Control of ixodid ticks and prevention of tick-borne diseases in the United States: The prospect of a new Lyme disease vaccine and the continuing problem with tick exposure on residential properties

Background:In the United States, tick-borne illnesses account for a significant number of patients that have been seen and treated by health care facilities. This in turn, has resulted in a significant morbidity and mortality and economic costs to the country.Methods:The distribution of these illnesses is geographically variable and is related to the climate as well. Many of these illnesses can be diagnosed and treated successfully, if recognized and started on appropriate antimicrobial therapy early in the disease process. Patient with illnesses such as Lyme disease, Wet Nile illness can result in chronic debilitating diseases if not recognized early and treated.Conclusion:This paper covers illnesses such as Lyme disease, West Nile illness, Rocky Mountain Spotted fever, Ehrlichia, Tularemia, typhus, mosquito borne illnesses such as enteroviruses, arboviruses as well as arthropod and rodent borne virus infections as well. It covers the epidemiology, clinical features and diagnostic tools needed to make the diagnosis and treat these patients as well.

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Surveillance of Lyme Disease in the United States, 1982

The Journal of Infectious Diseases ◽

10.1093/infdis/151.6.1144 ◽

1985 ◽

Vol 151 (6) ◽

pp. 1144-1149 ◽

Cited By ~ 29

Author(s):

G. P. Schmid ◽

R. Horsley ◽

A. C. Steere ◽

J. P. Hanrahan ◽

J. P. Davis ◽

...

Keyword(s):

United States ◽

Lyme Disease ◽

The United States

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1428. Lyme Disease Treatment in the United States: Prescribing Patterns from a Nationwide Commercial Insurance Database, 2016-2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1610 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S720-S720

Author(s):

Amy M Beeson ◽

Grace E Marx ◽

Amy M Schwartz ◽

Alison F Hinckley

Keyword(s):

United States ◽

Lyme Disease ◽

Standard Treatment ◽

Age Distribution ◽

Public Health Problem ◽

The United States ◽

Adverse Outcomes ◽

Prescribing Patterns ◽

Antibiotic Prescribing ◽

Low Incidence

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p< 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p< 0.0001) and during non-summer months (OR 2.2, p< 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures

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Human Coinfection withBorrelia burgdorferiandBabesia microtiin the United States

Journal of Parasitology Research ◽

10.1155/2015/587131 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 21

Author(s):

Kristen L. Knapp ◽

Nancy A. Rice

Keyword(s):

United States ◽

Lyme Disease ◽

Causative Agent ◽

Ixodes Scapularis ◽

Immunological Response ◽

The United States ◽

Babesia Microti ◽

Current State ◽

Tick Borne Disease ◽

Multiple Pathogens

Borrelia burgdorferi, the causative agent of Lyme disease, andBabesia microti, a causative agent of babesiosis, are increasingly implicated in the growing tick-borne disease burden in the northeastern United States. These pathogens are transmitted via the bite of an infected tick vector,Ixodes scapularis, which is capable of harboring and inoculating a host with multiple pathogens simultaneously. Clinical presentation of the diseases is heterogeneous and ranges from mild flu-like symptoms to near-fatal cardiac arrhythmias. While the reason for the variability is not known, the possibility exists that concomitant infection with bothB. burgdorferiandB. microtimay synergistically increase disease severity. In an effort to clarify the current state of understanding regarding coinfection withB. burgdorferiandB. microti, in this review, we discuss the geographical distribution and pathogenesis of Lyme disease and babesiosis in the United States, the immunological response of humans toB. burgdorferiorB. microtiinfection, the existing knowledge regarding coinfection disease pathology, and critical factors that have led to ambiguity in the literature regarding coinfection, in order to eliminate confusion in future experimental design and investigation.

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The Epidemiology of Lyme Disease in the United States 1987-1988

Laboratory Medicine ◽

10.1093/labmed/21.5.285 ◽

1990 ◽

Vol 21 (5) ◽

pp. 285-289 ◽

Cited By ~ 13

Author(s):

Gayle L. Miller ◽

Robert B. Craven ◽

Ray E. Bailey ◽

Theodore F. Tsai

Keyword(s):

United States ◽

Lyme Disease ◽

The United States

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Changing Trends in Age and Sex Distributions of Lyme Disease—United States, 1992-2016

Public Health Reports ◽

10.1177/00333549211026777 ◽

2021 ◽

pp. 003335492110267

Author(s):

Kiersten J. Kugeler ◽

Paul S. Mead ◽

Amy M. Schwartz ◽

Alison F. Hinckley

Keyword(s):

United States ◽

Lyme Disease ◽

Disease Incidence ◽

Age Distribution ◽

Relative Size ◽

The United States ◽

Male Predominance ◽

Age Related ◽

Over Time ◽

Age And Sex

Lyme disease is the most common vector-borne disease in the United States and is characterized by a bimodal age distribution and male predominance. We examined trends in reported cases during a 25-year period to describe changes in the populations most affected by Lyme disease in the United States. We examined demographic characteristics of people with confirmed cases of Lyme disease reported to the Centers for Disease Control and Prevention during 1992-2016 through the National Notifiable Diseases Surveillance System. We grouped cases into 5-year periods (1992-1996, 1997-2001, 2002-2006, 2007-2011, 2012-2016). We calculated the average annual incidence by age and sex and used incidence rate ratios (IRRs) to describe changes in Lyme disease incidence by age and sex over time. We converted patient age at time of illness into patient birth year to ascertain disease patterns according to birth cohorts. The incidence of Lyme disease in the United States doubled from 1992-1996 to 2012-2016 (IRR = 1.74; 95% CI, 1.70-1.78) and increased disproportionately among males; IRRs were 39%-89% higher among males than among females for most age groups. During the study period, children aged 5-9 years were most frequently and consistently affected. In contrast, the average age of adults with Lyme disease increased over time; of all adults, people born during 1950-1964 were the most affected by Lyme disease. Our findings suggest that age-related behaviors and susceptibilities may drive infections among children, and the shifting peak among adults likely reflects a probability proportional to the relative size of the baby boom population. These findings can inform targeted and efficient public health education and intervention efforts.

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