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Szaroz D, Kulkarni M, Robayo González CX, Zinszer K. Study protocol for a scoping review of Lyme disease prediction methodologies. BMJ Open 2024; 14:e071402. [PMID: 38772589 PMCID: PMC11110606 DOI: 10.1136/bmjopen-2022-071402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 03/27/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION In the temperate world, Lyme disease (LD) is the most common vector-borne disease affecting humans. In North America, LD surveillance and research have revealed an increasing territorial expansion of hosts, bacteria and vectors that has accompanied an increasing incidence of the disease in humans. To better understand the factors driving disease spread, predictive models can use current and historical data to predict disease occurrence in populations across time and space. Various prediction methods have been used, including approaches to evaluate prediction accuracy and/or performance and a range of predictors in LD risk prediction research. With this scoping review, we aim to document the different modelling approaches including types of forecasting and/or prediction methods, predictors and approaches to evaluating model performance (eg, accuracy). METHODS AND ANALYSIS This scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines. Electronic databases will be searched via keywords and subject headings (eg, Medical Subject Heading terms). The search will be performed in the following databases: PubMed/MEDLINE, EMBASE, CAB Abstracts, Global Health and SCOPUS. Studies reported in English or French investigating the risk of LD in humans through spatial prediction and temporal forecasting methodologies will be identified and screened. Eligibility criteria will be applied to the list of articles to identify which to retain. Two reviewers will screen titles and abstracts, followed by a full-text screening of the articles' content. Data will be extracted and charted into a standard form, synthesised and interpreted. ETHICS AND DISSEMINATION This scoping review is based on published literature and does not require ethics approval. Findings will be published in peer-reviewed journals and presented at scientific conferences.
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Affiliation(s)
- Daniel Szaroz
- École de santé publique, Département de médecine sociale et préventive, Université de Montréal, Montreal, Québec, Canada
- Centre de Recherche en Santé Publique (CReSP), Montréal, Québec, Canada
| | - Manisha Kulkarni
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Claudia Ximena Robayo González
- École de santé publique, Département de médecine sociale et préventive, Université de Montréal, Montreal, Québec, Canada
- Centre de Recherche en Santé Publique (CReSP), Montréal, Québec, Canada
| | - Kate Zinszer
- École de santé publique, Département de médecine sociale et préventive, Université de Montréal, Montreal, Québec, Canada
- Centre de Recherche en Santé Publique (CReSP), Montréal, Québec, Canada
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2
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Siegel EL, Olivera M, Roig EM, Perry M, Li AY, D’hers S, Elman NM, Rich SM. Spatial repellents transfluthrin and metofluthrin affect the behavior of Dermacentor variabilis, Amblyomma americanum, and Ixodes scapularis in an in vitro vertical climb assay. PLoS One 2022; 17:e0269150. [PMID: 36346809 PMCID: PMC9642883 DOI: 10.1371/journal.pone.0269150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Repellents serve an important role in bite protection. Tick repellents largely rely on biomechanisms that induce responses with direct contact, but synthetic pyrethroids used as spatial repellents against insects have received recent attention for potential use in tick protection systems. An in vitro vertical climb assay was designed to assess spatial repellency against Dermacentor variabilis, Amblyomma americanum, and Ixodes scapularis adult, female ticks. Climbing behavior was assessed with and without the presence of two spatial repellents, transfluthrin and metofluthrin. Repellency parameters were defined to simulate the natural questing behavior of ambushing ticks, including measures of detachment, pseudo-questing duration, climbing deterrence, and activity. Significant effects were observed within each parameter. D. variabilis showed the greatest general susceptibility to each repellent, followed by A. americanum, and I. scapularis. The most important and integrative measure of repellency was climbing deterrence-a measure of the spatial repellent's ability to disrupt a tick's natural propensity to climb. Transfluthrin deterred 75% of D. variabilis, 67% of A. americanum, and 50% of I. scapularis. Metofluthrin was slightly more effective, deterring 81% of D. variabilis, 73% of A. americanum, and 72% of I. scapularis. The present study poses a novel paradigm for repellency and reports a preliminary assessment of spatial repellent effect on tick behavior. Further research will assess spatial repellency in a more natural setting, scale exposure conditions, and incorporate host cues.
