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Powassan virus is an emerging tick-borne pathogen capable of causing severe neuroinvasive disease. As the incidence of human Powassan virus grows both in magnitude and geographical range, the development of sensitive detection methods for diagnostics and surveillance is critical. In this study, a Taqman-based triplex real-time PCR assay was developed for the simultaneous and quantitative detection of Powassan virus and Powassan virus lineage II (deer tick virus) in Ixodes scapularis ticks. An exon–exon junction internal control was built-in to allow for accurate detection of RNA quality and the failure of RNA extraction. The newly developed assay was also applied to survey deer tick virus in tick populations at 13 sites on Cape Cod and Martha's Vineyard Island in Massachusetts. The assay's performance was compared with the Luminex xMAP MultiFLEX Vector-borne Panel 2. The results suggested that the real-time PCR method was more sensitive. Powassan virus infection rates among ticks collected from these highly endemic tick areas ranged from 0.0 to 10.4%, highlighting the fine-scale geographic variations in deer tick virus presence in this region. Looking forward, our PCR assay could be adopted in other Powassan virus surveillance systems. [ABSTRACT FROM AUTHOR]

In 2011, Ehrlichia muris eauclairensis (EME) was described as a human pathogen spread by the blacklegged tick, Ixodes scapularis. Until very recently, its reported distribution was limited to the upper midwestern United States, mainly in Minnesota and Wisconsin. In this study, we report the detection of EME DNA in 4 of 16,146 human biting I. scapularis ticks submitted from Massachusetts to a passive tick surveillance program. Active tick surveillance yielded evidence of EME local transmission in the northeastern United States through detection of EME DNA in 2 of 461 host-seeking I. scapularis nymphs, and in 2 white-footed mice (Peromyscus leucopus) of 491 rodent samples collected in the National Ecological Observatory Network (NEON) Harvard Forest site in Massachusetts. [ABSTRACT FROM AUTHOR]

In 2011, Ehrlichia muris eauclairensis (EME) was described as a human pathogen spread by the blacklegged tick, Ixodes scapularis . Until very recently, its reported distribution was limited to the upper midwestern United States, mainly in Minnesota and Wisconsin. In this study, we report the detection of EME DNA in 4 of 16,146 human biting I. scapularis ticks submitted from Massachusetts to a passive tick surveillance program. Active tick surveillance yielded evidence of EME local transmission in the northeastern United States through detection of EME DNA in 2 of 461 host-seeking I. scapularis nymphs, and in 2 white-footed mice ( Peromyscus leucopus ) of 491 rodent samples collected in the National Ecological Observatory Network (NEON) Harvard Forest site in Massachusetts.

This study aimed to analyze human-biting Ixodes scapularis ticks submitted to TickReport tick testing service from 2015-2019 in Massachusetts to (1) examine possible patterns of pathogen-positive adult and nymphal ticks over time and (2) explore how socioeconomic factors can influence tick submissions. A passive surveillance data set of ticks and tick-borne pathogens was conducted over 5 years (2015-2019) in Massachusetts. The percentages of four tick-borne pathogens: Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti , and Borrelia miyamotoi were determined by Massachusetts county and by month and year. Regression models were used to examine the association between zip-code-level socioeconomic factors and submissions. A total of 13,598 I. scapularis ticks were submitted to TickReport from Massachusetts residents. The infection rate of B. burgdorferi, A. phagocytophilum , and B. microti was 39%, 8%, and 7% in adult ticks; 23%, 6%, and 5% in nymphal ticks, respectively. A relatively higher level of education was associated with high tick submission. Passive surveillance of human-biting ticks and associated pathogens is important for monitoring tick-borne diseases, detecting areas with potentially high risks, and providing public information. Socioeconomic factors should be considered to produce more generalizable passive surveillance data and to target potentially underserved areas.

