Urban woodland habitat is important for tick presence and density in a city in England

Lyme disease in UK primary care: a knowledge, attitude, and practice survey

BACKGROUND

Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding GP experience with diagnosis and treatment.

AIM

This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England.

DESIGN & SETTING

Online KAP survey on LD for UK-based practising GPs.

METHOD

An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK-based research networks, professional societies, and via social media.

RESULTS

A total of 191 complete responses were analysed (England n = 130, Scotland n = 61). The Scotland-based responder group had more relevant consultations in the previous 3 years. Responders from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for LD and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with LD by both responder groups for the former and England-based responders for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses.

CONCLUSION

Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based responders' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.

The Release of Non-Native Gamebirds Is Associated With Amplified Zoonotic Disease Risk

Spillback-where non-native species increase native pathogen prevalence-is potentially an important mechanism by which non-natives contribute to zoonotic disease emergence. However, spillback has not yet been directly demonstrated because it is difficult to disentangle from confounding factors which correlate with non-native species abundance and native pathogen prevalence. Here, we capitalise on replicated, quasi-experimental releases of non-native pheasants (Phasianus colchicus) to compare vector abundance and native pathogen prevalence between sites with similar local conditions but different non-native densities. Prevalence of Borrelia spp. (the causative agent of Lyme disease) in questing ticks was almost 2.5x higher in woods where pheasants are released compared to control woods, with a particularly strong effect on Borrelia garinii, a bird specialist genospecies. Furthermore, adult (but not nymphal) ticks tended to be more abundant at pheasant-release woods. This work provides evidence that non-native species can impact zoonotic pathogen prevalence via spillback in ecologically relevant contexts.

From host individual traits to community structure and composition: Bartonella infection insights

BACKGROUND

Phylogeny, combined with trait-based measures, offers insights into parasite sharing among hosts. However, the specific traits that mediate transmission and the aspects of host community diversity that most effectively explain parasite infection rates remain unclear, even for the Bartonella genus, a vector-borne bacteria that causes persistent blood infections in vertebrates.

METHODS

This study investigated the association between rodent host traits and Bartonella infection, as well as how rodent community diversity affects the odds of infection in the Atlantic Forest, using generalized linear models. Additionally, we assessed how host traits and phylogenetic similarities influence Bartonella infection among mammal species in Brazil. To this end, rodents were sampled from ten municipalities in Rio de Janeiro, southeastern Brazil. Then, we calculated several diversity indices for each community, including Rényi's diversity profiles, Fisher's alpha, Rao's quadratic entropy (RaoQ), Functional Diversity (FDis), Functional Richness (FRic), and Functional Evenness (FEve). Finally, we compiled a network encompassing all known interactions between mammal species and Bartonella lineages recorded in Brazil.

RESULTS

We found no significant relationship between diversity indices and the odds of Bartonella infection in rodent communities. Furthermore, there was no statistical support for the influence of individual-level traits (e.g., body length, sex, and age) or species-level ecological traits (e.g., locomotor habitat, dietary guild, and activity period) on Bartonella infection in rodents. A country-scale analysis, considering all mammal species, revealed no effect of host traits or phylogeny on Bartonella infection.

CONCLUSIONS

This study highlighted wild mammals that share Bartonella lineages with livestock, synanthropic, and domestic animals, underscoring the complexity of their maintenance cycle within the One Health framework. A key question arising from our findings is whether molecular host-cell interactions outweigh host body mass and ecological traits in influencing Bartonella infection, potentially opening new avenues for understanding host-parasite relationships and infection ecology.

Ixodes scapularis density and Borrelia burgdorferi prevalence along a residential-woodland gradient in a region of emerging Lyme disease risk

The environmental risk of Lyme disease, defined by the density of Ixodes scapularis ticks and their prevalence of Borrelia burgdorferi infection, is increasing across the Ottawa, Ontario region, making this a unique location to explore the factors associated with environmental risk along a residential-woodland gradient. In this study, we collected I. scapularis ticks and trapped Peromyscus spp. mice, tested both for tick-borne pathogens, and monitored the intensity of foraging activity by deer in residential, woodland, and residential-woodland interface zones of four neighbourhoods. We constructed mixed-effect models to test for site-specific characteristics associated with densities of questing nymphal and adult ticks and the infection prevalence of nymphal and adult ticks. Compared to residential zones, we found a strong increasing gradient in tick density from interface to woodland zones, with 4 and 15 times as many nymphal ticks, respectively. Infection prevalence of nymphs and adults together was 15 to 24 times greater in non-residential zone habitats. Ecological site characteristics, including soil moisture, leaf litter depth, and understory density, were associated with variations in nymphal density and their infection prevalence. Our results suggest that high environmental risk bordering residential areas poses a concern for human-tick encounters, highlighting the need for targeted disease prevention.

The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations

Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.