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Affiliation(s)
- Eric L. Siegel
- Department of Microbiology, Laboratory of Medical Zoology, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Marcos Olivera
- Computational Mechanics Center, Instituto Tecnológico de Buenos Aires (ITBA), Ciudad Autónoma de Buenos Aires, Argentina
| | - Esteban Martinez Roig
- Computational Mechanics Center, Instituto Tecnológico de Buenos Aires (ITBA), Ciudad Autónoma de Buenos Aires, Argentina
| | - Melynda Perry
- Textile Materials Evaluation Team, Combat Capabilities Development Command Soldier Center, United States Army Garrison-Natick, Natick, Massachusetts, United States of America
| | - Andrew Y. Li
- United States Department of Agriculture, Agricultural Research Service, Invasive Insect Biocontrol & Behavior Laboratory, Beltsville, Maryland, United States of America
| | - Sebastián D’hers
- Computational Mechanics Center, Instituto Tecnológico de Buenos Aires (ITBA), Ciudad Autónoma de Buenos Aires, Argentina
| | - Noel M. Elman
- GearJump Technologies, Limited Liability Company, Brookline, Massachusetts, United States of America
| | - Stephen M. Rich
- Department of Microbiology, Laboratory of Medical Zoology, University of Massachusetts, Amherst, Massachusetts, United States of America
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Eisen L. Personal protection measures to prevent tick bites in the United States: Knowledge gaps, challenges, and opportunities. Ticks Tick Borne Dis 2022; 13:101944. [DOI: 10.1016/j.ttbdis.2022.101944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/27/2022] [Accepted: 03/24/2022] [Indexed: 01/07/2023]
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Aenishaenslin C, Charland K, Bowser N, Perez-Trejo E, Baron G, Milord F, Bouchard C. Behavioral risk factors associated with reported tick exposure in a Lyme disease high incidence region in Canada. BMC Public Health 2022; 22:807. [PMID: 35459149 PMCID: PMC9027878 DOI: 10.1186/s12889-022-13222-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Tick-borne diseases, and especially Lyme Disease (LD), are on the rise in Canada and have been met with increasing public health concern. To face these emerging threats, education on the prevention of tick bites remains the mainstay of public health intervention. The objective of this study was to assess the adoption of preventive behaviors toward tick bites and LD and to investigate the association between behavioral risk factors and reported tick exposure in a Canadian, LD high incidence region (Estrie region, Quebec, Canada). Methods A cross-sectional study was conducted in 2018 which used a telephone questionnaire administered to a random sample of 10,790 adult residents of the study region. Questions investigated tick exposure, LD awareness, attitudes towards LD risk, outdoor and preventive behaviors, as well as antibiotic post-exposure prophylaxis (PEP) treatments in the case of a tick bite. Descriptive and multivariable analyses were carried out, considering the nine administrative subregions and the stratified survey design. Results The sub-regional prevalence of reported tick exposure in the previous year ranged from 3.4 to 21.9%. The proportion of respondents that adopted preventive behaviors varied from 27.0% (tick checks) to 30.1% (tick repellent) and 44.6% (shower after outdoor activities). A minority of respondents (15.9%) that sought healthcare after a tick bite received a PEP treatment. Performing tick checks (Odds ratio = 4.33), time spent outdoors (OR = 3.09) and living in a subregion with a higher public health LD risk level (OR = 2.14) were associated with reported tick exposure in multivariable models. Conclusions This study highlights the low level of adoption of preventive behaviors against tick bites in a region where LD risk is amongst the highest in Canada. This suggests a concerning lack of improvement in LD prevention, as low levels of adoption were already reported in studies conducted in the last decade. Innovative and evidence-based approaches to improve education on ticks and tick-borne diseases and to promote behavior changes are urgently needed in Canada. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13222-9.