Background: The blacklegged tick, Ixodes scapularis, is the primary vector of the Lyme disease spirochete Borrelia burgdorferi in North America. Though the tick is found across the eastern United States, Lyme disease is endemic to the northeast and upper midwest and rare or absent in the southern portion of the vector's range. In an effort to better understand the tick microbiome from diverse geographic and climatic regions, we analysed the bacterial community of 115 I. scapularis adults collected from vegetation in Texas and Massachusetts, representing extreme ends of the vector's range, by massively parallel sequencing of the 16S V4 rRNA gene. In addition, 7 female I. scapularis collected from dogs in Texas were included in the study. Results: Male I. scapularis ticks had a more diverse bacterial microbiome in comparison to the female ticks. Rickettsia spp. dominated the microbiomes of field-collected female I. scapularis from both regions, as well as half of the males from Texas. In addition, the male and female ticks captured from Massachusetts contained high proportions of the pathogens Anaplasma and Borrelia, as well as the arthropod endosymbiont Wolbachia. None of these were found in libraries generated from ticks collected in Texas. Pseudomonas, Acinetobacter and Mycobacterium were significantly differently abundant (p < 0.05) between the male ticks from Massachusetts and Texas. Anaplasma and Borrelia were found in 15 and 63% of the 62 Massachusetts ticks, respectively, with a co-infection rate of 11%. Female ticks collected from Texas dogs were particularly diverse, and contained several genera including Rickettsia, Pseudomonas, Bradyrhizobium, Sediminibacterium, and Ralstonia. Conclusions: Our results indicate that the bacterial microbiomes of I. scapularis ticks vary by sex and geography, with significantly more diversity in male microbiomes compared to females. We found that sex plays a larger role than geography in shaping the composition/diversity of the I. scapularis microbiome, but that geography affects what additional taxa are represented (beyond Rickettsia) and whether pathogens are found. Furthermore, recent feeding may have a role in shaping the tick microbiome, as evident from a more complex bacterial community in female ticks from dogs compared to the wild-caught questing females. These findings may provide further insight into the differences in the ability of the ticks to acquire, maintain and transmit pathogens. Future studies on possible causes and consequences of these differences will shed additional light on tick microbiome biology and vector competence. [ABSTRACT FROM AUTHOR]

An important symbolic and subsistence animal for many Native American Tribes, the moose (Alces alces; mos in Algonquin, Penobscot language) has been under consistent threat in the northeastern United States because of winter tick (Dermacentor albipictus) parasitism over the past several decades, causing declines in moose populations throughout the region. This decline has raised concern for Tribes and agencies that are invested in moose. Given this concern, it is increasingly important to effectively monitor and develop strategies to manage winter ticks to address consistent population declines of moose due to winter ticks. The Penobscot Nation developed a novel strategy to sample questing winter ticks (i.e., ticks that are actively seeking hosts) using a plot‐based sampling protocol that may be suitable for heterogeneous habitats. We deployed this protocol in the northeastern United States in 2022 during the tick questing period (Sep–Dec) on Penobscot Nation sovereign trust lands, the White Mountain National Forest and Umbagog National Wildlife Refuge, and western‐central Massachusetts, USA. We analyzed the data using occupancy and N‐mixture models. Detection probability peaked during mid‐October and tick occupancy and abundance were greatest at sites with intermediate understory vegetation height. The sampling protocol was successful at sampling ticks in Massachusetts, where abundances were expected to be low, indicating that it may be useful for studies planning to monitor winter tick distribution and abundance in areas with sub‐optimal moose habitat and where winter tick abundance is expected to be low. This approach may also benefit managers or researchers intending to monitor many species of hard ticks, and where imperfect detection is expected. [ABSTRACT FROM AUTHOR]

Variations in the composition and diversity of tick microbiome due to high temperatures may influence the hierarchy of community members as a response to environmental change. Modifications in the community structure are hypothesized to drive alterations in the presence and/or abundance of functional pathways in the bacterial metagenome. In this study, this hypothesis was tested by using published 16S rRNA datasets of Ixodes scapularis males incubated at different temperatures (i.e., 4, 20, 30, and 37 °C) in a laboratory setting. Changes in community structure and functional profiles in response to temperature shifts were measured using co-occurrence networks and metagenome inference. Results from laboratory-reared ticks were then compared with those of field-collected ticks. The results from laboratory-reared ticks showed that high temperature altered the structure of the microbial community and decreased the number of keystone taxa. Notably, four taxa were identified as keystone in all the temperatures, and the functional diversity of the tick microbiome was contained in the four thermostable keystone their associated bacterial taxa. Three of the thermostable keystone taxa were also found in free-living ticks collected in Massachusetts. Moreover, the comparison of functional profiles of laboratory-reared and field-collected ticks revealed the existence of an important set of metabolic pathways that were common among the different datasets. Similar to the laboratory-reared ticks, the keystone taxa identified in field-collected ticks alongside their consortia (co-occurring taxa) were sufficient to retain the majority of the metabolic pathways in the functional profile. These results suggest that keystone taxa are essential in the stability and the functional resiliency of the tick microbiome under heat stress. [ABSTRACT FROM AUTHOR]

In order to assess the effect of bird feeders on the distribution of ticks on a residential lawn, ticks collected beneath bird feeders were compared to similar control areas on a residential property in Worcester County, MA. Host-seeking ticks were sampled from August 8, 2005 to July 25, 2007 by dragging with white flannel cloth. All ticks were counted and removed from the cloth. Sampling was conducted 38 times. A total of 12 ticks (larvae and nymphs) was collected. Significantly more ticks were collected from under the bird feeders (n = 10) than the control areas (n = 2). [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the distribution of ixodid ticks recovered from vegetation in Massachusetts. Methodology; Results of the study; Discussion.

