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Rich SN, Carpenter A, Dell B, Henderson R, Adams S, Bestul N, Grano C, Sprague B, Leopold J, Schiffman EK, Lomeli A, Zadeh H, Alarcón J, Halai UA, Nam YS, Seifu L, Slavinski S, Crum D, Mosites E, Salzer JS, Hinckley AF, McCormick DW, Marx GE. Knowledge and practices related to louse- and flea-borne diseases among staff providing services to people experiencing homelessness in the United States. Zoonoses Public Health 2024. [PMID: 38514461 DOI: 10.1111/zph.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND AND AIMS Louse-borne Bartonella quintana infection and flea-borne murine typhus are two potentially serious vector-borne diseases that have led to periodic outbreaks among people experiencing homelessness in the United States. Little is known about louse- and flea-borne disease awareness and prevention among staff who provide services to the population. We surveyed staff in seven US states to identify gaps in knowledge and prevention practices for these diseases. METHODS AND RESULTS Surveys were administered to 333 staff at 89 homeless shelters and outreach teams in California, Colorado, Georgia, Maryland, Minnesota, New York and Washington from August 2022 to April 2023. Most participants (>68%) agreed that body lice and fleas are a problem for people experiencing homelessness. About half were aware that diseases could be transmitted by these vectors; however, most could not accurately identify which diseases. Less than a quarter of staff could describe an appropriate protocol for managing body lice or fleas. Misconceptions included that clients must isolate or be denied services until they are medically cleared. CONCLUSIONS Our findings reveal significant knowledge gaps among staff who provide services to people experiencing homelessness in the prevention and control of louse- and flea-borne diseases. This demonstrates an urgent need for staff training to both reduce disease and prevent unnecessary restrictions on services and housing.
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Affiliation(s)
- Shannan N Rich
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Division of Workforce Development, National Center for State, Tribal, Local, and Territorial (STLT) Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Ann Carpenter
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Division of Workforce Development, National Center for State, Tribal, Local, and Territorial (STLT) Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bree Dell
- Communicable Disease Epidemiology & Immunization Section, Public Health - Seattle & King County, Seattle, Washington State, USA
| | - Rachel Henderson
- University of Colorado Anschutz Medical Campus at Colorado State University, Fort Collins, Colorado, USA
| | - Sydney Adams
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, USA
| | - Nicolette Bestul
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher Grano
- Communicable Disease Branch, Colorado Department of Public Health & Environment, Denver, Colorado, USA
| | - Briana Sprague
- Communicable Disease Branch, Colorado Department of Public Health & Environment, Denver, Colorado, USA
| | - Josh Leopold
- Infectious Disease Epidemiology, Prevention, and Control Division, Minnesota Department of Health, Saint Paul, Minnesota, USA
| | - Elizabeth K Schiffman
- Infectious Disease Epidemiology, Prevention, and Control Division, Minnesota Department of Health, Saint Paul, Minnesota, USA
| | - Andrea Lomeli
- Medical and Preventive Services, Fulton County Board of Health, Atlanta, Georgia, USA
| | - Hassan Zadeh
- Medical and Preventive Services, Fulton County Board of Health, Atlanta, Georgia, USA
| | - Jemma Alarcón
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Division of Workforce Development, National Center for State, Tribal, Local, and Territorial (STLT) Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - Umme-Aiman Halai
- Acute Communicable Disease Control Program, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - Yoon-Sung Nam
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Division of Workforce Development, National Center for State, Tribal, Local, and Territorial (STLT) Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, New York City, New York, USA
| | - Leah Seifu
- Epidemic Intelligence Service, Epidemiology and Laboratory Workforce Branch, Division of Workforce Development, National Center for State, Tribal, Local, and Territorial (STLT) Public Health Infrastructure and Workforce, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, New York City, New York, USA
| | - Sally Slavinski
- Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York City, New York, USA
| | - David Crum
- Infectious Disease Epidemiology and Outbreak Response Bureau, Maryland Department of Health, Baltimore, Maryland, USA
| | - Emily Mosites
- Office of the Director, Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Johanna S Salzer
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alison F Hinckley
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - David W McCormick
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Grace E Marx
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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2