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Affiliation(s)
- Cécile Aenishaenslin
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada.
| | - Katia Charland
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Natasha Bowser
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | | | - Geneviève Baron
- Direction de la santé publique, CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada.,Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
| | - François Milord
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada.,CISSS de la Montérégie-Centre, Longueuil, Canada
| | - Catherine Bouchard
- Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada
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5
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Zhou G, Xu X, Zhang Y, Yue P, Luo S, Fan Y, Chen J, Liu M, Dong Y, Li B, Kong J, Wen S, Liu A, Bao F. Antibiotic prophylaxis for prevention against Lyme disease following tick bite: an updated systematic review and meta-analysis. BMC Infect Dis 2021; 21:1141. [PMID: 34749665 PMCID: PMC8573889 DOI: 10.1186/s12879-021-06837-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022] Open
Abstract
Background In areas where Lyme disease is endemic, bites from ticks are common, but no vaccine is currently available against Lyme disease for humans. Therefore, the feasibility of using antibiotic prophylaxis to prevent Lyme disease after a tick bite is worth further exploration. Previous meta-analyses lack sufficient power to demonstrate the efficacy of about antibiotic prophylaxis for the prevention of Lyme disease following a tick bite. In this study, we explored more precise evidence and attempted to identify and update optimum treatment strategies. Methods We searched PubMed, Embase, and the Cochrane Library for studies until March 23, 2021. We included studies if the enrolled patients were randomly allocated to a treatment or control group within 72 h following a tick bite and had no clinical evidence of Lyme disease at enrolment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed for data abstraction. Two authors (GZZ and XX) independently reviewed the abstracts and identified articles for detailed assessment. We used a random-effects model to calculate the pooled results and reported the 95% confidence interval (CI). Study quality was assessed using a modified Jadad scale, and publication bias was assessed using Egger’s test. We calculated the risk ratio (RR) for the rates of unfavorable events in patients who received intervention versus the control group. This study is registered with PROSPERO, number CRD42021245002. Results Six studies (3,766 individuals) were included. The pooled rate of unfavorable events in persons receiving treatment and the control group were 0.4% (95%CI: 0.1–1.1%) and 2.2% (95%CI: 1.6–3.0%), respectively. The pooled RR was 0.38 (95%CI: 0.22–0.66). Subgroup analysis revealed that the pooled RR was 0.29 (95%CI: 0.14–0.60) in the single-use 200-mg doxycycline group; 0.28 (95%CI: 0.05–1.67) in a 10-day course group (Amoxicillin, Penicillin or tetracycline); and 0.73 (95%CI: 0.25–2.08) in a topical antibiotic treatment group (Azithromycin). Conclusions The available evidence supports the use of antibiotics for the prevention of Lyme disease, and reveals advantages of using single-dose; however, further confirmation is needed.
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Affiliation(s)
- Guozhong Zhou
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Xin Xu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Yu Zhang
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Peng Yue
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Shiqi Luo
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Yuxin Fan
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Jingjing Chen
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Meixiao Liu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Yan Dong
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Bingxue Li
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Jing Kong
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Shiyuan Wen
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China
| | - Aihua Liu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China. .,Yunnan Province Key Laboratory for Tropical Infectious Diseases in Universities, Kunming Medical University, Kunming, 650500, China.
| | - Fukai Bao
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, China. .,Yunnan Province Key Laboratory for Tropical Infectious Diseases in Universities, Kunming Medical University, Kunming, 650500, China.
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6
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Ho BM, Davis HE, Forrester JD, Sheele JM, Haston T, Sanders L, Lee MC, Lareau S, Caudell M, Davis CB. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Management of Tick-Borne Illness in the United States. Wilderness Environ Med 2021; 32:474-494. [PMID: 34642107 DOI: 10.1016/j.wem.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention and management of tick-borne illness (TBI). Recommendations are graded based on quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. The guidelines include a brief review of the clinical presentation, epidemiology, prevention, and management of TBI in the United States, with a primary focus on interventions that are appropriate for resource-limited settings. Strong recommendations are provided for the use of DEET, picaridin, and permethrin; tick checks; washing and drying clothing at high temperatures; mechanical tick removal within 36 h of attachment; single-dose doxycycline for high-risk Lyme disease exposures versus "watchful waiting;" evacuation from backcountry settings for symptomatic tick exposures; and TBI education programs. Weak recommendations are provided for the use of light-colored clothing; insect repellents other than DEET, picaridin, and permethrin; and showering after exposure to tick habitat. Weak recommendations are also provided against passive methods of tick removal, including the use of systemic and local treatments. There was insufficient evidence to support the use of long-sleeved clothing and the avoidance of tick habitat such as long grasses and leaf litter. Although there was sound evidence supporting Lyme disease vaccination, a grade was not offered as the vaccine is not currently available for use in the United States.
