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Stark JH, McFadden B, Patel N, Kelly PH, Gould LH, Riis J. Intention to vaccinate for Lyme disease using the Health Belief Model. Zoonoses Public Health 2024; 71:349-358. [PMID: 38177978 DOI: 10.1111/zph.13107] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/20/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
AIMS Lyme disease (LD) cases in the United States are estimated to be approaching 500,000 annually. Protective measures, such as repellent use and wearing protective clothing are recommended by public health officials. However, no protective measure has been proven to be consistently effective, partly because they require consistent and persistent behaviour change. While safe and effective vaccines are in development, it is unclear what factors influence the intention to vaccinate against LD. This study uses the Health Belief Model (HBM) framework to determine key drivers associated with vaccine intention. The HBM is widely applied in public health research and uses the following constructs: perceived susceptibility and severity of disease, perceived benefits and barriers to disease prevention, and cues to action for disease prevention to predict health behaviours. To date, the HBM framework has not been applied to vaccination intention for LD. METHODS AND RESULTS Data were collected from 874 adults and 834 caregivers of children residing in US states endemic to LD. Sampling adults and caregivers allows us to explore how the intention to vaccinate differs among those at-risk. Estimates from structural equation modelling (SEM) show that the HBM constructs explain much of the variation in intention to vaccinate against LD. Both adult and caregiver intentions to vaccinate are positively influenced by cues to action, perceived susceptibility of LD, and perceived benefits to vaccination. However, there is variation in the influence of constructs across the samples. Caregiver's intention to vaccinate is positively influenced by the perceived severity of LD and negatively influenced by safety concerns about the vaccine, whereas adult intention is negatively influenced by perceived barriers to vaccination. CONCLUSION A strong relationship of cues to action on vaccine intention in samples of adults and caregivers suggests the importance of a recommendation from a healthcare provider or the Centers for Disease Control and Prevention (CDC).
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Affiliation(s)
- James H Stark
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma Group, Cambridge, Massachusetts, USA
| | - Brandon McFadden
- Behavioralize LLC, Wynnewood, Pennsylvania, USA
- The Department of Agricultural Economics and Agribusiness, University of Arkansas, Fayetteville, Arkansas, USA
| | | | - Patrick H Kelly
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma Group, Collegeville, Pennsylvania, USA
| | - L Hannah Gould
- Vaccines, Antivirals, and Evidence Generation, Pfizer Biopharma Group, New York, New York, USA
| | - Jason Riis
- Behavioralize LLC, Wynnewood, Pennsylvania, USA
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Vance DJ, Basir S, Piazza CL, Willsey GG, Haque HME, Tremblay JM, Rudolph MJ, Muriuki B, Cavacini L, Weis DD, Shoemaker CB, Mantis NJ. Single-domain antibodies reveal unique borrelicidal epitopes on the Lyme disease vaccine antigen, outer surface protein A (OspA). Infect Immun 2024; 92:e0008424. [PMID: 38470113 PMCID: PMC11003225 DOI: 10.1128/iai.00084-24] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/13/2024] Open
Abstract
Camelid-derived, single-domain antibodies (VHHs) have proven to be extremely powerful tools in defining the antigenic landscape of immunologically heterogeneous surface proteins. In this report, we generated a phage-displayed VHH library directed against the candidate Lyme disease vaccine antigen, outer surface protein A (OspA). Two alpacas were immunized with recombinant OspA serotype 1 from Borrelia burgdorferi sensu stricto strain B31, in combination with the canine vaccine RECOMBITEK Lyme containing lipidated OspA. The phage library was subjected to two rounds of affinity enrichment ("panning") against recombinant OspA, yielding 21 unique VHHs within two epitope bins, as determined through competition enzyme linked immunosorbent assays (ELISAs) with a panel of OspA-specific human monoclonal antibodies. Epitope refinement was conducted by hydrogen exchange-mass spectrometry. Six of the monovalent VHHs were expressed as human IgG1-Fc fusion proteins and shown to have functional properties associated with protective human monoclonal antibodies, including B. burgdorferi agglutination, outer membrane damage, and complement-dependent borreliacidal activity. The VHHs displayed unique reactivity profiles with the seven OspA serotypes associated with B. burgdorferi genospecies in the United States and Europe consistent with there being unique epitopes across OspA serotypes that should be considered when designing and evaluating multivalent Lyme disease vaccines.
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Affiliation(s)
- David J. Vance
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, New York, USA
- Department of Biomedical Sciences, University at Albany, Albany, New York, USA
| | - Saiful Basir
- Department of Biomedical Sciences, University at Albany, Albany, New York, USA
| | - Carol Lyn Piazza
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, New York, USA
| | - Graham G. Willsey
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, New York, USA
| | | | - Jacque M. Tremblay
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | | | - Beatrice Muriuki
- Department of Medicine, University of Massachusetts Chan School of Medicine, Worcester, Massachusetts, USA
| | - Lisa Cavacini
- Department of Medicine, University of Massachusetts Chan School of Medicine, Worcester, Massachusetts, USA
| | - David D. Weis
- Department of Chemistry, The University of Kansas, Lawrence, Kansas, USA
| | - Charles B. Shoemaker
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Nicholas J. Mantis
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, New York, USA
- Department of Biomedical Sciences, University at Albany, Albany, New York, USA
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Logan JJ, Sawada M, Knudby A, Ramsay T, Blanford JI, Ogden NH, Kulkarni MA. Knowledge, protective behaviours, and perception of Lyme disease in an area of emerging risk: results from a cross-sectional survey of adults in Ottawa, Ontario. BMC Public Health 2024; 24:867. [PMID: 38509528 PMCID: PMC10956326 DOI: 10.1186/s12889-024-18348-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The number of Lyme disease risk areas in Canada is growing. In regions with emerging tick populations, it is important to emphasize peridomestic risk and the importance of protective behaviours in local public health communication. This study aims to identify characteristics associated with high levels of Lyme disease knowledge and adoption of protective behaviours among residents in the Ottawa, Ontario region. METHODS A geographically stratified web survey was conducted in November 2020 (n = 2018) to determine knowledge, attitudes, and practices regarding Lyme disease among adult residents. Responses were used to calculate: (i) composite scores for knowledge and adoption of protective practices; and (ii) an exposure risk index based on reported activity in woodlands during the spring-to-fall tick exposure risk period. RESULTS 60% of respondents had a high knowledge of Lyme disease, yet only 14% indicated they often use five or more measures to protect themselves. Factors strongly associated with a high level of Lyme disease knowledge included being 55 or older (Odds Ratio (OR) = 2.04), living on a property with a yard (OR = 3.22), having a high exposure index (OR = 1.59), and knowing someone previously infected with Lyme disease (OR = 2.05). Strong associations with the adoption of a high number of protective behaviours were observed with membership in a non-Indigenous racialized group (OR = 1.70), living on a property with a yard (OR = 2.37), previous infection with Lyme disease (OR = 2.13), prior tick bite exposure (OR = 1.62), and primarily occupational activity in wooded areas (OR = 2.31). CONCLUSIONS This study highlights the dynamics between Lyme disease knowledge, patterns of exposure risk awareness, and vigilance of personal protection in a Canadian region with emerging Lyme disease risk. Notably, this study identified gaps between perceived local risk and protective behaviours, presenting opportunities for targeted enhanced communication efforts in areas of Lyme disease emergence.
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Affiliation(s)
- James J Logan
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
| | - Michael Sawada
- Laboratory for Applied Geomatics and GIS Science (LAGGISS), Department of Geography, Environment & Geomatics, University of Ottawa, Ottawa, ON, Canada
| | - Anders Knudby
- Department of Geography, Environment & Geomatics, University of Ottawa, Ottawa, ON, Canada
| | - Tim Ramsay
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Justine I Blanford
- Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, University of Twente, Enschede, Netherlands
| | - Nicholas H Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada
| | - Manisha A Kulkarni
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
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Gidengil C, Scherer AM, Parker AM, Gedlinske A, Fleck-Derderian S, Hinckley AF, Hook SA, Lindley MC, Marx GE. Lyme disease vaccine attitudes and intentions among parents of children aged 5-18 years in the United States. Vaccine 2024; 42:1899-1905. [PMID: 38418339 DOI: 10.1016/j.vaccine.2024.01.081] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Lyme disease (LD) is the most common vector-borne disease in the United States, with increasing incidence and geographic range. Case incidence peaks among school-aged children. New LD preventives are in clinical trials. METHODS We conducted an online survey of parents of children aged 5-18 years in states with high or emerging incidence of LD. Our primary outcome was willingness ("definitely" or "probably") for their child to receive an LD vaccine. Our secondary outcome was preference for annual monoclonal antibody injections compared to a 3-dose vaccine series with boosters. Analyses were weighted to reflect parent gender, parent race/ethnicity, and child age by state. RESULTS Among 1,351 parent respondents, most (68.0 %) would have their child vaccinated against LD, with significantly more being willing in high compared to emerging incidence states (70.4 % versus 63.6 %, p = 0.027). Of parents who were unsure or unwilling, 33.5 % and 16.5 %, respectively, would do so with a provider recommendation. Vaccine safety concerns were among the top reasons for LD vaccine hesitancy. More parents preferred a pre-formed antibody (42.3 %) compared to a 3-dose vaccine series (34.7 %). Significant predictors of willingness to have one's child vaccinated were higher parental education; higher perceived risk of child getting LD; child spending time outdoors daily or weekly; following a regular vaccine schedule; and positive attitude towards vaccines. Significant predictors of preference for monoclonal antibody over a 3-dose vaccine series included prior awareness of LD, living in a rural area, and less positive attitudes towards vaccines. CONCLUSIONS Two-thirds of parents in high and emerging incidence states would vaccinate their children against Lyme disease. Addressing safety concerns will be important, and a health care provider recommendation could also encourage those who are unsure or unwilling. Given the slight preference for monoclonal antibody over vaccine, particularly in rural areas, access to both may increase LD prevention.
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Affiliation(s)
| | - Aaron M Scherer
- University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Andrew M Parker
- RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA 15213, USA
| | - Amber Gedlinske
- University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Shannon Fleck-Derderian
- Centers for Disease Control and Prevention, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Sarah A Hook
- Centers for Disease Control and Prevention, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Megan C Lindley
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Immunization Services Division, 1600 Clifton Road, Atlanta, GA 30329, USA
| | - Grace E Marx
- Centers for Disease Control and Prevention, National Centers for Emerging and Zoonotic Infectious Diseases, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, USA
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Pavia CS, Saggio G, Plummer MM. The major epidemiologic, microbiologic, immunologic, and clinical aspects of Lyme disease that form the basis for a newly developed vaccine that may become available soon for human use. Front Immunol 2024; 14:1326623. [PMID: 38420513 PMCID: PMC10899802 DOI: 10.3389/fimmu.2023.1326623] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/27/2023] [Indexed: 03/02/2024] Open
Abstract
Working together, two major pharmaceutical companies have developed a Lyme disease vaccine consisting of recombinant-derived outer surface protein A (OspA) of the etiologic agent Borrelia burgdorferi. Multiple clinical trials have shown the vaccine to have good safety and efficacy results, and it is hoped that it would become available for human use at least by the year 2025 after receiving approval from the U.S. Food and Drug Administration. There are still challenges left to ensure that the vaccine has, at most, minimal side effects. Also, because the previously developed Lyme disease vaccine was discontinued in 2002 after four years of distribution, due in part, for frivolous reasons having little or no scientific basis, that even led to legal entanglements involving the vaccine manufacturer and some of the medical personnel overseeing the clinical trials, there will be concerns that this newly developed one could be subject again to some of the same unnecessary scrutiny rendering its implementation suboptimal. Initially this review will focus on the key epidemiological, microbiologic, immunologic and clinical aspects of Lyme disease that provide the foundation for developing this type of vaccine that could have a serious impact on the prevalence of this and even certain other tick-transmitted infections.
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Affiliation(s)
- Charles S. Pavia
- Department of Biomedical Sciences, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, United States
- Division of Infectious Diseases, New York Medical College, Valhalla, NY, United States
| | - Gregory Saggio
- Department of Clinical Specialties, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, United States
| | - Maria M. Plummer
- Department of Clinical Specialties, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY, United States
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Chen YL, Lee J, Liu Z, Strych U, Bottazzi ME, Lin YP, Chen WH. Biophysical and biochemical characterization of a recombinant Lyme disease vaccine antigen, CspZ-YA. Int J Biol Macromol 2024; 259:129295. [PMID: 38211914 DOI: 10.1016/j.ijbiomac.2024.129295] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
Lyme disease, caused by Lyme Borrelia spirochetes, is the most common vector-borne illness in the United States. Despite its global significance, with an estimated 14.5 % seroprevalence, there is currently no licensed vaccine. Previously, we demonstrated that CspZ-YA protein conferred protection against Lyme Borrelia infection, making it a promising vaccine candidate. However, such a protein was tagged with hexahistidine, and thus not preferred for vaccine development; furthermore, the formulation to stabilize the protein was understudied. In this work, we developed a two-step purification process for tag-free E. coli-expressed recombinant CspZ-YA. We further utilized various bioassays to analyze the protein and determine the suitable buffer system for long-term storage and formulation as a vaccine immunogen. The results indicated that a buffer with a pH between 6.5 and 8.5 stabilized CspZ-YA by reducing its surface hydrophobicity and colloidal interactions. Additionally, low pH values induced a change in local spatial conformation and resulted in a decrease in α-helix content. Lastly, an optimal salinity of 22-400 mM at pH 7.5 was found to be important for its stability. Collectively, this study provides a fundamental biochemical and biophysical understanding and insights into the ideal stabilizing conditions to produce CspZ-YA recombinant protein for use in vaccine formulation and development.
