A framework for adaptive surveillance of emerging tick-borne zoonoses

Borrelia burgdorferi sensu lato prevalence in Ixodes scapularis from Canada: A thirty-year summary and meta-analysis (1990-2020)

Borrelia burgdorferi sensu lato (Bb) are a complex of bacteria genospecies that can cause Lyme disease (LD) in humans after the bite of an infected Ixodes spp. vector tick. In Canada, incidence of LD is increasing in part due to the rapid geographic expansion of Ixodes scapularis across the southcentral and eastern provinces. To better understand temporal and spatial (provincial) prevalence of Bb infection of I. scapularis and how tick surveillance is utilized in Canada to assess LD risk, a literature review was conducted. Tick surveillance studies published between January 1975 to November 2023, that measured the prevalence of Bb in I. scapularis via "passive surveillance" from the public citizenry or "active surveillance" by drag or flag sampling of host-seeking ticks in Canada were included for review. Meta-analyses were conducted via random effects modeling. Forty-seven articles, yielding 26 passive and 28 active surveillance studies, met inclusion criteria. Mean durations of collection for I. scapularis were 2.1 years in active surveillance studies (1999-2020) and 5.5 years by passive surveillance studies (1990-2020). Collectively, data were extracted on 99,528 I. scapularis nymphs and adults collected between 1990-2020 across nine provinces, including Newfoundland & Labrador (33 ticks) and Alberta (208 ticks). More studies were conducted in Ontario (36) than any other province. Across nine provinces, the prevalence of Bb infection in I. scapularis collected by passive surveillance was 14.6% with the highest prevalence in Nova Scotia at 20.5% (minimum studies >1). Among host-seeking I. scapularis collected via active surveillance, Bb infection prevalence was 10.5% in nymphs, 31.9% in adults, and 23.8% across both life stages. Host-seeking I. scapularis nymphs and adults from Ontario had the highest Bb prevalence at 13.6% and 34.8%, respectively. Between 2007-2019, Bb infection prevalence in host-seeking I. scapularis was positively associated over time (p<0.001) which is concurrent with a ∼25-fold increase in the number of annually reported LD cases in Canada over the same period. The prevalence of Bb-infection in I. scapularis has rapidly increased over three decades as reported by tick surveillance studies in Canada which coincides with increasing human incidence for LD. The wide-ranging distribution and variable prevalence of Bb-infected I. scapularis ticks across provinces demonstrates the growing need for long-term standardized tick surveillance to monitor the changing trends in I. scapularis populations and best define LD risk areas in Canada.

Statewide surveillance of Ixodes scapularis (Acari: Ixodidae) for the presence of the human pathogen Borrelia miyamotoi (Spirochaetales: Spirochaetaceae), a relapsing fever spirochete in Pennsylvania, USA, 2019-2020

Borrelia miyamotoi disease is an emerging tick-borne human illness in the United States caused by Borrelia miyamotoi (Spirochaetales: Spirochaetaceae) bacterium. With Pennsylvania reporting thousands of tick-borne disease cases annually, determining the minimum infection rate (MIR) of B. miyamotoi in Ixodes scapularis (Say, Acari: Ixodidae) adults within Pennsylvania is of utmost importance. Active surveillance was performed from October 2019 to April 2020 to collect a minimum of 50 I. scapularis ticks from every county within Pennsylvania and then screened for B. miyamotoi via qPCR. Ticks were collected from all 67 counties with the majority of those being adult I. scapularis. Additional ticks collected were Dermacentor albipictus (Packard, Acari: Ixodidae), Haemaphysalis longicornis (Neumann, Acari: Ixodidae), and immature I. scapularis. Adult I. scapularis were pooled and tested for B. miyamotoi. MIR for positive B. miyamotoi pools and density of infected adult I. scapularis varied by county, with positive pools from 38 Pennsylvania counties. This is the first statewide evaluation of B. miyamotoi in Pennsylvania in questing adult I. scapularis. These prevalence and distribution data will aid health care practitioners within the state of Pennsylvania and the northeast United States to understand potential risk and bring awareness to the lesser known human Borrelia illness, Borrelia miyamotoi disease.

