Archive for the ‘Rocky Mountain Spotted Fever’ Category

CDC Creates Interactive Training For Diagnosis, Management of Rocky Mountain Spotted Fever

https://www.cdc.gov/media/releases/2019/p0513-rocky-mountain-spotted-fever-training.html

CDC Creates Interactive Training for Diagnosis, Management of Rocky Mountain Spotted Fever

Press Release

For Immediate Release, Monday, May 13, 2019
Contact: Media Relations
(404) 639-3286

 

The Centers for Disease Control and Prevention (CDC) has created a first-of-its-kind education module to help clinicians recognize and diagnose Rocky Mountain spotted fever (RMSF), a sometimes serious and fatal disease spread by the bite of an infected tick.

“Rocky Mountain spotted fever can be deadly if not treated early – yet cases often go unrecognized because the signs and symptoms are similar to those of many other diseases,” said CDC Director Robert R. Redfield, M.D. “With tickborne diseases on the rise in the U.S., this training will better equip healthcare providers to identify, diagnose, and treat this potentially fatal disease.”

The module includes scenarios based on real cases to help healthcare providers recognize the early signs of RMSF and differentiate it from similar diseases. Continuing education credit is available for physicians, nurse practitioners, physician assistants, veterinarians, nurses, epidemiologists, public health professionals, educators, and health communicators.

In 2017, a record number of cases of tickborne spotted fever rickettsiosisexternal icon, including RMSF, were reported to the CDC. While the number of spotted fever cases in 2017 is striking (6,248 cases, up from 4,269 the previous year), fewer than 1% of those cases had sufficient laboratory evidence to be confirmed, pointing to the need to better train health care providers on the best methods to diagnose tickborne diseases.

RMSF is treatable with doxycycline, the antibiotic of choice in people of all ages. Disability and death from RMSF can be prevented when doxycycline is prescribed within the first five days of illness, meaning that early recognition and treatment can save lives. RMSF begins with non-specific symptoms such as fever and headache, and sometimes rash, but when left untreated, the disease can lead to devastating consequences. Severely ill patients may require amputation of fingers, toes, or limbs due to poor blood flow; heart and lung specialty care; and management in intensive care units. Roughly 1 in 5 untreated cases are fatal. Half of those deaths occur within the first 8 days of illness.

For more information about Rocky Mountain spotted fever and other rickettsial diseases:

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESexternal icon

CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

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For More:  https://madisonarealymesupportgroup.com/2018/07/10/first-rmsf-death-in-wisconsin/

https://madisonarealymesupportgroup.com/2018/09/14/rocky-mountain-spotted-fever-rmsf/

https://madisonarealymesupportgroup.com/2018/08/16/new-tick-causes-epidemic-of-rmsf/  Excerpt:

It’s usually spread by the American dog tick and the closely related Rocky Mountain wood tick. But in recent years the bacterial infection has also been spread by the brown dog tick — a completely different species.

The researchers were investigating an epidemic of the infection that broke out in the border town of Mexicali starting in 2008. It’s already sickened at least 4,000 people, according to Mexican government estimates. Several hundred have died, and at least four people have died in the U.S. after crossing the border, according to this report and others.

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

https://madisonarealymesupportgroup.com/2018/10/21/all-his-symptoms-pointed-toward-the-flu-but-the-test-was-negative-rmsf-in-connecticut/

Again, testing is abysmal.  Doctors NEED education.

If interested:  https://madisonarealymesupportgroup.com/2018/02/19/calling-all-doctors-please-become-educated-regarding-tick-borne-illness-heres-how/

https://madisonarealymesupportgroup.com/2018/06/06/lyme-education-for-healthcare-professionals/

https://madisonarealymesupportgroup.com/2019/03/15/global-lyme-alliance-announces-new-partnership-with-delaware-lyme-board-to-help-educate-physicians-about-lyme-disease/

 

Rickettsiales in Ticks Removed From Outdoor Workers From Georgia & Florida

https://wwwnc.cdc.gov/eid/article/25/5/18-0438_article

Volume 25, Number 5—May 2019

Research Letter

Rickettsiales in Ticks Removed from Outdoor Workers, Southwest Georgia and Northwest Florida, USA

