Global & Disaster Medicine

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At a crossroads for Lyme and other serious tick-borne diseases in the U.S.

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“…….In 2017, mosquito-borne West Nile virus, which currently infects about 2,000 people annually in the U.S. received $42 million in support from the U.S. National Institutes of Health. Lyme disease, with 20 times the number of reported cases, got half as much, a figure that has changed little in a decade. ……..Lyme disease from black-legged ticks is only a part of the problem. Cases of anaplasmosis and ehrlichiosis have soared, increasing sixfold since 2004. Malaria-like babesiosis, once limited to coastal islands, has been reported in 27 states; it makes Lyme disease far worse. The lone star tick, common in the South, has migrated to vast tracts of new territory as the climate has warmed, its bite causing a potentially severe meat allergy unheard of a decade ago. In 2017 the Asian longhorned tick became the first new tick species in the U.S. in 80 years. Now in 11 states, the ticks so infested five cows in North Carolina recently that they died of anemia from blood loss. The implications for agriculture could be dire because female longhorned ticks can clone themselves, vastly increasing birthrates. …..”

American dog tick (Dermacentor variabilis)

Where found: Widely distributed east of the Rocky Mountains. Also occurs in limited areas on the Pacific Coast.
Transmits: Tularemia and Rocky Mountain spotted fever.
Comments: The highest risk of being bitten occurs during spring and summer. Dog ticks are sometimes called wood ticks. Adult females are most likely to bite humans.

Approximate distribution of the American dog tick in the United States of America

Blacklegged tick (Ixodes scapularis)

Where found: Widely distributed across the eastern United States.
Transmits: Borrelia burgdorferi and B. mayonii (which cause Lyme disease), Anaplasma phagocytophilum (anaplasmosis), B. miyamotoi disease (a form of relapsing fever), Ehrlichia muris eauclairensis (ehrlichiosis), Babesia microti (babesiosis), and Powassan virus (Powassan virus disease).
Comments: The greatest risk of being bitten exists in the spring, summer, and fall. However, adults may be out searching for a host any time winter temperatures are above freezing. Stages most likely to bite humans are nymphs and adult females.

Approximate distribution of the Blacklegged tick in the United States of America.  The map shows that the blacklegged tick is widely distributed across the entire eastern half of the United States

Brown dog tick (Rhipicephalus sanguineus)Where found: Worldwide.
Transmits: Rocky Mountain spotted fever (in the southwestern U.S. and along the U.S.-Mexico border).
Comments: Dogs are the primary host for the brown dog tick in each of its life stages, but the tick may also bite humans or other mammals.

Map of the United States showing approximate distribution of the Brown dog tick.  The entire United States is affected.

Image for Gulf Coast tick (Amblyomma maculatum)

Where found: Coastal areas of the U.S. along the Atlantic coast and the Gulf of Mexico.
Transmits: Rickettsia parkeri rickettsiosis, a form of spotted fever.
Comments: Larvae and nymphs feed on birds and small rodents, while adult ticks feed on deer and other wildlife. Adult ticks have been associated with transmission of R. parkeri to humans.

Map of the United States showing the approximate distribution of the Gulf coast tick.  Distribution area is the southeastern part of the country.

Lone star tick (Amblyomma americanum)

Where found: Widely distributed in the southeastern and eastern United States.
Transmits: Ehrlichia chaffeensis and Ehrlichia ewingii (which cause human ehrlichiosis), Heartland virus, tularemia, and STARI.
Comments: A very aggressive tick that bites humans. The adult female is distinguished by a white dot or “lone star” on her back. Lone star tick saliva can be irritating; redness and discomfort at a bite site does not necessarily indicate an infection. The nymph and adult females most frequently bite humans and transmit disease.

Map of the United States showing the approximate distribution of the Lone Star tick.  The area affected is the eatern half of the country.

Rocky Mountain wood tick (Dermacentor andersoni)Where found: Rocky Mountain states and southwestern Canada from elevations of 4,000 to 10,500 feet.
Transmits: Rocky Mountain spotted fever, Colorado tick fever, and tularemia.
Comments: Adult ticks feed primarily on large mammals. Larvae and nymphs feed on small rodents. Adult ticks are primarily associated with pathogen transmission to humans.

Map of the United States showing the approximate distribution of the Rocky mountain wood tick.  The area effected is the Northwestern part of the country.

Western blacklegged tick (Ixodes pacificus)Where found: Along the Pacific coast of the U.S., particularly northern California.
Transmits: Anaplasmosis and Lyme disease.
Comments: Nymphs often feed on lizards, as well as other small animals. As a result, rates of infection are usually low (~1%) in adults. Stages most likely to bite humans are nymphs and adult females.

Map of the United States showing the approximate distribution of the Western blacklegged tick.  The area affected is the western coast.


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