{"id":29682,"date":"2022-03-25T14:30:07","date_gmt":"2022-03-25T14:30:07","guid":{"rendered":"http:\/\/tvp.tv-multi-theme.com.216-70-96-51.jvv2-rfnp.accessdomain.com\/?p=29682"},"modified":"2022-09-20T15:59:06","modified_gmt":"2022-09-20T15:59:06","slug":"update-on-ticks-and-pathogens","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/parasitology\/update-on-ticks-and-pathogens\/","title":{"rendered":"It Is Always a Bad Year for Ticks: Update on Ticks and Pathogens"},"content":{"rendered":"<p class=\"p1\"><span class=\"s1\">Vector-borne diseases are important to the health of domestic animals, humans, and some wildlife species, and they are more than twice as likely to be emerging diseases (i.e., increasing in incidence in either new or existing populations) as non\u2013vector-borne diseases.<sup>1<\/sup> Worldwide vector-borne diseases are increasing, and specifically in the United States, from 2004 to 2016, the number of reported human cases of tick-borne disease more than doubled.<sup>2<\/sup> Several factors are thought to contribute to the increasing incidence of diseases caused by vector-borne pathogens, including climate change; habitat changes, such as suburbanization and reforestation, that bring people, wildlife, domestic animals, and pathogens together; and an increase in certain wildlife species (e.g., rodents, deer) that support vectors and\/or serve as reservoirs of infection. These factors are dynamic and, as a result, novel pathogens are expected to emerge and the incidence, prevalence, and spatial distribution of tick-borne diseases are expected to change, making monitoring essential.<\/span><\/p>\n<hr \/>\n<p><strong>Editor&#8217;s Note:<\/strong> Since publication, the Companion Animal Parasite Council released its 2022 Pet Parasite Forecasts, which <a href=\"https:\/\/capcvet.org\/articles\/2022-forecasts\/\" target=\"_blank\" rel=\"noopener\">can be accessed here<\/a>.<\/p>\n<hr \/>\n<h2 class=\"p2\">Tick-Borne Pathogens Continue to Emerge<\/h2>\n<p class=\"p1\"><span class=\"s1\">Until the early 1980s, Rocky Mountain spotted fever, caused by <i>Rickettsia rickettsii<\/i>, was the most commonly recognized human tick-borne disease in the U.S. However, since its initial description in the 1970s, Lyme disease, caused by <i>Borrelia<\/i> <i>burgdorferi<\/i>, has quickly become the most diagnosed tick-borne disease. Currently, approximately 30<\/span><span class=\"s2\">\u2009<\/span><span class=\"s1\">000 human Lyme disease cases are confirmed annually in the U.S., but it is estimated that the actual number of cases could range from at least 300<\/span><span class=\"s2\">\u2009<\/span><span class=\"s1\">000 to as many as 475<\/span><span class=\"s2\">\u2009<\/span><span class=\"s1\">000.<sup>3,4<\/sup> Additionally, in the past several decades, numerous new human pathogens have been recognized (at least 9 since 2004). Many of these also infect dogs, which are <\/span>commonly exposed to ticks; fewer infect cats and horses.<span class=\"s1\"><span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<hr \/>\n<p>The <a href=\"https:\/\/todaysveterinarypractice.com\/column\/parasitology\/\">Parasitology series<\/a> is brought to you by Merck Animal Health, the makers of Bravecto\u00ae (fluralaner) and Sentinel\u00ae (milbemycin oxime\/lufenuron).<\/p>\n<hr \/>\n<p class=\"p1\"><span class=\"s1\">The diversity of tick-borne pathogens recognized in dogs has also been increasing (<\/span><strong><span class=\"s3\">TABLE 1<\/span><\/strong><span class=\"s1\">). Among the most common are <i>B burgdorferi<\/i>, <i>Anaplasma<\/i> <i>phagocytophilum <\/i>and<i> Anaplasma platys<\/i> (agents of anaplasmosis), and <i>Ehrlichia<\/i> species (agents of ehrlichiosis). There are 3 primary agents for canine ehrlichiosis in the U.S.: <i>Ehrlichia canis, Ehrlichia ewingii, <\/i>and<i> Ehrlichia<\/i> <i>chaffeensis<\/i>, but dogs are also susceptible to infection by <i>Ehrlichia muris eauclairensis<\/i>, believed to be transmitted by <i>Ixodes scapularis,<\/i> and the \u201cPanola Mountain\u201d <i>Ehrlichia<\/i> species, which is transmitted by <i>Amblyomma americanum<\/i>. In dogs, tick-borne pathogens generally cause nonspecific illness characterized by fever, lethargy, and inappetence; some may cause lameness, rash, and clinical abnormalities.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\"><span class=\"Apple-converted-space\"><a href=\"http:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/02\/Yabsley_TickPathogens_TVPMarApr22_Table1.