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Hook SA, Hansen AP, Niesobecki SA, Meek JI, Bjork JKH, Kough EM, Peterson MS, Schiffman EK, Rutz HJ, Rowe AJ, White JL, Peel JL, Biggerstaff BJ, Hinckley AF. Evaluating public acceptability of a potential Lyme disease vaccine using a population-based, cross-sectional survey in high incidence areas of the United States. Vaccine 2021; 40:298-305. [PMID: 34895785 DOI: 10.1016/j.vaccine.2021.11.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/09/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lyme disease incidence is increasing, despite current prevention options. New Lyme disease vaccine candidates are in development, however, investigation of the acceptability of a Lyme disease vaccine among potential consumers is needed prior to any vaccine coming to market. We conducted a population-based, cross-sectional study to estimate willingness to receive a potential Lyme disease vaccine and factors associated with willingness. METHODS The web-based survey was administered to a random sample of Connecticut, Maryland, Minnesota, and New York residents June-July 2018. Survey-weighted descriptive statistics were conducted to estimate the proportion willing to receive a potential Lyme disease vaccine. Multivariable multinomial logistic regression models were used to quantify the association of sociodemographic characteristics and Lyme disease vaccine attitudes with willingness to be vaccinated. RESULTS Surveys were completed by 3313 respondents (6% response rate). We estimated that 64% of residents were willing to receive a Lyme disease vaccine, while 30% were uncertain and 7% were unwilling. Compared to those who were willing, those who were uncertain were more likely to be parents, adults 45-65 years old, non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. Those who were unwilling were also more likely to be non-White, have less than a bachelor's degree, or have safety concerns about a potential Lyme disease vaccine. In addition, the unwilling had low confidence in vaccines in general, had low perceived risk of contracting Lyme disease, and said they would not be influenced by a positive recommendation from a healthcare provider. DISCUSSION Overall, willingness to receive a Lyme disease vaccine was high. Effective communication by clinicians regarding safety and other vaccine parameters to those groups who are uncertain will be critical for increasing vaccine uptake and reducing Lyme disease incidence.
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Affiliation(s)
- Sarah A Hook
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - AmberJean P Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, One Church Street, 7th Floor, New Haven, CT 06510, USA.
| | - Jenna K H Bjork
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Erin M Kough
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | - Molly S Peterson
- Minnesota Department of Health, 625 Robert St N, St Paul, MN 55164, USA.
| | | | - Heather J Rutz
- Maryland Department of Health, 201 W. Preston Street, 3rd Floor, Baltimore, MD 21201, USA.
| | - Adam J Rowe
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L White
- New York State Department of Health, Empire Plaza, Corning Tower, State St, Albany, NY 12203, USA.
| | - Jennifer L Peel
- Colorado State University, Environmental Health Building, 350 W. Lake St., Fort Collins, CO 80523, USA.
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-borne Diseases, 3156 Rampart Rd., Fort Collins, CO 80521, USA.
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Lindsey NP, Messenger SL, Hacker JK, Salas ML, Scott-Waldron C, Haydel D, Rider E, Simonson S, Brown CM, Patel P, Smole SC, Neitzel DF, Schiffman EK, Palm J, Strain AK, Vetter SM, Nefzger B, Fischer M, Rabe IB. Expanded Molecular Testing on Patients with Suspected West Nile Virus Disease. Vector Borne Zoonotic Dis 2019; 19:690-693. [PMID: 31081745 DOI: 10.1089/vbz.2018.2412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Most diagnostic testing for West Nile virus (WNV) disease is accomplished using serologic testing, which is subject to cross-reactivity, may require cumbersome confirmatory testing, and may fail to detect infection in specimens collected early in the course of illness. The objective of this project was to determine whether a combination of molecular and serologic testing would increase detection of WNV disease cases in acute serum samples. A total of 380 serum specimens collected ≤7 days after onset of symptoms and submitted to four state public health laboratories for WNV diagnostic testing in 2014 and 2015 were tested. WNV immunoglobulin M (IgM) antibody and RT-PCR tests were performed on specimens collected ≤3 days after symptom onset. WNV IgM antibody testing was performed on specimens collected 4-7 days after onset and RT-PCR was performed on IgM-positive specimens. A patient was considered to have laboratory evidence of WNV infection if they had detectable WNV IgM antibodies or WNV RNA in the submitted serum specimen. Of specimens collected ≤3 days after symptom onset, 19/158 (12%) had laboratory evidence of WNV infection, including 16 positive for only WNV IgM antibodies, 1 positive for only WNV RNA, and 2 positive for both. Of specimens collected 4-7 days after onset, 21/222 (9%) were positive for WNV IgM antibodies; none had detectable WNV RNA. These findings suggest that routinely performing WNV RT-PCR on acute serum specimens submitted for WNV diagnostic testing is unlikely to identify a substantial number of additional cases beyond IgM antibody testing alone.
