TICKS AND TICKBORNE DISEASES Presented by Nicole Chinnici, MS, C.W.F.S East Stroudsburg University Northeast Wildlife DNA Laboratory
PA Lyme Medical Conference 2018 New Frontiers in Lyme and Related Tick Borne Diseases The Hershey Lodge, Hershey, PA April 6 7, 2018 Disclosure Statement: I do not have any financial arrangements or affiliations with any commercial entities whose products, research, or services may be discussed in these materials.
TICKS
ENGORGED TICKS
TICK-BORNE DISEASES Lyme disease is the fastest growing infectious disease in the Northeast Very little is known about polymicrobial infections or the relationship among non-pathogenic and pathogenic microorganisms What role do they play? How do they manifest within individuals? How does this affect diagnosis? treatment? We don t know what we don t know?
Fig 1. County level of confirmed cases of Lyme disease in the United States, aggregated from 2000-2015.
Fig 2. County level raw prevalence for B. burgdorferi antibodies in domestic dogs aggregated from 2011-2015. Watson SC, Liu Y, Lund RB, Gettings JR, Nordone SK, et al. (2017) A Bayesian spatio-temporal model for forecasting the prevalence of antibodies to Borrelia burgdorferi, causative agent of Lyme disease, in domestic dogs within the contiguous United States. PLOS ONE 12(5): e0174428. https://doi.org/10.1371/journal.pone.0174428 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174428
COMMON TICKS IN THE NORTHEAST
BROWN DOG TICK -HOME INFESTATION-
WINTER TICK -FOUND IN PA ON ELK AND WTD-
PATHOGENS IN PA Lyme or Lyme Like diseases Borrelia burgdorferi Borrelia miyamotoi Borrelia lonestari Babesiosis Babesia microti Babesia duncani Viruses Powassan virus*, a Tick borne Encephalitis HGA Human Granulocytic Anaplasmosis Anaplasma phagocytophilum Bartonellosis Bartonella spp. Q Fever Coxiella burnetii Tularemia Francisella tularensis HMA Human Monolytic Ehrlichiosis Ehrlichia chaffeenesis Mycoplasma Mycoplasma spp. Rocky Mountain Spotted Fever (RMSF) Rickettsia rickettsii Rickettsia parkeri Rickettsia amblyommi Rickettsia philipii
RESEARCH Identifying co-infections in Ixodes ticks Characterizing tick species from Pennsylvania Elk Identification of Babesia odocoilei in PA Elk Identifying the microbiome of tick mouthparts Surveillance of tick-borne pathogens
MILFORD BOROUGH STUDY 2017 Pathogen Prevalence of Adult Ixodes scapularis 2017 100 80 60 40 20 0 Number of ticks collected by site 54 29 14 46 25 11 12 9 Site 1 Site 2 Site 3 Total Females Males 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% Lyme disease, 37.0% babesiosis, 4.0% Bartonella sp., 7.0% Co-infection, 3.0% 0.00% Lyme disease babesiosis Bartonella sp. Co-infection Site 1 29.63% 3.7% 7.41% 1.85% Site 2 34.62% 0.0% 11.54% 0.0% Site 3 60.0% 10.0% 0.0% 10.0% Overall 37.0% 4.0% 7.0% 3.0% Site 1 Site 2 Site 3 Overall
Site 1 Site 3 Site 2
POWASSAN VIRUS AND LYME DISEASE Knox et. al 2015 Patient exposure of POWV and Lyme disease 106 serum/plasma samples TTS for Lyme disease and flavivirus mosaic IFA and TBEV-complex ELISA 10.4% (11) were positive for sero-prevalence for POWV 9/11 or 81.8% were also positive for Lyme disease 16.4% of Lyme positive samples were co-infected with POWV Knox et. al. 2017 4.17% - 16.67% POWV positive ticks by regions 50% of ticks which tested positive for POWV also tested positive for Lyme disease
CHARACTERIZING TICKS Continuous surveillance of tick species Identify ticks infesting wildlife What is the human risk associated?
TICKS PA ELK Tick Species on Elk - Fall 2017 200 180 160 140 120 100 80 60 40 20 0 6 180 103 76 1 23 Elk Male Female Nymph Total Ixodes scapularis unknown Elk
UNKNOWN TICK IDENTIFICATION INSERT DATA HERE
CONCLUSIONS Building a database of tick infection rates across PA Physicians can access data for free at www.tickchek.com/stats This information provides significant insight into treatment If infection rates are greater than 20% it is suggested for physician to consider prophylactic treatment Become aware and accurately identify ticks of all species and life stages and at different engorgements
THANK YOU!!