Elizabeth R. Gleim1Comments to Author , L. Mike Conner, Galina E. Zemtsova, Michael L. Levin, Pamela Wong, Madeleine A. Pfaff, and Michael J. Yabsley  DOI: 10.3201/eid2505.180438

The southeastern United States has multiple tick species that can transmit pathogens to humans. The most common tick species, Amblyomma americanum, is the vector for the causative agents of human ehrlichioses and southern tick-associated rash illness, among others (1). Dermacentor variabilis ticks can transmit the causative agent of Rocky Mountain spotted fever, and Ixodes scapularis ticks can transmit the causative agents of Lyme disease, babesiosis, and human granulocytic anaplasmosis (1). Although less common in the region, A. maculatum ticks are dominant in specific habitats and can transmit the causative agent of Rickettsia parkeri rickettsiosis (1).

Persons who have occupations that require them to be outside on a regular basis might have a greater risk for acquiring a tickborne disease (2). Although numerous studies have been conducted regarding risks for tickborne diseases among forestry workers in Europe, few studies have been performed in the United States (2,3). The studies that have been conducted in the United States have focused on forestry workers in the northeastern region (2). However, because of variable phenology and densities of ticks, it is useful to evaluate tick activity and pathogen prevalence in various regions and ecosystems.

Burn-tolerant and burn-dependent ecosystems, such as pine (Pinus spp.) and mixed pine forests commonly found in the southeastern United States, have unique tick dynamics compared with those of other habitats (4). The objective of this study was to determine the tick bite risk and tickborne pathogen prevalence in ticks removed from forestry workers working in pine and mixed pine forests in southwest Georgia and northwest Florida, USA.

During June 2009–December 2011, forestry workers in southwestern Georgia (7 counties) and northwestern Florida (1 county) submitted ticks crawling on or attached to them. We identified ticks and tested them for selected pathogens (Appendix). Immature forms of the same species from the same day and person were pooled (<5 nymphs and <20 larvae) for testing.

A total of 53 persons submitted 362 ticks (Table). Excluding larvae, the most common tick species submitted was A. maculatum, followed by A. americanum, I. scapularis, and D. variabilis. On 4 occasions, 1 person submitted A. tuberculatum ticks (3 batches of larvae and 1 batch of nymphs) from a longleaf pine site in Baker County, Georgia. Average submissions per persons were 2.6 ticks (median 1 tick), but 1 person submitted 100 ticks. A total of 24 persons submitted ticks more than once, and they submitted an average of 0.08–6.5 ticks/month (overall average submission rate of 1.1 ticks/month). Three ticks were engorged (1 D. variabilis adult, 1 A. americanum nymph, and 1 Amblyomma sp. nymph); only the Amblyomma sp. nymph was positive for a pathogen (R. amblyommatis).

  • Rickettsia spp. prevalence was 36.4% in adult, 27.9% in nymphal, and 20% in larval A. americanum ticks; R. amblyommatis was the only species identified (Table).
  • Rickettsia spp. were detected in 23% of A. maculatum adults; R. amblyommatis was most common (6.0%), followed by R. parkeri (4.8%).
  • A previously detected novel Rickettsia sp. was identified in 10 of 11 A. tuberculatum larval pools and was reported by Zemtsova et al. (6). An additional pool of A. tuberculatum nymphs was tested in this study and also was positive for the novel Rickettsia sp.
  • E. chaffeensis was detected in 1 A. maculatum adult (prevalence 1.2%), and Panola mountain Ehrlichia sp. was detected in 2 A. maculatum adults (prevalence 2.4%) and 1 D. variabilis adult (prevalence 10%).
  • No ticks were positive for Borrelia spp., E. ewingii, or Anaplasma phagocytophilum.

Thus, forestry workers were found to encounter ticks on a regular basis, and peak encounter rates reflected previously reported tick seasonality in this region (4). Only 3 (0.8%) of the ticks submitted were engorged, indicating prompt removal of most ticks and thus low risk for pathogen transmission. A. maculatum, a fairly uncommon tick in the southeastern United States, was the most commonly submitted tick. However, A. maculatum ticks dominate in regularly burned pine ecosystems (4), which is where most of these workers spent their time.

