Spread Of Lyme Disease Research Articles

STRUCTURE AND CHARACTERISTICS OF THE SPREAD OF INFECTIOUS DISEASES AMONG THE POPULATION OF THE OSTROG DISTRICT FOR 2010–2020

Topicality. Infectious diseases, despite the achievements of modern medicine, remain an extremely important medical, social and economic problem for modern society. The goal of the work is to analyze the structure and study the features of the spread of infectious diseases among the population of Ostroh district during 2010–2020. Materials and methods. Analytical techniques of the epidemiological method, descriptive, statistical and graphic methods were used in the work. A retrospective epidemiological analysis of the incidence of infectious diseases in the population of Ostroh district for 2010–2020 was carried out. Statistical reporting data were used for the work (form of state statistical reporting, No. 18, No. 40-health. Report on the work of the Rivne Regional Sanitary and Epidemiological Station, Main Department of the State Sanitary and Epidemiological Service in Rivne region, Rivne Regional Laboratory Center of the Ministry of Health of Ukraine, state statistical reporting form No. 1 “Report on individual infections and parasitic diseases” (monthly); No. 2 “Report on individual infections and parasitic diseases” (annual) of the Ostroh interdistrict department of the “Rivnensky OLC of the Ministry of Health of Ukraine”. Research results. After conducting an analysis of the epidemic situation in the territory of the Ostroh district during 2010–2020, the incidence of infectious diseases was analyzed, the etiological structure, growth trends and outbreaks, features of the spread of the most relevant infectious diseases among the urban and rural population, and age-sex characteristics were studied. The general infectious morbidity during the studied period is characterized by the spread and constant circulation of pathogens of intestinal infections: gastroenterocolitis of various etiologies, salmonellosis, shigellosis; airborne infections: chicken pox, measles, whooping cough, meningitis, scarlet fever, infectious mononucleosis, epidemic parotitis. Airborne infections (74.8%) of the total amount and intestinal infections (gastroenterocolitis, salmonellosis, and shigellosis), which make up 21.9% of the total amount, occupy the largest specific weight in the total infectious morbidity (PPE). Conclusions. It was established that PPE in the Ostroh district has a tendency to fluctuate and periodically increase, especially over the last 5 years. The peculiarities of the spread of natural-source infections have been determined, the spread of Lyme disease and leptospirosis are relevant in the territory of Ostroh district, the indicators of these diseases are characterized by a trend of constant growth

Middle-School Student Engagement in a Tick Testing Community Science Project.

Simple SummaryLyme disease is a common tickborne illness endemic to many countries, including the United States. Scientists have a role to play in disseminating public health knowledge to decrease the prevalence of tickborne disease, which can include encouraging preventive behaviors and recognizing the early signs of the disease. Middle-school students are at significant risk of developing Lyme disease and an ideal population to engage in community-based science, since these experiences provide valuable opportunities for career explorations and to extend the students’ understanding of science. Our work shows that the students can meaningfully contribute to research by generating samples that can be used to test whether the ticks contain pathogens.Studies of tickborne illness have benefited from interactions between scientists and community members. Most participants in community science projects are well-educated adults, but there are anticipated benefits from engaging younger students in research. We evaluated whether an outreach experience for rural middle-school students promoted student interest in science and resulted in the generation of samples that could be used for tick testing to assess disease risk. Middle-school students from 78 Wisconsin communities developed interdisciplinary hypotheses about the spread of Lyme disease, identified ticks, and extracted DNA from ticks to assess the prevalence of pathogens Borrelia burgdorferi, Anaplasma phagocytophillium, and Babesia microti. As a result of this intervention, students were able to successfully complete the research protocol and explain the rationale for completing the experiment. Of student participants, 84.7% reported no difficulty completing the protocol, 66% of the student samples gave reliable PCR results, and 76% of students reported interest in participating in similar experiments. Our study shows that tick outreach programs that incorporate community-based science promote knowledge about Lyme disease, facilitate engagement between students and scientists, and generate samples that can be successfully utilized for pathogen testing.