In order to identify potential vectors of human babesiosis (Babesia microli) in southern Massachusetts, I attempted to transmit the infection via nymphal ticks of that species found to be most abundant on reservoir hosts (Peromyscus leucopus) in nature. Mice were collected at frequent intervals throughout a year in a known enzootic focus on Nantucket Island, and ticks were removed by hand. Ticks of only two species were present; larvae and nymphs of Ixodes scapularis were about 10 times as numerous as were those of Dermacentor variabilis. Accordingly, I. scapularis were used in attempts to transmit a strain of Babesia derived from a human infection recently acquired near the study site. Larvae were permitted to feed on an infected hamster and nymphs derived from these larvae were placed on each of 11 non-infected hamsters. All but one hamster became infected. Nymphs reared from larvae that had attached to a non-infected hamster did not transmit babesiosis to other hamsters. These results suggest that I. scapularis serves as a vector of babesios-s on Nantucket hamsters. These results suggest that I. scapularis serves as a vector of babesiosis on Nantucket Island.

An entomophagous wasp (Hunterellus hookeri Howard) parasitizes about a third of the host-seeking nymphal Ixodes dammini Spielman et al. ticks on Naushon Island in Massachusetts (U.S.A.) where the agents of Lyme disease (Borrelia burgdorferi Johnson et al.) and human babesiosis (Babesia microti Franca) are enzootic. Following blood-feeding, wasp-parasitized ticks are destroyed by the developing wasp. The prevalence of either human pathogen in host-seeking ticks collected in wasp-infested sites is nearly 40% lower than that found in other sites. Nymphal ticks, collected early in their season of activity, are more frequently parasitized by the wasp and less frequently by the Lyme disease spirochaete than those collected later in the summer. Spirochaetes never infected wasp-infected ticks, and few wasp-infected ticks were concurrently infected by the Babesia piroplasm. Taken together, these correlations indicate that the wasp may render the tick inhospitable to both pathogens. The presence of the wasp may have reduced risk of human infection on the island by either pathogen by as much as a third.

The island of Martha's Vineyard, Massachusetts, is the site of a sustained outbreak of tularemia due to Francisella tularensis tularensis. Dog ticks, Dermacentor variabilis, appear to be critical in the perpetuation of the agent there. Tularemia has long been characterized as an agent of natural focality, stably persisting in characteristic sites of transmission, but this suggestion has never been rigorously tested. Accordingly, we sought to identify a natural focus of transmission of the agent of tularemia by mapping the distribution of PCR-positive ticks. From 2004 to 2007, questing D. variabilis were collected from 85 individual waypoints along a 1.5 km transect in a field site on Martha's Vineyard. The positions of PCR-positive ticks were then mapped using ArcGIS. Cluster analysis identified an area approximately 290 meters in diameter, 9 waypoints, that was significantly more likely to yield PCR-positive ticks (relative risk 3.3, P = 0.001) than the rest of the field site. Genotyping of F. tularensis using variable number tandem repeat (VNTR) analysis on PCR-positive ticks yielded 13 different haplotypes, the vast majority of which was one dominant haplotype. Positive ticks collected in the cluster were 3.4 times (relative risk = 3.4, P,0.0001) more likely to have an uncommon haplotype than those collected elsewhere from the transect. We conclude that we have identified a microfocus where the agent of tularemia stably perpetuates and that this area is where genetic diversity is generated. [ABSTRACT FROM AUTHOR]

In order to derive direct evidence implicating Ixodes dammini as a vector of human babesiosis, we determined the prevalence of Babesia microti infection in nymphal I. dammini collected on Nantucket Island. In experiments in the laboratory we found that nymphs remained attached to hamsters for about 3 days. Babesial infection was transmitted more often during 54 hours of attachment then during 36 or 48 hours. Since parasites were demonstrable in salivary glands solely after 48 hours, we derived an engorgement index for identifying ticks attached for 2 days or more. Of 156 nymphal I. dammini, collected from white-footed mice in 1979, 86 were engorged sufficiently to satisfy this index of attachment, and the salivary glands of four contained B. microti parasites. This demonstrates that about 5% of nymphal I. dammini are infected in nature. Risk of human infection can be reduced by prompt removal of attached ticks.