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-large wp-image-25070\" src=\"http:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/02\/Yabsley_TickPathogens_TVPMarApr22_Table1-1024x880.png\" alt=\"\" width=\"1024\" height=\"880\" \/><\/a><\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">As shown in <strong>T<\/strong><\/span><strong><span class=\"s3\">ABLE 1<\/span><\/strong><span class=\"s1\">, individual tick species can be associated with several pathogens, meaning that a person or dog infested with one species of tick may be at risk of several tick-borne diseases. For example, <i>I<\/i>\u00a0<i>scapularis<\/i> is a competent vector for <i>A\u00a0phagocytophilum <\/i>as well as<i> B burgdorferi, <\/i>while <i>Rhipicephalus sanguineus<\/i> can transmit <i>E canis<\/i> and is the presumed vector for <i>A\u00a0platys<\/i>. Similarly, <i>A\u00a0americanum<\/i> can transmit several important pathogens. The distributions of these pathogens follow those of the associated tick vectors (<\/span><strong><span class=\"s3\">FIGURES 1\u20133<\/span><\/strong><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_29635\" style=\"width: 826px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure1.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-29635\" class=\"wp-image-29635 size-full\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure1.png\" alt=\"\" width=\"816\" height=\"631\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure1.png 816w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure1-300x232.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure1-768x594.png 768w\" sizes=\"(max-width: 816px) 100vw, 816px\" \/><\/a><p id=\"caption-attachment-29635\" class=\"wp-caption-text\">Figure 1. Prevalence of Borrelia burgdorferi antibodies in dogs in the United States for 2021. Darker shades indicate higher prevalence. Data sourced from the Companion Animal Parasite Council Parasite Prevalence Maps.<\/p><\/div>\n<div id=\"attachment_29636\" style=\"width: 826px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure2.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-29636\" class=\"wp-image-29636 size-full\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure2.png\" alt=\"\" width=\"816\" height=\"640\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure2.png 816w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure2-300x235.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure2-768x602.png 768w\" sizes=\"(max-width: 816px) 100vw, 816px\" \/><\/a><p id=\"caption-attachment-29636\" class=\"wp-caption-text\">Figure 2. Prevalence of Anaplasma species antibodies in dogs in the United States for 2021. Darker shades indicate higher prevalence. Data sourced from the Companion Animal Parasite Council Parasite Prevalence Maps.<\/p><\/div>\n<div id=\"attachment_29637\" style=\"width: 826px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure3.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-29637\" class=\"wp-image-29637 size-full\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure3.png\" alt=\"\" width=\"816\" height=\"636\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure3.png 816w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure3-300x234.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/03\/Yabsley_TickPathogens_TVPMarApr22_Figure3-768x599.png 768w\" sizes=\"(max-width: 816px) 100vw, 816px\" \/><\/a><p id=\"caption-attachment-29637\" class=\"wp-caption-text\">Figure 3. Prevalence of Ehrlichia species antibodies in dogs in the United States for 2021. Darker shades indicate higher prevalence. Data sourced from the Companion Animal Parasite Council Parasite Prevalence Maps.<\/p><\/div>\n<p class=\"p1\"><span class=\"s1\">While the specific agent may not be clinically significant (e.g., treatment for <i>E chaffeensis<\/i> and <i>A\u00a0phagocytophilum<\/i> is the same), accurate diagnosis is important epidemiologically, as different vectors may be involved and some tick-borne pathogens (e.g., <i>Babesia<\/i> species, viruses) are not susceptible to the same treatment protocols as bacterial pathogens. Also, many species of ticks may coexist on the same dog; therefore, collection and identification of one species do not rule out the presence of another species that may be responsible for the presenting disease.<\/span><\/p>\n<h2 class=\"p2\">Ticks Are on the Move, and They Take Their Pathogens with Them<\/h2>\n<p class=\"p1\"><span class=\"s1\">It is well established that several tick species are expanding their ranges and\/or developing higher densities within their historical range. As ticks expand their range, they take their pathogens with them. This can cause diagnostic difficulties in areas where multiple pathogens may cause tick-borne diseases that present with similar signs. For example, anaplasmosis has long been endemic in dogs and humans in the northeastern U.S., but in recent years the lone star tick has expanded into the area and ehrlichiosis is now a differential in this region.