1206. Effects of Climatic Variability on Lyme Disease Outbreaks in California

BackgroundClimate change has increased the risk of tick borne infections. The life cycle and prevalence of deer ticks are strongly influenced by temperature. Warmer temperatures associated with climate change are projected to increase the range of suitable tick habitats driving the spread of Lyme disease (LD). Short winters could also increase tick activity increasing the risk of exposure. This study examines the relationship between LD incidence and temperature-precipitation and their anomalies in CA counties.MethodsTrends and relationships of Lyme Disease (LD) cases and climatic factors were analyzed among the California counties from 2000 to 2019. Lyme disease tabulate data and climatic data were obtained from Centers for Disease Control, and NOAA, and Climate Data Guide respectively. Canonical correspondence analysis (CCA) was performed using variables: (i) LD cases, (ii) precipitation & anomaly, and temperature & anomaly. The CCA ordination explained the variability between LD cases and climatic variables. Biplots were used to visualize the associations between LD cases and climatic anomalies.ResultsWe compared the countywide LD cases in relation to climatic factors in California from 2000 to 2019. A total of 96 cases in 2000, 117 cases in 2009, and 144 cases in 2019 were reported in the 55 counties of California. Santa Clara reported the highest LD cases in 2003 (23 cases; 16%), followed by Los Angeles in 2013 (20 cases; 18%) and Santa Cruz in 2017 (19 cases; 13%). CCA ordination showed distinguishable clustering patterns between southern California counties (Santa Clara, Santa Cruz, Alameda, and San Diego) and northern coast and Klamath mountains range (Humboldt, Trinity, Shasta, and Siskiyou) regions (Fig. 1). Moderate mean annual temperature (56.5 °F - 62.5 °F) and temperature anomaly (3.8 °F - 5.5 °F) were the most important variable predictor for high LD outbreak. The CCA ordination shows the relationships between Lyme Disease and climatic variables for the 55 Counties of California. The bottom right circle represents Lyme cases positively correlated with temperature anomaly (3.8 °F - 5.5 °F) and moderate annual mean temperature (56.5 °F - 62.5 °F). The upper left circle represents Lyme cases negatively correlated with mean annual precipitation.ConclusionModerate temperature with low moist spell anomalies in the south neighboring CA counties showed a positive influence on LD outbreak. The climatic conditions in those areas suitable for Oak trees and masting acorn resulting in the establishment of tick and host (deer) populations. We recommend robust surveillance and lab testing for patients with a history of tick bites in these regions.Disclosures All Authors: No reported disclosures

Clinical and epidemiological features of lyme borreliosis

Lyme borreliosis (LB) is the most common transmissible disease of tick-borne origin. This disease is a significant medical challenge due to the damage to many organs and systems and the tendency to chronicity and long-term disability in the future. Currently, there is an upward trend in the incidence of Lyme disease in Sumy Oblast. Thus, in Ukraine in 2015 the incidence was 7.96 per 100,000 population, and in 2019 it increased to 10.62. The average level of indicators was exceeded in Kyiv Oblast (29.0), Cherkasy Oblast (25.4), Vinnytsia Oblast (23.09), Sumy (25.89) Oblast, and Kyiv (2.54). The peak of tick activity in Ukraine is registered in May and has increased by 4.23 times. The maximum number of patients falls within the working population and causes significant state financial damage. The increase in the number of cases indicates a spread of Lyme disease in Sumy Oblast. In order to prevent the spread, it is necessary to study all possible causes of this disease and find ways to eliminate them. This was the ground for the creation of a unified anonymous questionnaire, which covers the main issues regarding this disease from the standpoint of different population groups. A unified anonymous "Questionnaire for Lyme disease patients" contains 16 multiple choice questions and an option for comments. The first group of questions concerned gender, age, and social data of respondents (the largest part of patients fell within the working population – 42.86%). The next group of questions clarified the epidemiological features of this pathology (circumstances, date, time, location, body part bitten). Most often tick bites occurred during walks in the urban forests (42.86% of cases). Most respondents reported that tick bites had happened in June and July (39.29%). Other questions were designed to determine patients' awareness about Lyme borreliosis prevention. The next group of questions was aimed at clarifying the clinical features of the disease (lower extremities were the most frequent site of a tick bite) (46.43%), with erythema dominating among the clinical manifestations of Lyme borreliosis (91.07%). According to the anonymous questionnaire, we analyzed and evaluated awareness of diagnosis, clinical signs, and measures of Lyme disease prevention in the patients who were receiving treatment at Municipal Non-Commercial Enterprise of Sumy Regional Council "Medical Clinical Center of Infectious Diseases and Dermatology Named After Z. Krasovytskyi" and SSU University Clinic.

