Geographic and Seasonal Characterization of Tick Populations in Maryland Lauren DiMiceli, MSPH, MT(ASCP)
Background Mandated reporting of human tick-borne disease No statewide program for tick surveillance geographic distribution and seasonality of tick species not systematically characterized Opportunity recognized to compile and analyze data already being collected by the Maryland Department of Agriculture (MDA) through its Tick Identification Program
MDA Tick Identification Program MDA entomologist identifies ticks by MD residents Submitter provides the following: Demographic information Geographic location (town) of the tick encounter Date of collection The host (human, pet, or other) Anatomic site of attachment
MDA Tick Identification Program Entomologist identifies the following: type of tick life stage of the tick degree of engorgement Reports have been stored in paper format at MDA data have not been systematically characterized Submitted ticks not tested for pathogens
Ticks of Public Health Importance in Ixodes scapularis Lyme disease Anaplasmosis Babesiosis Amblyomma americanum Ehrlichiosis Dermacentor variabilis Rocky Mountain spotted fever Tularemia Maryland Assessed at: http://www.dpd.cdc.gov/dpdx/html/imagelibrary/s-z/ticks/body_ticks_il3.htm
PHASE Objectives Purpose: Characterize tick submission data collected by MDA Complement human tick-borne disease surveillance Create electronic data base for prospective use
Methods Literature search and review Designed and developed Microsoft Access database Entered data from 2009 2011 Analyzed Data Described frequency of submissions Assessed trends of submissions according to month and life stage by year Assessed distributions of submissions by Maryland jurisdiction by year
Ticks Submitted for Identification to the MDA by Tick Species and Year, Maryland, 2009-2011 (total number of submissions = 501) 120 100 80 60 American Dog Tick - Dermacenter variabilis Black-legged Deer Tick - Ixodes scapularis 40 Lone Star Tick - Amblyoma americanum 20 0 2009 2010 2011
Blacklegged adult ticks by month and year of submission, Maryland, 2009-2011 12 10 8 6 2009 2010 2011 4 2 0 January February March April May June July August September October November December
Blacklegged tick nymphs by month and year of submission, Maryland, 2009-2011 14 12 10 8 6 2009 2010 2011 4 2 0 January February March April May June July August September October November December
Lone Star adult ticks by month and year of submission, Maryland, 2009-2011 16 14 12 10 8 6 2009 2010 2011 4 2 0 January February March April May June July August September October November December
Lone Star tick nymphs by month and year of submission, Maryland, 2009-2011 35 30 25 20 15 2009 2010 2011 10 5 0 January February March April May June July August September October November December
Location of Blacklegged ticks and Lone Star ticks by Maryland jurisdiction 2009 Location of Blacklegged ticks and Lone Star ticks by Maryland jurisdiction - 2011
Limitations and Challenges Convenience sample Variability in how forms were completed Missing Data Mapping does not demonstrate intensity of host-tick encounters
Public Health Impact and Practice Addressed knowledge gap potential for development of public health activities Maryland DHMH has increased awareness of distribution and seasonality Aids in public health activity development Educational campaigns and/or environmental modification Electronic capture mechanism Fostered interagency relationships
Public Health Impact and Practice Professional Development Developed and designed database Conducting descriptive epidemiological analysis Geographic Information Systems Applied lessons learned from course work to real world public health problems Critical thinking and leadership skills Excellent mentoring
Acknowledgements Maryland Department of Agriculture Gaye Williams Department of Health and Mental Hygiene Katherine Feldman, DVM, MPH Erin Jones, MS SB Wee, MHS Heather Rutz, MCRP, MHS Kimberly Mitchell, MPH Mary Armolt
Questions?
References Bhate, Chinmoy and Schwartz, Robert A. Lyme Disease Part I. Advances and Perspectives. J Am Acad Dermatol. 2011;64:619-36. Heymann, David L. Control of Communicable Diseases Manual. Washington, D.C.: Association of Public Health, 2008. Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene. Available at: http://ideha.dhmh.md.gov/oideor/czvbd/sitepages/lyme-disease.aspx. Assessed May 4, 2012. Killilea, ME, Swei A, Lane RS, et al. Spatial Dynamics of Lyme Disease: A Review. EcoHealth. 2008; 5:167-195. Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene. Available at: http://ideha.dhmh.md.gov/oideor/czvbd/shared%20documents/2000-2010_lymedisease.pdf. Assessed May 1, 2012. Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene. Available at: http://ideha.dhmh.maryland.gov/idehashareddocuments/counts_rates/2010summary_printcriteria_counts_fin AL.pdf. Assessed May 5, 2012. Bacon RM, Kugeler KJ, Mead PS, et al. WMMR Surveillance Summary. Surveillance for Lyme disease -- United States, 1992 2006. 2008;57(10): 1-9. Centers for Disease Control and Prevention. http://www.cdc.gov/anaplasmosis/. Assessed May 5, 2012.
References Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene. Available at: http://ideha.dhmh.md.gov/idehashareddocuments/ehrlich_anapl_factsheet.pdf. Assessed May 5, 2011.. Centers for Disease Control and Prevention. Ticks: Geographic Distribution. http://www.cdc.gov/ticks/geographic_distribution.html. Assessed May 5, 2011. Glass, G.E., et al., Predicting Ixodes scapularis abundance on white-tailed deer using geographic information systems. Am J Trop Med Hyg, 1994. 51(5): p. 538-44. Zhang, X., et al., Economic impact of Lyme disease. Emerg Infect Dis, 2006. 12(4): p. 653-60. Sarwari, A.R., et al., Tick exposure and Lyme disease at a summer camp in Maryland. W V Med J, 2005. 101(3): p. 126-30. Malouin R, Winch P, Leontsin E, et al. Longitudinal Evaluation of an Educational Intervention for Preventing Tick Bites in an Area with Endemic Lyme Disease in Baltimore County, Maryland. Am J Epidemiol, 2003. 157(11): 1039-51. Armstrong PM, Brunet LR, Spielman A et al. Risk of Lyme Disease: Perceptions of Residents of a Lone Star Tick-infested Community. Bull World Health Organ, 2001. 79 (10): 916-25. Caroll JF and Kramer M. Winter Activity of Ixodes scapularis (Acari: Ixodidae) and the Operation of Deer-Targeted Tick Control Devices in Maryland. J Med Entomol, 2003. 40(2):238-44. Carroll JF. A Survey for Nymphs of Host-seeking Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) on Tree Trunks in Deciduous Forests. J Med Entomol, 2002. 39(1): 237-40.