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Affiliation(s)
- Yi-Lin Chen
- Department of Pediatrics, Division of Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Houston, TX, USA
| | - Jungsoon Lee
- Department of Pediatrics, Division of Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Houston, TX, USA
| | - Zhuyun Liu
- Department of Pediatrics, Division of Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Houston, TX, USA
| | - Ulrich Strych
- Department of Pediatrics, Division of Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Houston, TX, USA
| | - Maria Elena Bottazzi
- Department of Pediatrics, Division of Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA
| | - Yi-Pin Lin
- Division of Infectious Diseases, Wadsworth Center, NYSDOH, Albany, NY, USA; Department of Biomedical Sciences, SUNY Albany, Albany, NY, USA.
| | - Wen-Hsiang Chen
- Department of Pediatrics, Division of Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Houston, TX, USA.
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Hornbostel VL, Meek JI, Hansen AP, Niesobecki SA, Nawrocki CC, Hinckley AF, Connally NP. Operational Considerations for Using Deer-Targeted 4-Poster Tick Control Devices in a Tick-borne Disease Endemic Community. J Public Health Manag Pract 2024; 30:111-121. [PMID: 37566802 PMCID: PMC10840788 DOI: 10.1097/phh.0000000000001809] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
CONTEXT In the northeastern United States, recommendations to prevent diseases spread by black-legged ticks ( Ixodes scapularis ) and lone star ticks ( Amblyomma americanum ) often rely on individuals to use personal protection or yard-based strategies. The 4-Poster deer treatment stations (4-Posters) suppress tick populations by treating deer hosts with acaricide, potentially offering a community-wide approach for reducing tick-borne diseases in endemic areas. The 4-Poster deployment logistics in mainland community settings are not well documented but are needed for future public health tick control efforts. PROGRAM As part of a public health research effort to design a population-based 4-Poster effectiveness study aimed at reducing tick-borne disease incidence, TickNET researchers partnered with the Town of Ridgefield (Connecticut) to understand the feasibility and operational logistics of deploying 4-Posters on public land within a residential community to inform future public health interventions by municipalities or vector control agencies. IMPLEMENTATION We deployed three 4-Posters on a municipal property from July to December 2020 and used motion-activated cameras to record wildlife activity nearby. We documented per-device operational details, costs, materials consumed, and animal activity. EVALUATION Operation of 4-Posters was feasible, and device challenges were easily remedied. Deer visitation and heavy nontarget animal use were documented at all devices. Unexpectedly, monthly corn consumption was not correlated with monthly deer-view days. The monthly cost per device was US $1279 or US $305 per hectare with an average 21 minutes of weekly service time. DISCUSSION Use of 4-Posters by communities, public health agencies, or vector control programs may be a practicable addition to tick management programs in tick-borne disease endemic areas in the Northeast. Such programs should carefully consider local and state regulations, follow manufacturer and pesticide label guidelines, and include wildlife monitoring. High labor costs incurred in this project could be mitigated by training vector control agency or municipality staff to service 4-Posters.
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Affiliation(s)
- Victoria L Hornbostel
- Department of Biology, Western Connecticut State University, Danbury, Connecticut (Ms Hornbostel and Dr Connally); Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut (Mr Meek and Mss Hansen and Niesobecki); and Division of Vector-Borne Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado (Ms Nawrocki and Dr Hinckley)
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Begier E, Pilz A, Loew-Baselli A, Harper LR, Stark JH, Bowdery M, Halsby K, Dzingina M, Bézay N, Allen KE, Parslow B, Gessner BD. Prospective incidence epidemiology study protocol: conducting active surveillance to assess the burden of Lyme disease (BOLD) in primary care practices in endemic areas of six European countries. BMJ Open 2023; 13:e070903. [PMID: 38072499 PMCID: PMC10729257 DOI: 10.1136/bmjopen-2022-070903] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Lyme disease (LD) is the most frequent tick-borne disease in the moderate climates of Europe. This study will inform the phase III efficacy study for Pfizer and Valneva's investigational Lyme disease vaccine, VLA15. VLA15 phase III will be conducted in the USA and Europe due to the vaccine's serotype coverage and public health burden of LD. In Europe, the existence and location of sites that have access to populations with high LD annual incidence is uncertain. This active, prospective surveillance study assesses annual LD incidence at general practice (GP)/primary care sites, allowing for phase III site vetting and better characterisation of LD burden in selected regions for study size calculations. METHODS AND ANALYSIS This burden of Lyme disease (BOLD) study will assess LD incidence overall and by site at 15 GP/primary care practices in endemic areas of 6 European countries from Spring 2021 to December 2022 and will be summarised with counts (n), percentages (%) and associated 95% CIs. Suspected LD cases identified from site's practice panels are documented on screening logs, where clinical LD manifestations, diagnoses and standard of care diagnostic results are recorded. In the initial 12-month enrolment phase, suspected LD cases are offered enrolment. Participants undergo interview and clinical assessments to establish medical history, final clinical diagnosis, clinical manifestations and quality of life impact. Study-specific procedures include LD serology, skin punch biopsies and Lyme manifestation photographs. For every enrolled participant diagnosed with LD, 6-10 age-matched controls are randomly selected and offered enrolment for an embedded LD risk factor analysis. Persistent symptoms or post-treatment LD will be assessed at follow-up visits up to 2 years after initial diagnosis, while patients remain symptomatic. ETHICS AND DISSEMINATION This study has been approved by all sites' local ethics committees. The results will be presented at conferences and published in peer-reviewed journals.
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Affiliation(s)
| | | | | | - Lisa R Harper
- Pfizer Biopharma Group, Collegeville, Pennsylvania, USA
| | - James H Stark
- Pfizer Biopharma Group, Collegeville, Pennsylvania, USA
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9
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Nawrocki CC, Piedmonte N, Niesobecki SA, Rowe A, Hansen AP, Kaufman A, Foster E, Meek JI, Niccolai L, White J, Backenson B, Eisen L, Hook SA, Connally NP, Hornbostel VL, Hinckley AF. Acceptability of 4-poster deer treatment devices for community-wide tick control among residents of high Lyme disease incidence counties in Connecticut and New York, USA. Ticks Tick Borne Dis 2023; 14:102231. [PMID: 37531890 PMCID: PMC10883357 DOI: 10.1016/j.ttbdis.2023.102231] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/12/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
The 4-Poster Tick Control Deer Feeder (4-poster) device applies acaricide to white-tailed deer (Odocoileus virginianus) and can reduce populations of the blacklegged tick (Ixodes scapularis), which transmits the agents of Lyme disease, anaplasmosis, babesiosis, and Powassan virus disease in the Northeastern United States. While 4-poster devices have the potential to provide community-wide management of blacklegged ticks in Lyme disease endemic areas, no recent study has assessed their acceptability among residents. We conducted a survey of residents from 16 counties with high annual average Lyme disease incidence (≥ 10 cases per 100,000 persons between 2013 and 2017) in Connecticut and New York to understand perceptions and experiences related to tickborne diseases, support or concerns for placement of 4-poster devices in their community, and opinions on which entities should be responsible for tick control on private properties. Overall, 37% of 1652 respondents (5.5% response rate) would support placement of a 4-poster device on their own property, 71% would support placement on other private land in their community, and 90% would support placement on public land. Respondents who were male, rented their property, resided on larger properties, or were very or extremely concerned about encountering ticks on their property were each more likely to support placement of 4-poster devices on their own property. The primary reason for not supporting placement of a 4-poster device on one's own property was the need for weekly service visits from pest control professionals, whereas the top reason for not supporting placement on other land (private or public) was safety concerns. Most respondents (61%) felt property owners should be responsible for tick control on private properties. Communities considering 4-poster devices as part of a tick management strategy should consider targeting owners of larger properties and placing devices on public lands.
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Affiliation(s)
- Courtney C Nawrocki
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
| | - Nicholas Piedmonte
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Adam Rowe
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - AmberJean P Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Alison Kaufman
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Erik Foster
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Linda Niccolai
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Jennifer White
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Bryon Backenson
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Lars Eisen
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Sarah A Hook
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Neeta P Connally
- Department of Biology, Western Connecticut State University, Danbury, CT, USA
| | | | - Alison F Hinckley
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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Gyura AN, Buser JM, Keesing H, Nelsen L, Marx GE, Hinckley AF, Seman C, Nelson CA. Lyme Disease Knowledge, Practices, and Vaccine Acceptability Among Nurse Practitioners in Pediatric Practice. J Pediatr Health Care 2023; 37:673-683. [PMID: 37702645 DOI: 10.1016/j.pedhc.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Lyme disease (LD) is a major public health problem in the United States. Given its incidence and geographic expansion, nurse practitioners (NPs) will likely encounter patients with this condition. METHOD NPs were invited to participate in an electronic survey via email, newsletter, and social media posts. The 31-question survey collected information on provider characteristics, clinical scenario decisions, resources used, and vaccine sentiment for LD. RESULTS Survey participants (n = 606) were primarily cisgender female (75%) and aged 30-49 years (62%). Responding to six hypothetical clinical scenarios, only 31% of participants answered most questions correctly. If an LD vaccine becomes available, 39% said they would incorporate it into practice; 48% would seek further information before deciding. DISCUSSION Additional education on LD prevention, diagnosis, and treatment is needed for NPs. Increasing provider awareness of current guidelines and developing tailored resources for NPs may improve patient care.
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Bézay N, Hochreiter R, Kadlecek V, Wressnigg N, Larcher-Senn J, Klingler A, Dubischar K, Eder-Lingelbach S, Leroux-Roels I, Leroux-Roels G, Bender W. Safety and immunogenicity of a novel multivalent OspA-based vaccine candidate against Lyme borreliosis: a randomised, phase 1 study in healthy adults. Lancet Infect Dis 2023; 23:1186-1196. [PMID: 37419129 DOI: 10.1016/s1473-3099(23)00210-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/16/2023] [Accepted: 03/20/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Lyme borreliosis, potentially associated with serious long-term complications, is caused by the species complex Borrelia burgdorferi sensu lato. We investigated a novel Lyme borreliosis vaccine candidate (VLA15) targeting the six most common outer surface protein A (OspA) serotypes 1-6 to prevent infection with pathogenic Borrelia spp prevalent in Europe and North America. METHODS This was a partially randomised, observer-masked, phase 1 study in healthy adults older than 18 years to younger than 40 years (n=179) done in trial sites in Belgium and the USA. Following a non-randomised run-in phase, a sealed envelope randomisation method was applied with a 1:1:1:1:1:1 ratio; three dose concentrations of VLA15 (12 μg, 48 μg, and 90 μg) were administered by intramuscular injection on days 1, 29, and 57. The primary outcome was safety (frequency of adverse events up to day 85) assessed in participants who received at least one vaccination. Immunogenicity was a secondary outcome. The trial is registered with ClinicalTrials.gov, NCT03010228, and is complete. FINDINGS Between Jan 23, 2017 and Jan 16, 2019, of 254 participants screened for eligibility, 179 were randomly assigned into six groups: alum-adjuvanted 12 μg (n=29), 48 μg (n=31), or 90 μg (n=31) and non-adjuvanted 12 μg (n=29 participants), 48 μg (n=29), or 90 μg (n=30). VLA15 was safe and well tolerated and the majority of adverse events were mild or moderate. Overall, adverse events were more frequent in the 48 μg and 90 μg groups (range 28-30 participants [94-97%]) when compared with the 12 μg group (25 [86%] participants, 95% CI 69·4-94·5) for adjuvanted and non-adjuvanted groups. Common local reactions were tenderness (151 [84%] participants; 356 events, 95% CI 78·3-89·4) and injection site pain (120 [67%]; 224 events, 59·9-73·5); most frequent systemic reactions were headache (80 [45%]; 112 events, 37·6-52·0), excessive fatigue (45 [25%]; 56 events, 19·4-32·0), and myalgia (45 [25%]; 57 events, 19·4-32·0). A similar safety and tolerability profile was observed between adjuvanted and non-adjuvanted formulations. The majority of solicited adverse events were mild or moderate. VLA15 was immunogenic for all OspA serotypes with higher immune responses induced in the adjuvanted higher dose groups (geometric mean titre range 90 μg with alum 61·3 U/mL-321·7 U/mL vs 23·8 U/mL-111·5 U/mL at 90 μg without alum). INTERPRETATION This novel multivalent vaccine candidate against Lyme borreliosis was safe and immunogenic and paves the way to further clinical development. FUNDING Valneva Austria.