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">In addition, an exotic tick species, <i>Haemaphysalis<\/i> <i>longicornis<\/i> (Asian longhorned tick), was first detected in the U.S. in 2017 and is now widespread in the eastern states.<sup>5<\/sup> The potential for pathogen transmission by this exotic tick is a major concern. To date, there is limited evidence of natural infection of <i>H<\/i>\u00a0<i>longicornis<\/i> with <i>B burgdorferi<\/i>, a variant of <i>A\u00a0phagocytophilum<\/i>, and <i>Rickettsia felis<\/i>.<sup>6<\/sup> Experimentally, this tick can transmit <i>R\u00a0rickettsii<\/i> but was not successful in transmitting <i>B\u00a0burgdorferi<\/i> or a human variant of <i>A\u00a0phagocytophilum<\/i>.<sup>7-9<\/sup> Additional research is clearly needed to understand the pathogen risk of this new tick, keeping in mind that this risk may change over time as the tick spreads or uses novel hosts that may be infected with different pathogens.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<h2 class=\"p2\">Prevalence Maps Provide Real-Time Data on Pathogens<span class=\"Apple-converted-space\">\u00a0<\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">Mapping the distribution of ticks and their pathogens has obvious importance, but it is complicated by many factors. A significant limitation is the great expense and logistics of gathering real-time data on the presence and density of ticks across the potential range of each tick species. For pathogens, especially multi-host pathogens, it is even more difficult to determine distribution. However, the Companion Animal Parasite Council (CAPC) provides free, interactive parasite prevalence maps for a limited group of pathogens (<a href=\"http:\/\/www.capcvet.org\"><span class=\"s3\">capcvet.org<\/span><\/a>). These maps provide a local, real-time quantification of risk, and they are now being used to develop annual forecasts to allow preventive care recommendations to be proactively strengthened.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">To create the maps, the CAPC receives monthly serologic data from the U.S. and Canada for several vector-borne pathogens, antigen data for heartworm (<i>Dirofilaria immitis<\/i>), fecal flotation data for intestinal parasites, and data on exposure to selected viruses in dogs and cats. The maps are updated monthly and data can be viewed at the national, state\/province, or county level (for the U.S.) going back to January 2012, giving veterinarians expert insight into local pathogen prevalence with which to advise their clients.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Some of the pathogens included in the mapping effort are zoonotic, meaning they can infect humans. In the past, several studies have suggested and investigated the utility of domestic dogs as sentinels for where human infections may occur. Dogs live in the same general environment as their owners, often spend more time outdoors, and may have increased exposure to ideal tick habitats; therefore, their owners may be exposed to ticks that infest them. Using the very large CAPC <i>B\u00a0burgdorferi<\/i> dataset, it was found that the mean incidence of human Lyme disease case numbers increases with canine seroprevalence until the seroprevalence in dogs reaches approximately 30%.<sup>10<\/sup> This finding reinforces the use of dogs as sentinels for human risk, especially with respect to identifying geographic areas of concern for potential human exposure.<\/span><\/p>\n<h2 class=\"p2\">Trends in Prevalence of Selected Tick-Borne P<span class=\"s4\">athogens Show Changing Risk<\/span><span class=\"Apple-converted-space\">\u00a0<\/span><\/h2>\n<p class=\"p1\"><span class=\"s1\">These data can also be used to look at trends in prevalence. Using <i>B burgdorferi<\/i> as an example,<sup>11,12<\/sup> modeling shows that areas with significant increases in canine <i>B burgdorferi<\/i> seroprevalence between January 2012 and December 2016 are the same states in which 95% of human cases occur: Maine, New Hampshire, Vermont, Massachusetts, New York, Rhode Island, Connecticut, Pennsylvania, New Jersey, Delaware, Maryland, Virginia, West Virginia, Minnesota, and Wisconsin (<\/span><strong><span class=\"s3\">FIGURE 4<\/span><\/strong><span class=\"s1\">). There is also a significant increase in the surrounding states: the upper peninsula and west coast of the lower peninsula of Michigan, eastern North Dakota, northeastern South Dakota, eastern Iowa, northern and eastern Illinois, Indiana, eastern Kentucky, northeastern Tennessee, eastern Ohio, North Carolina, northern California, and southern Oregon. The rate of increase in seroprevalence was highest within the high-incidence states, while seroprevalence in transitional zones immediately bordering the high-incidence regions is increasing at a slower rate.