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Affiliation(s)
- Benjamin M Ho
- Southern Wisconsin Emergency Associates, Janesville, Wisconsin.
| | - Hillary E Davis
- Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado; Department of Emergency Medicine, University of Tennessee Medical Center, Knoxville, Tennessee
| | | | | | - Taylor Haston
- Department of Emergency Medicine, Medical College of Georgia, Augusta, Georgia
| | - Linda Sanders
- Department of Emergency Medicine, Memorial Hospital, Colorado Springs, Colorado
| | - Mary Caroll Lee
- Department of Emergency Medicine, Virginia Tech-Carilion Clinic, Roanoke, Virginia
| | - Stephanie Lareau
- Department of Emergency Medicine, Virginia Tech-Carilion Clinic, Roanoke, Virginia
| | - Michael Caudell
- Department of Emergency Medicine, Medical College of Georgia, Augusta, Georgia
| | - Christopher B Davis
- Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado
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Sosa JP, Ferreira Caceres MM, Agadi K, Pandav K, Mehendale M, Mehta JM, Go CC, Matos WF, Guntipalli P, Belizaire MPE. Diseases Transmitted by the Black-Legged Ticks in the United States: A Comprehensive Review of the Literature. Cureus 2021; 13:e17526. [PMID: 34471586 PMCID: PMC8403000 DOI: 10.7759/cureus.17526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 11/05/2022] Open
Abstract
The black-legged tick is endemic to the midwestern, northeastern, western, south-eastern, and southern regions of the United States. There has been an increased burden of black-legged ticks in humans in recent years. COVID-19 pandemic has further heightened this burden. We thereby reviewed the literature to discuss the seasonality, infections, and clinical spectrum of diseases transmitted by the black-legged ticks. We also discuss the reported delay in the diagnosis of these diseases during the pandemic situation, the alpha-gal syndrome, the importance of prompt diagnosis, and early medical intervention with an aim to increase awareness of the black-legged tick-borne diseases.
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Affiliation(s)
- Juan P Sosa
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, USA
| | | | - Kuchalambal Agadi
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, USA
| | - Krunal Pandav
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, USA
| | - Meghana Mehendale
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, USA
| | - Jayati M Mehta
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, USA
| | | | | | - Prathima Guntipalli
- Division of Research & Academic Affairs, Larkin Community Hospital, South Miami, USA
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8
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Bobe JR, Jutras BL, Horn EJ, Embers ME, Bailey A, Moritz RL, Zhang Y, Soloski MJ, Ostfeld RS, Marconi RT, Aucott J, Ma'ayan A, Keesing F, Lewis K, Ben Mamoun C, Rebman AW, McClune ME, Breitschwerdt EB, Reddy PJ, Maggi R, Yang F, Nemser B, Ozcan A, Garner O, Di Carlo D, Ballard Z, Joung HA, Garcia-Romeu A, Griffiths RR, Baumgarth N, Fallon BA. Recent Progress in Lyme Disease and Remaining Challenges. Front Med (Lausanne) 2021; 8:666554. [PMID: 34485323 PMCID: PMC8416313 DOI: 10.3389/fmed.2021.666554] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/12/2021] [Indexed: 12/14/2022] Open
Abstract
Lyme disease (also known as Lyme borreliosis) is the most common vector-borne disease in the United States with an estimated 476,000 cases per year. While historically, the long-term impact of Lyme disease on patients has been controversial, mounting evidence supports the idea that a substantial number of patients experience persistent symptoms following treatment. The research community has largely lacked the necessary funding to properly advance the scientific and clinical understanding of the disease, or to develop and evaluate innovative approaches for prevention, diagnosis, and treatment. Given the many outstanding questions raised into the diagnosis, clinical presentation and treatment of Lyme disease, and the underlying molecular mechanisms that trigger persistent disease, there is an urgent need for more support. This review article summarizes progress over the past 5 years in our understanding of Lyme and tick-borne diseases in the United States and highlights remaining challenges.
