Archive for the ‘Anaplasmosis’ Category

Tickborne Diseases – Confronting a Growing Threat

https://www.nejm.org/doi/full/10.1056/NEJMp1807870

Tickborne Diseases — Confronting a Growing Threat

Catharine I. Paules, M.D., Hilary D. Marston, M.D., M.P.H., Marshall E. Bloom, M.D., and Anthony S. Fauci, M.D.

July 25, 2018, at NEJM.org.

Every spring, public health officials prepare for an upsurge in vectorborne diseases. As mosquito-borne illnesses have notoriously surged in the Americas, the U.S. incidence of tickborne infections has risen insidiously, triggering heightened attention from clinicians and researchers.

nejmp1807870_f1

Common Ticks Associated with Lyme Disease in North America.

According to the Centers for Disease Control and Prevention (CDC), the number of reported cases of tickborne disease has more than doubled over the past 13 years.1 Bacteria cause most tickborne diseases in the United States, and Lyme disease accounts for 82% of reported cases, although other bacteria (including Ehrlichia chaffeensis, Anaplasma phagocytophilum, and Rickettsia rickettsii) and parasites (such as Babesia microti) also cause substantial morbidity and mortality. In 1982, Willy Burgdorfer, a microbiologist at the Rocky Mountain Laboratories of the National Institute of Allergy and Infectious Diseases, identified the causative organism of Lyme disease, a spirochete eponymously named Borrelia burgdorferi. B. burgdorferi (which causes disease in North America and Europe) and B. afzelii and B. garinii (found in Europe and Asia) are the most common agents of Lyme disease. The recently identified B. mayonii has been described as a cause of Lyme disease in the upper midwestern United States. Spirochetes that cause Lyme disease are carried by hard-bodied ticks (see graphic), notably Ixodes scapularis in the northeastern United States, I. pacificus in western states, I. ricinus in Europe, and I. persulcatus in eastern Europe and Asia. B. miyamotoi, a borrelia spirochete found in Europe, North America, and Asia, more closely related to the agents of tickborne relapsing fever, is also transmitted by I. scapularis and should be considered in the differential diagnosis of febrile illness occurring after a tick bite.

Patterns of spirochete enzootic transmission are geographically influenced and involve both small-mammal reservoir hosts, such as white-footed mice, and larger animals, such as white-tailed deer, which are critical for adult tick feeding. The rising incidence and expanding distribution of Lyme disease in the United States are probably multifactorial, but increased density and range of the tick vectors play a key role. The geographic range of I. scapularis is apparently increasing: by 2015, it had been detected in nearly 50% more U.S counties than in 1996.

Lyme disease’s clinical manifestations range from relatively mild, nonspecific findings and classic erythema migrans rash in early disease to more severe manifestations, including neurologic disease and carditis (often with heart block) in early disseminated disease, and arthritis, which may occur many months after infection (late disease). Although most cases are successfully treated with antibiotics, 10 to 20% of patients report lingering symptoms after receiving appropriate therapy.2 Despite more than four decades of research, gaps remain in our understanding of Lyme disease pathogenesis, particularly its role in these less well-defined, post-treatment symptoms.

Meanwhile, tickborne viral infections are also on the rise and could cause serious illness and death.1 One example is Powassan virus (POWV), the only known North American tickborne encephalitis-causing flavivirus.3 POWV was recognized as a human pathogen in 1958 after being isolated from the brain of a child who died of encephalitis in Powassan, Ontario. People infected with POWV often have a febrile illness that can be followed by progressive and severe neurologic manifestations, resulting in death in 10 to 15% of cases and long-term sequelae in 50 to 70% of survivors.3 An antigenically similar virus, POWV lineage II, or deer tick virus, was discovered in New England in 1997. Both POWV subtypes are linked to human disease, but their distinct enzootic cycles may affect their likelihood of causing such disease. Lineage II seems to be maintained in an enzootic cycle between I. scapularis and white-footed mice — which may portend increased human transmission, because I. scapularis is the primary vector of other serious pathogens, including B. burgdorferi. Whereas only 20 U.S. cases of POWV infection were reported before 2006,3 99 were reported between 2006 and 2016. Other tickborne encephalitis flaviviruses cause thousands of cases of neuroinvasive illness in Europe and Asia each year, despite the availability of effective vaccines in those regions. The increase in POWV cases coupled with the apparent expansion of the I. scapularis range highlight the need for increased attention to this emerging virus.

