The Backyard Integrated Tick Management Study

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The Backyard Integrated Tick Management Study Principal Investigators: Neeta Connally and Thomas Mather Western Connecticut State University University of Rhode Island Centers for Disease Control and Prevention www.backyardtickstudy.org

TickNET: Lyme and other tickborne diseases prevention study 2011-2012 Randomized, blinded, placebo-controlled trial Assessed efficacy of single springtime application of pesticide to residential yards

Tick abundance at acaricide vs. placebo groups 63% reduction in questing blacklegged tick nymphs 62% fewer p<0.001 Hinckley et al. J Infect Dis 2016

Human outcomes

Despite reduction in ticks at intervention sites, human disease incidence and human-tick encounters were not reduced Future studies should: Also use interventions that include reducing tick infection rates Understand behavior of humans in the backyard environment Hinckley et al. J Infect Dis 2016

TickNET: Bait Box Intervention Study (2013-2016) Randomized, blinded, placebo-controlled trial Assess efficacy of rodent-targeted tick control (Select TCS bait box) Outcome measures: physician-diagnosed tickborne illness tick-human encounters ticks attached ticks crawling

METHODS Participants 125 households from 2012 2015 (Pilot) 500 households from 2013 2016 (Full) Enrolled, surveyed, and randomized to receive Treated bait boxes (fipronil-treated wick) Placebo bait boxes (no wick)

STUDY GOALS Backyard Integrated Tick Management Study 2016-2020 1. Evaluate two tick management tick tactics at single vs. contiguously treated backyards 2. Understand how people use outdoor environments particularly backyards

Photos: www.tickboxtcs.com, www.tickencounter.org TWO TICK MANAGEMENT INTERVENTIONS Select TCS bait boxes Targeted application of acaricide spray

STUDY DESIGN Enrolled properties/households in western CT and southern RI ITM approach: single acaricide spray plus bait boxes Entomologic measures: tick abundance and infection rates Human outcome measures: self reported tick encounters and human disease; daily activity log of property use

RESIDENTIAL TREATMENT GROUPS SINGLE TREATED YARD (acaricide spray, active bait boxes) CLUSTER OF TREATED YARDS (acaricide spray, active bait boxes) SINGLE PLACEBO YARD (water spray, bait boxes without wick)

SPRAY APPLIED BAIT BOXES INSTALLED

STUDY DESIGN Two year treatment Households are blinded to treatment group Monthly surveys administered to measure tick encounters and disease diagnosis Ticks detected on humans/pets submitted to URI TickSpotters for confirmatory ID Daily activity survey administered for one week in June

DAILY ACTIVITY SURVEY Time spent in outdoor locations: In backyard: Forest edge Lawn adjacent to edge Lawn far from edge Gardens Non-backyard locations

BITM STUDY CURRENT STATUS 132 properties enrolled single treated treated clusters single placebo Ticks sampled twice at all enrolled properties (pre-treatment) in late May-July 2017 Monthly surveys conducted May Aug 2017 Daily activity survey conducted in June 2017 Bait boxes installed in late July 2017 weighed 4 weeks post-installment

BITM STUDY WHAT S NEXT? First acaricide treatment May 2018 Second bait box installment July 2018 Continue surveys, TickSpotters, residential tick sampling

For more information www.backyardtickstudy.org

Spray Safe, Play Safe: Promoting Integrated Tick Management for Preventing Lyme Disease in Children STUDY GOALS Develop educational videos and other materials that address safe use of effective pesticides for tick control by families. Disseminate educational materials to community members using multiple public platforms. EPA Healthy Communities Grant Program 2017

Acknowledgments Western Connecticut State University Rayda Krell Karen Thompson University of Rhode Island Thomas Mather Howard Ginsberg Steve Engborg Centers for Disease Control and Prevention Division of Vector-Borne Infectious Diseases Lars Eisen Alison Hinckley Rebecca Eisen Nicole Bruener CDC Cooperative Agreement 1U01CK000492 Town of Ridgefield, CT Health Department Jennifer Reid Ed Briggs