Martha's Vineyard, Mass., has been the site of two outbreaks of tularemia (1978 and 2000). Although most patients from both outbreaks presented with pneumonic disease and although aerosol transmission has been suggested, the bite of a dog tick and exposure to rabbits remain the only proven modes of transmission. The factors that precipitated the tularemia outbreaks or the proximal determinants of human risk remain undescribed. We sought to test the hypothesis that the ongoing outbreak is due to a recent introduction event as opposed to amplification of a cryptic enzootic cycle. From 2001-2003, we collected 4,246 dog ticks and tested them in pools for evidence of tularemia by PCR. We then measured the genetic diversity of Francisella tularensis by using multiple-locus variable-number tandem repeat analysis. The prevalence of F. tularensis in dog ticks averaged 0.7%. From 29 positive pools, we identified 10 unique genotypes, which was an unexpectedly large degree of diversity (Simpson's index = 0.86). This degree of genetic diversity is inconsistent with a recent introduction event. We conclude that there has been long-standing enzootic transmission of tularemia on the island.

The diversity of bacteria associated with the deer tick (Ixodes scapularis) was assessed using PCR amplification, cloning, and sequencing of 16S rRNA genes originating from seven ticks collected from Nantucket Island and Wellfleet, Cape Cod, Mass. The majority of sequences obtained originated from gram-negative proteobacteria. Four intracellular bacteria were detected including strains of Ehrlichia, Rickettsia, and Wolbachia and an organism related to intracellular insect symbionts from the Cytophaga-Flavobacterium-Bacteroides group. Several strains of members of the Sphingomonadaceae were also detected in all but one tick. The results provide a view of the diversity of bacteria associated with I. scapularis ticks in the field.

Questing female blacklegged ticks, Ixodes scapularis, Say in Massachusetts rarely bear more than one endospermatophore in their reproductive tracts. We evaluated the cause of this nonrandom distribution by examining the stability of endospermatophore retention in females and the effect of prior insemination of females on the copulatory behavior of male ticks. Endospermatophores were retained without degradation in unfed female ticks for >1 yr at 5 degrees C and for at least 4 mo at 21 degrees C. Males were much more likely to abort preprandial (before feeding) copulations without inseminating females bearing endospermatophores. This remating inhibition activity persisted in unfed females for at least 2 mo after insemination. Perprandial (during feedng) copulations were less restrictive, particularly when females became partially engorged. Males were more likely to remain in copula with previously inseminated females that were engorged, but generally did not transfer spermatophores to them until their fifth day of attachment to a rabbit. Little inhibitory activity was evident during the final, rapid engorgement phase of feeding. Thus, remating inhibition appears to degrade as feeding progresses. In summary, an unknown factor associated with the previous insemination of females inhibits subsequent spermatophore transfer by causing mating pairs to interrupt copulation soon after initiation. Remating inhibition is strongest in unfed ticks and becomes less apparent as females become engorged.

To determine whether the presence of nonpathogenic piroplasms may confound field estimates of risk of Babesia microti infection, we identified sporozoites infecting the salivary glands of deer ticks (Ixodes dammini) by parallel microscopy and polymerase chain reaction assays. Piroplasms were evident in 14.4% of adult ticks from sites in the northcentral and northeastern United States. Of these, 83.3% contained DNA characteristic of Ba. odocoilei. This cervid piroplasm was detected in all of the sites examined and generally was more prevalent than was Ba. microti. Because deer ticks transmit both Ba. odocoilei and Ba. microti, estimates of pathogen prevalence based solely on microscopy may overestimate the risk of human babesiosis.

Adult ixodid ticks were collected from Westchester County, New York, and Ipswich, Massachusetts, to determine the presence of infection with a human granulocytic ehrlichiosis (HGE) agent by using the polymerase chain reaction (PCR). The presence of Borrelia burgdorferi in ticks collected from New York was also determined by PCR. Of the 229 ticks from New York and 47 ticks from Massachusetts, 9% (22/229) and 25% (12/47) of ticks contained HGE agent, respectively. Fifty-four percent (123/229) of the ticks collected from New York were B. burgdorferi positive; 4% (9/229) of these ticks contained both HGE agent and B. burgdorferi. This finding indicates that animals with Lyme borreliosis may be also exposed to the etiologic agent of HGE. More extensive laboratory diagnosis may be necessary when multiple tick-borne diseases are suspected in animals.

Subtropical lone star tick larvae typically emerge in late summer. We found clusters of host-seeking lone star tick larvae during early June 2018 in New York and Massachusetts, USA. Invasion and persistence of this tick in more northern locations may have been promoted by adaptation to an accelerated life cycle. [ABSTRACT FROM AUTHOR]

We determined whether the density of Lyme disease spirochetes varied between individual host-seeking deer ticks. Guts were dissected from 30 adult Ixodes dammini collected from three intensely zoonotic coastal Massachusetts sites, and the number of Borrelia burgdorferi present was estimated by a modified counting technique using indirect immunofluorescence. A median of 1,925 spirochetes was observed; ticks from the three sites contained similar numbers of spirochetes. No tick contained more than 4,500 spirochetes. Initial experimental reports establishing the efficiency of spirochetal transmission may have been based on ticks with a uniform spirochetal density, and extrapolations from these studies may thus overestimate the infectivity of host-seeking ticks in nature.