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Affiliation(s)
- Nicole Bézay
- Valneva Austria, Campus Vienna Biocenter 3, Vienna, Austria
| | | | - Vera Kadlecek
- Valneva Austria, Campus Vienna Biocenter 3, Vienna, Austria
| | - Nina Wressnigg
- Valneva Austria, Campus Vienna Biocenter 3, Vienna, Austria
| | | | - Anton Klingler
- Assign Data Management and Biostatistics, Innsbruck, Austria
| | | | | | - Isabel Leroux-Roels
- Center for Vaccinology (CEVAC), Ghent University Hospital, 9000 Ghent, Belgium
| | - Geert Leroux-Roels
- Center for Vaccinology (CEVAC), Ghent University Hospital, 9000 Ghent, Belgium
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12
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Hajdusek O, Perner J. VLA15, a new global Lyme disease vaccine undergoes clinical trials. Lancet Infect Dis 2023; 23:1105-1106. [PMID: 37419127 DOI: 10.1016/s1473-3099(23)00312-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Ondrej Hajdusek
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, Ceske Budejovice 37005, Czech Republic.
| | - Jan Perner
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, Ceske Budejovice 37005, Czech Republic
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13
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Zając V, Sroka J, Wójcik-Fatla A. Knowledge, protection behaviours and seroprevalence of Lyme borreliosis in inhabitants of Lublin Province, eastern Poland - evaluation of a prophylaxis programme. Ann Agric Environ Med 2023; 30:413-424. [PMID: 37772517 DOI: 10.26444/aaem/171331] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
INTRODUCTION AND OBJECTIVE Lyme borreliosis (LB) is the most frequent tick-borne disease with 17,338 cases reported in Poland in 2022. Since research on a LB vaccine is still ongoing, the promotion of individual behaviours and limiting of tick exposure is one of the most effective ways to prevent LB. The aim of the study was to evaluate the effectiveness of the LB prevention programme by assessing the knowledge, practice behaviours, seroprevalence of LB and satisfaction among the population of the Lublin Province in eastern Poland. MATERIAL AND METHODS The prevention programme was carried out among 2,920 participants who were asked about their exposure to ticks, history of LB and prevention behaviours. Awareness of knowledge was evaluated before and after training. Seroprevalence of LB was rated by ELISA and immunoblot assays. RESULTS Over 73% of participants reported tick bites in their lifetime, without significant differences between rural and urban area inhabitants. More than 80% of individuals declared that they use protective measures (PPM), such as proper clothes and body checking; repellents were the least frequently used by participants. The diagnosis of LB but not tick bites in a lifetime influenced the more frequent use of PPM. Increase in knowledge was observed in 86% of participants after education, and the highest knowledge was noted among respondents with higher education. The seroprevalence of anti-B. burgdorferi antibodies was 37% and was higher among men than women (40% vs. 36%). CONCLUSIONS The population of Lublin Province is highly exposed to tick bites and infection with B. burgdorferi. The high seroprevalence and increase in knowledge confirmed the effectiveness and need for preventive programmes. These results can be useful for optimizing and enhancing the effects of future prevention campaigns.
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Affiliation(s)
- Violetta Zając
- Department of Health Biohazards and Parasitology, Institute of Rural Health, Lublin, Poland
| | - Jacek Sroka
- Department of Health Biohazards and Parasitology, Institute of Rural Health, Lublin, Poland
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Puławy, Poland
| | - Angelina Wójcik-Fatla
- Department of Health Biohazards and Parasitology, Institute of Rural Health, Lublin, Poland
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14
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Pine M, Arora G, Hart TM, Bettini E, Gaudette BT, Muramatsu H, Tombácz I, Kambayashi T, Tam YK, Brisson D, Allman D, Locci M, Weissman D, Fikrig E, Pardi N. Development of an mRNA-lipid nanoparticle vaccine against Lyme disease. Mol Ther 2023; 31:2702-2714. [PMID: 37533256 PMCID: PMC10492027 DOI: 10.1016/j.ymthe.2023.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/02/2023] [Revised: 05/19/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
Lyme disease is the most common vector-borne infectious disease in the United States, in part because a vaccine against it is not currently available for humans. We propose utilizing the lipid nanoparticle-encapsulated nucleoside-modified mRNA (mRNA-LNP) platform to generate a Lyme disease vaccine like the successful clinical vaccines against SARS-CoV-2. Of the antigens expressed by Borrelia burgdorferi, the causative agent of Lyme disease, outer surface protein A (OspA) is the most promising candidate for vaccine development. We have designed and synthesized an OspA-encoding mRNA-LNP vaccine and compared its immunogenicity and protective efficacy to an alum-adjuvanted OspA protein subunit vaccine. OspA mRNA-LNP induced superior humoral and cell-mediated immune responses in mice after a single immunization. These potent immune responses resulted in protection against bacterial infection. Our study demonstrates that highly efficient mRNA vaccines can be developed against bacterial targets.
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Affiliation(s)
- Matthew Pine
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Gunjan Arora
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Thomas M Hart
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Emily Bettini
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Brian T Gaudette
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hiromi Muramatsu
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - István Tombácz
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Taku Kambayashi
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ying K Tam
- Acuitas Therapeutics, Vancouver, BC, Canada
| | - Dustin Brisson
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David Allman
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Michela Locci
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Drew Weissman
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Norbert Pardi
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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de la Fuente J, Estrada-Peña A, Gortázar C, Vaz-Rodrigues R, Sánchez I, Carrión Tudela J. Citizen Science on Lyme Borreliosis in Spain Reveals Disease-Associated Risk Factors and Control Interventions. Vector Borne Zoonotic Dis 2023; 23:441-446. [PMID: 37462912 DOI: 10.1089/vbz.2023.0016] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Background: Lyme borreliosis (LB) caused by Borrelia burgdorferi sensu lato complex spirochetes is one of the tick-borne diseases with high prevalence and social/economic burden in the United States, Spain, and other European countries. The objective is to address limited information available about the incidence, prevalence, and symptoms of LB, current prevention, and treatment interventions that are not adequately focused and thus not very effective against this disease. Methods: To address these limitations, in this study, we used a citizen science approach to evaluate the LB-associated risks and implementation of control interventions in Spain. A total of 405 participants in the survey were included in the analysis. Responses to the questionnaire were received during January-July 2022. The questionnaire contained qualitative and quantitative questions. Homogeneity among binary variables was analyzed using a Fisher's exact test. Results: Despite limitations of the study associated with response to the questionnaire and information on tick species, the results evidenced the effect of factors such as age, gender, tick bites, disease clinical signs, comorbidities such as alpha-gal syndrome, health care services, and treatment effectiveness affecting LB. Conclusions: The main conclusions of the study highlight the need for better surveillance of tick infestations, pathogen infection, and diagnosis of LB and related comorbidities. To advance in disease prevention, diagnosis, and treatment, new interventions need to be developed and implemented in both public and private health care services. Providing access to these results to the society, health care system, and scientists is important to further advance in disease surveillance, diagnosis, control, and prevention.
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Affiliation(s)
- José de la Fuente
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Agustín Estrada-Peña
- Department of Animal Health, Faculty of Veterinary Medicine, Zaragoza, Spain
- Group of Research on Emerging Zoonoses, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - Christian Gortázar
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain
| | - Rita Vaz-Rodrigues
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain
| | - Isabel Sánchez
- Asociación de Enfermedades Raras D'Genes, Totana-Murcia, Spain
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Martin AM, Buttke D, Raphael J, Taylor K, Maes S, Parise CM, Ginsberg HS, Cross PC. Deer management generally reduces densities of nymphal Ixodes scapularis, but not prevalence of infection with Borrelia burgdorferi sensu stricto. Ticks Tick Borne Dis 2023; 14:102202. [PMID: 37244157 DOI: 10.1016/j.ttbdis.2023.102202] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
Human Lyme disease-primarily caused by the bacterium Borrelia burgdorferi sensu stricto (s.s.) in North America-is the most common vector-borne disease in the United States. Research on risk mitigation strategies during the last three decades has emphasized methods to reduce densities of the primary vector in eastern North America, the blacklegged tick (Ixodes scapularis). Controlling white-tailed deer populations has been considered a potential method for reducing tick densities, as white-tailed deer are important hosts for blacklegged tick reproduction. However, the feasibility and efficacy of white-tailed deer management to impact acarological risk of encountering infected ticks (namely, density of host-seeking infected nymphs; DIN) is unclear. We investigated the effect of white-tailed deer density and management on the density of host-seeking nymphs and B. burgdorferi s.s. infection prevalence using surveillance data from eight national parks and park regions in the eastern United States from 2014-2022. We found that deer density was significantly positively correlated with the density of nymphs (nymph density increased by 49% with a 1 standard deviation increase in deer density) but was not strongly correlated with the prevalence of B. burgdorferi s.s. infection in nymphal ticks. Further, while white-tailed deer reduction efforts were followed by a decrease in the density of I. scapularis nymphs in parks, deer removal had variable effects on B. burgdorferi s.s. infection prevalence, with some parks experiencing slight declines and others slight increases in prevalence. Our findings suggest that managing white-tailed deer densities alone may not be effective in reducing DIN in all situations but may be a useful tool when implemented in integrated management regimes.
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Affiliation(s)
- Alynn M Martin
- Caesar Kleberg Wildlife Research Institute, Texas A&M University - Kingsville, Kingsville, TX, 78363, USA; US Geological Survey, Northern Rocky Mountain Science Center, 2327 University Way, Suite #2, Bozeman, MT, 59715 USA.
| | | | - Jordan Raphael
- US National Park Service, Fire Island National Seashore, Patchogue, NY, 11772 USA
| | - Kelsey Taylor
- US National Park Service, Fire Island National Seashore, Patchogue, NY, 11772 USA
| | - Sarah Maes
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521
| | - Christina M Parise
- Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521
| | - Howard S Ginsberg
- U.S. Geological Survey, Eastern Ecological Science Center, Woodward Hall-PSE, University of Rhode Island, Kingston, RI, 02881 USA
| | - Paul C Cross
- US Geological Survey, Northern Rocky Mountain Science Center, 2327 University Way, Suite #2, Bozeman, MT, 59715 USA
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17
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Hansen MF, Sørensen PK, Sørensen AE, Krogfelt KA. Can protection motivation theory predict protective behavior against ticks? BMC Public Health 2023; 23:1214. [PMID: 37349761 PMCID: PMC10286392 DOI: 10.1186/s12889-023-16125-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/14/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Cases of reported tick-borne diseases in humans have increased over the past decades. Strategies informing the public about ticks, their associated diseases, and preventive measures are often highlighted as important in limiting pathogen transfer and disease. However, knowledge about the motivation for people to apply preventative measures is sparse. METHODS The aim was to examine if Protection Motivation Theory, a model of disease prevention and health promotion, can predict the use of protective measures against ticks. Ordinal logistic regression and Chi-square tests were used on data from a cross-sectional survey with respondents from Denmark, Norway, and Sweden (n = 2658). We examined the effect of (1) the perceived seriousness of tick bites, Lyme borreliosis (LB), and tick-borne encephalitis (TBE), and (2) the perceived probability of getting a tick bite, Lyme borreliosis, and tick-borne encephalitis on protection against ticks. Finally, we examined if there was an association between the use of a protective measure and the perceived efficacy of that measure. RESULTS The perceived seriousness of a tick bite and LB significantly predict who is more likely to apply protective measures for all three countries combined. The perceived seriousness of TBE did not significantly predict the level of adoption of protective measures applied by respondents. The perceived likelihood of getting a tick bite within the next 12 months and the perceived likelihood of getting LB if bitten by a tick significantly predicted the application of protective measures. However, the increases in the likelihood of protection were very small. The application of a certain type of protection was always correlated with the perceived efficacy of the same protective measure. CONCLUSION Some variables of PMT may be used to predict the level of adoption of protection applied against ticks and tick-borne diseases. We found that the perceived seriousness of a tick bite and LB significantly predict the level of adoption protection. The perceived likelihood of getting a tick bite or LB also significantly predicted the level of adoption of protection, although the change was very small. The results regarding TBE were less clear. Lastly, there was an association between applying a protective measure and the perceived efficacy of the same measure.