We observed several unique findings related to pathogens during this study. Larvae and nymphs of A. tuberculatum ticks were submitted on multiple occasions, a tick rarely reported on humans (7). These findings in conjunction with the identification of a novel Rickettsia sp. (6), suggest that additional research is warranted. This study also identified E. chaffeensis and Panola Mountain Ehrlichia in A. maculatum ticks. Although A. americanum ticks are considered the primary vector of Ehrlichia spp., these pathogens have been occasionally reported in questing A. maculatum ticks, suggesting that this tick might be involved in their transmission cycles (5,8). We also detected Panola Mountain Ehrlichia in 1 D. variabilis tick. Thus, further research regarding these alternative tick species as potential vectors of these pathogens is warranted, particularly in the case of A. maculatum ticks, which were a common species on forestry workers and are widespread in this region (4).

At the time of this study, Dr. Gleim was a research scientist at the University of Georgia, Athens, GA. She is currently a disease ecologist at Hollins University, Roanoke, VA. Her research interests include wildlife and zoonotic diseases with a particular emphasis on tickborne diseases.

Acknowledgments

We thank the persons whom submitted ticks for this study and members of the Yabsley and Levin laboratories for providing laboratory assistance.

This study was supported by the Centers for Disease Control and Prevention/University of Georgia (UGA) collaborative grant (#8212, Ecosystem Health and Human Health: Understanding the Ecological Effects of Prescribed Fire Regimes on the Distribution and Population Dynamics of Tick-Borne Zoonoses); the Oxford Research Scholars Program at Oxford College of Emory University; the Joseph W. Jones Ecological Research Center, the Warnell School of Forestry and Natural Resources (UGA); the Southeastern Cooperative Wildlife Disease Study (UGA) through the Federal Aid to Wildlife Restoration Act (50 Statute 917); and Southeastern Cooperative Wildlife Disease Study sponsorship from fish and wildlife agencies of member states.

References

  1. Stromdahl  EY, Hickling  GJ. Beyond Lyme: aetiology of tick-borne human diseases with emphasis on the south-eastern United States. Zoonoses Public Health. 2012;59(Suppl 2):4864. DOIPubMed
  2. Covert  DJ, Langley  RL. Infectious disease occurrence in forestry workers: a systematic review. J Agromed. 2002;8:95111. DOIPubMed
  3. Lee  S, Kakumanu  ML, Ponnusamy  L, Vaughn  M, Funkhouser  S, Thornton  H, et al. Prevalence of Rickettsiales in ticks removed from the skin of outdoor workers in North Carolina. Parasit Vectors. 2014;7:607. DOIPubMed
  4. Gleim  ER, Conner  LM, Berghaus  RD, Levin  ML, Zemtsova  GE, Yabsley  MJ. The phenology of ticks and the effects of long-term prescribed burning on tick population dynamics in southwestern Georgia and northwestern Florida. PLoS One. 2014;9:e112174. DOIPubMed
  5. Loftis  AD, Kelly  PJ, Paddock  CD, Blount  K, Johnson  JW, Gleim  ER, et al. Panola Mountain Ehrlichia in Amblyomma maculatum From the United States and Amblyomma variegatum (Acari: Ixodidae) From the Caribbean and Africa. J Med Entomol. 2016;53:6968. DOIPubMed
  6. Zemtsova  GE, Gleim  E, Yabsley  MJ, Conner  LM, Mann  T, Brown  MD, et al. Detection of a novel spotted fever group Rickettsia in the gophertortoise tick. J Med Entomol. 2012;49:7836. DOIPubMed
  7. Goddard  J. A ten-year study of tick biting in Mississippi: implications for human disease transmission. J Agromed. 2002;8:2532. DOIPubMed
  8. Allerdice  ME, Hecht  JA, Karpathy  SE, Paddock  CD. Evaluation of Gulf Coast ticks (Acari: Ixodidae) for Ehrlichia and Anaplasma species. J Med Entomol. 2017;54:4814.https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=28031351&dopt=Abstract

Table

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**Comment**

Again, folks down South should be taken seriously when they present with symptoms.  BTW: Southern advocates tell me that STARI looks, smells, and feels just like Lyme disease.  