Еpidemiological aspects of ixodid tick-borne borrelioses in Kemerovo region

Aim. To study the epidemiological patterns of Lyme disease in the Kemerovo Region. Materials and Methods. We performed a descriptive and retrospective epidemiological study of 3,133 cases to investigate the spread of Lyme disease in the Kemerovo Region during the recent 15 years (2005-2019). 1,000 ticks of the Ixodes genus were investigated for the presence of Borrelia burgdorferi senso lato s. l. and Borrelia miyamotoi DNA, while 98 patients with tick-borne fevers of unknown aetiology were examined to identify the DNA of the causative agents of ixodid tick-borne borrelioses and tick-borne recurrent fevers by PCR. Antibodies to Borrelia in the patient serum were detected by enzyme-linked immunosorbent assay. Results. In the structure of tick-borne infections over the study period, the proportion of ixodid tickborne borrelioses was 29.88% [95% CI = 27,25- 32,61]. The incidence demonstrated a 2,8-fold increase from 3.2200 / 0000 [95% CI = 3,20-4,57] in 2005 up to 9,2000 / 0000 [95% CI = 12,47-15,31] in 2019. Annually, around 30,000 people suffered from the tick attack. Bite rates ranged from 813.510 / 0000 [95% CI = 804,05-825,50] to 1506.100 / 0000 [95% CI = 1491,57-1520,02]. Two-thirds of the victims were attacked by ticks during the unorganized recreation in the forest, gathering wild plants and working in the garden plots. Lyme disease was characterised by a spring-summer seasonality with a maximum incidence in June. Rural population showed a higher level of ixodid tick-borne borrelioses incidence as compared to the urban population. In age groups, the maximum rates were recorded in the individuals over 40 years of age. Northern territories of the region showed the highest prevalence of ixodid tickborne borrelioses. In a study of 1000 ticks, DNA of Burgdorferi s. l. and B. miyamotoi was detected in 32.5% and 5.2%, respectively. In contrast, B. miyamotoi prevailed in patients with tick-borne fevers (13.26% of positive cases in comparison with 4.08% for B. Burgdorferi s. l. Tick-borne aetiology of the diseases was confirmed by the enzyme-linked immunosorbent assay measurements. Conclusions. Ixodid tick-borne borrelioses is prevalent in Kemerovo Region, demonstrating an upward and seasonal trend. Risk groups include rural population and those > 40 years of age. A high level of Ixodes persulcatus-mediated transmission of B. burgdorferi s. l. and B. miyamotoi infections was revealed; the latter agent often caused tick-borne fevers of unknown etiology

Landscape features predict the current and forecast the future geographic spread of Lyme disease: Landscape predicts Lyme disease spread

Landscape features predict the current and forecast the future geographic spread of Lyme disease: Landscape predicts Lyme disease spread

Individualized environments, individual cures: An examination of Lyme disease activism in Virginia

Doctors, patients, and public health professionals widely recognize that certain physical environments are more conducive to the emergence and spread of Lyme disease. However, ecological solutions to the spread of the disease are rarely pursued. Drawing on interviews with Lyme activists, politicians, and state and local administrators dealing with Lyme disease related issues as well as an analysis of Lyme disease legislation in the state of Virginia, we examine why solutions to Lyme disease most often focus on expanding individual choices for diagnosis and treatment over changing the environments that enhance the risk of Lyme disease. We argue that the emergence of Lyme disease in a neoliberal society pushed debates on how to best deal with the disease away from its underpinning environmental causes and into individual human bodies.

Risk Factors for Bites and Diseases Associated With Black-Legged Ticks: A Meta-Analysis.

The emergence and spread of Lyme disease and other infections associated with black-legged ticks is causing a public health crisis. No human vaccines are currently available, and both diagnosis and treatment are sometimes ineffectual, leading to advocacy for self-directed preventative measures. These recommendations are widely communicated to the public, but there is limited evidence for their efficacy. We undertook a systematic review and mixed-effects meta-regression analysis of factors purported to increase or decrease risk of black-legged tick bites and tick-borne disease. Published articles used in the study spanned the years 1984–2018. Variables associated with increased probability of tick-borne disease, with odds ratios significantly greater than 1, included deer abundance, high density of nymph-stage black-legged ticks, landscapes with interspersed herbaceous and forested habitat, low human population density, gardens, cat ownership, and race. Contrary to recommendations, use of landscape-related tick control measures, such as clearing brush, trimming branches, and having a dry barrier between lawn and woods, tended to increase risk. Pet ownership increased bite risk. Bite risk was highest for children aged 5 years or less, with a secondary peak in persons aged 50–70 years. Although some widely disseminated recommendations are supported by the research analyzed, others require further evaluation. Additional research is also needed to understand the mechanisms underlying significant relationships.