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Affiliation(s)
- Mette Frimodt Hansen
- Department of Science and Environment, Roskilde University, Universitetsvej 1, Roskilde, DK-4100 Denmark
| | - Pelle Korsbaek Sørensen
- Research Centre for Health Promotion, Roskilde University, Roskilde, Denmark
- Research and Development, Centre for Nursing, University College Absalon, Roskilde, Denmark
| | - Anja Elaine Sørensen
- Department of Science and Environment, Roskilde University, Universitetsvej 1, Roskilde, DK-4100 Denmark
| | - Karen Angeliki Krogfelt
- Department of Science and Environment, Roskilde University, Universitetsvej 1, Roskilde, DK-4100 Denmark
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Vannier E, Richer LM, Dinh DM, Brisson D, Ostfeld RS, Gomes-Solecki M. Deployment of a Reservoir-Targeted Vaccine Against Borrelia burgdorferi Reduces the Prevalence of Babesia microti Coinfection in Ixodes scapularis Ticks. J Infect Dis 2023; 227:1127-1131. [PMID: 36416014 PMCID: PMC10175066 DOI: 10.1093/infdis/jiac462] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
In the Northeast and upper Midwest of the United States, Babesia microti and Borrelia burgdorferi use Ixodes scapularis ticks as vector and Peromyscus leucopus mice as major reservoir host. We previously established, in a 5-year field trial, that a reservoir-targeted outer surface protein A vaccine reduces the prevalence of B. burgdorferi-infected ticks. We accessed ticks and mouse blood samples collected during the trial, extracted total DNA, and amplified the B. microti 18S rRNA gene. Vaccine deployment reduced the prevalence of ticks coinfected with B. microti and that of mice infected with B. microti. Breaking the enzootic cycle of B. burgdorferi may reduce the incidence of babesiosis.
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Affiliation(s)
- Edouard Vannier
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
| | - Luciana M Richer
- Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Duy M Dinh
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA
| | - Dustin Brisson
- Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Maria Gomes-Solecki
- Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Ostfeld RS, Mowry S, Bremer W, Duerr S, Evans AS, Fischhoff IR, Hinckley AF, Hook SA, Keating F, Pendleton J, Pfister A, Teator M, Keesing F. Impacts Over Time of Neighborhood-Scale Interventions to Control Ticks and Tick-Borne Disease Incidence. Vector Borne Zoonotic Dis 2023; 23:89-105. [PMID: 36848248 PMCID: PMC9993163 DOI: 10.1089/vbz.2022.0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Background: Controlling populations of ticks with biological or chemical acaricides is often advocated as a means of reducing human exposure to tick-borne diseases. Reducing tick abundance is expected to decrease immediate risk of tick encounters and disrupt pathogen transmission cycles, potentially reducing future exposure risk. Materials and Methods: We designed a placebo-controlled, randomized multiyear study to assess whether two methods of controlling ticks-tick control system (TCS) bait boxes and Met52 spray-reduced tick abundance, tick encounters with people and outdoor pets, and reported cases of tick-borne diseases. The study was conducted in 24 residential neighborhoods in a Lyme disease endemic zone in New York State. We tested the hypotheses that TCS bait boxes and Met52, alone or together, would be associated with increasing reductions in tick abundance, tick encounters, and cases of tick-borne disease over the 4-5 years of the study. Results: In neighborhoods with active TCS bait boxes, populations of blacklegged ticks (Ixodes scapularis) were not reduced over time in any of the three habitat types tested (forest, lawn, shrub/garden). There was no significant effect of Met52 on tick abundance overall, and there was no evidence for a compounding effect over time. Similarly, we observed no significant effect of either of the two tick control methods, used singly or together, on tick encounters or on reported cases of tick-borne diseases in humans overall, and there was no compounding effect over time. Thus, our hypothesis that effects of interventions would accumulate through time was not supported. Conclusions: The apparent inability of the selected tick control methods to reduce risk and incidence of tick-borne diseases after years of use requires further consideration.
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Affiliation(s)
| | - Stacy Mowry
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
| | - William Bremer
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
| | - Shannon Duerr
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
| | - Andrew S. Evans
- Department of Behavioral and Community Health, Dutchess County, Poughkeepsie, New York, USA
| | | | | | - Sarah A. Hook
- Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Fiona Keating
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
| | | | - Ashley Pfister
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
| | - Marissa Teator
- Cary Institute of Ecosystem Studies, Millbrook, New York, USA
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Trentelman JJA, de Vogel FA, Colstrup E, Sima R, Coumou J, Koetsveld J, Klouwens MJ, Nayak A, Ersoz J, Barriales D, Tomás-Cortázar J, Narasimhan S, Hajdusek O, Anguita J, Hovius JW. Identification of novel conserved Ixodes vaccine candidates; a promising role for non-secreted salivary gland proteins. Vaccine 2022; 40:7593-7603. [PMID: 36357287 DOI: 10.1016/j.vaccine.2022.10.032] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022]
Abstract
Ixodes ricinus and Ixodes scapularis are the main vectors for the causative agents of Lyme borreliosis and a wide range of other pathogens. Repeated tick-bites are known to lead to tick rejection; a phenomenon designated as tick immunity. Tick immunity is mainly directed against tick salivary gland proteins (TSGPs) and has been shown to partially protect against experimental Lyme borreliosis. TSGPs recognized by antibodies from tick immune animals could therefore be interesting candidates for an anti-tick vaccine, which might also block pathogen transmission. To identify conserved Ixodes TSGPs that could serve as a universal anti-tick vaccine in both Europe and the US, a Yeast Surface Display containing salivary gland genes of nymphal I. ricinus expressed at 24, 48 and 72 h into tick feeding was probed with either sera from rabbits repeatedly exposed for 24 h to I. ricinus nymphal ticks and/or sera from rabbits immune to I. scapularis. Thus, we identified thirteen TSGP vaccine candidates, of which ten were secreted. For vaccination studies in rabbits, we selected six secreted TSGPs, five full length and one conserved peptide. None of these proteins hampered tick feeding. In contrast, vaccination of guinea pigs with four non-secreted TSGPs - two from the current and two from a previous human immunoscreening - did significantly reduce tick attachment and feeding. Therefore, non-secreted TSGPs appear to be involved in the development of tick immunity and are interesting candidates for an anti-tick vaccine.
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Affiliation(s)
- Jos J A Trentelman
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| | - Fons A de Vogel
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Emil Colstrup
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Radek Sima
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, Ceske Budejovice, Czech Republic; Biopticka laborator s.r.o., Plzen, Czech Republic
| | - Jeroen Coumou
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Joris Koetsveld
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Michelle J Klouwens
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Abhijeet Nayak
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jasmin Ersoz
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Diego Barriales
- CIC bioGUNE-Basque Research & Technology Alliance, Derio 48160, Spain
| | - Julen Tomás-Cortázar
- CIC bioGUNE-Basque Research & Technology Alliance, Derio 48160, Spain; UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Sukanya Narasimhan
- Section of Infectious Diseases, Department of Internal Medicine, Yale University, New Haven, CT, USA
| | - Ondrej Hajdusek
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, Ceske Budejovice, Czech Republic
| | - Juan Anguita
- CIC bioGUNE-Basque Research & Technology Alliance, Derio 48160, Spain; Ikerbasque, Basque Foundation for Science, Bilbao 48012, Spain
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine, Amsterdam Infection and Immunity, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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21
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Pelletier J, Rocheleau JP, Aenishaenslin C, Dimitri Masson G, Lindsay LR, Ogden NH, Bouchard C, Leighton PA. Fluralaner Baits Reduce the Infestation of Peromyscus spp. Mice (Rodentia: Cricetidae) by Ixodes scapularis (Acari: Ixodidae) Larvae and Nymphs in a Natural Environment. J Med Entomol 2022; 59:2080-2089. [PMID: 35980603 DOI: 10.1093/jme/tjac106] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Indexed: 06/15/2023]
Abstract
The development of interventions that reduce Lyme disease incidence remains a challenge. Reservoir-targeted approaches aiming to reduce tick densities or tick infection prevalence with Borrelia burgdorferi have emerged as promising ways to reduce the density of infected ticks. Acaricides of the isoxazoline family offer high potential for reducing infestation of ticks on small mammals as they have high efficacy at killing feeding ticks for a long period. Fluralaner baits were recently demonstrated as effective, in the laboratory, at killing Ixodes scapularis larvae infesting Peromyscus mice, the main reservoir for B. burgdorferi in northeastern North America. Here, effectiveness of this approach for reducing the infestation of small mammals by immature stages of I. scapularis was tested in a natural environment. Two densities of fluralaner baits (2.1 baits/1,000 m2 and 4.4 baits/1,000 m2) were used during three years in forest plots. The number of I. scapularis larvae and nymphs per mouse from treated and control plots were compared. Fluralaner baiting reduced the number of larvae per mouse by 68% (CI95: 51-79%) at 2.1 baits/1,000 m2 and by 86% (CI95: 77-92%) at 4.4 baits/1,000 m2. The number of nymphs per mouse was reduced by 72% (CI95: 22-90%) at 4.4 baits/1,000 m2 but was not significantly reduced at 2.1 baits/1,000 m2. Reduction of Peromyscus mouse infestation by immature stages of I. scapularis supports the hypothesis that an approach targeting reservoirs of B. burgdorferi with isoxazolines has the potential to reduce tick-borne disease risk by decreasing the density of infected ticks in the environment.
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Affiliation(s)
- Jérôme Pelletier
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Jean-Philippe Rocheleau
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Département de santé animale, CÉGEP de Saint-Hyacinthe, Saint-Hyacinthe, Québec, Canada
| | - Cécile Aenishaenslin
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Gabrielle Dimitri Masson
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - L Robbin Lindsay
- One Health Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nicholas H Ogden
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
| | - Catherine Bouchard
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
| | - Patrick A Leighton
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
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22
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Kugeler KJ, Cervantes K, Brown CM, Horiuchi K, Schiffman E, Lind L, Barkley J, Broyhill J, Murphy J, Crum D, Robinson S, Kwit NA, Mullins J, Sun J, Hinckley AF. Potential quantitative effect of a laboratory-based approach to Lyme disease surveillance in high-incidence states. Zoonoses Public Health 2022; 69:451-457. [PMID: 35253377 PMCID: PMC10949917 DOI: 10.1111/zph.12933] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 11/26/2022]
Abstract
Historically, public health surveillance for Lyme disease has required clinical follow-up on positive laboratory reports for the purpose of case classification. In areas with sustained high incidence of the disease, this resource-intensive activity yields a limited benefit to public health practice. A range of burden-reducing strategies have been implemented in many states, creating inconsistencies that limit the ability to decipher trends. Laboratory-based surveillance, or surveillance based solely on positive laboratory reports without follow-up for clinical information on positive laboratory reports, emerged as a feasible alternative to improve standardization in already high-incidence areas. To inform expectations of a laboratory-based surveillance model, we conducted a retrospective analysis of Lyme disease data collected during 2012-2018 from 10 high-incidence states. The number of individuals with laboratory evidence of infection ranged from 1302 to 20,994 per state and year. On average, 55% of those were ultimately classified as confirmed or probable cases (range: 29%-86%). Among all individuals with positive laboratory evidence, 18% (range: 2%-37%) were determined to be 'not a case' upon investigation and 23% (range: 2%-52%) were classified as suspect cases due to lack of associated clinical information and thus were not reported to the Centers for Disease Control and Prevention (CDC). The number of reported cases under a laboratory-based approach to surveillance in high-incidence states using recommended two-tier testing algorithms is likely to be, on average, 1.2 times higher (range: 0.6-1.8 times) than what was reported to CDC during 2012-2018. A laboratory-based surveillance approach for high-incidence states will improve standardization and reduce burden on public health systems, allowing public health resources to focus on prevention messaging, exploration of novel prevention strategies and alternative data sources to yield information on the epidemiology of Lyme disease.