To determine whether the relative abundance of immature Ixodes dammini (the vector of Lyme disease and human babesiosis) is related to habitat structure, we examined tick burdens on their main host, the white-footed mouse (Peromyscus leucopus), in 4 structurally diverse sites on Great Island, Massachusetts, USA. Vegetation structure at each site was quantified with respect to 25 habitat variables. Principal components analysis was used to reduce this set of habitat variables to seven new and orthogonal variables. Immature tick abundance varied widely among grids. Regression analysis of tick burdens on the habitat principal components showed that larval burdens were related strongly to the density of woody vegetation and negatively to herbaceous vegetation. Nymphal burdens were related negatively to herbaceous vegetation, but the relationship was not as strong as in the case of larvae. An experimental reduction in the abundance of white-tailed deer (Odocoileus virginianus), the main host of adult ticks, substantially reduced tick burdens and altered their relationships to habitat structure. Nymphal burdens were unrelated to habitat structure following deer removal. Manipulating habitat structure may have utility as a control strategy against this important vector.

The seasonal host-seeking pattern of nymphal Ixodes dammini infected with Babesia microti or Borrelia burgdorferi was determined on Nantucket Island, Massachusetts, during 1985. The peak period of host-seeking by infected nymphal I. dammini occurred in May and June. On a per person-hour basis, the number of infected ticks collected reached a maximum in May (Babesia = 17.3; Borrelia = 16.2). The number of infected ticks remained high in June, but decreased notably in July, August, and September. Transmission risk of the tick-borne etiologic agents of Lyme disease and human babesiosis in Massachusetts is greatest during the late spring-early summer months of May and June.

Background: In 2002, a previously healthy 69-year-old man travelled to France from the United States and presented to our hospital with a febrile illness that subsequently was determined to be babesiosis. The blood isolated from this patient served as a source for propagation of the Babesia microti R1 strain with subsequent sequencing and annotation of the parasite genome., Methods: Upon admission, we obtained a medical history, performed a physical examination, and examined his blood for the presence of a blood borne pathogen by microscopy, PCR and indirect immunofluorescence antibody testing. Once the diagnosis of babesiosis was made, we reviewed the literature to assess the distribution of B. microti-associated babesiosis cases in immunocompetent patients from outside the USA., Results: The patient recalled a tick bite during the previous month on Cape Cod, Massachusetts. The diagnosis was confirmed by identification of Babesia-infected red blood cells on blood smears, amplification of B. microti DNA in blood by PCR and the presence of B. microti antibody in the serum. This strain was the first isolate of B. microti to be fully sequenced and its annotated genome serves as a reference for molecular and cell biology studies aimed at understanding B. microti pathophysiology and developing diagnostic tests and therapies. A review of babesiosis cases demonstrates a worldwide distribution of B. microti and identifies potential emerging endemic areas where travelers may be at risk of contracting B. microti infection., Conclusion: This case provides clinical information about the patient infected with the R1 isolate and a review of travel risk, diagnosis and treatment of babesiosis in endemic and non-endemic areas., (© International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com)

We determined the prevalence of Babesia microti and Borrelia burgdorferi in four populations of Ixodes dammini in eastern Massachusetts. The Feulgen's reaction was more sensitive than the Giemsa method for detecting salivarian Babesia. A combination of darkfield and direct-fluorescent-antibody examination proved more sensitive than either method alone for detecting spirochetal infection. The prevalence of spirochetes was greater than the prevalence of Babesia in each of the tick populations studied. Overall, 24% of nymphs and 47% of adults examined were infected with spirochetes; in contrast, 11% of nymphs and 14% of adults were infected with Babesia. The difference between the spirochetal and babesial prevalence was greatest in the most recently infested site. The rising incidence of Lyme disease, as compared to the stable incidence of human babesiosis, may result from the relatively greater abundance of Bo. burgdorferi infected I. dammini ticks in newly infested locations.

Both the Dermacentor variabilis and Ixodes dammini adult diapause seasons are followed by a breeding period. At the edge of the ticks' range, where diapause and breeding occur under adverse climatic conditions, the species still conserves its fixed response for the onset of diapause. As a result, most of the following breeding effort is wasted; the population can only be maintained by an aberrant breeding period during the normal diapause season. When the diapause and breeding periods are suitable for the climate at the edge of the ticks' range, the rate of immature development versus the temperature regime can result in the appearance of the immature stages out of phase with the timing for the optimal life cycle in the marginal climate. The ticks are limited to minor adjustments of their development rates but, if this is all that is required for an optimum life cycle, this response can preadapt the species to the foreign climate.