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<div id=\"attachment_25032\" style=\"width: 922px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/02\/Yabsley_TickPathogens_TVPMarApr22_Figure4.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-25032\" class=\"size-full wp-image-25032\" src=\"http:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/02\/Yabsley_TickPathogens_TVPMarApr22_Figure4.png\" alt=\"\" width=\"912\" height=\"568\" \/><\/a><p id=\"caption-attachment-25032\" class=\"wp-caption-text\">Figure 4. Regional change in Borrelia burgdorferi seroprevalence in dogs from 2012 to 2018. Regional trends range from decreases or stability of seroprevalence (blue to yellow) to increases (orange to dark red).<sup>11<\/sup><\/p><\/div>\n<p class=\"p1\"><span class=\"s1\">These kinds of data are important because they show that the seroprevalence in high-incidence regions is still increasing despite the availability of acaricides and anti-<i>Borrelia<\/i> vaccines, which suggests that current compliance with these preventive measures is inadequate. Veterinarians and pet owners in high-incidence regions need to recognize the growing risk of exposure and implement appropriate preventive measures. Additionally, veterinarians in the areas surrounding high-incidence regions need to recognize that the seroprevalence is rising and adjust screening and preventive care protocols accordingly. Similar studies on the trends of <i>Anaplasma<\/i> and <i>Ehrlichia<\/i> species have been conducted, and they show similar trends in certain regions of the U.S.<sup>13<\/sup> When all of these pathogens are combined, it shows that dogs are at risk of a tick-borne disease in most regions of the U.S., and the risk is increasing in certain areas.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">These historical prevalence data can also be combined with climatological and ecological data to construct annual forecast maps that display the expected prevalence of each pathogen in dogs for the upcoming year. These forecasts are released annually at <a href=\"http:\/\/www.capcvet.org\"><span class=\"s3\">capcvet.org<\/span><\/a><\/span> <span class=\"s1\">and at a more \u201cclient-friendly\u201d site, <a href=\"http:\/\/www.petsandparasites.org\/\"><span class=\"s3\">petsandparasites.org<\/span><\/a>. Monthly forecasts and alerts are available at <a href=\"http:\/\/www.petdiseasealerts.org\"><span class=\"s3\">petdiseasealerts.org<\/span><\/a>.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<h2 class=\"p2\">Conclusion<\/h2>\n<p class=\"p1\"><span class=\"s1\">It seems veterinarians are constantly bombarded with annual warnings that \u201cthis year will be a bad tick year\u201d or \u201cLyme disease cases are increasing\u201d or \u201ctick-borne diseases are on the rise,\u201d but importantly, the data do support a concern that tick-borne diseases are getting worse in people and pets. However, an arsenal of tools exists to help. Pet owners and veterinarians should always practice appropriate care in preventing exposure to ticks (e.g., using tick preventives, performing thorough examinations for ticks, avoiding tick habitats if possible), especially in areas with high risk.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p1\"><span class=\"s1\"><i>Note: This article is adapted and updated from the NAVC\u2019s 2020 VMX Conference Proceedings.<\/i><\/span><\/p>\n<p class=\"p3\"><strong>Recommended Reading<\/strong><\/p>\n<p class=\"p1\"><span class=\"s1\">For more discussion on the pathogen exposure data used in the CAPC parasite prevalence maps and how they are developed, see: Self SCW, Liu Y, Nordone SK, et al. Canine vector-borne disease: mapping and the accuracy of forecasting using big data from the veterinary community. <i>Anim Health Res Rev<\/i>. 2019;20(1):47-60. doi: 10.1017\/S1466252319000045<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>While research indicates that tick-borne diseases are getting worse for people and pets, preventive tools and prevalence mapping can help limit exposure.<\/p>\n","protected":false},"author":9,"featured_media":29639,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":269,"footnotes":""},"categories":[400],"tags":[],"class_list":["post-29682","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-march-april-2022","column-parasitology","clinical_topics-infectious-disease","clinical_topics-parasitology"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is 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