Lyme IS in the South:  https://madisonarealymesupportgroup.com/2016/10/25/hope-for-southerners/

The take home: Clark is finding borrelia (Lyme) strains in the South that the current CDC two-tier testing will never pick up in a thousand years.

https://www.researchgate.net/publication/285584725_Isolation_of_live_Borrelia_burgdorferi_sensu_lato_spirochetes_from_patients_with_undefined_disorders_and_symptoms_not_typical_for_Lyme_diseases

The take home: Clark found live Bbsl (bissettii-like strain) in people from the Southeast who had undefined disorders not typical of LD, and were treated for LD even though they were seronegative, proving that B. bissetti is responsible for worldwide human infection.

He also showed DNA of Bbsl in Lone Star ticks which might be a bridge vector of transmission to humans.

Dr. Clark was the first to report finding LD spirochetes in animals and ticks in South Carolina, as well as in wild lizards in South Carolina and Florida. He has documented the presence of LD Borrelia species, Babesia microti, Anaplasma phagocytophilum, Rickettsia species, and other tick-borne pathogens in wild animals, ticks, dogs, and humans in Florida and other southern states.

Clark is infected.  Surprised?  This is why he’s finding answers – it’s much more than a job to him.

https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/

https://madisonarealymesupportgroup.com/2019/03/19/jacksonville-family-shares-daughters-9-month-diagnosis-of-rare-disease-which-isnt-rare-lyme/

Time to start believing people!

Tick Data – 76% Infected With One Organism, 20% Have Three or More Pathogens

https://www.tickcheck.com/statistics?

Each tick submitted for testing contributes to the research being conducted at TickCheck. By keeping records of all the results generated, we have been able to gain valuable insights into disease prevalence and co-infection rates. The comprehensive testing panel has been especially helpful in contributing to this research by ensuring all diseases and coinfections are accounted for when examining a tick.

Our current research shows:
  • 76% of ticks tested have at least one disease causing organism
  • 49% are co-infected with two or more organisms
  • 20% carry three or more
  • 9% of the ticks tested carry four or more

Infection Visualization by Tick Species

All Ticks Tested
76% Positive for Infection
Negative (24%)
_____________________________
  • 93% Positive for Infection
  • Negative (7%)
  • 63% Positive for Infection
  • Negative (37%)
  • 48% Positive for Infection
  • Negative (52%)

Coinfection Visualization

  • 2+ coinfection 49%
  • No coinfection 51%

Pathogenic Prevalence

The information below shows the positive/negative prevalence ratio of selected pathogens we test for. These pathogens were observed in ticks from the United States and Canada. Data set includes tests performed since TickCheck’s founding in 2014 and is updated in real time. (

Go to link at beginning to filter by state.  I’ve added the 3 listed for Wisconsin next to the entire sample size.  Please note the small sample sizes of WI ticks. 

Borrelia burgdorferi (deer tick) associated with Lyme disease

Sample size of 3,280 ticks.           70 Wisconsin ticks
  • 30% postive                                           33% positive
  • 70% negative                                         67% negative

Borrelia burgdorferi (western blacklegged tick) associated with Lyme disease

Sample size of 279 ticks.
  • 4% positive
  • 96% negative

Borrelia burgdorferi (lone star tick) associated with Lyme disease

Sample size of 899 ticks.
  • 8% positive
  • 92% negative

Borrelia burgdorferi (American dog tick) associated with Lyme disease

Sample size of 901 ticks.
  • 2% positive
  • 98% negative

Anaplasma phagocytophilum associated with anaplasmosis

Sample size of 2,146 ticks.           36 Wisconsin ticks
  • 8% positive                                           11% positive in Wisconsin
  • 92% negative                                        89% negative in Wisconsin

Babesia microti associated with babesiosis

Sample size of 1,894 ticks.           32 Wisconsin ticks
  • 4% positive                                            6% positive
  • 96% negative                                        94% negative

Bartonella spp. associated with bartonellosis

Sample size of 1,060 ticks.
  • 47% positive
  • 53% negative

Ehrlichia chaffeensis associated with ehrlichiosis

Sample size of 857 ticks.
  • 2% positive
  • 98% negative

Rickettsia spp. associated with Rocky Mountain spotted fever

Sample size of 944 ticks.
  • 23% postive
  • 77% negative

Francisella tularensis associated with tularemia

Sample size of 1,028 ticks.
  • 1% positive
  • 99% negative

Borrelia miyamotoi associated with B. miyamotoi

Sample size of 1,091 ticks.
  • 6% postive
  • 94% negative

Borrelia lonestari associated with STARI

Sample size of 831 ticks.
  • 19% postitive
  • 81% negative

Babesia spp. associated with babesiosis

Sample size of 564 ticks.
  • 5% positive
  • 95% negative

Mycoplasma spp. associated with Mycoplasma spp.

