Monday, January 25, 2021

What does "reported" mean when discussing reported cases of Lyme?

According to a recent post by Dorothy Kupcha Leland at Lymedisease.org, the CDC has recently revised the numbers of estimated cases of Lyme in the U.S. to 476,000 new cases per year.  They have even retroactively adjusted estimates going back to 2010.  

Reported Lyme cases

But, when the CDC reports cases, it's not so cut and dry as it sounds.  Kupcha Leland explains that "'[r]eported cases' are those cases which have been thoroughly vetted and found to adhere to the CDC’s narrowly defined surveillance criteria."  The responsibility of verifying and reporting cases falls on local agencies, and some do better jobs at it than others.

The new estimates are apparently based on insurance claims which coded for Lyme disease.  However, medical diagnosis and treatment coding is not always cut and dry.  Various factors can impact the accuracy and reliability of assessing the true number of annual Lyme disease cases through insurance reporting.

A quote from the CDC apparently argues that the new figure "likely includes some patients who were not actually infected.”  To this Kupcha Leland rebuts that it is also likely that this figure excludes many misdiagnosed cases.

Click here to read the full article and Kupcha Leland's sources.

 

Post by C. Fisher


Monday, January 18, 2021

The Migration of Lyme Disease Due to Climate Change

Deer ticks, common carriers of Lyme disease, have seen an increase in habitat due to climate change and, with current trajectories, will continue to do so.

By Zoe E. Quin, undergraduate researcher 

 

    Lurking within the tall grasses of many backyards and forests is a dangerous little critter who is out to drink your blood. These real-life vampires can locate you by sensing your breath. And if you come close enough, they can latch on without you ever knowing. Sometimes they may even leave you with an unpleasant parting gift. 

Ixodes scapularis (deer tick).  James Gathany, Centers for Disease Control and Prevention

     This unwanted hitch hiker is called Ixodes scapularis, better known as a deer or a black-legged tick. This tick can harbor a slew of infectious bacteria in their gut that can be ‘gifted’ to you. One common bacterium is Borrelia burgdorferi, which causes Lyme disease. The most common symptoms of Lyme disease are fatigue, headache, chills, fever, and a bullseye shaped rash called an erythema migrans. The current treatment for Lyme disease is a course of antibiotics, but some people experience continued and worsening symptoms after completing their medication. Unfortunately, recent research has predicted the expansion of deer tick habitat due to climate change. They may even be coming soon in a backyard near you!

    Lyme disease has been highly prevalent within northeastern United States and just recently has become more apparent with in southern Canada. It was previously believed that the climate of Canada was uninhabitable for deer ticks because of its cold winters. The colder temperatures would kill off tick populations, inhibiting them from feeding on new animal hosts. However, climate change has altered overall temperatures, the lengths of winter, and the tick’s host populations. All of which, have led to a northward growth of tick habitat into Canada and colder parts of the United States; potentially giving rise to more cases of Lyme disease.

    Within their lifetime, deer ticks will latch onto an animal and drink their blood three separate times. Once when they are a larva, once when they are a nymph, and then again when they are an adult.

 

Visual representation of Ixodes scapularis at different life stages (not to scale). Unfed adults are 2-6 millimeters in length; Adult males are often smaller than the adult females and misidentified as nymphs. Unfed nymphs are about 1.5 mm, and larva are less than 1 mm long, about the size of a poppy seed.

    The animals that ticks feed on usually depend upon their current life stage and the availability of hosts. Larva and nymphs are usually found feeding from small rodents and birds, while adults are found on medium to large mammals such as white-tailed deer and humans. Generally, the smaller tick hosts like the white-footed mouse, will acquire B. burgdorferi and readily infect other ticks more than their larger host counterparts; This may be due to body size, but it is overall unclear why. The infectivity of white-footed mice and other small mammals makes nymphal ticks much more dangerous to humans because they are more likely to acquire B. burgdorferi from their prior host and they are much harder to see.