Geographic range and minimum infection rate of Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, and Borrelia miyamotoi in Ixodes scapularis (Acari: Ixodidae) ticks in Manitoba, Canada from 1995 to 2017

INTRODUCTION

The expanding geographical range of blacklegged ticks (BLTs), Ixodes scapularis, and its ability to transmit Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, and Borrelia miyamotoi poses an emerging public health risk. Our study determined the geographic distribution and the minimum infection rate (MIR) of B. burgdorferi-, A. phagocytophilum-, Ba. microti-, and B. miyamotoi-infected BLTs in Manitoba submitted to the Public Health Agency of Canada's passive tick surveillance programme from 1995 to 2017.

METHODS

Regression models were used to test the association of the MIR by year for each pathogen. Ticks were tested using PCR for B. burgdorferi since 1995, A. phagocytophilum since 2006, and Ba. microti and B. miyamotoi since 2013. The global positioning system coordinates of infected and uninfected ticks submitted during the surveillance period were plotted on a map of Manitoba using ArcGIS Pro version 3.1.2 to detect changes in the geographic distribution of ticks over time.

RESULTS

The overall MIR for B. burgdorferi was 139.7 (95% confidence interval [CI]: 129.0-150.5) per 1000 BLTs; however, it varied over time. After remaining stable from 1995 to 2005, the MIR increased by 12.1 per 1000 BLTs per year from 2005 to 2017 (95% CI: 7.0%-17.2%, p-value <0.01). The geographic distribution of B. burgdorferi-infected BLTs was centred around Winnipeg, Manitoba, and spread outward from this locality. The MIRs of A. phagocytophilum, Ba. microti, and B. miyamotoi were 44.8 per 1000 BLTs (95% CI: 38.1-51.6), 10.8 (95% CI: 6.6-15.0), and 5.2 (95% CI: 2.3-8.1) per 1000 BLTs, respectively, and showed no significant change over time.

CONCLUSION

Passive surveillance revealed the presence of A. phagocytophilum-, Ba. microti-, and B. miyamotoi-infected BLTs in southern Manitoba and revealed an increased risk of exposure to B. burgdorferi-infected BLTs due to the increasing geographic range and MIR.

Historical associations and spatiotemporal changes of pathogen presence in ticks in Canada: A systematic review

BACKGROUND

Starting in the early 20th century, ticks and their pathogens have been detected during surveillance efforts in Canada. Since then, the geographic spread of tick vectors and tick-borne pathogens has steadily increased in Canada with the establishment of tick and host populations. Sentinel surveillance in Canada primarily focuses on Ixodes scapularis, which is the main vector of Borrelia burgdorferi, the bacterium causing Lyme disease. Other tick-borne pathogens, such as Anaplasma, Babesia, and Rickettsia species, have lower prevalence in Canada, but they are emerging or re-emerging in tick and host populations.

AIMS/MATERIALS & METHODS

Here, we assessed the historical associations between tick vectors, hosts and pathogens and identified spatiotemporal clusters of pathogen presence in ticks in Canada using data extracted from the literature.

RESULTS

Approximately one-third of ticks were infected with a pathogen, and these ticks were feeding primarily on bird and mammal hosts. B. burgdorferi was the most detected pathogen and I. scapularis harboured the greatest number of pathogens. We identified several spatial outliers of high pathogen presence in ticks in addition to five spatiotemporal clusters in southern Canada, all of which have long-established tick populations. Six spatiotemporal clusters of high pathogen presence in ticks were also identified based on surveillance method, with four clusters associated with passive surveillance and two clusters associated with active surveillance.

DISCUSSION

Our review represents the first systematic assessment of the literature that identifies historical associations and spatiotemporal changes in tick-host-pathogen disease systems in Canada over broad spatial and temporal scales.

CONCLUSION

As distinct spatiotemporal clusters were identified based on surveillance method, it is imperative that surveillance efforts employ standardized methods and data reporting to comprehensively assess the presence, spread and risk of tick-borne pathogens in tick and host populations.