Risk factors for tick attachment in companion animals in Great Britain: a spatiotemporal analysis covering 2014-2021

BACKGROUND

Ticks are an important driver of veterinary health care, causing irritation and sometimes infection to their hosts. We explored epidemiological and geo-referenced data from > 7 million electronic health records (EHRs) from cats and dogs collected by the Small Animal Veterinary Surveillance Network (SAVSNET) in Great Britain (GB) between 2014 and 2021 to assess the factors affecting tick attachment in an individual and at a spatiotemporal level.

METHODS

EHRs in which ticks were mentioned were identified by text mining; domain experts confirmed those with ticks on the animal. Tick presence/absence records were overlaid with a spatiotemporal series of climate, environment, anthropogenic and host distribution factors to produce a spatiotemporal regression matrix. An ensemble machine learning spatiotemporal model was used to fine-tune hyperparameters for Random Forest, Gradient-boosted Trees and Generalized Linear Model regression algorithms, which were then used to produce a final ensemble meta-learner to predict the probability of tick attachment across GB at a monthly interval and averaged long-term through 2014-2021 at a spatial resolution of 1 km. Individual host factors associated with tick attachment were also assessed by conditional logistic regression on a matched case-control dataset.

RESULTS

In total, 11,741 consultations were identified in which a tick was recorded. The frequency of tick records was low (0.16% EHRs), suggesting an underestimation of risk. That said, increased odds for tick attachment in cats and dogs were associated with younger adult ages, longer coat length, crossbreeds and unclassified breeds. In cats, males and entire animals had significantly increased odds of recorded tick attachment. The key variables controlling the spatiotemporal risk for tick attachment were climatic (precipitation and temperature) and vegetation type (Enhanced Vegetation Index). Suitable areas for tick attachment were predicted across GB, especially in forests and grassland areas, mainly during summer, particularly in June.

CONCLUSIONS

Our results can inform targeted health messages to owners and veterinary practitioners, identifying those animals, seasons and areas of higher risk for tick attachment and allowing for more tailored prophylaxis to reduce tick burden, inappropriate parasiticide treatment and potentially TBDs in companion animals and humans. Sentinel networks like SAVSNET represent a novel complementary data source to improve our understanding of tick attachment risk for companion animals and as a proxy of risk to humans.

Tick-borne pathogens in ticks from urban and suburban areas of north-western Spain: Importance of Ixodes frontalis harbouring zoonotic pathogens

To identify the questing tick populations in urban and suburban areas from the city of Lugo (NW Spain), ticks were collected monthly by flagging. The presence of Borrelia spp., Rickettsia spp. and Anaplasma phagocytophilum also was determined by polymerase chain reaction (PCR) and sequence analysis. Overall, 342 questing ticks were collected; the tick abundance was higher in suburban (95.9%) than in urban areas (4.1%). Ixodes frontalis was the most abundant (86.5%); 88.5% were larvae, 11.1% nymphs and 0.3% adults. All development stages of I. ricinus (7.3%) and adults of Rhipicephalus sanguineus sensu lato (5.8%) and Dermacentor reticulatus (0.3%) were found. Rickettsia spp. (31.9%) was more prevalent than Borrelia spp. (2.7%); no ticks were positive to A. phagocytophilum. Six Rickettsia species were identified (R. slovaca, R. monacensis, R. massiliae, R. raoultii, R. sibirica subsp. mongolitimonae and R. aeschielmanii); Candidatus Rickettsia rioja and two novel Rickettsia species also were detected. In addition, Borrelia turdi (1.8%) and B. valaisiana (0.9%) were identified in Ixodes ticks. This is the first report of R. slovaca in R. sanguineus s.l. and of R. monacensis, R. raoultii, R. slovaca, R. sibirica subsp. mongolitimonae and Ca. R. rioja in I. frontalis. Since most of the pathogens detected are zoonotic, their presence in these areas may have implications for public health.

The Risk of Exposure to Ticks and Tick-Borne Pathogens in a Spa Town in Northern Poland

The aim of this study was to determine the potential risk of human exposure to tick-borne infection in a recreation areas in a spa town located in northern Poland. Questing Ixodes ricinus and Dermacentor reticulatus ticks were collected in the spring of 2018. Tick-borne microorganisms were detected by PCR. Species were identified based on RFLP and the sequencing of DNA. In total, 38.3% of the ticks (34.6% of I. ricinus and 48.6% of D. reticulatus) were infected. The prevalence was 14.9% for Borrelia spp., 10.6% for Babesia spp. and 17.7% for Rickettsia spp. No Anaplasma phagocytophilum was detected. Spirochaetes B. afzelii, B. garinii and B. burgdorferi s.s. were detected only in I. ricinus ticks (20.2%). The differences in the infection rates of Babesia spp. between I. ricinus (7.7%) and D. reticulatus (18.9%) were not significant. DNA of B. canis and B. venatorum were identified in both tick species. B. microti were detected in D. reticulatus ticks. The prevalence of Rickettsia spp. was significantly higher in D. reticulatus (37.8%) than that in I. ricinus (10.6%). R. raoultii was identified only in D. reticulatus and R. helvetica in I. ricinus. Co-infections of at least two pathogens were recognized in 13% of positive ticks.