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Affiliation(s)
- Jason R. Bobe
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Brandon L. Jutras
- Department of Biochemistry, Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA, United States
| | | | - Monica E. Embers
- Tulane University Health Sciences, New Orleans, LA, United States
| | - Allison Bailey
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Ying Zhang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mark J. Soloski
- Division of Rheumatology, Department of Medicine, Lyme Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Richard T. Marconi
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, Richmond, VA, United States
| | - John Aucott
- Division of Rheumatology, Department of Medicine, Lyme Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Avi Ma'ayan
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - Kim Lewis
- Department of Biology, Northeastern University, Boston, MA, United States
| | | | - Alison W. Rebman
- Division of Rheumatology, Department of Medicine, Lyme Disease Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mecaila E. McClune
- Department of Biochemistry, Fralin Life Sciences Institute, Virginia Tech, Blacksburg, VA, United States
| | - Edward B. Breitschwerdt
- Department of Clinical Sciences, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | | | - Ricardo Maggi
- Department of Clinical Sciences, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Frank Yang
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Bennett Nemser
- Steven & Alexandra Cohen Foundation, Stamford, CT, United States
| | - Aydogan Ozcan
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Omai Garner
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Dino Di Carlo
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Zachary Ballard
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Hyou-Arm Joung
- University of California, Los Angeles, Los Angeles, CA, United States
| | - Albert Garcia-Romeu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Roland R. Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nicole Baumgarth
- Center for Immunology and Infectious Diseases and the Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Brian A. Fallon
- Columbia University Irving Medical Center, New York, NY, United States
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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:e1-e48. [PMID: 33417672 DOI: 10.1093/cid/ciaa1215] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Indexed: 12/13/2022] 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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Torkar G, Kos M. Do tick-borne diseases affect outdoor teaching in Slovenian preschools? Ticks Tick Borne Dis 2021; 12:101728. [PMID: 33848797 DOI: 10.1016/j.ttbdis.2021.101728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
Childhood experiences with nature are decisive for children's wellbeing. The need for outdoor activities has been duly recognized in the preschool curriculum in Slovenia. However, there are some obstacles to this approach-specifically, tick-borne diseases. This study examines the views and experiences of Slovenian preschool teachers (n = 158) with ticks and tick-borne diseases in order to create a safer environment for the further development of outdoor education. The majority of the respondents engage in outdoor teaching once or several times a week. They have very frequent contact with ticks and tick-borne diseases in their professional lives. More than four-fifths of the respondents carry out some tick-prevention measures in preschools, but room for improvement remains. The respondents report rare cases in which parents or guardians have tried to prohibit them from visiting outdoor areas because of tick-borne diseases, and they explain how they dealt with the situation. The attitude of preschool teachers toward ticks and tick-borne diseases did not correlate significantly with the frequency with which they went outdoors in preschools. This study therefore concludes that, despite the objective risks associated with tick-borne diseases, there is still broad consensus among educators and parents on the importance of outdoor education in the early years.
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Affiliation(s)
- Gregor Torkar
- Faculty of Education, University of Ljubljana, Slovenia.