Sample size of 948 ticks.
  • 8% positive
  • 92% negative

Borrelia spp. associated with Borrelia spp.

Sample size of 612 ticks.
  • 17% postive
  • 83% negative

Powassan virus Lineage II associated with Deer tick virus

Sample size of 102 ticks.
  • 24% positive
  • 76% negative

Borrelia mayonii associated with Lyme disease

Sample size of 376 ticks.
  • 100% negative

Ehrlichia ewingii associated with ehrlichiosis

Sample size of 283 ticks.
  • 100% negative

Rickettsia amblyommii associated with Rocky Mountain spotted fever

Sample size of 177 ticks.
  • 46% positive
  • 54% negative

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For more about Tickcheckhttps://www.tickcheck.com/about

You can request free tick identification by sending in a quality picture of your tick. Using real-time PCR (Polymerase Chain Reaction), Tickcheck can determine the presence of certain pathogens with an accuracy level of over 99.9%.  All information about how to send in your tick, costs of various tests, time for results, etc. is found here:  https://www.tickcheck.com/info/faq

Jonathan Weber is the founder and CEO of TickCheck and became acutely aware of the dangers of tick-borne diseases after his father caught Lyme during a family trip on the Appalachian Trail.

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**Comment**

This information supports current research showing many patients are infected with numerous pathogens causing more severe illness & requiring far more than the CDC’s mono therapy of doxycycline:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

It also supports previous work showing coinfections within ticks:  https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/

What I want to know is WHY nothing’s being done about this?  Why are people STILL given 21 days of doxycycline when that particular med will not work on numerous pathogens?
Lastly, a word about statistics – this tick data should be used with caution & never to turn sick patients away due to a statistic. If you are the sorry sucker who gets bit by that ONE tick carrying a “statistically insignificant” pathogen, you still got bit and have to deal with it.  
Shame on doctors for turning sick people away due to statistics and maps.
There’s no such thing as an “insignificant” tick bite!

But, Patients are STILL being turned away:  https://madisonarealymesupportgroup.com/2019/04/22/its-just-crazy-why-is-lyme-disease-treatment-so-difficult-to-find-in-mississippi/

https://madisonarealymesupportgroup.com/2019/03/19/jacksonville-family-shares-daughters-9-month-diagnosis-of-rare-disease-which-isnt-rare-lyme/

https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/

https://madisonarealymesupportgroup.com/2017/10/24/no-lyme-in-oklahoma-yeah-right/

https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/  “They had the classic symptoms, they had the bulls eye rash, they had the joint pain, they had fevers and had flu like symptoms, yet we were denied treatment for at least two of them and I don’t understand how this is legal,” said Bowerman.

According to Dr. Naveen Patil, Director of the Infectious Disease Program, ADH,

“We don’t have Lyme Disease in Arkansas, we have the ticks that transmit Lyme Disease but we don’t have any recorded cases of Lyme Disease.” 

Bowerman also received a letter from the clinic stating doctors would no longer treat her children because she consistently questioned their medical advice and recommendations.

This is getting to be way beyond ludicrous.

 

Eye Problems in Tick-borne Diseases Other Than Lyme

http://danielcameronmd.com/eye-problems-tick-borne-diseases-lyme/

EYE PROBLEMS IN TICK-BORNE DISEASES OTHER THAN LYME

“Why should an ophthalmologist have a good understanding of Lyme diagnosis and treatment?” asks Sathiamoorthi [1], from the Mayo Clinic, in an article published in the Current Opinion in Ophthalmology. “Vision-threatening ophthalmic manifestations are relatively common in Lyme disease (LD) and Rocky Mountain spotted fever.”

by Daniel J. Cameron, MD MPH

“Knowledge of systemic and ophthalmic manifestations combined with an understanding of the epidemiology of disease vectors is crucial for the diagnosis of tick-borne diseases,” she explains.