    With current climate change trajectories warming cold climates, white-footed mice have been predicted to have a 186-mile shift north within the next forty years. This suggests that there will be an increase of hosts that can infect larval and nymphal ticks with the bacteria causing Lyme disease. These ticks can then grow into an adult to feed on another host, such as a white-tailed deer or humans. Over the last half of the 20th century, white-tailed deer populations have had an 88% increase in probability of white-tailed deer presence by area due to climate change and land use. The white-tailed deer acts as vehicles to transport pregnant deer ticks to new destinations where they lay their eggs, thus expanding the area where larval and nymphal ticks are found.  Within northern Alberta Canada alone, there is a predicted 50,268 square mile increase in white-tail deer range size.

     As temperatures continue to rise due to climate change so do populations of deer ticks and their hosts. This brings humans closer in contact with B. burgdorferi thus increasing their risk of contracting Lyme disease. Researchers have yet to determine the extent that climate change will affect Lyme disease cases. Despite this, citizens need to be informed about where ticks are most likely to be found, how to prevent getting bitten by a tick, and what to do when bitten by a tick.

    To protect yourself against tick bites, you should know that they are commonly found in areas that are grassy and wooded. If you are hiking in these areas, be sure to stay in the middle of the trail to avoid brushing up against plants that may have ticks on them. You should use Environmental Protection Agency (EPA) registered insect repellent and even treat your clothing with products that contain 0.5% permethrin. After being outdoors you should check your body, clothing, gear, and pets that came with you.

    If you find a tick attached to your skin, you should remove it as soon as possible. To do this, you should use a set of fine-tipped tweezers and position them as close to the skin as possible. Then clamp the tweezers down and steadily pull the tick away from your body without twisting. If the mouth part of the tick stays embedded in your skin, remove it if possible. Afterwards, you should clean the wound and dispose of the tick in an escape-proof container.

    Other than individual tick safety practices, areas at risk from the range expansion of ticks could implement integrated tick management, consisting of host population removal which has been seen to positively reduce the number of nymphs looking for blood meals. By reducing host population or attempting to alter our climate change trajectory, we may be able to prevent many new cases of Lyme disease.

    In conclusion, while the expansion of deer ticks and the successive spread of Lyme disease due to current climate change predictions should be expected, preparative measures can be taken to minimize tick bite risk.

 

To learn more about tick bite prevention and tick removal head to the CDC’s website:

https://www.cdc.gov/ticks/index.html

To learn more about tick and host migration, here are the following articles explored:

Brunner, Jesse L, et al. “Estimating Reservoir Competence of BorreliaBurgdorferi     Hosts: Prevalence and Infectivity, Sensitivity, and Specificity.” Validate User, 1 Jan. 2008, academic.oup.com/jme/article/45/1/139/874411. 

Dawe, Kimbery L., and Stan Boutin. 2016. “Climate change is the primary driver of white-tailed deer (Odocoileus virginianus) range expansion at the northern extent of its range; land use is secondary.” Ecology and Evolution 6, no. 18. https://doi.org/10.1002/ece3.2316 

Dumic, Igor, and Edson Severnini. 2018. “‘Ticking Bomb’: The Impact of Climate Change on the Incidence of Lyme Disease.” Canadian Journal of Infectious Diseases and Medical Microbiology. Hindawi. October 24. https://www.hindawi.com/journals/cjidmm/2018/5719081/.

Ebi, Kristie L., Ogden, Nicholas H., Semenza, Jan C., and Woodward Alistar. 2017. “Detecting and Attributing Health Burdens to Climate Change.” Environmental Health Perspectives 125, no. 8. https://doi.org/10.1289/EH

Gandy, Sara Louise (2020) “The impacts of host community composition on Lyme disease risk in Scotland”. PhD thesis, University of Glasgow. http://theses.gla.ac.uk/81708/

Little, Eliza, Scott C. Williams, Kirby C. Stafford III, Megand A. Linske, and Gourdarz Molaei. “Evaluating the effectiveness of an integrated tick management approach on multiple pathogen infection in Ixodes scapularis questing nymphs and larvae parasitizing white-footed mice”. Experimental and Applied Acarology 80 (2020): 127-136 . https://doi.org/10.1007/s10493-019-00452-7