Surveillance and response strategies for zoonotic diseases: a comprehensive review

Out of all emerging infectious diseases, approximately 75% are of zoonotic origin, with their source often traced back to animals. The emergence of zoonoses is driven by a complex interplay between anthropogenic, genetic, ecological, socioeconomic, and climatic factors. This intricate web of influences poses significant challenges for the prediction and prevention of zoonotic outbreaks. Effective coordination and collaboration among the animal, human, and environmental health sectors are essential for proactively addressing major zoonotic diseases. Despite advancements in surveillance and diagnostic practices, the emergence of zoonoses continues to be a pressing global concern. Therefore, prioritizing zoonotic disease surveillance is of paramount importance as part of a comprehensive disease prevention and containment strategy. Furthermore, evaluating existing surveillance systems provides insights into the challenges faced, which can be mitigated through implementation of One Health principles involving relevant stakeholders. To initiate multisectoral partnerships, it is crucial to identify the priorities and core themes of surveillance systems with equitable inputs from various sectors. Strengthening surveillance, promoting data sharing, enhancing laboratory testing capabilities, and fostering joint outbreak responses in both the human and animal health sectors will establish the necessary infrastructure to effectively prevent, predict, detect, and respond to emerging health threats, thereby reinforcing global health security. This review assesses existing surveillance approaches by offering an overview of global agencies engaged in monitoring zoonoses and outlines the essential components required at the human-animal-environment interface for designing comprehensive surveillance networks. Additionally, it discusses the key steps necessary for executing effective zoonotic disease surveillance through a One Health approach, while highlighting the key challenges encountered in establishing such a robust surveillance system.

Molecular Evidence of Rickettsia conorii subsp. raoultii and Rickettsia felis in Haemaphysalis intermedia Ticks in Sirumalai, Eastern Ghats, Tamil Nadu, South India

Rickettsia is an important pathogenic entity among tick-borne diseases (TBD), which are considered serious emerging public health problems globally. In India, though the widespread distribution of ticks and TBD has been documented, its real burden remains underreported. In a preliminary attempt, rickettsial surveillance was carried out in ticks collected from Sirumalai, Eastern Ghats in Tamil Nadu, India by using pathogen genome-based phylogenetic inferences generated through multi-locus sequence typing (MLST), targeting the genes 16s rRNA, OmpA, OmpB, and gltA by nested PCR. The laboratory evidence confirms the circulation of Rickettsia in Haemaphysalis intermedia species collected from this area. Analysis of the four gene sequences detected demonstrates their closest identity to the spotted fever group (SFG) available in the GenBank database. Further, multiple sequence alignment with other sequences derived from the GenBank database showed close relatedness to Rickettsia conorii subsp. raoultii (16s rDNA-99.32%, OmpA-93.38%, OmpB-97.39%, and gltA-98.57%) and Rickettsia felis (16s rDNA 99.54%, OmpA-100%, OmpB-100% and gltA-99.41%). With this genomic evidence, the circulation of rickettsial pathogens in the pools of H. intermedia ticks infesting livestock in the Sirumalai foothill area has been demonstrated and to complement the microscopic identification of the tick species, DNA barcodes were generated for H. intermedia using the mitochondrial cytochrome c oxidase subunit I gene (COI). Nevertheless, R. raoultii and R. felis were found to be the aetiological agents of tick-borne lymphadenopathy and flea-borne spotted fever in human cases, respectively, further study on the determination of their diversity, distribution, clinical relevance, and potential risk to the local community in these areas is highly warranted.

Assessing the spatial and temporal patterns and risk factors for acquisition of Ixodes spp. by companion animals across Canada

Climatic and land use changes have contributed to substantial changes in the abundance, distribution, and activity patterns of ticks in Canada, which have led to an increased risk of tick bites and tick-borne pathogen exposure for companion animals. The objectives of this study were to describe current spatial and temporal patterns of Ixodes spp. on companion animals in Canada and explore the association between tick bites and dog and cat demographic factors. Ticks were collected for one year (April 2019 - March 2020) from 94 veterinary clinics. Included with each submission was a short questionnaire containing owner-reported information on travel history, date of removal and suspected location of tick acquisition, and animal-specific demographic factors. Ticks were identified morphologically using a stereomicroscope, standard keys, and through PCR analyses. Mixed effect multivariable logistic regression models were built to explore the association between an Ixodes scapularis bite and animal demographic factors; veterinary clinic was included as a random effect. Approximately 2300 submissions were received from clinics across Canada, totalling 4425 ticks. The most common Ixodes spp. was I. scapularis (n = 2168), followed by Ixodes pacificus (n = 172) and Ixodes cookei (n = 155). Ixodes scapularis were well distributed in regions across central and eastern Canada. Ixodes cookei was found in eastern Canada, with the greatest numbers from Quebec and New Brunswick. Ixodes pacificus submissions were restricted to British Columbia. Across eastern Canada, dogs of the herding, mixed breed (large and small), sporting, working, terrier, and toy breed groups, and spayed cats were all found to have higher odds of acquiring I. scapularis, compared to other tick species. For the dog model, significant interactions were found between predictor variables age and sex. Regional information on tick distribution, seasonality, and risk factors for acquisition contribute to evidence-based veterinary practices for tick and tick-borne disease control in Canada.