| | - Marjanca Kos
- Faculty of Education, University of Ljubljana, Slovenia
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11
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Boulanger N, Wikel S. Induced Transient Immune Tolerance in Ticks and Vertebrate Host: A Keystone of Tick-Borne Diseases? Front Immunol 2021; 12:625993. [PMID: 33643313 PMCID: PMC7907174 DOI: 10.3389/fimmu.2021.625993] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/22/2021] [Indexed: 12/23/2022] Open
Abstract
Ticks and tick transmitted infectious agents are increasing global public health threats due to increasing abundance, expanding geographic ranges of vectors and pathogens, and emerging tick-borne infectious agents. Greater understanding of tick, host, and pathogen interactions will contribute to development of novel tick control and disease prevention strategies. Tick-borne pathogens adapt in multiple ways to very different tick and vertebrate host environments and defenses. Ticks effectively pharmacomodulate by its saliva host innate and adaptive immune defenses. In this review, we examine the idea that successful synergy between tick and tick-borne pathogen results in host immune tolerance that facilitates successful tick infection and feeding, creates a favorable site for pathogen introduction, modulates cutaneous and systemic immune defenses to establish infection, and contributes to successful long-term infection. Tick, host, and pathogen elements examined here include interaction of tick innate immunity and microbiome with tick-borne pathogens; tick modulation of host cutaneous defenses prior to pathogen transmission; how tick and pathogen target vertebrate host defenses that lead to different modes of interaction and host infection status (reservoir, incompetent, resistant, clinically ill); tick saliva bioactive molecules as important factors in determining those pathogens for which the tick is a competent vector; and, the need for translational studies to advance this field of study. Gaps in our understanding of these relationships are identified, that if successfully addressed, can advance the development of strategies to successfully disrupt both tick feeding and pathogen transmission.
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Affiliation(s)
- Nathalie Boulanger
- Fédération de Médecine Translationnelle - UR7290, Early Bacterial Virulence, Group Borrelia, Université de Strasbourg, Strasbourg, France.,Centre National de Référence Borrelia, Centre Hospitalier Universitaire, Strasbourg, France
| | - Stephen Wikel
- Department of Medical Sciences, Frank H. Netter, M.D., School of Medicine, Quinnipiac University, Hamden, CT, United States
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12
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Abstract
PURPOSE OF REVIEW Lyme disease is an important, vector-borne infection found throughout the temperate Northern hemisphere. The disease causes rash, acute systemic illness, and in some untreated patients, inflammatory arthritis. This review examines the emergence, clinical features and management of early Lyme disease and Lyme arthritis. RECENT FINDINGS There has been continuing progress in characterizing the clinical manifestations, diagnostic testing and treatment of Lyme disease. Almost all patients with early Lyme disease can be cured with antibiotic treatment. In most cases, Lyme arthritis also responds to antibiotics, but some patients require additional treatment approaches. SUMMARY The diagnosis of Lyme disease is based on clinical manifestations and adjunctive laboratory testing. For the rheumatologist, Lyme arthritis should be recognized by a pattern of attacks of asymmetric, oligo-arthritis, recognizable by clinical manifestations in the same way that other rheumatic diseases, such as gout or rheumatoid arthritis, are diagnosed.
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13
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Control of ixodid ticks and prevention of tick-borne diseases in the United States: The prospect of a new Lyme disease vaccine and the continuing problem with tick exposure on residential properties. Ticks Tick Borne Dis 2021; 12:101649. [PMID: 33549976 DOI: 10.1016/j.ttbdis.2021.101649] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/13/2020] [Accepted: 12/29/2020] [Indexed: 01/09/2023]
Abstract
In the United States, exposure to human-biting ixodid ticks can occur while spending time on residential properties or in neighborhood green spaces as well as during recreational or occupational activities on public lands. Human-biting tick species collectively transmit >15 species of pathogenic microorganisms and the national burden of tick-borne diseases is increasing. The prospect of a new Lyme disease vaccine for use in humans provides hope for substantial reduction in the >450,000 estimated annual cases of Lyme disease but this breakthrough would not reduce cases of other tick-borne diseases, such as anaplasmosis, babesiosis, ehrlichiosis, spotted fever group rickettsiosis, and Powassan encephalitis. One intriguing question is to what extent a new Lyme disease vaccine would impact the use of personal protection measures acting broadly against tick-bites. The main tick vector for Lyme disease spirochetes in the eastern United States, Ixodes scapularis, also transmits causative agents of anaplasmosis, babesiosis, and Powassan encephalitis; and this tick species co-occurs with other human-biting vectors such as Amblyomma americanum and Dermacentor variabilis. It therefore is important that a new Lyme disease vaccine does not result in reduced use of tick-bite prevention measures, such as tick repellents, permethrin-treated clothing, and frequent tick checks. Another key issue is the continuing problem with tick exposure on residential properties, which represents a heavily used outdoor environment the residents cannot reasonably avoid and where they tend to spend large amounts of time outside. As it may not be realistic to keep up daily vigilance with personal protective measures against tick-bites on residential properties during many months of every year, homeowners may also consider the option to suppress host-seeking ticks by means of deer fencing, landscaping, vegetation management, and use of products to kill host-seeking ticks or ticks infesting rodents. When considering the full range of options for actions that can be taken to suppress host-seeking ticks on residential properties, it is clear that individual homeowners face a difficult and bewildering task in deciding what to do based on very general guidance from public health agencies (developed without the benefit of a strong evidence base) and often without ready access to local public health professionals experienced in tick control. This situation is not satisfactory but cannot be corrected without first addressing knowledge gaps regarding the impact of peridomestic tick control measures on host-seeking ticks, human tick-bites, and tick-borne diseases. In parallel with this effort, there also is a need to increase the local public health workforce with knowledge of and experience with tick control to provide better access for homeowners to sound and objective advice regarding tick control on their properties based on key characteristics of the landscaping, habitat composition, and use patterns by wild animal tick hosts as well as the residents.