While manifestations may be present with LD and Rocky Mountain spotted fever, ocular involvement is rare in other tick-borne diseases such as babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever, Sathiamoorthi points out.

However, the true prevalence of ocular involvement due to tick-borne illnesses is unknown. Limitations with testing can make it difficult to identify patients. “It is crucial to know who is appropriate to test in order to avoid false positive results.” If an individual has been symptomatic for only a short period of time, they “may not have detectable serum IgM antibodies to the causative organism because it takes time for this immune response to develop.”

It can also be difficult to determine the cause of the ocular complaints if there is evidence of more than one tick-borne illness.

“One case report [2] describes a patient with optic neuritis and orbital myositis who had serologic evidence of HME [Human Monocytic Ehrlichioisis], Borrelia burgdorferi, and Babesia,” cites Sathiamoorthi.

There are more than one species of ticks associated with ocular findings, as well. According to Sathiamoorthi, those include Ornithodoros genus, Dermacentor variabilis Ambylomma americanum, Ixodes scapularis, and Dermacentor andersonii.

Sathiamoorthi advises doctors to “carefully generate a reasonable differential based on clues in the medical and social history regarding exposures and risks.”

“Patients who are most likely to have ophthalmic Lyme disease,” explains Sathiamoorthi, “are those with ocular manifestations commonly associated with Lyme disease (i.e. Bells palsy, cranial nerve palsies and keratitis); tick exposure in Lyme endemic regions; other signs/symptoms of late Lyme disease (i.e. inflammatory arthritis, carditis, acrodermatitis chronica atrophicans rash, encephalopathy and meningitis); and negative syphilis testing.”

Read more on eye problems in tick-borne diseases in “A growing list of eye problems in Lyme disease.”

References:

1. Sathiamoorthi S, Smith WM. The eye and tick-borne disease in the United States. Curr Opin Ophthalmol. 2016;27(6):530-537.
2. Pendse S, Bilyk JR, Lee MS. The ticking time bomb. Surv Ophthalmol. 2006;51(3):274-279.

 

Rocky Mountain Spotted Fever is Not the Only Rickettsiosis

https://www.galaxydx.com/rickettsiosis_rocky_mountain_spotted_fever/

Rocky Mountain Spotted Fever is not the only Rickettsiosis

 

 

Tularemia in Minnesotan Ticks

https://www.liebertpub.com/doi/abs/10.1089/vbz.2018.2388

Prevalence of Francisella tularensis in Dermacentor variabilis Ticks, Minnesota, 2017

Tory Whitten, Courtney Demontigny, Jenna Bjork, Mandy Foss, Molly Peterson, Joni Scheftel, Dave Neitzel, Maureen Sullivan, and Kirk Smith
Published Online:https://doi.org/10.1089/vbz.2018.2388

Introduction: The prevalence of Francisella tularensis in Minnesota ticks is unknown. Ticks collected at seven sites were tested to determine the infection prevalence of F. tularensis in Dermacentor variabilis in Minnesota.

Materials and Methods: Ticks were collected from two properties at an epizootic site and at five long-term tick research sites. Ticks were pooled by species, sex, date, and site with a maximum of 10 ticks per pool. Ticks were bisected and homogenized; DNA from supernatant was extracted and tested by real-time PCR (RT-PCR). Twice, additional ticks were collected for bacterial culture and isolation of F. tularensis. Proportion of positive pools and minimum infection rate (MIR) were calculated.

Results: A total of 3527 ticks were tested for F. tularensis including 1601 male D. variabilis and 1926 female D. variabilis. Across all sites, 128 (34%) of 378 pools were RT-PCR positive for F. tularensis. Of 128 positive pools, F. tularensis from 96 (75%) was identified as type A; F. tularensis from 32 pools was unable to be subtyped. The overall MIR was 3.6%. The MIR was significantly lower at the epizootic site compared with Morrison County 1 (3.9% vs. 7.2%; p = 0.02) but did not differ between the epizootic site and Pine County 1 (3.9% vs. 2.1%; p = 0.49). Within the epizootic site, the MIR was significantly higher at Washington County 2 compared with the adjacent property (5.7% vs. 2.3%; p < 0.001). F. tularensis was cultured from 6 (15%) of 40 pools.