Comparing Canadian Lyme disease risk area classification methodologies

Lyme disease risk areas have increased across Canada in recent decades with the ongoing range expansion of Ixodes scapularis and Borrelia burgdorferi. Different methodologies are used by federal and provincial governments to determine local Lyme disease risk, which can make comparisons between regions challenging. In this study, seven Canadian Lyme disease risk classification methodologies were compared with each other to highlight the strengths and limitations of how each definition measured I. scapularis and B. burgdorferi risk. Each methodology was applied to active surveillance data from Ontario, and per cent agreement and kappa statistics were calculated. The methodologies varied in their measurements of the risk of exposure to I. scapularis and B. burgdorferi based on their use of active surveillance techniques, multiple types of collected surveillance data and laboratory confirmation of B. burgdorferi. Most initial Lyme disease risk site classifications were maintained over time. Kappa and per cent agreement statistics highlighted large differences between 8 of the 15 methodology pairings, indicating the presence of inconsistencies between most methodologies. Accurate, consistent surveillance and assessment of the spread of I. scapularis and its pathogens will aid with communicating Lyme disease risk to the public and preventing tick-borne pathogen transmission.

Spatial patterns of Borrelia burgdorferi, Borrelia miyamotoi and Anaplasma phagocytophilum detected in Ixodes spp. ticks from Canadian companion animals, 2019-2020

Increasing temperatures due to climate change have contributed to a northward range expansion of Ixodes scapularis ticks in Canada. These ticks harbour pathogens of public and animal health significance, including Borrelia burgdorferi and Anaplasma phagocytophilum, which cause Lyme disease and anaplasmosis, respectively, in humans, dogs and horses, and Borrelia miyamotoi, which causes a flu-like relapsing fever in humans. To address the risks associated with these vector-borne zoonotic diseases, continuous tick surveillance is advised. This study examined spatial patterns of B. burgdorferi, B. miyamotoi and A. phagocytophilum from ticks submitted through a national study on ticks of companion animals. From 1 April 2019 to 31 March 2020, we received a total of 1541 eligible submissions from 94 veterinary clinics across Canada. Individual and pooled samples of a maximum of either 5 I. scapularis, I. pacificus or I. angustus samples from the same animal and of the same life stage were screened using real-time PCR targeting genes 23S rRNA for Borrelia spp. and msp2 for A. phagocytophilum. Confirmatory testing was conducted on all 23S rRNA positive samples using a duplex assay for ospA and flaB to differentiate B. burgdorferi and B. miyamotoi, respectively. Prevalence estimates were highest (>20%) for B. burgdorferi in southwestern Manitoba, eastern Ontario, southwestern Quebec, New Brunswick and Nova Scotia. Estimates of B. miyamotoi and A. phagocytophilum were much lower (<5%), except for higher A. phagocytophilum (>5%) estimates for southern Manitoba, eastern Ontario and Prince Edward Island. Findings from this study, combined with other surveillance approaches, can be used to guide veterinary and public health approaches for ticks and tick-borne diseases.

Tick Control in a Connected World: Challenges, Solutions, and Public Policy from a United States Border Perspective

Ticks are able to transmit the highest number of pathogen species of any blood-feeding arthropod and represent a growing threat to public health and agricultural systems worldwide. While there are numerous and varied causes and effects of changes to tick-borne disease (re)emergence, three primary challenges to tick control were identified in this review from a U.S. borders perspective. (1) Climate change is implicated in current and future alterations to geographic ranges and population densities of tick species, pathogens they can transmit, and their host and reservoir species, as highlighted by Ixodes scapularis and its expansion across southern Canada. (2) Modern technological advances have created an increasingly interconnected world, contributing to an increase in invasive tick species introductions through the increased speed and frequency of trade and travel. The introduction of the invasive Haemaphysalis longicornis in the eastern U.S. exemplifies the challenges with control in a highly interconnected world. (3) Lastly, while not a new challenge, differences in disease surveillance, control, and management strategies in bordering countries remains a critical challenge in managing ticks and tick-borne diseases. International inter-agency collaborations along the U.S.-Mexico border have been critical in control and mitigation of cattle fever ticks (Rhipicephalus spp.) and highlight the need for continued collaboration and research into integrated tick management strategies. These case studies were used to identify challenges and opportunities for tick control and mitigation efforts through a One Health framework.