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Affiliation(s)
- Kiersten J. Kugeler
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Kim Cervantes
- New Jersey Department of Health, Trenton, New Jersey, USA
| | | | - Kalanthe Horiuchi
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | | | - Leah Lind
- Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA
| | - Jonathan Barkley
- Rhode Island Department of Health, Providence, Rhode Island, USA
| | | | - Julia Murphy
- Virginia Department of Health, Richmond, Virginia, USA
| | - David Crum
- Maryland Department of Health, Baltimore, Maryland, USA
| | - Sara Robinson
- Maine Center for Disease Control and Prevention, Augusta, Maine, USA
| | | | - Jocelyn Mullins
- Connecticut Department of Health, Hartford, Connecticut, USA
| | - Jianxin Sun
- Connecticut Department of Health, Hartford, Connecticut, USA
| | - Alison F. Hinckley
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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23
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Connally NP, Rowe A, Kaufman A, Meek JI, Niesobecki SA, Hansen AP, White J, Nawrocki C, Foster E, Hinckley AF, Eisen L. Designing an Intervention Trial of Human-Tick Encounters and Tick-Borne Diseases in Residential Settings Using 4-Poster Devices to Control Ixodes scapularis (Acari: Ixodidae): Challenges for Site Selection and Device Placement. J Med Entomol 2022; 59:911-921. [PMID: 35294011 PMCID: PMC10903785 DOI: 10.1093/jme/tjac027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/28/2021] [Indexed: 06/14/2023]
Abstract
Blacklegged ticks, Ixodes scapularis Say, transmit Lyme disease spirochetes and other human pathogens in the eastern United States. White-tailed deer (Odocoileus virginianus) are key reproductive hosts for I. scapularis adults, and therefore control methods targeting deer have the potential for landscape-wide tick suppression. A topical acaricide product, containing 10% permethrin, is self-applied by deer to kill parasitizing ticks when they visit 4-Poster Tick Control Deer Feeders (hereafter, 4-Posters) Previous 4-Poster intervention studies, including in residential settings, demonstrated suppression of I. scapularis populations but did not include human-based outcomes. To prepare for a proposed 4-Poster intervention trial in residential areas of Connecticut and New York that would include human-tick encounters and tick-borne diseases as outcomes, we sought to identify areas (study clusters) in the 80-100 ha size range and specific locations within these areas where 4-Poster devices could be deployed at adequate density (1 device per 20-25 ha) and in accordance with regulatory requirements. Geographic Information System-based data were used to identify prospective study clusters, based on minimum thresholds for Lyme disease incidence, population density, and forest cover. Ground truthing of potential 4-Poster placement locations was done to confirm the suitability of selected clusters. Based on these efforts, we failed to identify more than a few residential areas fulfilling all criteria for a treatment cluster. We, therefore, reconsidered pursuing the intervention trial, which required inclusion of >30 treatment clusters to achieve adequate statistical power. The 4-Poster methodology may be more readily evaluated in natural or public areas than in residential settings in NY or CT.
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Affiliation(s)
- Neeta P. Connally
- Department of Biological & Environmental Sciences, Western Connecticut State University, Danbury, CT, USA
| | - Adam Rowe
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Alison Kaufman
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - James I. Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Sara A. Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Amberjean P. Hansen
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Jennifer White
- Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY, USA
| | - Courtney Nawrocki
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Erik Foster
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Alison F. Hinckley
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Lars Eisen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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24
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Johnson N, Phipps LP, Hansford KM, Folly AJ, Fooks AR, Medlock JM, Mansfield KL. One Health Approach to Tick and Tick-Borne Disease Surveillance in the United Kingdom. Int J Environ Res Public Health 2022; 19:ijerph19105833. [PMID: 35627370 PMCID: PMC9142090 DOI: 10.3390/ijerph19105833] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022]
Abstract
Where ticks are found, tick-borne diseases can present a threat to human and animal health. The aetiology of many of these important diseases, including Lyme disease, bovine babesiosis, tick-borne fever and louping ill, have been known for decades whilst others have only recently been documented in the United Kingdom (UK). Further threats such as the importation of exotic ticks through human activity or bird migration, combined with changes to either the habitat or climate could increase the risk of tick-borne disease persistence and transmission. Prevention of tick-borne diseases for the human population and animals (both livestock and companion) is dependent on a thorough understanding of where and when pathogen transmission occurs. This information can only be gained through surveillance that seeks to identify where tick populations are distributed, which pathogens are present within those populations, and the periods of the year when ticks are active. To achieve this, a variety of approaches can be applied to enhance knowledge utilising a diverse range of stakeholders (public health professionals and veterinarians through to citizen scientists). Without this information, the application of mitigation strategies to reduce pathogen transmission and impact is compromised and the ability to monitor the effects of climate change or landscape modification on the risk of tick-borne disease is more challenging. However, as with many public and animal health interventions, there needs to be a cost-benefit assessment on the most appropriate intervention applied. This review will assess the challenges of tick-borne diseases in the UK and argue for a cross-disciplinary approach to their surveillance and control.
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Affiliation(s)
- Nicholas Johnson
- Vector-Borne Diseases, Virology Department, Animal and Plant Health Agency (APHA), Woodham Lane, Surrey KT15 3NB, UK; (L.P.P.); (A.J.F.); (K.L.M.)
- Correspondence:
| | - Lawrence Paul Phipps
- Vector-Borne Diseases, Virology Department, Animal and Plant Health Agency (APHA), Woodham Lane, Surrey KT15 3NB, UK; (L.P.P.); (A.J.F.); (K.L.M.)
| | - Kayleigh M. Hansford
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, Porton Down SP4 0JG, UK; (K.M.H.); (J.M.M.)
| | - Arran J. Folly
- Vector-Borne Diseases, Virology Department, Animal and Plant Health Agency (APHA), Woodham Lane, Surrey KT15 3NB, UK; (L.P.P.); (A.J.F.); (K.L.M.)
| | - Anthony R. Fooks
- International Development Team, Animal and Plant Health Agency (APHA), Woodham Lane, Surrey KT15 3NB, UK;
| | - Jolyon M. Medlock
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, Porton Down SP4 0JG, UK; (K.M.H.); (J.M.M.)
| | - Karen L. Mansfield
- Vector-Borne Diseases, Virology Department, Animal and Plant Health Agency (APHA), Woodham Lane, Surrey KT15 3NB, UK; (L.P.P.); (A.J.F.); (K.L.M.)
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25
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Beck A, Bjork J, Biggerstaff BJ, Eisen L, Eisen R, Foster E, Signs K, Tsao JI, Kough E, Peterson M, Schiffman E, Muganda CP, Osborn R, Wozniak R, Bron GM, Phaneuf D, Smith D, Bartholomay L, Paskewitz S, Hinckley AF. Knowledge, attitudes, and behaviors regarding tick-borne disease prevention in Lyme disease-endemic areas of the Upper Midwest, United States. Ticks Tick Borne Dis 2022; 13:101925. [PMID: 35255349 PMCID: PMC10947721 DOI: 10.1016/j.ttbdis.2022.101925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/22/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
Lyme disease and other tick-borne diseases are a major public health threat in the Upper Midwestern United States, including Michigan, Minnesota, and Wisconsin. To prevent tick bites and tick-borne diseases, public health officials commonly recommend personal protective measures and property management techniques. Adoption of tick-borne disease prevention behaviors and practices by individuals are, however, highly variable. We aimed to characterize current tick-borne disease knowledge, attitudes, and prevention behaviors (KAB) practiced by the public in these states, as well as their willingness to use specific tick control methods. We conducted a population-based survey in summer 2019 in 48 high-risk counties (those having a five-year average (2013-2017) Lyme disease incidence of ≥ 10 cases per 100,000 persons per year), in Michigan, Minnesota, and Wisconsin. A total of 2713 surveys were analyzed; survey weights were used to account for household selection probability and post-stratified to match county-level joint age and sex population distributions in population-level inference. An estimated 98% of the population had heard of Lyme disease, with most perceiving it as very or extremely serious (91%); however, only an estimated 25% perceived tick-borne diseases as very or extremely common in their community. Among those who spent time in places with ticks from April through October, an estimated 68% check themselves thoroughly for ticks most of the time or always and 43% use bug repellent on skin or clothing most of the time or always. An estimated 13% of the population had ever treated their property with a pesticide to kill ticks, and 3% had ever used devices that apply pesticide to rodents to kill ticks on their property. Willingness to practice tick bite prevention behaviors, however, was estimated to be much higher; with 82% being willing to perform tick checks at least once a day, and more than 60% willing to use bug repellent, tick control products on pets, or to bathe within two hours of being outdoors. We found that residents would likely be willing to support a county-wide tick control program to reduce the risk of tick-borne disease in their community (81%) or to apply tick control products to their property to reduce the risk of tick-borne disease in their household (79%). Tick checks were more likely to be practiced among participants who perceived tick-borne diseases to be highly prevalent in their community, if they or a household member had been previously diagnosed with a tick-borne disease?, or if they perceived tick exposure to be likely around their home, cabin, or vacation home. In addition, property-based tick control methods were associated with perceived risk of encountering ticks around the home, cabin, or vacation home. Participants who had seen information from state health departments were also more likely to practice preventive measures. The most common reported barriers to using any of these methods were forgetfulness, safety concerns, and lack of awareness. Our survey findings shed light on how residents from these Upper Midwest states may adopt tick control and tick bite prevention measures and how public health outreach may be most effective for this population.
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Affiliation(s)
- Alyssa Beck
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Jenna Bjork
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Lars Eisen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Rebecca Eisen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Erik Foster
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Kimberly Signs
- Michigan Department of Health and Human Services, 333 South Grand Avenue, South Grand Building, Lansing, MI 48933, United States
| | - Jean I Tsao
- Michigan State University, Department of Fisheries and Wildlife and Department of Large Animal Clinical Sciences, 480 Wilson Road, Natural Resources Building, East Lansing, MI 48824, United States
| | - Erin Kough
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Molly Peterson
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Elizabeth Schiffman
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Christine P Muganda
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Rebecca Osborn
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Ryan Wozniak
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Gebbiena M Bron
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Daniel Phaneuf
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Danielle Smith
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Lyric Bartholomay
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Susan Paskewitz
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States.
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26
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Keesing F, Mowry S, Bremer W, Duerr S, Evans AS, Fischhoff IR, Hinckley AF, Hook SA, Keating F, Pendleton J, Pfister A, Teator M, Ostfeld RS. Effects of Tick-Control Interventions on Tick Abundance, Human Encounters with Ticks, and Incidence of Tickborne Diseases in Residential Neighborhoods, New York, USA. Emerg Infect Dis 2022; 28:957-966. [PMID: 35447066 PMCID: PMC9045441 DOI: 10.3201/eid2805.211146] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 01/01/2023] Open
Abstract
Tickborne diseases (TBDs) such as Lyme disease result in ≈500,000 diagnoses annually in the United States. Various methods can reduce the abundance of ticks at small spatial scales, but whether these methods lower incidence of TBDs is poorly understood. We conducted a randomized, replicated, fully crossed, placebo-controlled, masked experiment to test whether 2 environmentally safe interventions, the Tick Control System (TCS) and Met52 fungal spray, used separately or together, affected risk for and incidence of TBDs in humans and pets in 24 residential neighborhoods. All participating properties in a neighborhood received the same treatment. TCS was associated with fewer questing ticks and fewer ticks feeding on rodents. The interventions did not result in a significant difference in incidence of human TBDs but did significantly reduce incidence in pets. Our study is consistent with previous evidence suggesting that reducing tick abundance in residential areas might not reduce incidence of TBDs in humans.
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Kontowicz E, Brown G, Torner J, Carrel M, Baker KK, Petersen CA. Inclusion of environmentally themed search terms improves Elastic net regression nowcasts of regional Lyme disease rates. PLoS One 2022; 17:e0251165. [PMID: 35271589 PMCID: PMC8912246 DOI: 10.1371/journal.pone.0251165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022] Open
Abstract
Lyme disease is the most widely reported vector-borne disease in the United States. 95% of confirmed human cases are reported in the Northeast and upper Midwest (25,778 total confirmed cases from Northeast and upper Midwest / 27,203 total US confirmed cases). Human cases typically occur in the spring and summer months when an infected nymph Ixodid tick takes a blood meal. Current federal surveillance strategies report data on an annual basis, leading to nearly a year lag in national data reporting. These lags in reporting make it difficult for public health agencies to assess and plan for the current burden of Lyme disease. Implementation of a nowcasting model, using historical data to predict current trends, provides a means for public health agencies to evaluate current Lyme disease burden and make timely priority-based budgeting decisions. The objective of the study was to develop and compare the performance of nowcasting models using free data from Google Trends and Centers of Disease Control and Prevention surveillance reports. We developed two sets of elastic net models for five regions of the United States: 1. Using only monthly proportional hit data from the 21 disease symptoms and tick related terms, and 2. Using monthly proportional hit data from terms identified via Google correlate and the disease symptom and vector terms. Elastic net models using the full-term list were highly accurate (Root Mean Square Error: 0.74, Mean Absolute Error: 0.52, R2: 0.97) for four of the five regions of the United States and improved accuracy 1.33-fold while reducing error 0.5-fold compared to predictions from models using disease symptom and vector terms alone. Many of the terms included and found to be important for model performance were environmentally related. These models can be implemented to help local and state public health agencies accurately monitor Lyme disease burden during times of reporting lag from federal public health reporting agencies.