Modeling transmission dynamics of lyme disease: Multiple vectors, seasonality, and vector mobility.

Lyme disease is the most prevalent tick-borne disease in the United States, which humans acquire from an infected tick of the genus Ixodes (primarily Ixodes scapularis). While previous studies have provided useful insights into various aspects of Lyme disease, the tick's host preference in the presence of multiple hosts has not been considered in the existing models. In this study, we develop a transmission dynamics model that includes the interactions between the primary vectors involved: blacklegged ticks (I. scapularis), white-footed mice (Peromyscus leucopus), and white-tailed deer (Odocoileus virginianus). Our model shows that the presence of multiple vectors may have a significant impact on the dynamics and spread of Lyme disease. Based on our model, we also calculate the basic reproduction number, , a threshold value that predicts whether a disease exists or dies out. Subsequent extensions of the model consider seasonality of the tick's feeding period and mobility of deer between counties. Our results suggest that a longer tick peak feeding period results in a higher infection prevalence. Moreover, while the deer mobility may not be a primary factor for short-term emergence of Lyme disease epidemics, in the long-run it can significantly contribute to local infectiousness in neighboring counties, which eventually reach the endemic steady state.

The making of Lyme disease: a political ecology of ticks and tick-borne illness in Virginia

ABSTRACTScholars often attribute the increases in the incidence of tick-borne diseases to anthropogenic factors such as climate change and shifting land use patterns. However, they tend to overlook the politics and economics underpinning such factors and, in turn, what is necessary to change them. To remedy these problems, I take a political ecological approach to understand why and when anthropogenic changes, such as sub- and ex-urban development, facilitate the emergence and spread of ticks, their hosts, and the diseases they carry. Examining the case of Lyme disease in Northern Virginia, I argue that the emergence and spread of Lyme disease to new locations is not only the result of climate change and sub- and ex-urbanization, but also the result of the adoption of liberal economic policies, specifically financial deregulation and the privatization of government services. To support this argument, I demonstrate how changing forms of housing finance and the rise in federal government subcontracting from the 1970s onward propelled the growth of large-lot suburbs south of Washington D.C. and resulted in the creation of a landscape in which tick-hosts, ticks, and tick-borne disease thrive.

Evaluating the utility of companion animal tick surveillance practices for monitoring spread and occurrence of human Lyme disease in West Virginia, 2014-2016.

Domestic dogs and cats are potentially effective sentinel populations for monitoring occurrence and spread of Lyme disease. Few studies have evaluated the public health utility of sentinel programmes using geo-analytic approaches. Confirmed Lyme disease cases diagnosed by physicians and ticks submitted by veterinarians to the West Virginia State Health Department were obtained for 2014-2016. Ticks were identified to species, and only Ixodes scapularis were incorporated in the analysis. Separate ordinary least squares (OLS) and spatial lag regression models were conducted to estimate the association between average numbers of Ix. scapularis collected on pets and human Lyme disease incidence. Regression residuals were visualised using Local Moran's I as a diagnostic tool to identify spatial dependence. Statistically significant associations were identified between average numbers of Ix. scapularis collected from dogs and human Lyme disease in the OLS (β=20.7, P<0.001) and spatial lag (β=12.0, P=0.002) regression. No significant associations were identified for cats in either regression model. Statistically significant (P≤0.05) spatial dependence was identified in all regression models. Local Moran's I maps produced for spatial lag regression residuals indicated a decrease in model over- and under-estimation, but identified a higher number of statistically significant outliers than OLS regression. Results support previous conclusions that dogs are effective sentinel populations for monitoring risk of human exposure to Lyme disease. Findings reinforce the utility of spatial analysis of surveillance data, and highlight West Virginia's unique position within the eastern United States in regards to Lyme disease occurrence.

Dispatches

Dispatches

Delay differential systems for tick population dynamics.