Criteria for selecting sentinel unit locations in a surveillance system for vector-borne disease: A decision tool

Objectives

With vector-borne diseases emerging across the globe, precipitated by climate change and other anthropogenic changes, it is critical for public health authorities to have well-designed surveillance strategies in place. Sentinel surveillance has been proposed as a cost-effective approach to surveillance in this context. However, spatial design of sentinel surveillance system has important impacts on surveillance outcomes, and careful selection of sentinel unit locations is therefore an essential component of planning.

Methods

A review of the available literature, based on the realist approach, was used to identify key decision issues for sentinel surveillance planning. Outcomes of the review were used to develop a decision tool, which was subsequently validated by experts in the field.

Results

The resulting decision tool provides a list of criteria which can be used to select sentinel unit locations. We illustrate its application using the case example of designing a national sentinel surveillance system for Lyme disease in Canada.

Conclusions

The decision tool provides researchers and public health authorities with a systematic, evidence-based approach for planning the spatial design of sentinel surveillance systems, taking into account the aims of the surveillance system and disease and/or context-specific considerations.

Design theory to better target public health priorities: An application to Lyme disease in France

In the context of complex public health challenges led by interdependent changes such as climate change, biodiversity loss, and resistance to treatment, it is important to mobilize methods that guide us to generate innovative interventions in a context of uncertainty and unknown. Here, we mobilized the concept-knowledge (CK) design theory to identify innovative, cross-sectoral, and cross-disciplinary research and design programs that address the challenges posed by tick-borne Lyme disease in France, which is of growing importance in the French public health and healthcare systems. Within the CK methodological framework, we developed an iterative approach based on literature analysis, expert interviews, analysis of active French research projects, and work with CK experts to contribute to design "an action plan against Lyme disease." We produced a CK diagram that highlights innovative concepts that could be addressed in research projects. The outcome is discussed within four areas: (i) effectiveness; (ii) environmental sustainability in prevention actions; (iii) the promotion of constructive involvement of citizens in Lyme challenges; and (iv) the development of care protocols for chronic conditions with an unknown diagnosis. Altogether, our analysis questioned the health targets ranging from population to ecosystem, the citizen involvement, and the patient consideration. This means integrating social and ecological science, as well as the multidisciplinary medical patient journey, from the start. CK theory is a promising framework to assist public health professionals in designing programs for complex yet urgent contexts, where research and data collection are still not sufficient to provide clear guidance.

A One Health Evaluation of the Surveillance Systems on Tick-Borne Diseases in the Netherlands, Spain and Italy

Simple Summary

Ixodid ticks and tick-borne diseases are expanding their geographical range, but surveillance activities vary among countries. We analysed the surveillance systems in place in the Netherlands, Spain and Italy, to identify ideal elements to monitor tick-borne diseases, by using a One Health evaluation protocol. We identified differences among the three surveillance systems, with the Dutch initiative showing a high level of transdisciplinary collaboration, good identification of the actors and engagement of the public in research and education. Measurable outcomes have been generated, such as the reduction in tick bites and the discovery of new pathogens and tick species. In Italy and Spain, surveillance systems are based on compulsory notification to health authorities; legislation seems relevant but law enforcement alongside the availability of economic resources is rather fragmented and limited to the most severe diseases. The non-scientific community is marginally considered and collaborations are limited to local initiatives. Research activities in both countries have mostly contributed to gaining knowledge on the distribution of tick species and the discovery of new pathogens. Although all TBD surveillance plans comply with the EU regulations, the initiatives characterised by trans-disciplinary collaboration may be more effective for the surveillance and prevention of tick-transmitted diseases.