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Affiliation(s)
- Eric Kontowicz
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa, United States of America
| | - Grant Brown
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
| | - James Torner
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
| | - Margaret Carrel
- Department of Geographical and Sustainability Sciences, College of Liberal Arts & Sciences, University of Iowa, Iowa City, Iowa, United States of America
| | - Kelly K. Baker
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, United States of America
| | - Christine A. Petersen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa, United States of America
- Immunology Program, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
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Nguyen CT, Cifu AS, Pitrak D. Prevention and Treatment of Lyme Disease. JAMA 2022; 327:772-773. [PMID: 35191942 DOI: 10.1001/jama.2021.25302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Di L, Akther S, Bezrucenkovas E, Ivanova L, Sulkow B, Wu B, Mneimneh S, Gomes-Solecki M, Qiu WG. Maximum antigen diversification in a lyme bacterial population and evolutionary strategies to overcome pathogen diversity. ISME J 2022; 16:447-464. [PMID: 34413477 PMCID: PMC8376116 DOI: 10.1038/s41396-021-01089-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 12/03/2022]
Abstract
Natural populations of pathogens and their hosts are engaged in an arms race in which the pathogens diversify to escape host immunity while the hosts evolve novel immunity. This co-evolutionary process poses a fundamental challenge to the development of broadly effective vaccines and diagnostics against a diversifying pathogen. Based on surveys of natural allele frequencies and experimental immunization of mice, we show high antigenic specificities of natural variants of the outer surface protein C (OspC), a dominant antigen of a Lyme Disease-causing bacterium (Borrelia burgdorferi). To overcome the challenge of OspC antigenic diversity to clinical development of preventive measures, we implemented a number of evolution-informed strategies to broaden OspC antigenic reactivity. In particular, the centroid algorithm-a genetic algorithm to generate sequences that minimize amino-acid differences with natural variants-generated synthetic OspC analogs with the greatest promise as diagnostic and vaccine candidates against diverse Lyme pathogen strains co-existing in the Northeast United States. Mechanistically, we propose a model of maximum antigen diversification (MAD) mediated by amino-acid variations distributed across the hypervariable regions on the OspC molecule. Under the MAD hypothesis, evolutionary centroids display broad cross-reactivity by occupying the central void in the antigenic space excavated by diversifying natural variants. In contrast to vaccine designs based on concatenated epitopes, the evolutionary algorithms generate analogs of natural antigens and are automated. The novel centroid algorithm and the evolutionary antigen designs based on consensus and ancestral sequences have broad implications for combating diversifying pathogens driven by pathogen-host co-evolution.
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Affiliation(s)
- Lia Di
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Saymon Akther
- Graduate Center, City University of New York, New York, NY, USA
| | - Edgaras Bezrucenkovas
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Larisa Ivanova
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
- Pediatrics Department, New York Medical College, Valhalla, NY, USA
| | - Brian Sulkow
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Bing Wu
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Saad Mneimneh
- Graduate Center, City University of New York, New York, NY, USA
- Department of Computer Science, Hunter College, City University of New York, New York, NY, USA
| | - Maria Gomes-Solecki
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Wei-Gang Qiu
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA.
- Graduate Center, City University of New York, New York, NY, USA.
- Department of Physiology and Biophysics & Institute for Computational Biomedicine, Weil Cornell Medical College, New York, NY, USA.
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Devchand R, Koehler L, Hook S, Marx GE, Hooks H, Schwartz A, Hinckley A. Understanding consumer and clinician perceptions of a potential Lyme disease vaccine. Health Educ Res 2022; 36:494-504. [PMID: 34529775 PMCID: PMC10911045 DOI: 10.1093/her/cyab032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/01/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Each year, over 450 000 Lyme disease diagnoses are estimated to occur in the United States, and current preventive measures have been insufficient to stem the rising incidence. An effective human Lyme disease vaccine could be a powerful intervention for population-level impact. In advance of new Lyme disease vaccines coming to market, this study explored barriers to acceptability and motivations for the uptake of a new Lyme disease vaccine. Researchers conducted 9 online focus groups among consumers who may potentially benefit from the vaccine and 30 in-depth interviews among clinician groups who may provide the vaccine. All participants were recruited from three US regions of high Lyme disease incidence. Researchers found that participants shared common motivators to either recommend (clinicians) or accept (consumers) a Lyme disease vaccine, largely driven by perceived benefits of the vaccine, the lack of current effective preventive measures and a greater peace of mind. The concern about the challenges associated with diagnosing and treating Lyme disease is a primary motivator for clinicians to recommend the vaccine, while the concern about getting Lyme disease is a primary motivator for consumers to desire the vaccine.
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Affiliation(s)
| | - Laura Koehler
- Hager Sharp, 1030 15th Street NW, Washington, DC 20005, USA
| | - Sarah Hook
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Grace E. Marx
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Holley Hooks
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Amy Schwartz
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Alison Hinckley
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
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Abstract
Arthropod vectors account for a number of animal and human diseases, posing substantial threats to health and safety on a global scale. Ticks are considered as one of the most prominent vectors, as they can parasitize almost any vertebrate class and transmit a multitude of infectious diseases, particularly ones that affect humans and domestic animals. While various tick species elicit different tick-borne infections in specific geographic regions, single species can have widespread effects, such as blacklegged ticks, which are widely distributed across the eastern United States and can transmit a variety of infections, including Lyme borreliosis, anaplasmosis, relapsing fever disease, ehrlichiosis, babesiosis, and Powassan virus disease. Despite increasing awareness about ticks as serious disease vectors, effective vaccines against most tick-borne infections are not available. Previously, the successful development of an anti-tick vaccine for use in veterinary animals was based on an 86-kDa midgut antigen from Rhipicephalus (formerly Boophilus) microplus ticks. Herein we describe the fundamentals of vaccine development using protein antigens as model vaccinogen candidates, beginning with the cloning, expression, and purification of recombinant proteins, host immunization, and the assessment of protective efficacy in laboratory settings using a tick-borne murine model of Lyme borreliosis.
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Affiliation(s)
- Chrysoula Kitsou
- Department of Veterinary Medicine, University of Maryland, College Park and Virginia-Maryland Regional College of Veterinary Medicine, College Park, MD, USA.
| | - Utpal Pal
- Department of Veterinary Medicine, University of Maryland, College Park and Virginia-Maryland Regional College of Veterinary Medicine, College Park, MD, USA.
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Thomas S. Structure-Based Design of Diagnostics and Vaccines for Lyme Disease. Methods Mol Biol 2022; 2410:411-422. [PMID: 34914060 DOI: 10.1007/978-1-0716-1884-4_21] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Changes in climate have increased the geographical range of insect vectors responsible for the transmission of several diseases. Lyme disease, caused by the bacterial pathogen Borrelia burgdorferi, has become recognized as the most prevalent arthropod-borne infection in the USA. It is transmitted to humans through the bite of infected blacklegged ticks. As yet, there are no commercial vaccines available that effectively provide protection against Lyme disease. Vaccination strategies involving use of subunit vaccines developed in many laboratories have been found to be less efficient in protecting against the disease. Hence, there is a need to develop powerful vaccines that provide robust protection against Borrelia. Recently, using the principle of structure-based design, we designed and developed novel diagnostics and vaccine candidates that protected against Lyme disease in animal models. This chapter describes design and development of peptides based on the principle of structure-based design for use in diagnostics and vaccines to protect against Lyme disease in an animal model.
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Affiliation(s)
- Sunil Thomas
- Lankenau Institute for Medical Research, Wynnewood, PA, USA.
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Zbrzeźniak J, Paradowska-Stankiewicz I. Lyme disease in Poland in 2020. Przegl Epidemiol 2022; 76:385-390. [PMID: 36524881 DOI: 10.32394/pe.76.36] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Lyme borreliosis, also known as Lyme disease, is a zoonotic disease transmitted by ticks. The infection occurs through a bite by a common tick (Ixodes ricinus). Due to the annual cycle of tick activity, mainly dependent on temperature, Lyme disease is seasonal. In certain cases, post-exposure prophylaxis may be indicated, while the vaccine is in phase III clinical trials. AIM OF THE STUDY The aim of the study is to assess the epidemiological situation of Lyme disease in Poland in 2020 compared to the situation in previous years. MATERIAL AND METHODS The epidemiological situation of Lyme disease in Poland was assessed on the basis of the data sent to NIPH NIH - NRI by voivodeship sanitary-epidemiological stations and published in the bulletin "Infectious diseases and poisoning in Poland in 2020". RESULTS In 2020, 12,934 Lyme borreliosis cases and 459 hospitalizations were registered which, compared to 2019, means a 37.3% decrease in morbidity and a 73% decrease in hospitalization. It may be related to the outbreak of the SARS-CoV-2 virus at the end of 2019, which reached Poland at the beginning of March 2020. It can be seen that in Q2, due to the lower activity of people due to the epidemic, the number of cases of Lyme disease was less than in Q1 (2,064 in Q2 compared to 2,253 in Q1). The decrease compared to 2019 also continued in the third and fourth quarter, by 28% and 49%, respectively. SUMMARY AND CONCLUSION The impact of the SARS-CoV-2 outbreak on the distribution of Lyme disease incidence is noticeable, in particular on the decrease in the overall number of cases during the year, as well as on hospitalization due to Lyme disease with the previously observed stabilization of the incidence. The pandemic could have influenced this state of affairs on various levels. The main reason was, of course, the introduction of the epidemic and the related restrictions (including reduced mobility), but it cannot be ruled out that the cause was not an excessive burden on the health care system and sanitary inspection (delay in registration of reports).
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Affiliation(s)
- Jakub Zbrzeźniak
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Iwona Paradowska-Stankiewicz
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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Ozdenerol E, Bingham-Byrne RM, Seboly JD. The Effects of Lifestyle on the Risk of Lyme Disease in the United States: Evaluation of Market Segmentation Systems in Prevention and Control Strategies. Int J Environ Res Public Health 2021; 18:12883. [PMID: 34948494 PMCID: PMC8702151 DOI: 10.3390/ijerph182412883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate lifestyles at risk of Lyme disease, and to geographically identify target populations/households at risk based on their lifestyle preferences. When coupled with geographically identified patient health information (e.g., incidence, diagnostics), lifestyle data provide a more solid base of information for directing public health objectives in minimizing the risk of Lyme disease and targeting populations with Lyme-disease-associated lifestyles. We used an ESRI Tapestry segmentation system that classifies U.S. neighborhoods into 67 unique segments based on their demographic and socioeconomic characteristics. These 67 segments are grouped within 14 larger "LifeModes" that have commonalities based on lifestyle and life stage. Our dataset contains variables denoting the dominant Tapestry segments within each U.S. county, along with annual Lyme disease incidence rates from 2000 through 2017, and the average incidence over these 18 years. K-means clustering was used to cluster counties based on yearly incidence rates for the years 2000-2017. We used analysis of variance (ANOVA) statistical testing to determine the association between Lyme disease incidence and LifeModes. We further determined that the LifeModes Affluent Estates, Upscale Avenues, GenXurban, and Cozy Country Living were associated with higher Lyme disease risk based on the results of analysis of means (ANOM) and Tukey's post hoc test, indicating that one of these LifeModes is the LifeMode with the greatest Lyme disease incidence rate. We further conducted trait analysis of the high-risk LifeModes to see which traits were related to higher Lyme disease incidence. Due to the extreme regional nature of Lyme disease incidence, we carried out our national-level analysis at the regional level. Significant differences were detected in incidence rates and LifeModes in individual regions. We mapped Lyme disease incidence with associated LifeModes in the Northeast, Southeast, Midcontinent, Rocky Mountain, and Southwest regions to reflect the location-dependent nature of the relationship between lifestyle and Lyme disease.
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Affiliation(s)
- Esra Ozdenerol
- Spatial Analysis and Geographic Education Laboratory, Department of Earth Sciences, University of Memphis, Memphis, TN 38152, USA;
| | - Rebecca Michelle Bingham-Byrne
- Spatial Analysis and Geographic Education Laboratory, Department of Earth Sciences, University of Memphis, Memphis, TN 38152, USA;
| | - Jacob Daniel Seboly
- Department of Geosciences, Mississippi State University, Starkville, MS 39762, USA;
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Curriero FC, Wychgram C, Rebman AW, Corrigan AE, Kvit A, Shields T, Aucott JN. The Lyme and Tickborne Disease Dashboard: A map-based resource to promote public health awareness and research collaboration. PLoS One 2021; 16:e0260122. [PMID: 34851988 PMCID: PMC8635336 DOI: 10.1371/journal.pone.0260122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/02/2021] [Indexed: 11/19/2022] Open
Abstract
With the incidence of Lyme and other tickborne diseases on the rise in the US and globally, there is a critical need for data-driven tools that communicate the magnitude of this problem and help guide public health responses. We present the Johns Hopkins Lyme and Tickborne Disease Dashboard (https://www.hopkinslymetracker.org/), a new tool that harnesses the power of geography to raise awareness and fuel research and scientific collaboration. The dashboard is unique in applying a geographic lens to tickborne diseases, aiming not only to become a global tracker of tickborne diseases but also to contextualize their complicated geography with a comprehensive set of maps and spatial data sets representing a One Health approach. We share our experience designing and implementing the dashboard, describe the main features, and discuss current limitations and future directions.
