Anthropogenic Change and the Emergence of Tick-Borne Pathogens in the Northeast US

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1 Anthropogenic Change and the Emergence of Tick-Borne Pathogens in the Northeast US Durland Fish, Ph.D. Yale School of Public Heath Yale School of Forestry and Environmental Studies Yale Institute for Biospheric Studies Center for EcoEpidemiology

2 TICKS: EXCELLENT VECTORS OF DISEASE AGENTS ZOOPHILIC FEEDING PROLONGED HOST CONTACT PHARMACOLOGIC SALIVA HIGH PATHOGEN PREVALENCE

3 Diuk-Wasser et al J. Med. Entomol. 43:166 CDC HOST-SEEKING TICK SURVEY

4 Tick-Borne Pathogens of the Northeastern US AGENT DISEASE VECTOR BORRELIA BURGDORFERI LYME DISEASE IXODES SCAPULARIS ANAPLASMA PHAGOCYTOPHILUM ANAPLASMOSIS IXODES SCAPULARIS BABESIA MICROTI BABESIOSIS IXODES SCAPULARIS BORRELIA near MIYAMOTOI UNKNOWN IXODES SCAPULARIS EHRLICHIA CHAFFEENSIS EHRLICHIOSIS AMBLYOMMA AMERICANUM RICKETTSIA RICKETSII TICK-BORNE TYPHUS DERMACENTOR VARIABILIS POWASSAN VIRUS POW ENCEPHALITIS IXODES COOKEI

5 Emergence of Tick-Borne Pathogens in the Northeastern US Number of Emerging Agents Date

6 Reported Lyme Disease Cases by Year United States, ,000 20,000 Cases 15,000 10,000 5, Year

7 Reported Cases of Lyme Disease by Year, United States, ,000 20,000 15,000 Cases 10,000 5,

8 Borrelia burgdorferi RESERVOIRS VECTOR Tamias striatus Ixodes scapularis Peromyscus leucopus Turdus migratorius

9 POPULATIONS OF Ixodes scapularis ARE DEPENDENT UPON WHITE-TAILED DEER

10

11 RE-FORESTATION OF THE NORTHEAST 1900 DEER ABSENT OR RARE 1970 DEER ABUNDANT

12 REFUGIA FOR IXODES SCAPULARIS CA Kilometers

13 IXODES SCAPULARIS ROUTES OF EXPANSION Kilometers

14

15 Min. Minimum Temperature SD of Maximum Temperature Max Vapour Pressure DATABASE DISTRIBUTION OF IXODES SCAPULARIS Dennis et al J. Med. Entomol. 35:629

16 AUTOLOGISITC MODEL Variables: -Min. Maximum Temp -Mean Maximum Temp -Min. Mean Temp -Mean Minimum Temp -SD of Vapour Pressure Likelihood ratio: p< Wald statistic: p< Accuracy=95%

17 RECLASSIFICATION Brownstein et al Environmental Health Perspectives 111:

18 MODEL PROJECTIONS PRESENT % CHANGE IN SUITABLE AREA NORTH AMERICA: +69% UNITED STATES: +28% CANADA: +213%

19 Year Cohnsteadt, et al In prep.

20 CELLULAR AUTOMATA MODEL FOR DISPERSAL Using host home range location and size to predict spread of ticks For each host: Density Home range: probability of moving from one cell to the other Average tick burden: number moved Legend T 2 1 km Mouse Home Range T 1 Deer Home Range Bird Home Range T 1 Ticks Starting Location

21 CONCLUSIONS Deer have the most significant role in moving ticks across the landscape Holding deer densities constant, mice may moderate dispersal caused by deer Robins had no significant effect in any modeled scenario Madhav, et al J. Med. Entomol. 41:842

22 SUBURBANIZATION

23 FOREST FRAGMENTATION (CONNECTICUT) LANDSAT-TM LAND COVER CLASSIFICATION NYMPHAL TICK DENSITY 500 METER BUFFER FRAGSTATS GIS SOFTWARE Patch Size Patch Shape Complexity Patch Isolation Compare indices to sampled tick densities

24 Forest Fragmentation Predicts Nymphal I. scapularis density PATTERN METRIC ESTIMATE SIGNIFICANCE Patch Size Mean Patch Size P<0.05 Shape Complexity Isolation Mean Shape Index Mean Nearest Neighbor P< P<0.01 Fit log linear models assuming Poisson distribution for nymphal count Brownstein et al Oecologia 146: 469

25 Ixodes scapularis FEEDS ON HUMANS Westchester Co., NY Population 874,866 (1990) 178,889 bites/year (20.4 per 100 person-years) Campbell, et al., American Journal of Epidemiology 148:

26 Anaplasma phagocytophilum RESERVOIRS VECTOR PROCYON LOTOR SCIURUS CAROLINENSIS IXODES SCAPULARIS PEROMYSCUS LEUCOPUS DUMETELLA CAROLINENSIS