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14
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Chauhan G, McClure J, Hekman J, Marsh PW, Bailey JA, Daniels RF, Genereux DP, Karlsson EK. Combining Citizen Science and Genomics to Investigate Tick, Pathogen, and Commensal Microbiome at Single-Tick Resolution. Front Genet 2020; 10:1322. [PMID: 32038704 PMCID: PMC6985576 DOI: 10.3389/fgene.2019.01322] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 12/04/2019] [Indexed: 12/27/2022] Open
Abstract
The prevalence of tickborne diseases worldwide is increasing virtually unchecked due to the lack of effective control strategies. The transmission dynamics of tickborne pathogens are influenced by the tick microbiome, tick co-infection with other pathogens, and environmental features. Understanding this complex system could lead to new strategies for pathogen control, but will require large-scale, high-resolution data. Here, we introduce Project Acari, a citizen science-based project to assay, at single-tick resolution, species, pathogen infection status, microbiome profile, and environmental conditions of tens of thousands of ticks collected from numerous sites across the United States. In the first phase of the project, we collected more than 2,400 ticks wild-caught by citizen scientists and developed high-throughput methods to process and sequence them individually. Applying these methods to 192 Ixodes scapularis ticks collected in a region with a high incidence of Lyme disease, we found that 62% were colonized by Borrelia burgdorferi, the Lyme disease pathogen. In contrast to previous reports, we did not find an association between the microbiome diversity of a tick and its probability of carrying B. burgdorferi. However, we did find undescribed associations between B. burgdorferi carriage and the presence of specific microbial taxa within individual ticks. Our findings underscore the power of coupling citizen science with high-throughput processing to reveal pathogen dynamics. Our approach can be extended for massively parallel screening of individual ticks, offering a powerful tool to elucidate the ecology of tickborne disease and to guide pathogen-control initiatives.
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Affiliation(s)
- Gaurav Chauhan
- Bioinformatics and Integrative Biology Program, University of Massachusetts Medical School, Worcester, MA, United States.,Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Jesse McClure
- Bioinformatics and Integrative Biology Program, University of Massachusetts Medical School, Worcester, MA, United States.,Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Jessica Hekman
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Patrick W Marsh
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Rachel F Daniels
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, United States.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Diane P Genereux
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Elinor K Karlsson
- Bioinformatics and Integrative Biology Program, University of Massachusetts Medical School, Worcester, MA, United States.,Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, United States.,Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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15
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Associations Between Personal Protective Measures and Self-Reported Tick-Borne Disease Diagnosis in Indiana Residents. J Community Health 2020; 45:739-750. [DOI: 10.1007/s10900-020-00789-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Omodior O, Kianersi S, Luetke M. Spatial Clusters and Non-spatial Predictors of Tick-Borne Disease Diagnosis in Indiana. J Community Health 2019; 44:1111-1119. [DOI: 10.1007/s10900-019-00691-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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