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Affiliation(s)
- Frank C. Curriero
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Cara Wychgram
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Alison W. Rebman
- Division of Rheumatology, Department of Medicine, Lyme Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Anne E. Corrigan
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Anton Kvit
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Timothy Shields
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - John N. Aucott
- Division of Rheumatology, Department of Medicine, Lyme Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Wadman M. To fight Lyme disease, vaccine targets ticks. Science 2021; 374:925. [PMID: 34793236 DOI: 10.1126/science.acx9658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Ticks fed poorly, transmitted pathogen less often to guinea pigs given mRNA vaccine
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Sajid A, Matias J, Arora G, Kurokawa C, DePonte K, Tang X, Lynn G, Wu MJ, Pal U, Strank NO, Pardi N, Narasimhan S, Weissman D, Fikrig E. mRNA vaccination induces tick resistance and prevents transmission of the Lyme disease agent. Sci Transl Med 2021; 13:eabj9827. [PMID: 34788080 DOI: 10.1126/scitranslmed.abj9827] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Ixodes scapularis ticks transmit many pathogens that cause human disease, including Borrelia burgdorferi. Acquired resistance to I. scapularis due to repeated tick exposure has the potential to prevent tick-borne infectious diseases, and salivary proteins have been postulated to contribute to this process. We examined the ability of lipid nanoparticle–containing nucleoside-modified mRNAs encoding 19 I. scapularis salivary proteins (19ISP) to enhance the recognition of a tick bite and diminish I. scapularis engorgement on a host and thereby prevent B. burgdorferi infection. Guinea pigs were immunized with a 19ISP mRNA vaccine and subsequently challenged with I. scapularis. Animals administered 19ISP developed erythema at the bite site shortly after ticks began to attach, and these ticks fed poorly, marked by early detachment and decreased engorgement weights. 19ISP immunization also impeded B. burgdorferi transmission in the guinea pigs. The effective induction of local redness early after I. scapularis attachment and the inability of the ticks to take a normal blood meal suggest that 19ISP may be used either alone or in conjunction with traditional pathogen-based vaccines for the prevention of Lyme disease, and potentially other tick-borne infections.
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Affiliation(s)
- Andaleeb Sajid
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Jaqueline Matias
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Gunjan Arora
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Cheyne Kurokawa
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Kathleen DePonte
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Xiaotian Tang
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Geoffrey Lynn
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Ming-Jie Wu
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Utpal Pal
- Department of Veterinary Medicine, University of Maryland, College Park, MD 20472, USA
- Virginia-Maryland Regional College of Veterinary Medicine, College Park, MD 20472, USA
| | - Norma Olivares Strank
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Norbert Pardi
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sukanya Narasimhan
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Drew Weissman
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Erol Fikrig
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
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Forest-Bérard K, Ripoche M, Irace-Cima A, Thivierge K, Adam-Poupart A. More than ticking boxes: Training Lyme disease education ambassadors to meet outreach and surveillance challenges in Québec, Canada. PLoS One 2021; 16:e0258466. [PMID: 34637465 PMCID: PMC8509862 DOI: 10.1371/journal.pone.0258466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 09/28/2021] [Indexed: 11/18/2022] Open
Abstract
Lyme disease (LD) is an emerging public health threat in Canada, associated with the northward range expansion of the black-legged tick (Ixodes scapularis). To address this, public health authorities have been carrying out surveillance activities and awareness campaigns targeting vulnerable populations such as outdoor workers. Implementing these measures is time-consuming and resource-intensive, prompting the assessment of alternatives. Our goal was to evaluate the feasibility and implementation of a training-of-trainers-inspired approach in raising awareness about LD risk and prevention among workers and general population, as well as to evaluate its potential to contribute to provincial LD surveillance efforts. We trained a group of workers from publicly-accessible outdoor parks of the province of Québec to become "LD education ambassadors". Ambassadors were trained to raise tick and LD awareness, share information on preventive measures in their respective communities, and lead tick sampling activities using a standardised protocol similar to that used by Public Health authorities. Ambassador-led outreach activities, public reach, sampling activities and collected ticks were documented, as well as ambassadors' satisfaction with the training using forms and semi-structured interviews. In total, 18 ambassadors from 12 organizations were trained. Between June and September 2019, they led 28 independent outreach activities, reaching over 1 860 individuals (from occupational and general public settings) in seven public health units. Ambassadors led 28 tick samplings, together collecting 11 I. scapularis ticks. This study suggests that an adapted training-of-trainers is a feasible approach to raising tick and LD risk awareness among Québec outdoor workers and public. Trained ambassadors have the potential of reaching a large portion of the population visiting or working in outdoor parks while also providing much-needed outreach regarding risk and prevention. Pushing this concept further to include other types of workers and jurisdictions may contribute to national LD surveillance efforts.
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Affiliation(s)
- Karl Forest-Bérard
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
| | - Marion Ripoche
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
| | - Alejandra Irace-Cima
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
- École de Santé Publique de l’Université de Montréal (ESPUM), Université de Montréal, Montréal, Québec, Canada
| | - Karine Thivierge
- Laboratoire de santé publique du Québec (LSPQ), Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
- Institute of Parasitology, Faculty of Agricultural and Environmental Sciences, McGill University, Montréal, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Ariane Adam-Poupart
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
- École de Santé Publique de l’Université de Montréal (ESPUM), Université de Montréal, Montréal, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
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Poché DM, Dawson K, Tseveenjav B, Poché RM. Efficacy of low-dose fipronil bait against blacklegged tick (Ixodes scapularis) larvae feeding on white-footed mice (Peromyscus leucopus) under simulated field conditions. Parasit Vectors 2021; 14:459. [PMID: 34493330 PMCID: PMC8424918 DOI: 10.1186/s13071-021-04930-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lyme disease, caused primarily by Borrelia burgdorferi sensu stricto, is the most prevalent vector-borne disease in the United States. Treatment of rodent pathogen reservoirs with an oral acaricide may suppress the production of infected host-seeking ticks posing a risk for human infection. A previous study showed that an oral fipronil bait effectively controlled larval Ixodes scapularis ticks on white-footed mice (Peromyscus leucopus) up to 15 days post-bait exposure. The present study expands upon this finding by exposing group-housed white-footed mice to fipronil bait under simulated field conditions prior to tick infestation. METHODS Mice (n = 80) were housed in groups of 10 within large enclosures and offered a choice between fipronil bait within a commercial bait station and an alternative diet. The mice were assigned to two treatment groups and two control groups to undergo bait exposure durations of either 24 h (reduced) or 168 h (extended). Groups were further differentiated by the time point post-bait exposure when larval ticks were applied to mice within feeding capsules (reduced day 1, day 15; extended day 21, day 35). For 4 days post-tick introduction, attached larvae were observed by microscopy and replete larvae were recovered. Replete larvae were monitored for molting success. Plasma was collected from all treatment group mice to obtain fipronil plasma concentrations (CP). RESULTS The fipronil bait (0.005% fipronil) was palatable and controlled larval ticks on white-footed mice when presented under simulated field conditions. Efficacy in preventing attached larvae from feeding to repletion was 100% (day 1), 89.0% (day 15), 85.8% (day 21), and 75.2% (day 35). When also considering molting success, the fipronil bait prevented 100% (day 1), 91.1% (day 15), 91.7% (day 21), and 82.5% (day 35) of larvae attaching to mice from molting. The mean CP per mouse was 191.5 ng/ml (day 1), 29.4 ng/ml (day 15), 10.6 ng/ml (day 21), and 1.0 ng/ml (day 35). CONCLUSIONS The results suggest that fipronil bait will be consumed by white-footed mice in the presence of an alternative diet, and effectively control larval ticks on treated mice. A field trial is needed to confirm the results of this study. Low-dose fipronil bait may provide a cost-effective means of controlling blacklegged ticks to be integrated into tick management programs.
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Hinckley AF, Niesobecki SA, Connally NP, Hook SA, Biggerstaff BJ, Horiuchi KA, Hojgaard A, Mead PS, Meek JI. Prevention of Lyme and other tickborne diseases using a rodent-targeted approach: A randomized controlled trial in Connecticut. Zoonoses Public Health 2021; 68:578-587. [PMID: 34050628 PMCID: PMC10898493 DOI: 10.1111/zph.12844] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Abstract
Tickborne diseases are an increasing public health problem in the northeastern USA. Bait boxes that apply acaricide to rodents have been shown in small field studies to significantly reduce abundance of Ixodes scapularis ticks as well as their pathogen infection rates in treated areas. The effectiveness of this intervention for preventing human tickborne diseases (TBDs) has not been demonstrated. During 2012-2016, TickNET collaborators conducted a randomized, blinded, placebo-controlled trial among 622 Connecticut households. Each household received active (containing fipronil wick) or placebo (empty) bait boxes in their yards over two consecutive years. Information on tick encounters and TBDs among household members was collected through biannual surveys. Nymphal ticks were collected from a subset of 100 properties during spring at baseline, during treatment, and in the year post-intervention. Demographic and property characteristics did not differ between treatment groups. There were no significant differences post-intervention between treatment groups with respect to tick density or pathogen infection rates, nor for tick encounters or TBDs among household members. We found no evidence that rodent-targeted bait boxes disrupt pathogen transmission cycles or significantly reduce household risk of tick exposure or TBDs. The effectiveness of this intervention may depend on scale of use or local enzootic cycles.
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Affiliation(s)
- Alison F Hinckley
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Sara A Niesobecki
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
| | - Neeta P Connally
- Department of Biological & Environmental Sciences, Western Connecticut State University, Danbury, CT, USA
| | - Sarah A Hook
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Kalanthe A Horiuchi
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Andrias Hojgaard
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Paul S Mead
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - James I Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, USA
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Camire AC, Hatke AL, King VL, Millership J, Ritter DM, Sobell N, Weber A, Marconi RT. Comparative analysis of antibody responses to outer surface protein (Osp)A and OspC in dogs vaccinated with Lyme disease vaccines. Vet J 2021; 273:105676. [PMID: 34148599 PMCID: PMC8254658 DOI: 10.1016/j.tvjl.2021.105676] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/25/2021] [Accepted: 04/09/2021] [Indexed: 11/25/2022]
Abstract
Lyme disease (LD), the most common tick-borne disease of canines and humans in N. America, is caused by the spirochete Borreliella burgdorferi. Subunit and bacterin vaccines are available for the prevention of LD in dogs. LD bacterin vaccines, which are comprised of cell lysates of two strains of B. burgdorferi, contain over 1000 different proteins and cellular constituents. In contrast, subunit vaccines are defined in composition and consist of either outer surface protein (Osp)A or OspA and an OspC chimeritope. In this study, we comparatively assessed antibody responses to OspA and OspC induced by vaccination with all canine bacterin and subunit LD vaccines that are commercially available in North America. Dogs were administered a two-dose series of the vaccine to which they were assigned (3 weeks apart): Subunit-AC, Subunit-A, Bacterin-1, and Bacterin-2. Antibody titers to OspA and OspC were determined by ELISA and the ability of each vaccine to elicit antibodies that recognize diverse OspC proteins (referred to as OspC types) assessed by immunoblot. While all of the vaccines elicited similar OspA antibody responses, only Subunit-AC triggered a robust and broadly cross-reactive antibody response to divergent OspC proteins. The data presented within provide new information regarding vaccination-induced antibody responses to key tick and mammalian phase antigens by both subunit and bacterin LD canine vaccine formulations.
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Affiliation(s)
- A C Camire
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, 1112 East Clay Street, McGuire Hall Room 101, Richmond, VA 23298-0678, USA
| | - A L Hatke
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, 1112 East Clay Street, McGuire Hall Room 101, Richmond, VA 23298-0678, USA
| | - V L King
- Zoetis Inc., 333 Portage Road, Kalamazoo, MI 49007-4931, USA
| | - J Millership
- Zoetis Inc., 333 Portage Road, Kalamazoo, MI 49007-4931, USA
| | - D M Ritter
- Zoetis Inc., 333 Portage Road, Kalamazoo, MI 49007-4931, USA
| | - N Sobell
- Zoetis Inc., 333 Portage Road, Kalamazoo, MI 49007-4931, USA
| | - A Weber
- Zoetis Inc., 333 Portage Road, Kalamazoo, MI 49007-4931, USA
| | - R T Marconi
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, 1112 East Clay Street, McGuire Hall Room 101, Richmond, VA 23298-0678, USA.