Ticks play a critical role as vectors in the transmission and spread of Lyme disease, an emerging infectious disease which can cause severe illness in humans or animals. To understand the transmission dynamics of Lyme disease and other tick-borne diseases, it is necessary to investigate the population dynamics of ticks. Here, we formulate a system of delay differential equations which models the stage structure of the tick population. Temperature can alter the length of time delays in each developmental stage, and so the time delays can vary geographically (and seasonally which we do not consider). We define the basic reproduction number [Formula: see text] of stage structured tick populations. The tick population is uniformly persistent if [Formula: see text] and dies out if [Formula: see text]. We present sufficient conditions under which the unique positive equilibrium point is globally asymptotically stable. In general, the positive equilibrium can be unstable and the system show oscillatory behavior. These oscillations are primarily due to negative feedback within the tick system, but can be enhanced by the time delays of the different developmental stages.

Disease risk in a dynamic environment: the spread of tick-borne pathogens in Minnesota, USA.

As humans and climate change alter the landscape, novel disease risk scenarios emerge. Understanding the complexities of pathogen emergence and subsequent spread as shaped by landscape heterogeneity is crucial to understanding disease emergence, pinpointing high-risk areas, and mitigating emerging disease threats in a dynamic environment. Tick-borne diseases present an important public health concern and incidence of many of these diseases are increasing in the United States. The complex epidemiology of tick-borne diseases includes strong ties with environmental factors that influence host availability, vector abundance, and pathogen transmission. Here, we used 16 years of case data from the Minnesota Department of Health to report spatial and temporal trends in Lyme disease (LD), human anaplasmosis, and babesiosis. We then used a spatial regression framework to evaluate the impact of landscape and climate factors on the spread of LD. Finally, we use the fitted model, and landscape and climate datasets projected under varying climate change scenarios, to predict future changes in tick-borne pathogen risk. Both forested habitat and temperature were important drivers of LD spread in Minnesota. Dramatic changes in future temperature regimes and forest communities predict rising risk of tick-borne disease.

Assessment of human health risk for lyme disease in a peri-urban park in southern Québec

&#x0D; &#x0D; &#x0D; Introduction: climate change has contributed to the spread of the hard tick Ixodes scapularis into increasingly northern latitudes, and subsequently has caused the spread of the lyme dis-ease causing bacterium, Borrelia burdorferi, into these northern areas. The spread of these ticks into the region of southern Québec is highly likely within the near future. As a result, new human populations are being exposed to these ticks and are at risk for contracting lyme disease. intent: This exploratory study examines the spatial and behavioral factors associated with human activity in longueuil regional park in relation to risk for lyme disease. Methods: we conducted exit surveys of park-goers to determine spatial and behavioral patterns of park use, as well as lyme disease awareness. results and conclusion: we found higher awareness of ticks in female park-goers, park-goers over 50, and high-frequency park-goers. our results, importantly, imply a discrepancy between peoples' awareness of tick bite precautions, and their perception of tick bite risk. we hope that these findings may help future research on the spread of lyme disease into Canada, as well as in the formulation of public health policy.&#x0D; &#x0D; &#x0D;

Tracking the Deer Tick: Emerging Lyme Disease Threat in Canada

Vol. 118, No. 7 NewsOpen AccessTracking the Deer Tick: Emerging Lyme Disease Threat in Canada Tanya TillettMA Tanya Tillett Search for more papers by this author Published:1 July 2010https://doi.org/10.1289/ehp.118-a305aAboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit Lyme disease was first diagnosed during an outbreak in the Northeast and upper Midwest of the United States in the late 1970s. Since that time, the disease has become well established in the northeastern United States. A new study now indicates Lyme disease is continuing to spread north into Canada and, because of a convergence of environmental factors, is poised to emerge as a potential public health threat in southern Quebec [EHP118(7):909–914; Ogden et al.].Caused by the bacterium Borrelia burgdorferi, Lyme disease is spread through the bite of the deer tick (Ixodes scapularis). Symptoms can include skin rash, joint pain, fatigue, and more serious neurologic disorders if the disease is left untreated. Until recently, cooler climate patterns in Canada did not favor the infiltration of I. scapularis and consequent spread of Lyme disease, but a warmer climate in southern Quebec may be easing the way for “adventitious” ticks—nonnative ticks introduced most likely by migratory birds—to become established.In the current study, researchers analyzed data for I. scapularis presence and B. burgdorferi infection based on passive surveillance (that is, ticks collected voluntarily by medical and veterinary clinics in Quebec were submitted to the provincial public health laboratory) and active surveillance (the research team’s own field analysis of 71 woodland sites in three regions of southern Quebec) to identify areas where Lyme disease is emerging.I. scapularis have been collected through passive surveillance in Quebec since 1990, but the investigators observed that between 2004 and 2008 the number of ticks collected increased exponentially to more than 1,700 per year. Given that no marked increase occurred in the number of participating clinics during this time, the increase suggests that in addition to the presence of adventitious ticks, breeding populations of I. scapularis have now become established in the region. The authors observed a B. burgdorferi infection rate of 13.2% in ticks collected through passive surveillance but a lower prevalence of infection in ticks collected at the active surveillance sites (7.7% overall), implying the I. scapularis populations that are becoming established are initially free of B. burgdorferi. Ticks that did carry B. burgdorferi carried strains that were mostly identical to those seen in the northeastern United States.The authors postulate that warming climate conditions, a growing tick population, and infected ticks hitchhiking from the United States have set up a favorable scenario for increasing the threat of Lyme disease in southern Quebec. They write that increased surveillance in Quebec and the rest of southeastern Canada would help track the progression of risk areas and protect public health.Deer tick (Ixodes scapularis)FiguresReferencesRelatedDetails Vol. 118, No. 7 July 2010Metrics About Article Metrics Publication History Originally published1 July 2010Published in print1 July 2010 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Role of bird migration in the long-distance dispersal of Ixodes dammini, the vector of Lyme disease.