The public health burden of tickborne pathogens is considerably underestimated. For example, the CDC reports approximately 30,000 cases of Lyme disease per year but estimates that the true incidence is 10 times that number.1 Multiple factors contribute to this discrepancy, including limitations in surveillance and reporting systems and constraints imposed by available diagnostics, which rely heavily on serologic assays.4 Diagnostic utility is affected by variability among laboratories, timing of specimen collection, suboptimal sensitivity during early infection, imperfect use of diagnostics (particularly in persons with low probability of disease), inability of a single test to identify coinfections in patients with acute infection, and the cumbersome nature of some assays. Current diagnostics also have difficulty distinguishing acute from past infection — a serious challenge in diseases characterized by nonspecific clinical findings. Moreover, tests may remain positive even after resolution of infection, leading to diagnostic uncertainty during subsequent unrelated illnesses. For less common tickborne pathogens such as POWV, serologic testing can be performed only in specialized laboratories, and currently available tests fail to identify novel tickborne organisms.
Such limitations have led researchers to explore new technologies. For example, one of the multiplex serologic platforms that have been developed can detect antibodies to more than 170,000 distinct epitopes, allowing researchers to distinguish eight tickborne pathogens.4 In addition to its utility in screening simultaneously for multiple pathogens, this assay offers enhanced pathogen detection, particularly in specimens collected during early disease. Further studies are needed to determine such assays’ applicability in clinical practice.

Nonserologic platform technologies may also improve diagnostic capabilities, particularly in identifying emerging pathogens. Two previously unknown tickborne RNA viruses, Heartland virus and Bourbon virus, were discovered by researchers using next-generation sequencing to help link organisms with sets of unexplained clinical symptoms. The development and widespread implementation of next-generation diagnostics will be critical to understanding the driving factors behind epidemiologic trends and the full clinical scope of tickborne disease. In addition, sensitive, specific and, where possible, point-of-care assays will facilitate appropriate clinical care for infected persons, guide long-term preventive efforts, and aid in testing of new therapeutics and vaccines.

In the United States, prevention and management of tickborne diseases include measures to reduce tick exposure, such as avoiding or controlling the vector itself, plus prompt, evidence-based treatment of infections. Although effective therapies are available for common tickborne bacteria and parasites, there are none for tickborne viruses such as POWV.

The biggest gap, however, is in vaccines: there are no licensed vaccines for humans targeting any U.S. tickborne pathogen. One vaccine that was previously marketed to prevent Lyme disease, LYMErix, generated an immune response against the OspA lipoprotein of B. burgdorferi, and antibodies consumed by the tick during a blood meal targeted the spirochete in the vector.5 Nonetheless, the manufacturer withdrew LYMErix from the market for a combination of reasons, including falling sales, liability concerns, and reports suggesting it might be linked to autoimmune arthritis, although studies supported the vaccine’s safety. Similar concerns will probably affect development of other Lyme disease vaccines.5

Historically, infectious-disease vaccines have targeted specific pathogens, but another strategy would be to target the vector.5 This approach could reduce transmission of multiple pathogens simultaneously by exploiting a common variable, such as vector salivary components. Phase 1 clinical trials are under way to evaluate mosquito salivary-protein–based vaccines in healthy volunteers living in areas where most mosquito-borne diseases are not endemic. Since tick saliva also contains proteins conserved among various tick species, this approach is being explored for multiple tickborne diseases.5