27 EMERGENCE OF HUMAN ANAPLASMOSIS First case of human infection with Ehrlichia canis, Detroit, MI Maeda, et al. New England Journal of Medicine 316: Six cases of granulocytotrophic ehrlichiosis (2 fatal) Minnesota and Wisconsin. Chen et al., Journal of Clinical Microbiology 1995 Human granulocytic ehrlichiosis in Connecticut: Report of a fatal case. Hardalo, et al. Clin Infect Dis.; 21: Human granulocytic ehrlichiosis: A case series from a medical center in New York state. AgueroRosenfeld. et. al. Annals of Internal Medicine 125: Prevalence of the agent of human granulocytic ehrlichiosis in ticks collected in 1984, NY and CT. Schwartz. et al., New England Journal of Medicine 337: 49-50

28 INFECTION PREVALENCE IN HOST-SEEKING Ixodes scapularis (%) STAGE SITE N A.p. B.b. BOTH EXP ADULT NY ADULT NY ADULT CT ADULT CT NYMPH NY NYMPH CT NYMPH CT Schwartz et al NEJM 337:49-50

29 Babesia microti VECTOR RESERVOIR IXODES SCAPULARIS PEROMYSCUS LEUCOPUS

30 BABESIOSIS EMERGENCE IN CONNECTICUT 1970 Babesiosis in a Massachusetts resident. Western et.al. N Engl J Med 283: Connecticut Cases 1989 Babesiosis in Eastern Connecticut. CDC MMWR 38: Babesiosis in Western Connecticut. Anderson & Magnarelli, Emerging Infectious Diseases 10:

31 SPREAD OF BABESIOSIS IN CONNECTICUT km/yr ± Km

32 PREVALENCE OF IXODES SCAPULARIS-BORNE PATHOGENS (NEW JERSEY) Pathogen % infected ticks B. Burgdorferi 43 A. phagocytophilum 17 B. microti 5 B. burgdorferi & A. phagocytophilum 6 B. burgdorferi & B. microti 2 A. phagocytophilum & B. microti 2 B. burgdorferi, A. phagocytophilum, & B. microti 0 Varde et al Emerging Infections Diseases 4: 97-99

33 Are there I. scapularis-borne Pathogens with Potential for Emergence? FEEDS UPON HUMANS (20.4 per 100 person-years)

34 S TURDI ANDERSONI AFZELII VALAISIANA PHYLOGENY TANUKII LUSITANIAE GARINII BISSETTI BURGDORFERI (N-40 CONTROL) SINICA JAPONICA ANSERINA 87 HERMSII SPOTTED OWL ISOLATE 85 TURICATAE 100 PARKERI FLORIDA DOG CORIACEAE MAXIMUM LIKELIHOOD TREE SELECTED BOOTSTRAP VALUES FROM NEIGHBOR JOINING LONESTARI 99 MIYAMOTOI NEW BORRELIA PERSICA CROCIDURAE DUTTONI RECURRENTIS HISPANICA SPANISH ISOLATE

35 POWASSAN VIRUS VECTOR RESERVOIR IXODES COOKEI MUSTELIDS

36 POTENTIAL FOR EMERGENCE OF POWASSAN VIRUS 1958 Powassan virus: isolation of virus from a fatal case of encephalitis. McLean, et Can Med Assoc J. 80: Powassan virus in Ixodes cookei and Mustelidae in New England. Main,et al. J Wildl Dis 15: Experimental transmission of Powassan virus (Flaviviridae) by Ixodes scapularis ticks. Costero, et al. Am J Trop Med Hyg 55: A new tick-borne encephalitis-like virus infecting New England deer ticks. Ixodes dammini. Telford, et al. Emerg Infect Dis 3: Enzootic transmission of deer tick virus in New England. Ebel, et al. American Journal of Tropical Medicine And Hygiene 63 (1-2): Four cases of Powassan encephalitis from Maine and Vermont. Courteny et. al. Journal of the American Medical Association 286:

37 POWASSAN VIRUS VECTOR RESERVOIR VECTOR IXODES COOKEI MUSTELIDS IXODES SCAPULARIS

38 FISHER Martes pennanti Extinct in mid-atlantic states in 1900 Reintroductions in Pa. and W. Va. Pest status in Connecticut Home range >4,000 ha (males)

39 POWASSAN VIRUS VECTORS RESERVOIR? IXODES SCAPULARIS IXODES COOKEI MARTES PENNANTI

40 Thanks to funding agencies: CDC, DVBID NIH, NIAID USDA,ARS EPA NASA MATHERS FOUNDATION YALE CENTER FOR ECOEPIDEMIOLOGY

41 YALE INSTITUTE FOR BIOSPHERIC STUDIES

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