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Affiliation(s)
- Nicole P Lindsey
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Sharon L Messenger
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California
| | - Jill K Hacker
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California
| | - Maria L Salas
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California
| | | | | | - Errin Rider
- Louisiana Office of Public Health, Baton Rouge, Louisiana
| | - Sean Simonson
- Louisiana Office of Public Health, Baton Rouge, Louisiana
| | - Catherine M Brown
- Massachusetts Department of Public Health, Jamaica Plain, Massachusetts
| | - Pinal Patel
- Massachusetts Department of Public Health, Jamaica Plain, Massachusetts
| | - Sandra C Smole
- Massachusetts Department of Public Health, Jamaica Plain, Massachusetts
| | | | | | - Jennifer Palm
- Minnesota Department of Health, Saint Paul, Minnesota
| | - Anna K Strain
- Minnesota Department of Health, Saint Paul, Minnesota
| | - Sara M Vetter
- Minnesota Department of Health, Saint Paul, Minnesota
| | - Brian Nefzger
- Minnesota Department of Health, Saint Paul, Minnesota
| | - Marc Fischer
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Ingrid B Rabe
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
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Johnson TL, Graham CB, Maes SE, Hojgaard A, Fleshman A, Boegler KA, Delory MJ, Slater KS, Karpathy SE, Bjork JK, Neitzel DF, Schiffman EK, Eisen RJ. Prevalence and distribution of seven human pathogens in host-seeking Ixodes scapularis (Acari: Ixodidae) nymphs in Minnesota, USA. Ticks Tick Borne Dis 2018; 9:1499-1507. [PMID: 30055987 DOI: 10.1016/j.ttbdis.2018.07.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/11/2018] [Accepted: 07/17/2018] [Indexed: 11/19/2022]
Abstract
In the north-central United States, the blacklegged tick (Ixodes scapularis) is currently known to vector seven human pathogens. These include five bacteria (Borrelia burgdorferi sensu stricto, Borrelia mayonii, Borrelia miyamotoi, Anaplasma phagocytophilum, Ehrlichia muris eauclairensis), one protozoan (Babesia microti) and one virus (Powassan). We sought to assess the prevalence and distribution of these pathogens in host-seeking nymphs collected throughout Minnesota, a state on the northwestern edge of the tick's expanding range, where reported cases of I. scapularis-borne diseases have increased in incidence and geographic range over the past decade. Among the 1240 host-seeking I. scapularis nymphs that we screened from 64 sites, we detected all seven pathogens at varying frequencies. Borrelia burgdorferi s.s. was the most prevalent and geographically widespread, found in 25.24% of all nymphs tested. Anaplasma phagocytophilum and Babesia microti were also geographically widespread, but they were less prevalent than Bo. burgdorferi s.s. (detected in 6.29% and 4.68% of ticks, respectively). Spatial clusters of sites with high prevalence for these three pathogens were identified in the north-central region of the state. Prevalence was less than 1.29% for each of the remaining pathogens. Two or more pathogens were detected in 90 nymphs (7.26%); coinfections with Bo. burgdorferi s.s. and either A. phagocytophilum (51 nymphs, 4.11%) or Ba. microti (43 nymphs, 3.47%) were the most common combinations. The distribution and density of infected ticks mirrors the distribution of notifiable tick-borne diseases in Minnesota and provides information on the distribution and prevalence of recently described human pathogens.
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Affiliation(s)
- Tammi L Johnson
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Christine B Graham
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Sarah E Maes
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Andrias Hojgaard
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Amy Fleshman
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Karen A Boegler
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Mark J Delory
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States
| | - Kimetha S Slater
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30329-4027, United States
| | - Sandor E Karpathy
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30329-4027, United States
| | - Jenna K Bjork
- Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164, United States
| | - David F Neitzel
- Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164, United States
| | | | - Rebecca J Eisen
- Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd., Fort Collins, CO 80521, United States.
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5
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Johnson TL, Boegler KA, Clark RJ, Delorey MJ, Bjork JKH, Dorr FM, Schiffman EK, Neitzel DF, Monaghan AJ, Eisen RJ. An Acarological Risk Model Predicting the Density and Distribution of Host-Seeking Ixodes scapularis Nymphs in Minnesota. Am J Trop Med Hyg 2018; 98:1671-1682. [PMID: 29637876 PMCID: PMC6086181 DOI: 10.4269/ajtmh.17-0539] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Ixodes scapularis is the vector of at least seven human pathogens in Minnesota, two of which are known to cause Lyme disease (Borrelia burgdorferi sensu stricto and Borrelia mayonii). In Minnesota, the statewide incidence of Lyme disease and other I. scapularis–borne diseases and the geographic extent over which cases have been reported have both increased substantially over the last two decades. These changes correspond with an expanding distribution of I. scapularis over a similar time frame. Because the risk of exposure to I. scapularis–borne pathogens is likely related to the number of ticks encountered, we developed an acarological risk model predicting the density of host-seeking I. scapularis nymphs (DON) in Minnesota. The model was informed by sampling 81 sites located in 42 counties in Minnesota. Two main foci were predicted by the model to support elevated densities of host-seeking I. scapularis nymphs, which included the seven-county Minneapolis-St. Paul metropolitan area and counties in northern Minnesota, including Lake of the Woods and Koochiching counties. There was substantial heterogeneity observed in predicted DON across the state at the county scale; however, counties classified as high risk for I. scapularis–borne diseases and counties with known established populations of I. scapularis had the highest proportion of the county predicted as suitable for host-seeking nymphs (≥ 0.13 nymphs/100 m2). The model provides insight into areas of potential I. scapularis population expansion and identifies focal areas of predicted suitable habitat within counties where the incidence of I. scapularis–borne diseases has been historically low.