Abstract

To identify ideal elements for the monitoring and prevention of tick-borne diseases (TBD), we analysed the surveillance systems in place in the Netherlands, Spain and Italy. We applied a semi-quantitative evaluation to identify outcomes and assess the degree of One Health implementation. Differences emerged in the surveillance initiatives, as well as the One Health scores. The Dutch surveillance is dominated by a high level of transdisciplinary and trans-sectoral collaboration, enabling communication and data sharing among actors. Different project-based monitoring, research and educational activities are centrally coordinated and the non-scientific community is actively involved. All this yielded measurable health outcomes. In Italy and Spain, TBD surveillance and reporting systems are based on compulsory notification. Law enforcement, alongside dedicated time and availability of economic resources, is fragmented and limited to the most severe health issues. Veterinary and human medicine are the most involved disciplines, with the first prevailing in some contexts. Stakeholders are marginally considered and collaborations limited to local initiatives. Research activities have mostly contributed to gaining knowledge on the distribution of tick vectors and discovery of new pathogens. Although all TBD surveillance plans comply with EU regulations, initiatives characterised by transdisciplinary collaboration may be more effective for the surveillance and prevention of TBD.

Adaptive risk-based targeted surveillance for foreign animal diseases at the wildlife-livestock interface

Animal disease surveillance is an important component of the national veterinary infrastructure to protect animal agriculture and facilitates identification of foreign animal disease (FAD) introduction. Once introduced, pathogens shared among domestic and wild animals are especially challenging to manage due to the complex ecology of spillover and spillback. Thus, early identification of FAD in wildlife is critical to minimize outbreak severity and potential impacts on animal agriculture as well as potential impacts on wildlife and biodiversity. As a result, national surveillance and monitoring programs that include wildlife are becoming increasingly common. Designing surveillance systems in wildlife or, more importantly, at the interface of wildlife and domestic animals, is especially challenging because of the frequent lack of ecological and epidemiological data for wildlife species and technical challenges associated with a lack of non-invasive methodologies. To meet the increasing need for targeted FAD surveillance and to address gaps in existing wildlife surveillance systems, we developed an adaptive risk-based targeted surveillance approach that accounts for risks in source and recipient host populations. The approach is flexible, accounts for changing disease risks through time, can be scaled from local to national extents and permits the inclusion of quantitative data or when information is limited to expert opinion. We apply this adaptive risk-based surveillance framework to prioritize areas for surveillance in wild pigs in the United States with the objective of early detection of three diseases: classical swine fever, African swine fever and foot-and-mouth disease. We discuss our surveillance framework, its application to wild pigs and discuss the utility of this framework for surveillance of other host species and diseases.

Abundance of Ixodes ricinus Ticks (Acari: Ixodidae) and the Diversity of Borrelia Species in Northeastern Poland

Monitoring the abundance of ticks and the prevalence of pathogens in ticks is an important activity in assessing the risk of tick-borne diseases and helps to develop preventive measures. This study aimed to estimate the density of Ixodes ricinus, the prevalence of Borrelia species, and their diversity in northeastern Poland. The overall mean I. ricinus density was 9.7 ticks/100 m². There were no differences between years, subregions, or habitats of study. The Borrelia infection rate was higher in females (22.6%) and males (14.3%) than in nymphs 5.5% (MIR). The most infected ticks came from the eastern subregion (10.1%) where the incidence of borreliosis among the inhabitants was over 20% higher than in the other subregions. In the infected ticks, B. afzelii (38.3%) and B. garinii (34.5%) were predominant. B. bavariensis was confirmed in I. ricinus in Poland for the first time. The most polymorphic was B. garinii. B. miyamotoi (belonged to the European type) was identified as a mono-infection in 0.9% of ticks and in 1.5% as a co-infection with B. afzelii and with B. garinii. Besides the risk of borreliosis and co-infections with different Borrelia species, physicians should also be aware of B. miyamotoi infections among patients.

Monitoring the patterns of submission and presence of tick-borne pathogens in Ixodes scapularis collected from humans and companion animals in Ontario, Canada (2011-2017)

BACKGROUND

The universal nature of the human-companion animal relationship and their shared ticks and tick-borne pathogens offers an opportunity for improving public and veterinary health surveillance. With this in mind, we describe the spatiotemporal trends for blacklegged tick (Ixodes scapularis) submissions from humans and companion animals in Ontario, along with pathogen prevalence.

METHODS

We tested tick samples submitted through passive surveillance (2011-2017) from humans and companion animals for Borrelia burgdorferi, Borrelia miyamotoi, Anaplasma phagocytophilum and Babesia microti. We describe pathogen prevalence in ticks from humans and from companion animals and constructed univariable Poisson and negative binomial regression models to explore the spatiotemporal relationship between the rates of tick submissions by host type.