The burden of tickborne diseases seems likely to continue to grow substantially. Prevention and management are hampered by suboptimal diagnostics, lack of treatment options for emerging viruses, and a paucity of vaccines. If public health and biomedical research professionals accelerate their efforts to address this threat, we may be able to fill these gaps. Meanwhile, clinicians should advise patients to use insect repellent and wear long pants when walking in the woods or tending their gardens — and check themselves for ticks when they are done.
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**Comment**

While this article repeats much of the same verbiage that’s been repeated for years, particularly the vaccine push, they are ignoring the following:

  1. Many TBI’s are congenitally transmitted:  https://madisonarealymesupportgroup.com/2018/06/19/33-years-of-documentation-of-maternal-child-transmission-of-lyme-disease-and-congenital-lyme-borreliosis-a-review/https://madisonarealymesupportgroup.com/2018/07/24/congenital-transmission-of-lyme-myth-or-reality/https://madisonarealymesupportgroup.com/2018/02/26/transplacental-transmission-fetal-damage-with-lyme-disease/
  2. There is a real probability of sexual transmission:  https://madisonarealymesupportgroup.com/2018/02/06/lyme-in-the-southern-hemisphere-sexual-transmission/https://madisonarealymesupportgroup.com/2017/02/24/pcos-lyme-my-story/
  3. While they mention Ehrlichia, Anaplasma, Rickettsia, and Babesia, there are many other players that are hardly getting a byline.  For a list to date:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/.  This is an important issue because to date the medical world is looking at this complex illness as a one pathogen one drug illness when nothing could be further from the truth.  No one has done any research on the complexity of being infected with more than one pathogen.  It will reveal the CDC’s guidelines of 21 days of doxy to be utter stupidity.
  4. Also, worth mentioning is that only a few of these are reportable illnesses so there is absolutely no data on how prevalent any of this is.  Surveillance is a real problem.
  5. Regarding what ticks are where….this ancient verbiage needs to change.  Ticks are moving everywhere.  This is on record in numerous places:  https://madisonarealymesupportgroup.com/2018/07/16/ticks-that-carry-lyme-disease-are-spreading-fast/https://madisonarealymesupportgroup.com/2018/07/10/we-have-no-idea-how-bad-the-us-tick-problem-is/https://madisonarealymesupportgroup.com/2018/07/22/citizen-scientists-help-track-tick-borne-illness-exposure/
  6. No tick is a good tick.  They all need blood meals and have the potential to transmit disease.  
  7. This article is silent about the Asian Longhorned tick that propagates itself by cloning and can drain cattle of their blood.  Found in six states so far it was recently found on a child in New Jersey:  https://www.northjersey.com/story/news/environment/2018/07/24/bergen-county-nj-child-may-first-carrying-longhorned-tick-us/825744002/.  Word in the tick world is it had NOT bitten the child and tested negative for pathogens.  What is concerning is that it is known to transmit SFTS virus and Japanese spotted fever in Asia. This story is a reminder that this tick is NOT just a livestock problem and that a normal child going about a normal day with NO contact with livestock had this tick on her.  Another clear reminder that it is foolish to put any of this in a box.
  8. They need to emphasize that the “classic erythema migrans rash” while indicative of Lyme, is unseen or variable in many patients.
  9. Constraints in testing is a true problem but an even bigger problem is untrained and uneducated medical professionals.  This stuff may never test clearly.  Get over it.  Get trained to know what to look for!
  10. The Lyme vaccine was a bust.  It still is.  Unless safety concerns are dealt with we want nothing to do with any vaccine.
  11. All I know is that mosquitoes and Zika get more attention that this modern day 21st century plague that is creeping everywhere and is a true pandemic.  It still isn’t being seriously dealt with or researched.  What research is being done is same – o – same -o stuff we already know.  Study the tough stuff – the unanswered questions or things that are just repeated as a mantra for decades.
We need answers out here not repeated gibberish that isn’t helping patients.
Afterthought:

The one thing I didn’t deal with that I will point out now is this regurgitated number in the NEJM article of 10-20% of patients moving on to chronic/persistent Lyme. The following informative article written by Lorraine Johnson points out this number to be considerably higher which corresponds to my experience as a patient advocate: https://madisonarealymesupportgroup.com/2018/07/22/lyme-costs-may-exceed-75-billion-per-year/. Excerpt below:

Besides the staggering financial cost to this 21st century plague, this paper, based on estimates of treatment failure rates associated with early and late Lyme, estimates that 35-50% of those who contract Lyme will develop persistent or chronic disease.