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Affiliation(s)
- Tammi L Johnson
- Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Karen A Boegler
- Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Rebecca J Clark
- Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Mark J Delorey
- Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | | | | | | | - Andrew J Monaghan
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado
| | - Rebecca J Eisen
- Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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6
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Schiffman EK, Neitzel DF, Lynfield R. Tick-borne Disease Prevention: Still No Silver Bullet. J Infect Dis 2016; 214:171-2. [PMID: 26740277 DOI: 10.1093/infdis/jiv776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 12/30/2015] [Indexed: 11/14/2022] Open
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7
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Johnson DKH, Schiffman EK, Davis JP, Neitzel DF, Sloan LM, Nicholson WL, Fritsche TR, Steward CR, Ray JA, Miller TK, Feist MA, Uphoff TS, Franson JJ, Livermore AL, Deedon AK, Theel ES, Pritt BS. Human Infection with Ehrlichia muris-like Pathogen, United States, 2007-2013(1). Emerg Infect Dis 2016; 21:1794-9. [PMID: 26402378 PMCID: PMC4593436 DOI: 10.3201/eid2110.150143] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This pathogen has been detected in patients from 5 states, all of whom reported likely tick exposure in Minnesota or Wisconsin. An Ehrlichia muris–like (EML) pathogen was detected among 4 patients in Minnesota and Wisconsin during 2009. We characterized additional cases clinically and epidemiologically. During 2004–2013, blood samples from 75,077 patients from all 50 United States were tested by PCR from the groEL gene for Ehrlichia spp. and Anaplasma phagocytophilum. During 2007–2013, samples from 69 (0.1%) patients were positive for the EML pathogen; patients were from 5 states: Indiana (1), Michigan (1), Minnesota (33), North Dakota (3), and Wisconsin (31). Most (64%) patients were male; median age was 63 (range 15–94) years; and all 69 patients reported likely tick exposure in Minnesota or Wisconsin. Fever, malaise, thrombocytopenia, and lymphopenia were the most common symptoms. Sixteen (23%) patients were hospitalized (median 4 days); all recovered, and 96% received doxycycline. Infection with the EML pathogen should be considered for persons reporting tick exposure in Minnesota or Wisconsin.
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8
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Johnson TL, Bjork JKH, Neitzel DF, Dorr FM, Schiffman EK, Eisen RJ. Habitat Suitability Model for the Distribution of Ixodes scapularis (Acari: Ixodidae) in Minnesota. J Med Entomol 2016; 53:598-606. [PMID: 27026161 PMCID: PMC5042859 DOI: 10.1093/jme/tjw008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/27/2016] [Indexed: 05/31/2023]
Abstract
Ixodes scapularis Say, the black-legged tick, is the primary vector in the eastern United States of several pathogens causing human diseases including Lyme disease, anaplasmosis, and babesiosis. Over the past two decades, I. scapularis-borne diseases have increased in incidence as well as geographic distribution. Lyme disease exists in two major foci in the United States, one encompassing northeastern states and the other in the Upper Midwest. Minnesota represents a state with an appreciable increase in counties reporting I. scapularis-borne illnesses, suggesting geographic expansion of vector populations in recent years. Recent tick distribution records support this assumption. Here, we used those records to create a fine resolution, subcounty-level distribution model for I. scapularis using variable response curves in addition to tests of variable importance. The model identified 19% of Minnesota as potentially suitable for establishment of the tick and indicated with high accuracy (AUC = 0.863) that the distribution is driven by land cover type, summer precipitation, maximum summer temperatures, and annual temperature variation. We provide updated records of established populations near the northwestern species range limit and present a model that increases our understanding of the potential distribution of I. scapularis in Minnesota.
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Affiliation(s)
- T L Johnson
- Bacterial Diseases Branch, Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO 80521 (; ),
| | - J K H Bjork
- Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164 (; ; ; )
| | - D F Neitzel
- Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164 (; ; ; )
| | - F M Dorr
- Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164 (; ; ; )
| | - E K Schiffman
- Minnesota Department of Health, 625 Robert St N, St. Paul, MN 55164 (; ; ; )
| | - R J Eisen
- Bacterial Diseases Branch, Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO 80521 (; )
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