Conclusions: F. tularensis was found in ticks at a majority of sites tested. The MIR of F. tularensis in D. variabilis ticks in Minnesota varied geographically. Our findings support the hypothesis that D. variabilis plays an important role in the natural history of tularemia in Minnesota. Further ecologic studies are needed to fully understand the importance of tick species in the maintenance and transmission of F. tularensis in Minnesota.

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**Comment**

The Dermacentor variabilis tick is a hard bodied tick, also known as the American Dog tick or Wood tick and is widely known.  It transmits Rocky Mountain spotted fever (RMSF) and tularemia to humans as well as canine tick paralysis to dogs.  http://edis.ifas.ufl.edu/in781

LyraEDISServlet-2

Dorsal view of American dog ticks, Dermacentor variabilis (Say), with male on left, and female on right.  Credit: J.F. Butler, University of Florida

It was been suggested that adult ticks move to the edge of the roads and trails in an attempt to find a host, or “quest.” Some have hypothesized that because many animals typically follow trails, they leave an odor that attracts these ticks causing them to move toward and quest alongside trails in attempts to find a host (Mcnemee et al. 2003).

More on Tularemia:  https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/ 

https://madisonarealymesupportgroup.com/2018/09/28/after-tularemia-death-experts-stress-education/

https://madisonarealymesupportgroup.com/2018/08/07/tularemia-hunting-dogs-as-possible-vectors/

https://madisonarealymesupportgroup.com/2018/02/27/tularemia-infected-ticks-found-on-sorrento-valley-trail-in-ca/

https://madisonarealymesupportgroup.com/2018/03/07/hantavirus-tularemia-warnings-issued-in-san-diego-county/

https://madisonarealymesupportgroup.com/2018/09/19/glandular-tularemia/

Normally thought of as inhabiting areas east of the Rocky Mountains, the Wood tick is obviously defying entomology maps and traipsing all over – from Minnesota to Missouri, California, and most probably everywhere in-between.

I remember hearing Timothy Lepore, MD, FACS, surgeon at Nantucket Cottage Hospital, at a Lyme conference.  He explained that Tularemia is also a disease of those who work with the land such as landscapers and farmers, as well as those who get bit by a tick. There are cases reported in every state but Hawaii, and many other wild and domestic animals can be infected. The highest rates of infection are in Arkansas.  Please see this link for more details but know that this is a bioweaponized pathogen:  https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/  The WHO estimates that an aerosol dispersal of 50 kg of F. tularensis over an area with 5 million people would result in 25,000 incapacitating casualties including 19,000 deaths.

Transmission: Transmission can occur through the skin or mucous membranes when handling infected animals as well as through tick bite, contact with fluids from infected deer flies, mosquitoes or ticks, handling or eating undercooked rabbit, drinking contaminated water, inhaling dust from contaminated soil, and handling contaminated pelts or paws of animals. It can also be inhaled from infected hay, grain, or soil. Dr. Lepore had patients who contracted it from their pet dog who shook rain water on them after chewing on a dead rabbit, as well as from folks eating road kill, a person who held sick animals, and a gentleman who slept with his pet bunny.

Another reminder – don’t sleep with pets!
The fact that 35% of Minnesotan ticks are infected with Tularemia is concerning.  Spread the word.

 

 

 

 

North Dakota Tick Survey Sees Large Uptick of Samples. Here’s What the Health Department Found

https://www.thedickinsonpress.com/lifestyle/health/4556529-north-dakota-tick-survey-sees-large-uptick-samples-heres-what-health

North Dakota tick survey sees large uptick of samples. Here’s what the health department found.

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The American Dog tick was the most common tick surveyed in 2018 by the North Dakota Department of Health. This adult female is a known carrier of Rocky Mountain spotted fever.   submitted photo
BISMARCK – Those creepy, crawly creatures are living up to their nasty reputation. In brief, the summary of a second season of a statewide survey of ticks confirms what most people fear – a high percentage of the bloodsucking, pincer pests are carriers of disgusting diseases that are easily transmitted to hosts.