Let that sink in.

And in the Hopkins study found 63% developed late/chronic Lyme symptoms.

For some time I’ve been rankled by the repeated CDC statement that only 10-20% of patents go on to develop chronic symptoms. This mantra in turn is then repeated by everyone else.

While still an estimate, I’d say 35 to over 60% is a tad higher than 10-20%, wouldn’t you? It also better reflects the patient group I deal with on a daily basis. I can tell you this – it’s a far greater number than imagined and is only going to worsen.

 

 

Rutgers Racing to Contain Asian Longhorned Tick

https://www.nj.com/news/index.ssf/2018/07/this_is_how_dna_helps_rutgers_scientists_crack_the.html

It spreads SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” causing fever, fatigue, headache, nausea, muscle pain, diarrhea, vomiting, abdominal pain, disease of the lymph nodes, and conjunctival congestion, but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, this Longhorned tick, also called the East Asian or bush tick, has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.

For a 2016 literature review on SFTS: http://infectious-diseases-and-treatment.imedpub.com/research-advances-on-epidemiology-of-severefever-with-thrombocytopenia-syndrome-asystematic-review-of-the-literature.php?aid=17986
Although the clinical symptoms of SFTS and HGA are similar to each other, but the treatment methods of the two diseases are totally different. Doctors notice that the biggest difference between the clinical symptom of SFTS and HGA is that SFTS patients generally without skin rash, the dermorrhagia is also not seriously, and few massive hemorrhage cases were reported [23]. It is also reported that SFTS patients had gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, which are rarely observed in HGA patients [2]. So these differences can be used as the auxiliary basis of differential diagnosis.
At present, there is still no specific vaccine or antiviral therapy for SFTSV infection. Supportive treatment, including plasma, platelet, granulocyte colony stimulating factor (GCSF), recombinant human interleukin 11, and gamma globulin is the most essential part of case treatment [44]. Meanwhile, some measures were taken to maintain water, electrolyte balance and treat complications are also very important.
Ribavirin is reported to be effective for treating Crimean-Congo Hemorrhagic Fever (CCHF) infections and hemorrhagic fever with renal syndrome, but it is still inadequate to judge the effect of ribavirin on SFTS patients because of the study limitation without adequate parameters were investigated [45]. Host immune responses play an important role in determining the severity and clinical outcome in patients with infection by SFTSV.
For Viral treatment options: https://madisonarealymesupportgroup.com/2016/03/28/combating-viruses/

And lastly, please know ticks parasitize one another, potentially spreading all manner of diseases to humans.  This fact also shoots holes in the regurgitated mantra that only certain ticks carry certain pathogens.  If they are feasting on one another, they can potentially infect each other and then us:  https://madisonarealymesupportgroup.com/2018/03/07/tick-bites-tick-hyperparasitism/

 

 

Asian Tick Now in North Carolina

https://www.charlotteobserver.com/news/local/article214748110.html

This article in the Charlotte Observer is noted to be an “aggressive biter.”  A warning has been given to veterinarians to be on the look out as this tick clones itself and spreads rapidly.  It has even drained cattle of their blood.

They can spread disease to humans.