Myers, Philip, Barabara L. Lundrigan, Susan M. G. Hoffman, Allison Poor Haraminac, and Stephanie H. Seto. “Climate-induced changes in the small mammal communities of the Northern Great Lakes Region.” Global Change Biology 15, no. 6 (2009). https://doi.org/10.1111/j.1365-2486.2009.01846.x

Roy-Dufresne, Emilie, Logan, Travis, Simon, Julie A., Chmura, Gail L., and Virginie Millien. 2013. “Poleward Expansion of the White-Footed Mouse (Peromyscus leucopus) under Climate Change: Implications for the Spread of Lyme Disease” PLoS One 8(11). Doi: 10.1371/journal.pone.0080724 

 

Monday, January 11, 2021

IOP 2020 Field Research Report


2020 Ixodes Outreach Project Report

Field Research Report 






In 2020 the Ixodes Outreach Project staff conducted two active field research projects in Carlton County, MN.  Our first was a typical tick drag, where our lab staff pull a weighted cloth through a predetermined area, called a transect, while walking a measured path.  Every 10 meters, the cloth is examined to see if any ticks have grabbed on.  Check out a short video of what a tick drag looks like:
 



We monitored the transect from April through October.  Over all we found 84 ticks and 18 of them were Ixodes scapularis, the tick that can transmit the bacteria responsible for Lyme disease.  The bulk of those I. scapularis ticks were caught between late April and early June, with the peak being the 3rd week of May.

We also experimented with a new tick collecting method, a dry ice trap.  Ticks are believed to be able to sense carbon dioxide exhaled by potential prey.  The carbon dioxide gas released as dry ice melts is thought to be a way to attract ticks searching for a meal.  We tested two different styles of trap, and appeared to have relatively equal success.  Our trapping process was started later in the summer, so we missed peak tick season, but ticks are out until snow falls again.  And, indeed we did catch several ticks in September and October with our traps.  

Two different trap designs

Male Dermacentor variabilis tick caught on tape used to hold trap fabric in place

Next year we plan to experiment with other carbon dioxide releasing methods in hopes of developing an inexpensive trapping method that can be used more frequently and at multiple locations.  Stay tuned in 2021 to see how this project unfolds!

Post by C. Fisher

Monday, January 4, 2021

IOP thanks you, community contributors!


 

2020 Ixodes Outreach Project Report

Community Contributions

 

    One of our projects at the IOP is to create a story map that documents where ticks are being found.  Thanks to our community contributors in 2020 we collected 152 ticks from Minnesota, Wisconsin and Michigan.  Ticks were primarily Ixodes scapularis and Dermacentor variabilis adults, but we did receive three I. scapularis nymphs from Minnesota.

    Eventually, tick submissions will be "pinned" to our story map so the community can see geographically where these ticks were found.  You can check out the 2018/2019 tick data on our story map here.

    These ticks are currently chilling at a frosty -80 degrees Celsius.  But, during the next several months our team of seven undergraduate researchers will be using them in several projects.  Some ticks will be tested for the presence of Borrelia burgdorferi, the bacteria responsible for Lyme disease, while others may be used in tests designed to investigate the variety of microorganisms inside the tick gut.  Studying the array of microorganisms inside the gut of the tick may help scientists better understand what competition or advantages await B. burgdorferi bacteria after being ingested during a bloodmeal.  It may also give insight into the risk of co-infection in humans and domestic animals as the result of a tick bite.  Some ticks may also be used for practicing and refining lab techniques or for other teaching purposes.

    No matter how these ticks are ultimately used, it is all possible due to the efforts of our community contributors, so hats off to you all!  

    With our thanks,

The Ixodes Outreach Project team


 

 

 

If you would like to submit tick specimens please seal your tick(s) in a Ziploc style baggie and mail them to:  

Ixodes Outreach Project
University of Minnesota Duluth
Department of Biomedical Sciences/SMed 332
1035 University Drive
Duluth, MN 55812

 


Post by C.Fisher