Tick-borne zoonoses pose a serious burden to global public health. To understand the distribution and determinants of these diseases, the many entangled environment–vector–host interactions which influence risk must be considered. Previous studies have evaluated how passive tick testing surveillance measures connect with the incidence of human Lyme disease. The present study sought to extend this to babesiosis and anaplasmosis, two rare tick-borne diseases. Human cases reported to the Massachusetts Department of Health and submissions to TickReport tick testing services between 2015 and 2021 were retrospectively analyzed. Moderate-to-strong town-level correlations using Spearman's Rho (ρ) were established between Ixodes scapularis submissions (total, infected, adult, and nymphal) and human disease. Aggregated ρ values ranged from 0.708 to 0.830 for anaplasmosis and 0.552 to 0.684 for babesiosis. Point observations maintained similar patterns but were slightly weaker, with mild year-to-year variation. The seasonality of tick submissions and demographics of bite victims also correlated well with reported disease. Future studies should assess how this information may best complement human disease reporting and entomological surveys as proxies for Lyme disease incidence in intervention studies, and how it may be used to better understand the dynamics of human–tick encounters. [ABSTRACT FROM AUTHOR]

The factors involved in the long-term perpetuation of Francisella tularensis tularensis in nature are poorly understood. Martha's Vineyard, Massachusetts, has become a site of sustained transmission of Type A tularemia, with nearly 100 human cases reported from 2000 to 2010. We have identified a stable focus of F. tularensis transmission there, where the annual prevalence in host-seeking Dermacentor variabilis is about 3%, suggesting that this tick perpetuates the agent. However, laboratory studies have shown that infection with F. tularensis has a profound negative effect on dog tick mortality, presenting a paradox: how can a vector perpetuate an agent that negatively affects its fitness? It may be that experimental infection does not mimic that of natural transmission. Accordingly, we examined the effects that F. tularensis has on the longevity of field-derived ticks. Of 63 PCR-positive ticks collected in early summer, 89% were dead by December compared to 48% of 214 uninfected ticks collected at the same time and site. However, the quantum of F. tularensis DNA within each tick was not correlated with increased mortality. Instead, ticks with an uncommon genotype were more likely to die early than those with the common genotype. We conclude that the interaction between F. tularensis and its vector is complex and certain bacterial genotypes appear to be better adapted to their arthropod host.

Objective: To describe clinical findings and the use of a tick-associated pathogen panel in a series of patients with human granulocytic anaplasmosis (HGA) at a suburban Boston hospital., Patients and Methods: Medical records were reviewed for inpatients and outpatients at Newton-Wellesley Hospital with a positive polymerase chain reaction (PCR) result for Anaplasma phagocytophilum during the study period March 1 through November 30, 2009. A PCR panel was used to test for tick-borne pathogens. Postal ZIP code data from the patients' areas of residence were used to estimate the area of disease transmission., Results: Thirty-three cases were confirmed during the 2009 transmission season, and 14 of these patients (42%) required hospitalization. Thrombocytopenia and/or leukopenia were observed at the time of presentation in 25 of 30 patients (86%) in whom both white blood cell and platelet counts were determined, and 28 of 33 patients (85%) reported fever. Rash occurred in only 2 of the 33 patients (6%), and 25 (76%) reported one or more respiratory or gastrointestinal symptom. Cases were geographically distributed diffusely throughout the hospital catchment area, with one possible focus of infection identified in Weston, MA. Due to a lack of clinical data reporting to the Massachusetts Department of Public Health, only 20 of 32 HGA cases (63%) fulfilled the case confirmation criteria., Conclusion: Diagnosis of HGA requires a high suspicion for infection even in endemic areas. Use of a tick-associated pathogen panel that includes PCR assays for several organisms could improve detection of underrecognized tick-borne diseases in endemic areas. Lack of epidemiological follow-up to confirm corroborating clinical findings prevents accurate case reporting and assessment of the true HGA burden., (Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)

Policy mobilities research has explored how policies—particularly urban development policies—spread among sites around the world, mutate along the way, and take hold in distinct contexts. Within the policy mobilities literature, there is particular attention to circulatory infrastructures, which facilitate encounters, learning, and exchange of knowledge that support the (re)production and movement of policies and "best practices." Policy mobilities scholarship thus understands policy implementation as emerging from relational assemblages of myriad actors and social processes. Drawing on assemblage theory, this work has been attentive to nonhuman objects and infrastructures, nonetheless it has given little attention to nonhuman life. This article draws on more-than-human geographies, particularly emerging work on nonhuman life and infrastructures, to incorporate nonhuman actors into an understanding of policy mobilization. We present a case study of suburban wildlife management programs in Massachusetts and discuss how human–nonhuman relationships undergird policy development, transfer, and change. Drawing insights from municipal surveys, in-depth interviews, and document analysis, we argue that nonhumans are active in the production of policy assemblages and the mobility of environmental policies. Deer, in particular, are lively actors entangled in the circulation of policies designed to manage social-ecological dynamics and processes that also include ticks, forests, bacteria, and many other nonhuman agents. Through this intervention to situate nonhuman life in policy mobilities, we highlight the political agency of nonhuman actors, the materialities of policy mobilization, and the role of nonhumans in shaping relational networks. [ABSTRACT FROM AUTHOR]