Read more here:

https://madisonarealymesupportgroup.com/2018/03/01/asian-ticks-mysteriously-turn-up-in-new-jersey/

https://madisonarealymesupportgroup.com/2018/04/21/ticks-from-hell-survived-the-winter/

https://madisonarealymesupportgroup.com/2018/06/27/tick-discovery-highlights-how-few-answers-we-have-about-these-pests-in-the-u-s/

https://madisonarealymesupportgroup.com/2018/06/12/first-longhorned-tick-confirmed-in-arkansas/

https://madisonarealymesupportgroup.com/2018/05/26/tick-from-hell-now-sited-in-west-virginia/

https://madisonarealymesupportgroup.com/2018/07/18/asian-tick-now-in-new-york/

Asian Tick Now in New York

https://www.wgrz.com/article/news/health/a-new-dangerous-tick-found-in-new-york/71-574781863

The New York state Health Department has found the Asian “long horned” (Haemaphysalis longicornis) or Bush tick in Westchester County.

Normally found in Asia, this tick clones itself and spreads rapidly.  It has been found in New Jersey, Virginia, West Virginia, North Carolina, Arkansas, and now New York.

If seen, contact the New York State Department of Agriculture and Markets Division of Animal Industry at 518-457-3502 or dai@agriculture.ny.gov.

For more on the Asian tick:  https://madisonarealymesupportgroup.com/2018/03/01/asian-ticks-mysteriously-turn-up-in-new-jersey/

https://madisonarealymesupportgroup.com/2018/04/21/ticks-from-hell-survived-the-winter/

https://madisonarealymesupportgroup.com/2018/06/27/tick-discovery-highlights-how-few-answers-we-have-about-these-pests-in-the-u-s/

https://madisonarealymesupportgroup.com/2018/06/12/first-longhorned-tick-confirmed-in-arkansas/

https://madisonarealymesupportgroup.com/2018/05/26/tick-from-hell-now-sited-in-west-virginia/

So far we know it can spread SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” causing fever, fatigue, headache, nausea, muscle pain, diarrhea, vomiting, abdominal pain, disease of the lymph nodes, and conjunctival congestion, but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, this Longhorned tick, also called the East Asian or bush tick, has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.

So, this is no benign little sucker…..

First RMSF Death in Wisconsin

https://www.dhs.wisconsin.gov/news/releases/071018.htm

FOR IMMEDIATE RELEASE
July 10, 2018
CONTACT: Jennifer Miller, 608-266-1683
Elizabeth Goodsitt, 608-266-1683
Jo Foellmi, 608-785-5753

DHS Confirms Death of a La Crosse County Resident from Rocky Mountain Spotted Fever

State and local health departments urge residents to take precautions to protect against tick bites

The Wisconsin Department of Health Services and the La Crosse County Health Department today announced the first documented death from Rocky Mountain spotted fever (RMSF) in the state.

RMSF is rarely reported in Wisconsin and most commonly occurs in the central and southeastern regions of the United States. Most tickborne diseases transmitted in Wisconsin are spread by the blacklegged (or deer) tick; RMSF, however, is spread by the bite of the American dog (or wood) tick (Picture Attached). Early symptoms of RMSF can be mild and typically include fever, headache, nausea, vomiting, rash, and stomach pain. If left untreated, however, a RMSF infection can rapidly develop into a serious illness.

dog-tick-closeup-rocky-mountain-spotted-fever

American dog tick, which can transmit RMSF

“We are saddened to learn of this death and encourage Wisconsin residents to take steps to protect themselves and their families from tick bites while enjoying the outdoors,” said Karen McKeown, State Health Officer.

  • Use an insect repellent with at least 20% DEET or another EPA-registered repellent according to the label instructions.
  • Use 0.5% permethrin products on clothing, socks, and shoes according to label instructions.
  • Stay on trails and avoid walking through tall grasses and brush.
  • Wear long sleeves and pants, and tuck pants into socks and shirts into pants to avoid ticks crawling under clothing.
  • Check your entire body for ticks after being outdoors.
  • Take a shower as soon as possible after coming in from outdoors.
  • Place clothes in the dryer on high heat for 10 minutes to kill any ticks on clothing.
  • Use a veterinarian-prescribed tick prevention treatment on pets.