RESULTS

During the study, there were 17,230 blacklegged tick samples submitted from humans and 4375 from companion animals. Tick submission rates from companion animals were higher than expected in several public health units (PHUs) lacking established tick populations, potentially indicating newly emerging populations. Pathogen prevalence in ticks was higher in PHUs where established blacklegged tick populations exist. Borrelia burgdorferi prevalence was higher in ticks collected from humans (maximum likelihood estimate, MLE = 17.5%; 95% confidence interval, CI 16.97-18.09%) than from companion animals (9.9%, 95% CI 9.15-10.78%). There was no difference in pathogen prevalence in ticks by host type for the remaining pathogens, which were found in less than 1% of tested ticks. The most common co-infection B. burgdorferi + B. miyamotoi occurred in 0.11% of blacklegged ticks from humans and animals combined. Borrelia burgdorferi prevalence was higher in unengorged (21.9%, 95% CI 21.12-22.65%) than engorged ticks (10.0%, 95% CI 9.45-10.56%). There were no consistent and significant spatiotemporal relationships detected via regression models between the annual rates of submission of each host type.

CONCLUSIONS

While B. burgdorferi has been present in blacklegged ticks in Ontario for several decades, other tick-borne pathogens are also present at low prevalence. Blacklegged tick and pathogen surveillance data can be used to monitor risk in human and companion animal populations, and efforts are under consideration to unite surveillance efforts for the different target populations.

A Generalized Additive Model Correlating Blacklegged Ticks With White-Tailed Deer Density, Temperature, and Humidity in Maine, USA, 1990-2013

Geographical range expansions of blacklegged tick [Ixodes scapularis Say (Acari: Ixodidae)] populations over time in the United States have been attributed to a mosaic of factors including 20th century reforestation followed by suburbanization, burgeoning populations of the white-tailed deer [Odocoileus virginianus Zimmerman (Artiodactyla: Cervidae)], and, at the northern edge of I. scapularis' range, climate change. Maine, a high Lyme disease incidence state, has been experiencing warmer and shorter winter seasons, and relatively more so in its northern tier. Maine served as a case study to investigate the interacting impacts of deer and seasonal climatology on the spatial and temporal distribution of I. scapularis. A passive tick surveillance dataset indexed abundance of I. scapularis nymphs for the state, 1990-2013. With Maine's wildlife management districts as the spatial unit, we used a generalized additive model to assess linear and nonlinear relationships between I. scapularis nymph abundance and predictors. Nymph submission rate increased with increasing deer densities up to ~5 deer/km2 (13 deer/mi2), but beyond this threshold did not vary with deer density. This corroborated the idea of a saturating relationship between I. scapularis and deer density. Nymphs also were associated with warmer minimum winter temperatures, earlier degree-day accumulation, and higher relative humidity. However, nymph abundance only increased with warmer winters and degree-day accumulation where deer density exceeded ~2 deer/km2 (~6/mi2). Anticipated increases in I. scapularis in the northern tier could be partially mitigated through deer herd management.

Decoupling of Blacklegged Tick Abundance and Lyme Disease Incidence in Southern Maine, USA

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt, and Brenner (Spirocheatales: Spirochaetaceae) which is transmitted through the bite of an infected blacklegged tick Ixodes scapularis Say (Ixodida: Ixodidae). Maine, USA, is a high Lyme disease incidence state, with rising incidence of Lyme disease and other tick-borne illnesses associated with increasing I. scapularis abundance and northward range expansion. Members of the public submitted ticks to a tick identification program (1990-2013). From these passive surveillance data, we characterized temporal trends in I. scapularis submission rate (an index of abundance), comparing Maine's northern tier (seven counties) versus southern tier (nine counties). In the northern tier, the I. scapularis submission rate increased throughout the duration of the time series, suggesting I. scapularis was emergent but not established. By contrast, in the southern tier, submission rate increased initially but leveled off after 10-14 yr, suggesting I. scapularis was established by the mid-2000s. Active (field) surveillance data from a site in the southern tier-bird tick burdens and questing adult tick collections-corroborated this leveling pattern. Lyme disease incidence and I. scapularis submission rate were temporally correlated in the northern but not southern tier. This suggested a decoupling of reported disease incidence and entomological risk.