TV News 3 Madison
MADISON, Wis. - A confirmed case of a virus that hasn't been reported in Wisconsin in 37 years has been reported, health officials said Thursday.
The Wisconsin Department of Health Services announced Friday that a confirmed human case of St. Louis encephalitis virus, or SLEV, was reported in a resident of Dane County, the first reported case in the state since 1981.
SLEV is related to the West Nile virus, and like West Nile virus, it is spread to people through the bite of an infected mosquito, according to DHS. SLEV is not transmitted person-to-person. The virus is rare in Wisconsin, with only six human cases reported between 1964 and 2018 and no major outbreaks ever reported in the state.
Most people infected with SLEV will not have any symptoms, state health officials said. Those who become ill may develop fever, headache, nausea and fatigue that last for a few days. When symptoms do occur, they typically begin between five and 15 days after being bitten by an infected mosquito. In rare cases, SLEV can cause severe disease with symptoms such as stiff neck, disorientation, tremors, inflammation of the brain and coma. Older adults and people with weakened immune systems are at an increased risk of severe disease from the virus.
There is no specific treatment for SLEV other than to treat symptoms.
Mosquito activity has essentially ended for the year, so there is little to no risk of mosquito-borne illnesses in Wisconsin for a few months. According to the news release, there are several things you can do next spring to minimize your exposure to mosquitoes and eliminate mosquito breeding grounds.
DHS recommended taking the following precautions any time when mosquitoes are active:
- Limit time spent outside at dawn and dusk, when mosquitoes are most active.
- Apply an insect repellent with DEET, IR3535, picaridin or oil of lemon eucalyptus to exposed skin and clothing.
- Make sure window and door screens are in good repair to prevent mosquito entry.
- Prevent mosquitoes from breeding by removing stagnant water from items around your property, such as tin cans, plastic containers, flower pots, discarded tires, roof gutters, and downspouts.
- Turn over wheelbarrows, wading pools, boats and canoes when not in use.
- Change the water in bird baths and pet dishes at least every three days.
- Chlorinate and clean swimming pools, outdoor saunas and hot tubs; drain water from pool covers.
- Landscape to prevent water from pooling in low-lying areas, and trim tall grass, weeds and vines since mosquitoes use these areas to rest during hot daylight hours.
See the original article here.
September 24, 2018
Record number of mosquitoes for September in Madison, WI
By Keely Arthur
WISC-TV- News 3- Madison
MADISON, Wis. - Mosquitoes are out in record breaking numbers in our area, according to public health officials. It’s a fact you’ve likely felt firsthand if you’ve stepped outside.
“This is a really unique year; we have data from 2018 through 2012. Every year except for this one, things really get low,” said John Hausbeck, a supervisor with Public Health Madison and Dane County .
Hausbeck says traps put out by the University of Wisconsin Entomology Department are collecting more than 25 times more mosquitoes than the previous record set in 2016.
“The week of September the seventh we were finding, on average, 5,000 mosquitos per trap night,” Hausbeck said. “The same time in 2016, roughly 200 were collected.
Public Health stopped spraying for mosquitoes. Hausbeck said staff has moved on to other seasonal positions. Also, these type of mosquitoes do not carry disease, which is the main reason why officials spray.
“We are seeing as properly named 'floodwater mosquitoes.' These are mosquitos that drive us nuts all season long," Hausbeck said. "Generally in this area they are not carrying disease.”
While the floodwater mosquitoes don’t pose a threat to public health, if you feel like these bugs are affecting your mental health, you can call in professionals.
Full article here: https://www.channel3000.com/ne...
September 17, 2018
I-Tick Study Conducted with University of Illinois
Dr. Lee Ann Lyons, I-TICK Coordinator with the University of Illinois, recently completed an interview with ciLiving on WCIA Channel 3 in Champaign. She talked about the types of ticks and tick-borne disease present in Illinois, and she showed an example of a tick drag and a I-TICK tick survey kit.
Watch the interview online here.
September 10, 2018
Madison News Highlights Abnormally Numbers of High Flood Water Mosquitoes After Recent Floods
Experts say mosquito population abnormally high
By Keely Arthur
September 8, 2018
MADISON, Wis. - Experts say the mosquito population is abnormally large for this time of year, and the heavy rain, which has led to more standing water, is to blame.
University of Wisconsin entomology experts said there are 10 to 50 times more mosquitoes than normally found in September. Certain breeds, known as floodwater mosquitoes have flourished, but they are more of a nuisance than a danger.
“You can expect to be annoyed by them. They are a nuisance but they are not known to carry any disease at all so there is no heightened risk of attracting a mosquito-born disease,” explained Tom Richards, a researcher at UW.
Richards said you won’t have to worry about the mosquitoes much longer as the temperature cools down.
"It is getting cooler, so the upshot is that these numbers will go down and will taper off to nothing pretty soon."
Watch the interview here.