Of the illnesses spread by ticks in Wisconsin, Lyme disease is the most common, but ticks can also spread anaplasmosis, ehrlichiosis, and more rarely RMSF and Powassan virus. Many people who contract a tickborne disease do not recall a tick bite, so it’s also important to be aware of the common symptoms of tickborne disease such as fever, rash, headache, body aches, and fatigue.

Most diseases spread by ticks in Wisconsin, including Lyme disease, anaplasmosis, ehrlichiosis, and RMSF, can be effectively treated with antibiotics, making early diagnosis critical. If symptoms develop after a tick bite or after possible tick exposure, see a health care provider.

__________________

**Comment**

Story here:  http://amp.wisn.com/article/wisconsin-woman-dies-from-rocky-mountain-spotted-fever/22108466

Jo Foellimi, a La Crosse County public health nurse, said the woman was bit while camping in western Wisconsin in early May.  The woman was diagnosed with RMSF in mid-June and died days later.  Foellimi said the woman was in her late 50s but declined to identify her.

More on RMSF:  https://madisonarealymesupportgroup.com/2018/06/12/georgia-mom-warns-others-after-son-contracts-rocky-mountain-spotted-fever-after-tick-bite/

https://madisonarealymesupportgroup.com/2015/08/13/severe-case-of-rmsf-had-to-remove-patients-arms-and-legs/

https://madisonarealymesupportgroup.com/2017/06/10/two-deaths-from-rmsf-indiana-has-tbis/

Treatment is doxycycline:  https://www.uptodate.com/contents/treatment-of-rocky-mountain-spotted-fever  Empiric therapy with doxycycline should be started if the diagnosis of Rocky Mountain spotted fever (RMSF) is suspected, even if the symptoms are mild.

We Have No Idea How Bad the US Tick Problem Is

https://www.wired.com/story/we-have-no-idea-how-bad-the-us-tick-problem-is/
AUTHOR: MEGAN MOLTENIMEGAN MOLTENI
SCIENCE
7.04.18

WE HAVE NO IDEA HOW BAD THE US TICK PROBLEM IS

WHEN RICK OSTFELD gets bitten by a tick, he knows right away. After decades studying tick-borne diseases as an ecologist at the Cary Institute of Ecosystem Studies in Millbrook, New York, Ostfeld has been bitten more than 100 times, and his body now reacts to tick saliva with an intense burning sensation. He’s an exception. Most people don’t even notice that they’ve been bitten until after the pest has had time to suck up a blood meal and transfer any infections it has circulating in its spit.

Around the world, diseases spread by ticks are on the rise. Reported cases of Lyme, the most common US tick-borne illness, have quadrupled since the 1990s. Other life-threatening infections like anaplasmosis, babesiosis, and Rocky Mountain spotted fever are increasing in incidence even more quickly than Lyme. Meat allergies caused by tick bites have skyrocketed from a few dozen a decade ago to more than 5,000 in the US alone, according to experts. And new tick-borne pathogens are emerging at a troubling clip; since 2004, seven new viruses and bugs transmitted through tick bite have shown up in humans in the US.

Scientists don’t know exactly which combination of factors—shifting climate patterns, human sprawl, deforestation—is leading to more ticks in more places. But there’s no denying the recent population explosion, especially of the species that carries Lyme disease: the black-legged tick.

“Whole new communities are being engulfed by this tick every year,” says Ostfeld. “And that means more people getting sick.

Tick science, surveillance, and management efforts have so far not kept pace. But the country’s increasingly dire tick-borne disease burden has begun to galvanize a groundswell of research interest and funding.

In 1942, Congress established the CDC specifically to prevent malaria, a public health crisis spreading through mosquitoes. Which is why many US states and counties today still have active surveillance programs for skeeters. The Centers for Disease Control and Prevention uses data from these government entities to regularly update distribution maps, track emerging threats (like Zika), and coordinate control efforts. No such system exists for ticks.

Public health departments are required to report back to the CDC on Lyme and six other tick-borne infections. Those cases combined with county-level surveys and some published academic studies make up the bulk of what the agency knows about national tick distribution. But this data, patchy and stuck in time, doesn’t do a lot to help public health officials on the ground.