Background: Outbreaks of Type A tularemia due to Francisella tularensis tularensis are typically sporadic and unstable, greatly hindering identification of the determinants of perpetuation and human risk. Martha's Vineyard, Massachusetts has experienced an outbreak of Type A tularemia which has persisted for 9 years. This unique situation has allowed us to conduct long-term eco-epidemiologic studies there. Our hypothesis is that the agent of Type A tularemia is perpetuated as a metapopulation, with many small isolated natural foci of transmission. During times of increased transmission, the foci would merge and a larger scale epizootic would occur, with greater likelihood that humans become exposed., Methods: We sampled questing dog ticks from two natural foci on the island and tested them for tularemia DNA. We determined whether the force of transmission differed between the two foci. In addition, we examined the population structure of F. tularensis from ticks by variable number tandem repeat (VNTR) analysis, which allowed estimates of diversity, linkage disequilibrium, and eBURST analysis., Results: The prevalence of tularemia DNA in ticks from our two field sites was markedly different: one site was stable over the course of the study yielding as many as 5.6% positive ticks. In contrast, infected ticks from the comparison site markedly increased in prevalence, from 0.4% in 2003 to 3.9% in 2006. Using 4 VNTR loci, we documented 75 different haplotypes (diversity = 0.91). eBURST analysis indicates that the stable site was essentially clonal, but the comparison site contained multiple unrelated lineages. The general bacterial population is evolving clonally (multilocus disequilibrium) and the bacteria in the two sites are reproductively isolated., Conclusion: Even within an isolated island, tularemia natural foci that are no more than 15 km apart are uniquely segregated. One of our sites has stable transmission and the other is emergent. The population structure at the stable site is that of a clonal complex of circulating bacteria, whereas the emerging focus is likely to be derived from multiple founders. We conclude that the agent of tularemia may perpetuate in small stable natural foci and that new foci emerge as a result of spillover from such stable sites.

To evaluate a theory-based educational program to prevent Lyme disease and other tick-borne illnesses (TBI), a randomized controlled trial of an educational program was delivered to ferry passengers traveling to an endemic area in southeastern Massachusetts. Rates of TBI and precautionary and tick check behaviors were measured over three summers in 30,164 passengers. There were lower rates of TBI among participants receiving TBI education compared with control participants receiving bicycle safety education (relative risk [RR] = 0.79) and a 60% reduction in risk among those receiving TBI education who visited Nantucket Island for more than 2 weeks compared to control participants (RR = 0.41, 95% confidence intervals = 0.18 to 0.95, p < .038). TBI-educated participants were also significantly more likely to take precautions (use repellent, protective clothing, limit time in tick areas) and check themselves for ticks. The study demonstrates that a theory-based Lyme disease prevention program can increase precautionary behavior and result in a significant reduction in TBI.

Genetic engineering of wild populations has been proposed for reducing human diseases by altering pathogens' hosts. For example, CRISPR-based genome editing may be used to create white-footed mice (Peromyscus leucopus) that are resistant to the Lyme disease spirochete vectored by blacklegged ticks (Ixodes scapularis). Toward this goal, academic researchers are developing Lyme-resistant and tick-resistant white-footed mice, which are a primary pathogen reservoir for Lyme disease in the United States. If field trials on small, experimental islands are successful, the project would scale up to the larger islands of Nantucket and Martha's Vineyard, Massachusetts, and possibly to the mainland, most likely with a local gene drive to speed the traits' proliferation, pending approvals from relevant constituents. Despite considerable publicity, this project has yet to be evaluated by independent professional ecologists. In the present article, I discuss key ecological and evolutionary questions that should be considered before such genetically engineered mice are released into natural habitats. [ABSTRACT FROM AUTHOR]

To determine whether short-tailed shrews (Blarina brevicauda) serve as reservoir hosts for the Lyme disease spirochete (Borrelia burgdorferi) and the agent of human babesiosis (Babesia microti), we examined nymphal ticks that had fed as larvae on shrews collected from 3 enzootic sites in coastal Massachusetts for evidence of infection by either or both of these agents. Xenodiagnosis indicated that 11 of 14 shrews were infected by B. burgdorferi. One of 3 piroplasm-infected shrews also infected ticks with B. microti. In a site where the piroplasm is endemic, 11 of 17 shrews showed patent parasitemias by thin blood smears. Of these, 4 had parasitemias exceeding 40%. Few immature ticks infested shrews, however, suggesting that B. brevicauda, although abundant in some endemic sites and serving as a competent reservoir, would contribute minimally to the population of infected nymphs.