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Conte CE, Leahy JE, Gardner AM. Active Forest Management Reduces Blacklegged Tick and Tick-Borne Pathogen Exposure Risk. Ecohealth 2021; 18:157-168. [PMID: 34155574 DOI: 10.1007/s10393-021-01531-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 06/13/2023]
Abstract
In the northeastern USA, active forest management can include timber harvests designed to meet silvicultural objectives (i.e., harvesting trees that meet certain maturity, height, age, or quality criteria). Timber harvesting is an important tool in enhancing regeneration and maintaining forest health. It also has considerable potential to influence transmission dynamics of tick-borne pathogens, which are deeply embedded in the forest ecosystem. We conducted a 2-year study to test the hypotheses that recent timber harvesting impacts blacklegged tick density and infection prevalence in managed nonindustrial forests. We found that (1) recent harvesting reduces the presence of nymphal and density of adult blacklegged ticks, (2) recently harvested stands are characterized by understory microclimate conditions that may inhibit tick survival and host-seeking behavior, (3) capture rates of small mammal species frequently parasitized by immature ticks are lower in recently harvested stands compared to control stands with no recent harvest history. In addition, a 1-year pilot study suggests that harvesting does not affect nymphal infection prevalence. Collectively, our results demonstrate that forest structure and understory conditions may impact ticks and the pathogens they transmit via a range of mechanistic pathways, and moreover, active forest management may offer sustainable tools to inhibit entomological risk of exposure to tick-borne pathogens in the landscape.
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Affiliation(s)
- Christine E Conte
- School of Biology and Ecology, University of Maine, 5722 Deering Hall, Orono, ME, 04469, USA
| | - Jessica E Leahy
- School of Forest Resources, University of Maine, 5755 Nutting Hall, Orono, ME, 04469, USA
| | - Allison M Gardner
- School of Biology and Ecology, University of Maine, 5722 Deering Hall, Orono, ME, 04469, USA.
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Antibacterial drugs for Lyme disease. Med Lett Drugs Ther 2021; 63:73-5. [PMID: 33976091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Lantos PM, Rumbaugh J, Bockenstedt LK, Falck-Ytter YT, Aguero-Rosenfeld ME, Auwaerter PG, Baldwin K, Bannuru RR, Belani KK, Bowie WR, Branda JA, Clifford DB, DiMario FJ, Halperin JJ, Krause PJ, Lavergne V, Liang MH, Meissner HC, Nigrovic LE, Nocton JJJ, Osani MC, Pruitt AA, Rips J, Rosenfeld LE, Savoy ML, Sood SK, Steere AC, Strle F, Sundel R, Tsao J, Vaysbrot EE, Wormser GP, Zemel LS. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clin Infect Dis 2021; 72:1-8. [PMID: 33483734 DOI: 10.1093/cid/ciab049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Indexed: 11/14/2022] Open
Abstract
This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America.
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Affiliation(s)
- Paul M Lantos
- Duke University School of Medicine, Durham, North Carolina, USA
| | | | | | - Yngve T Falck-Ytter
- Case Western Reserve University, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | | | - Paul G Auwaerter
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kelly Baldwin
- Geisinger Medical Center, Danville, Pennsylvania, USA
| | | | - Kiran K Belani
- Childrens Hospital and Clinical of Minnesota, Minneapolis, Minnesota, USA
| | - William R Bowie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - John A Branda
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David B Clifford
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | | | - Peter J Krause
- Yale School of Public Health, New Haven, Connecticut, USA
| | | | | | | | | | | | | | - Amy A Pruitt
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jane Rips
- Consumer Representative, Omaha, Nebraska, USA
| | | | | | | | - Allen C Steere
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Franc Strle
- University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Robert Sundel
- Boston Children's Hospital Boston, Massachusetts, USA
| | - Jean Tsao
- Michigan State University, East Lansing, Michigan, USA
| | | | | | - Lawrence S Zemel
- Connecticut Children's Medical Center, Hartford, Connecticut, USA
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Bron GM, Lee X, Paskewitz SM. Do-It-Yourself Tick Control: Granular Gamma-Cyhalothrin Reduces Ixodes scapularis (Acari: Ixodidae) Nymphs in Residential Backyards. J Med Entomol 2021; 58:749-755. [PMID: 33107559 DOI: 10.1093/jme/tjaa212] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/24/2020] [Indexed: 06/11/2023]
Abstract
Lyme disease is the most common vector-borne disease in the United States with hotspots in the Northeast and Midwest. Integrated vector control for mosquito-borne disease prevention is often organized at the community level, but tick control is primarily coordinated at the household and individual level. Management of the blacklegged tick, Ixodes scapularis (Say), the vector of the causative agent of Lyme disease in the Midwest and eastern United States in peridomestic environments may be critical as many tick encounters are reported to occur in the yard. Therefore, we assessed the effectiveness of a widely available and low-cost pesticide that targets common lawn pests and is labeled for use against ticks. In June 2019, we evaluated a granular form of gamma-cyhalothrin in a placebo-controlled residential backyard study (n = 90) in two communities in Wisconsin. The product applied by the research team reduced nymphal blacklegged ticks in plots established in the lawn part of the ecotone by 97% one week after application at both communities and by 89-97% three to four weeks postapplication. The proportion of homes with at least one nymphal tick postapplication was significantly lower at acaricide-treated homes and ranged from 4.2 to 29.2% compared with placebo homes where at least one nymphal tick was found at 50-81.5% of homes. These results support the efficacy of a low-cost do-it-yourself strategy for homeowners seeking to reduce blacklegged ticks in the yard.
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Affiliation(s)
- Gebbiena M Bron
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin - Madison, Madison, WI
| | - Xia Lee
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin - Madison, Madison, WI
| | - Susan M Paskewitz
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin - Madison, Madison, WI
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Bron GM, Fenelon H, Paskewitz SM. Assessing Recognition of the Vector of Lyme Disease Using Resin-Embedded Specimens in a Lyme Endemic Area. J Med Entomol 2021; 58:866-872. [PMID: 33128056 DOI: 10.1093/jme/tjaa234] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Lyme disease (LD) is the most common vector-borne disease in the United States. To assess whether a tick bite puts someone at risk for LD, adequate tick identification skills are needed. We surveyed residents of a high LD-incidence state, Wisconsin, on their ability to distinguish ticks from insects and to identify the specimens that could transmit the LD causative agent. Surveys were conducted using resin blocks with four insects and four tick specimens embedded. About half of the participants (64 of 130) recognized all of the ticks, and 60% of those individuals chose only ticks and no insects. Younger participants (18- to 44-yr old) were more likely to identify ticks correctly compared with those 45 yr and older. Participants who agreed strongly with the statement 'I know a lot about ticks` were also likelier to correctly identify ticks. When asked to identify which specimens could transmit LD, less than 25% of participants chose both the Ixodes scapularis Say adult female and nymph and about half of those (15% of participants) picked only those two and no other specimens. Although the relatively small convenience sample was biased toward younger participants who consider themselves 'outdoorsy', results showed that further assessments of tick recognition skills are needed to understand what determines whether people can recognize medically important ticks and to evaluate the potential benefits of enhanced education. In addition to the value of the resin blocks as research tools, the blocks may be useful as training tools to improve tick check efficacy.
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Affiliation(s)
- Gebbiena M Bron
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin - Madison, Madison, WI
| | - Hannah Fenelon
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin - Madison, Madison, WI
| | - Susan M Paskewitz
- Department of Entomology, College of Agricultural and Life Sciences, University of Wisconsin - Madison, Madison, WI
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Hornbostel VL, Krell RK, Reid JJ, Schappach BL, Volpe S, Connally NP. Spray Safe, Play Safe: Story-Based Films Increase Homeowner Confidence About Backyard Tick Management. J Med Entomol 2021; 58:857-865. [PMID: 33225365 DOI: 10.1093/jme/tjaa230] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Lyme disease incidence is increasing in the United States despite myriad efforts to educate individuals about effective prevention practices to reduce exposure to nymphal Ixodes scapularis Say (Acari: Ixodidae) (blacklegged tick), the primary vector of the pathogen causing Lyme disease. Furthermore, Lyme prevention educational needs currently exceed the ability of public health professionals to deliver the information in person. Past work has shown there is especially high confusion regarding the use of acaricides for tick management by homeowners. Story-based education is known to engage individuals and change behaviors. To increase the reach and engagement regarding Lyme disease prevention practices, especially residential acaricide use, we created short, story-based educational films (Spray Safe, Play Safe) and evaluated their educational benefit with a survey pre- and post-viewing. We determined that after viewing the films, a significantly higher percentage of respondents reported increased confidence in identifying the riskiest areas in their yards for ticks, using personal protective measures to prevent tick bites, using tick-safe landscaping, and using tick control products. This study also suggests that using short, engaging films that can be posted to popular websites and social media outlets could be employed more frequently for successful and engaging Lyme disease education, as creative and up-to-date educational methods are needed.
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Affiliation(s)
- Victoria L Hornbostel
- Tickborne Disease Prevention Laboratory, Western Connecticut State University, Danbury, CT
| | - Rayda K Krell
- Tickborne Disease Prevention Laboratory, Western Connecticut State University, Danbury, CT
| | | | - Brittany L Schappach
- Tickborne Disease Prevention Laboratory, Western Connecticut State University, Danbury, CT
| | - Scott Volpe
- Media Services & Instructional Technology, Western Connecticut State University, Danbury, CT
| | - Neeta P Connally
- Tickborne Disease Prevention Laboratory, Western Connecticut State University, Danbury, CT
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Bernard Q, Phelan JP, Hu LT. Controlling Lyme Disease: New Paradigms for Targeting the Tick-Pathogen-Reservoir Axis on the Horizon. Front Cell Infect Microbiol 2020; 10:607170. [PMID: 33344266 PMCID: PMC7744311 DOI: 10.3389/fcimb.2020.607170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/04/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Linden T. Hu
- Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, United States
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Mitchell C, Dyer M, Lin FC, Bowman N, Mather T, Meshnick S. Protective Effectiveness of Long-Lasting Permethrin Impregnated Clothing Against Tick Bites in an Endemic Lyme Disease Setting: A Randomized Control Trial Among Outdoor Workers. J Med Entomol 2020; 57:1532-1538. [PMID: 32277701 DOI: 10.1093/jme/tjaa061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/23/2019] [Indexed: 06/11/2023]
Abstract
Tick-borne diseases are a growing threat to public health in the United States, especially among outdoor workers who experience high occupational exposure to ticks. Long-lasting permethrin-impregnated clothing has demonstrated high initial protection against bites from blacklegged ticks, Ixodes scapularis Say (Acari: Ixodidae), in laboratory settings, and sustained protection against bites from the lone star tick, Amblyomma americanum (L.) (Acari: Ixodidae), in field tests. However, long-lasting permethrin impregnation of clothing has not been field tested among outdoor workers who are frequently exposed to blacklegged ticks. We conducted a 2-yr randomized, placebo-controlled, double-blinded trial among 82 outdoor workers in Rhode Island and southern Massachusetts. Participants in the treatment arm wore factory-impregnated permethrin clothing, and the control group wore sham-treated clothing. Outdoor working hours, tick encounters, and bites were recorded weekly to assess protective effectiveness of long-lasting permethrin-impregnated garments. Factory-impregnated clothing significantly reduced tick bites by 65% in the first study year and by 50% in the second year for a 2-yr protective effect of 58%. No significant difference in other tick bite prevention method utilization occurred between treatment and control groups, and no treatment-related adverse outcomes were reported. Factory permethrin impregnation of clothing is safe and effective for the prevention of tick bites among outdoor workers whose primary exposure is to blacklegged ticks in the northeastern United States.
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Affiliation(s)
- Cedar Mitchell
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Megan Dyer
- Center for Vector-Borne Disease, University of Rhode Island, Kingston, RI
| | - Feng-Chang Lin
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Natalie Bowman
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Thomas Mather
- Center for Vector-Borne Disease, University of Rhode Island, Kingston, RI
| | - Steven Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Jordan RA, Schulze TL. Availability and Nature of Commercial Tick Control Services in Three Lyme Disease Endemic States. J Med Entomol 2020; 57:807-814. [PMID: 31794013 DOI: 10.1093/jme/tjz215] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Indexed: 05/08/2023]
Abstract
In an update of earlier surveys conducted in Connecticut and New Jersey in the mid-1990s, an online survey of private commercial pest control firms engaged in residential tick control showed that the application of synthetic acaricides continues to be the primary method of control used. The carbamate and organophospate acaricides, previously the most commonly used against ticks, have given way to synthetic pyrethroids and, to a lesser extent, the use of natural product/organic acaricides. Typical costs for a single acaricide application today ($100-$200 for a 1 acre [0.4 ha] property) remain similar to those reported from the earlier surveys, although the frequency of applications and, therefore, also the overall annual cost has increased. The application habitats within residential properties, life stages targeted, and application equipment used have not changed appreciably since the mid-1990s. While most survey respondents expressed knowledge of natural product acaricides and Damminix Tick Tubes, many reported that they either did not employ or knew very little about other alternative tick control methods (including entomopathogenic fungus and topical application of acaricides to tick hosts via 4-Poster deer treatment stations or Select TCS rodent bait boxes). This suggests either a failure to adequately inform the pest management industry and their potential client base of the availability of alternate methods, and/or industry concerns about cost and effectiveness of the alternatives.
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