“We’ve got national maps, but we don’t have detailed local information about where the worst areas for ticks are located,” says Ben Beard, chief of the CDC’s bacterial diseases branch in the division of vector-borne diseases. “The reason for that is there has never been public funding to support systematic tick surveillance efforts.

That’s something Beard is trying to change. He says the CDC is currently in the process of organizing a nationwide surveillance program, which could launch within the year. It will pull data collected by state health departments and the CDC’s five regional centers about tick prevalence and the pathogens they’re carrying to build a better picture of where outbreaks and hot spots are developing, especially on the expanding edge of tick populations.

The CDC is also a few years into a massive nationwide study it’s conducting with the Mayo Clinic, which will eventually enroll 30,000 people who’ve been bitten by ticks. Each one will be tested for known tick diseases, and next-generation sequencing conducted at CDC will screen for any other pathogens that might be present. Together with patient data, it should provide a more detailed picture of exactly what’s out there.

Together, these efforts are helping to change the way people and government agencies think about ticks as a public health threat.

“Responsibility for tick control has always fallen to individuals and homeowners,” says Beard. “It’s not been seen as an official civic duty, but we think it’s time whole communities got engaged. And getting better tick surveillance data will help us define risk for these communities in areas where people aren’t used to looking for tick-borne diseases.”

The trouble is that scientists also know very little about which interventions actually reduce those risks.

“There’s no shortage of products to control ticks,” says Ostfeld. “But it’s never been demonstrated that they do a good enough job, deployed in the right places, to prevent any cases of tick-borne disease.”

In a double-blind trial published in 2016, CDC researchers treated some yards with insecticides and others with a placebo. The treated yards knocked back tick numbers by 63 percent, but families living in the treated homes were still just as likely to be diagnosed with Lyme.

Ostfeld and his wife and research partner Felicia Keesing are in the middle of a four-year study to evaluate the efficacy of two tick-control methods in their home territory of Dutchess County, an area with one of the country’s highest rates of Lyme disease. It’s a private-public partnership between their academic institutions, the CDC, and the Steven and Alexandra Cohen Foundation, which provided a $5 million grant.

Ostfeld and Keesing are blanketing entire neighborhoods in either a natural fungus-based spray or tick boxes, or both. The tick boxes attract small mammal hosts, which get a splash of tick-killing chemicals when they venture inside. They check with all the human participants every two weeks for 10 months of the year to see if anyone’s gotten sick. By the end of 2020 the study should be able to tell them how well these methods, used together or separately on a neighborhood-wide scale, can reduce the risk of Lyme.

“If we get a definitive answer that these work the next task would be to figure out how to make such a program more broadly available. Who’s going to pay for it, who’s going to coordinate it?” says Ostfeld. “If it doesn’t work then perhaps the conclusion is maybe environmental control just can’t be done.”

In that case, people would be stuck with pretty much the same options they have today: protective clothing, repellants, and daily partner tick-checks. It’s better than nothing. But with more and more people getting sick, the US will need better solutions soon.

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**Comment**

Great article pointing out the scary fact that only 6 pathogens transmitted by ticks are being reported on.  There are currently 18 pathogens and counting…..so the numbers are woefully inadequate.

Here’s the list so far:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

Babesiosis
Bartonellosis
Borrelia miyamotoi
Bourbon Virus
Colorado Tick Fever
Crimean-Congo hemorrhagic Fever
Ehrlichiosis/Anaplasmosis
Heartland Virus
Meat Allergy/Alpha Gal
Pacific Coast Tick Fever: Richettsia philipii
Powassan Encephalitis
Q Fever
Rickettsia parkeri Richettsiosis
Rocky Mountain Spotted Fever
STARI: Southern Tick-Associated Rash Illness
Tickborne meningoencephalitis
Tick Paralysis
Tularemia

And the number keeps growing…..but nobody’s keeping score.