Serological studies of cottontail rabbits sampled from Nantucket Island, Mass., have suggested exposure to at least two ehrlichiae. The agent of human granulocytic ehrlichiosis (Anaplasma phagocytophilum) is intensely enzootic in rabbits there, but the identity of the other ehrlichial infection remains undescribed. We sampled rabbits over five transmission seasons and tested their blood and tissues for evidence of infection using PCR targeting an Ehrlichia genus-wide 16S rDNA target. Sequence analysis of positive amplicons revealed the presence of Anaplasma bovis, an agent not known to be present in North America. The average annual prevalence of A. bovis within rabbits, as determined by PCR of blood samples, was 18%. Haemaphysalis leporispalustris appears to serve as vector. The public health (human or veterinary) significance of this finding remains speculative.

The history of babesiosis is traced from the discovery of the parasite in 1888, to its present endemic niche. The author uncovers clinical and epidemiological features of human babesiosis in a patient hospitalized in New Jersey.

In evaluating the white-footed mouse as a reservoir host for the Lyme disease spirochete, we compared spirochete infection in vector ticks (Ixodes dammini) having different histories of attachment to these mice, estimated their relative importance as hosts for immature I. dammini and compared the seasonality of tick activity and spirochetemia in mice. Infection in trapped white-footed mice appears to be universal. Prevalence of spirochetal infection in I. dammini correlates with frequency of attachment to mice, and in mice, with the season of vector activity. The relative abundance of this mouse makes it numerically the most important host for I. dammini. Most immature I. dammini appear to attach to white-footed mice. Taken together, these considerations demonstrate that the white-footed mouse serves as reservoir for the Lyme disease spirochete in coastal Massachusetts.

Lyme disease surveillance based on provider and laboratory reports underestimates incidence. We developed an algorithm for automating surveillance using electronic health record data. We identified potential Lyme disease markers in electronic health record data (laboratory tests, diagnosis codes, prescriptions) from January 2017-December 2018 in 2 large practice groups in Massachusetts, USA. We calculated their sensitivities and positive predictive values (PPV), alone and in combination, relative to medical record review. Sensitivities ranged from 57% (95% CI 47%-69%) for immunoassays to 87% (95% CI 70%-100%) for diagnosis codes. PPVs ranged from 53% (95% CI 43%-61%) for diagnosis codes to 58% (95% CI 50%-66%) for immunoassays. The combination of a diagnosis code and antibiotics within 14 days or a positive Western blot had a sensitivity of 100% (95% CI 86%-100%) and PPV of 82% (95% CI 75%-89%). This algorithm could make Lyme disease surveillance more efficient and consistent.

To evaluate the role of deer in regulating the abundance of the deer tick (Ixodes dammini) we attempted to treat with acaricide, but eventually removed, about 70 percent of deer from Great Island, Cape Cod, Massachusetts. Deer were captured in box traps, a corral, an entanglement net, and with rifle-fired tranquilizer. Failure of these attempts, combined with ineffective acaricides, led us to deer destruction begun in fall 1982. Larval tick abundance on mice was monitored before and after deer removal. We concluded that deer removal, to the extent accomplished, did not markedly reduce the abundance of the tick. Reduced abundance of deer may not result in reduced abundance of immature ticks if deer removal follows the period of adult tick feeding, or if intensity of infestation per deer increases, or if other mammals substitute as suitable hosts. Reduced tick abundance may be delayed if unattached immature ticks survive more than one year.

We describe a focal epidemic of Lyme disease, which spread from a nature preserve and affected an adjacent community of permanent residents in coastal Massachusetts. The attack rate from 1980 through 1987 was 35 percent among 190 residents living within 5 km of the nature preserve and was greatest (66 percent) among those living closest to the preserve. The risk of infection bore little relation to sex or age. Late Lyme disease, which clustered near the preserve, occurred mainly in residents infected early in the epidemic who did not have a history of erythema migrans and did not receive antibiotic therapy. All the residents with serologic evidence of infection had early or late clinical manifestations of Lyme disease, or both, during the period of study. The seasonal risk of infection was bimodal--greatest in June, with a secondary peak in October--and corresponded to periods of increased transmission. In the nature preserve, the density of the vector tick, Ixodes dammini, exceeded that in other New England sites. The zoonosis rapidly became endemic, and the severity of its impact correlated with the abundance of deer. This epidemic of Lyme disease demonstrated that outbreaks can be focal and can spread rapidly within a community of permanent residents.