To evaluate the role of migratory birds in the long-distance dispersal of Ixodes dammini ticks and in the spread of Lyme disease, a 6-year study of migrating birds to an offshore New England island was conducted during 1989-1994. I. dammini are not endemic on this island, therefore allowing assessment of long-distance tick dispersal rather than local infestation. Of 11,324 spring migrants examined, 1.2% were infested with I. dammini. Of 8607 fall migrants examined, 0.2% were infested. Of nymphal ticks examined, 20% were infected with Borrelia burgdorferi. OspB DNA sequencing of 6 B. burgdorferi isolates was identical to sequences of 2 strains common in coastal Maine. It is evident that bird migration allows for long-distance dispersal of I. dammini from areas where they are endemic to areas where they are not and that a few bird species account for the majority of tick dispersal. The likelihood of establishment of enzootic Lyme disease by this mechanism is discussed.

Competence of Peromyscus maniculatus (Rodentia: Cricetidae) as a reservoir host for Borrelia burgdorferi (Spirochaetares: Spirochaetaceae) in the wild.

Although capable of maintaining and transmitting Borrelia burgdorferi Johnson, Schmidt, Hyde, Steigerwalt & Brenner, the causative spirochete of Lyme disease, in the laboratory, the specific ability of deer mice, Peromyscus maniculatus Le Conte, to support this zoonosis has not been established. Demonstration that P. maniculatus is a competent reservoir host in the wild would indicate that the spread of Lyme disease is not limited to the range of the primary reservoir host, P. leucopus Rafinesque. Isle au Haut, an offshore Maine island upon which the vector tick Ixodes dammini Spielman, Clifford, Piesman & Corwin has become established, supports an isolated population of mice that are exclusively P. maniculatus. We examined the reservoir competence of this species by comparing infection rates of B. burgdorferi among juvenile ticks removed from livetrapped mice on this island with those removed from P. leucopus obtained at a mainland site endemic for Lyme disease. Equivalent rates of infection among engorged larval ticks, survival of infection through the larval-nymphal molt, and the isolation of B. burgdorferi from mice at both sites attest to the reservoir competence of P. maniculatus.

Human babesiosis in New York State: an epidemiological description of 136 cases.

Epidemiological data on 136 cases of human babesiosis reported from laboratories and clinicians in the state of New York from 1982 to 1991 were reviewed. All but two patients, who had traveled to Nantucket Island in Massachusetts, acquired disease in Suffolk County, Long Island. The highest average age-group-specific annual incidence rates occurred among men > or = 80 years of age (7.72 per 100,000) and among women 70-79 years of age (3.61 per 100,000). Seven patients (5%) had previously undergone splenectomy, and 31 (23%) had evidence of concurrent Lyme disease. One hundred three patients (76%) were hospitalized, and seven (5%) died. Although the geographic distribution of this disease has remained constant, the recent introduction of babesiosis in mainland Connecticut and the spread of Lyme disease in New York suggest that the geographic distribution of babesiosis could also spread in New York.

A Model of the Spread of Lyme Disease in Natural Populations

A Model of the Spread of Lyme Disease in Natural Populations