First Longhorned Tick Confirmed in Arkansas

http://www.4029tv.com/article/first-longhorned-tick-confirmed-in-arkansas/21274301  (News Video here)

First Longhorned Tick confirmed in Arkansas

The USDA confirmed the presence of the Longhorned Tick in Arkansas for the first time.

The tick came from a dog in Benton County, according to the Arkansas Agriculture Department.

The Longhorned Tick is an exotic East Asian tick associated with bacterial and viral disease of both humans and animals. The USDA considers it a serious threat to livestock.

The tick is also believed to cause diseases in humans, including severe fever with thrombocytopenia syndrome. That disease was described in a 2014 CDC dispatch as “a newly emerging infectious disease.”

Multiorgan failure occurs in severe cases, and 6%-30% of case-patients die,” according to the dispatch.

The Longhorned Tick was first confirmed to be in the United States in November 2017, when a specimen was identified in New Jersey. It has also been found in Virginia and West Virginia.

Longhorned Ticks are very small and resemble tiny spiders. The Arkansas Agriculture Department warns they can easily go unnoticed on animals and people.

The department asks that animal owners, veterinarians and farmers notify the Arkansas Agriculture Department if they notice unusual ticks or ticks that occur in large numbers on a single animal.

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**Comment**

The spread of the “tick from hell” has begun.  The reason we need to take note of this particular tick:  https://madisonarealymesupportgroup.com/2018/03/01/asian-ticks-mysteriously-turn-up-in-new-jersey/

 

  1. IT CLONES ITSELF & MULTIPLIES QUICKLY…..
  2. It can drain cattle of their blood:  https://madisonarealymesupportgroup.com/2018/03/12/asian-tick-found-in-new-jersey-can-kill-cattle-by-draining-them-of-blood/
  3. It spreads SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” causing fever, fatigue, headache, nausea, muscle pain, diarrhea, vomiting, abdominal pain, disease of the lymph nodes, and conjunctival congestion, but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, this Longhorned tick, also called the East Asian or bush tick, has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.
  4. A top ecologist wonders if infection by this tick has gone undetected in the past.
  5. There isn’t a systematic national method to look for invasive ticks.
  6. It’s quickly showing up in other states:  https://madisonarealymesupportgroup.com/2018/05/26/tick-from-hell-now-sited-in-west-virginia/
  7. It survives cold temps:  https://madisonarealymesupportgroup.com/2018/04/21/ticks-from-hell-survived-the-winter/  (Again, the spread infection has ZIPPO to do with climate change)

For a 2016 literature review on SFTS:  http://infectious-diseases-and-treatment.imedpub.com/research-advances-on-epidemiology-of-severefever-with-thrombocytopenia-syndrome-asystematic-review-of-the-literature.php?aid=17986

Although the clinical symptoms of SFTS and HGA are similar to each other, but the treatment methods of the two diseases are totally different. Doctors notice that the biggest difference between the clinical symptom of SFTS and HGA is that SFTS patients generally without skin rash, the dermorrhagia is also not seriously, and few massive hemorrhage cases were reported [23]. It is also reported that SFTS patients had gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, which are rarely observed in HGA patients [2]. So these differences can be used as the auxiliary basis of differential diagnosis.

At present, there is still no specific vaccine or antiviral therapy for SFTSV infection. Supportive treatment, including plasma, platelet, granulocyte colony stimulating factor (GCSF), recombinant human interleukin 11, and gamma globulin is the most essential part of case treatment [44]. Meanwhile, some measures were taken to maintain water, electrolyte balance and treat complications are also very important.

Ribavirin is reported to be effective for treating Crimean-Congo Hemorrhagic Fever (CCHF) infections and hemorrhagic fever with renal syndrome, but it is still inadequate to judge the effect of ribavirin on SFTS patients because of the study limitation without adequate parameters were investigated [45]. Host immune responses play an important role in determining the severity and clinical outcome in patients with infection by SFTSV.

For Viral treatment options:  https://madisonarealymesupportgroup.com/2016/03/28/combating-viruses/