 

The North Dakota Department of Health first ventured into tick surveillance in 2017 by collecting and testing a relatively small sample of ticks. The ticks in the sample were provided with the help of veterinarians and zoos in the state. The program was significantly expanded in 2018 with active participation from 37 veterinarians, four zoos, North Dakota Game and Fish, Department of Agriculture Wildlife Services and at least one individual.

“They all submitted ticks, which was a huge help,”said Laura Cronquist, NDDOH division of disease control. “We had more coverage throughout the state in 2018, which was real nice.”

Of the 13,640 ticks collected and sent to the state laboratory for disease testing, nearly half were contributed by a single interested individual – John Heiser of Grassy Butte. In all, ticks were submitted from 25 counties in the state.

“We had more participation last year, which was awesome,” said Cronquist. “More ticks were submitted. Our project is really unique for our area.”

The state’s most common tick is the American Dog tick. The dog tick and Rocky Mountain wood tick, which is also found within the state, are closely related. Both are known for their speciality, carrying the dreaded Rocky Mountain spotted fever virus.

Rocky Mountain spotted fever symptoms include stomach pain, nausea, vomiting, loss of appetite and muscle pain. Delayed treatment may lead to severe illness or death. Some Rocky Mountain spotted fever victims may suffer irreversible hearing loss, paralysis, mental disability and damage to blood vessels which could lead to amputation of extremities. Fourteen cases of Rocky Mountain spotted fever were reported in the state in 2017.

There’s another tick present in North Dakota with a well-deserved and ugly reputation too. A surprising number of them were collected in 2018.

“We ended up with more deer ticks from across the state,” noted Cronquist.

While the number of deer ticks submitted to the NDDOH was small in comparison to the number of other ticks, just 51, they were found in 22 of the 25 counties surveyed, including Ward County. Deer ticks are are known carriers of Lyme disease, 56 cases of which were reported in the state in 2017. In addition, deer ticks are believed to have transmitted 17 cases of anaplasmosis and one case of Powassan in 2017.

The symptoms of anaplasmosis are similar to Rocky Mountain spotted fever but can include chills, cough and confusion. Severe cases can lead to difficulty breathing, hemorrhage, kidney failure and disrupt various functions of the nervous system.

Fortunately, Powassan transmission from ticks remains quite rare in North Dakota. It is closely related to West Nile disease. A tick can transmit Powassan in as little as 15 minutes after biting a human. About 10 percent of Powassan cases result in death. According to the NDDOH report on the 2018 study, statistics show that approximately half of Powassan survivors have permanent neurologic conditions including headaches, muscle wasting and memory problems.

The Lone Star tick, whose range is primarily the southern and eastern United States, and has been linked to red meat allergies, is believed to be expanding its range. However, Lone Star ticks remain extremely rare in North Dakota.

“That’s correct,” said Cronquist. “Two years ago two were found. Last year just one and it’s unknown how they got here. They are not all that concerning yet.”

The state was divided into eight regions for the tick surveillance survey. Tick pools from each region, consisting of up to 20 ticks each, were tested for the presence of several diseases. Of the 176 pools made up of American Dog ticks and Rocky Mountain wood ticks, 106 tested positive for disease carrying pathogens. Half of the deer tick pools tested positive.

According to the NDDOH report, ticks can transfer some pathogens to their hosts in as little as 15 minutes. Some pathogens require that the tick to be attached from 24 to 48 hours. When a tick bites into flesh it inserts a feeding tube into the incision which enables the transmission of disease.

Complete results and information regarding the 2018 tick surveillance project can be found on the NDDOH website.

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For more:  https://madisonarealymesupportgroup.com/2018/07/22/citizen-scientists-help-track-tick-borne-illness-exposure/

https://madisonarealymesupportgroup.com/2018/04/10/canadian-citizen-scientists-helping-with-tick-surveillance/

https://madisonarealymesupportgroup.com/2018/10/26/scientists-high-school-students-find-new-pathogens-hiding-in-indiana-ticks/

https://madisonarealymesupportgroup.com/2018/10/22/tick-project-takes-a-deeper-look-at-disease/