Tickborne disease awareness and protective practices among U.S. Forest Service employees from the upper Midwest, USA

Background

People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.

Methods

We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures.

Results

Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals, 1.97–20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41–24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00–10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks.

Conclusions

Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.

In vivo dynamics of the microparasite Perkinsus marinus during progression and regression of infections in eastern oysters

We used a total body parasite burden assay for the oyster pathogen Perkinsus marinus to investigate quantitative changes in microparasite burdens and frequency distributions. Heretofore, this type of study was limited mainly to macroparasites. The apparent in vivo growth pattern of P. marinus was characterized by a "lag" phase (< 10 cells/g wet weight [g wwt], a "log" phase (10-10,000 cells/g wwt), and a "stationary" phase (> 10,000 cells/g wwt). Infections declined exponentially under conditions unfavorable to the parasite but with a lengthening half-life, suggesting that elimination of parasites became increasingly difficult at low densities. Oysters held for 11 wk at 15 C, a temperature considered more favorable for oyster hemocytes than for P. marinus, were not able to eliminate infections. Parasite distributions within host populations were aggregated; in each sample, 1 or 2 oysters contained more parasites than all other oysters in the sample combined and the variance-to-mean ratio exceeded 1:1. The few hosts with large parasite burdens may be the most important individuals for survival and transmission of parasites. They are likely to play a key role in initiating and maintaining epizootics either in situ or after introduction of infected animals into a naive population.