Geographic and Seasonal
Characterization of Tick Populations in
Maryland
Lauren DiMiceli, MSPH, MT(ASCP)
Background
• Mandated reporting of human tick-borne disease
• No statewide program for tick surveillance
– geographic distribution and seasonality of tick species
not systematically characterized
• Opportunity recognized to compile and analyze
data already being collected by the Maryland
Department of Agriculture (MDA) through its Tick
Identification Program
MDA Tick Identification Program
• MDA entomologist identifies ticks by MD
residents
• Submitter provides the following:
–
–
–
–
–
Demographic information
Geographic location (town) of the tick encounter
Date of collection
The host (human, pet, or other)
Anatomic site of attachment
MDA Tick Identification Program
• Entomologist identifies the following:
– type of tick
– life stage of the tick
– degree of engorgement
• Reports have been stored in paper format at
MDA
– data have not been systematically characterized
• Submitted ticks not tested for pathogens
Ticks of Public Health Importance in
Maryland
•
Ixodes scapularis
– Lyme disease
– Anaplasmosis
– Babesiosis
•
Amblyomma americanum
– Ehrlichiosis
•
Dermacentor variabilis
– Rocky Mountain spotted fever
– Tularemia
Assessed at: http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/S-Z/Ticks/body_Ticks_il3.htm
PHASE Objectives
• Purpose:
– Characterize tick submission data collected by MDA
– Complement human tick-borne disease surveillance
– Create electronic data base for prospective use
Methods
• Literature search and review
• Designed and developed Microsoft Access database
– Entered data from 2009 – 2011
• Analyzed Data
– Described frequency of submissions
– Assessed trends of submissions according to month and
life stage by year
– Assessed distributions of submissions by Maryland
jurisdiction by year
Ticks Submitted for Identification to the MDA by Tick Species and
Year, Maryland, 2009-2011 (total number of submissions = 501)
120
100
80
American Dog Tick - Dermacenter variabilis
60
Black-legged Deer Tick - Ixodes scapularis
40
Lone Star Tick - Amblyoma americanum
20
0
2009
2010
2011
Blacklegged adult ticks by month and year
of submission, Maryland, 2009-2011
12
10
8
2009
6
2010
2011
4
2
0
January
February
March
April
May
June
July
August September October November December
Blacklegged tick nymphs by month and year
of submission, Maryland, 2009-2011
14
12
10
8
2009
2010
6
2011
4
2
0
January
February
March
April
May
June
July
August September October November December
Lone Star adult ticks by month and year of
submission, Maryland, 2009-2011
16
14
12
10
2009
8
2010
2011
6
4
2
0
January
February
March
April
May
June
July
August September October November December
Lone Star tick nymphs by month and year of
submission, Maryland, 2009-2011
35
30
25
20
2009
2010
15
2011
10
5
0
January
February
March
April
May
June
July
August September October November December
Location of Blacklegged ticks and Lone Star
ticks by Maryland jurisdiction – 2009
Location of Blacklegged ticks and
Lone Star ticks by Maryland
jurisdiction - 2011
Limitations and Challenges
• Convenience sample
• Variability in how forms were completed
• Missing Data
• Mapping does not demonstrate intensity of host-tick
encounters
Public Health Impact and Practice
• Addressed knowledge gap
– potential for development of public health activities
• Maryland DHMH has increased awareness of
distribution and seasonality
– Aids in public health activity development
– Educational campaigns and/or environmental modification
• Electronic capture mechanism
• Fostered interagency relationships
Public Health Impact and Practice
• Professional Development
–
–
–
–
Developed and designed database
Conducting descriptive epidemiological analysis
Geographic Information Systems
Applied lessons learned from course work to real
world public health problems
– Critical thinking and leadership skills
– Excellent mentoring
Acknowledgements
• Maryland Department of Agriculture
– Gaye Williams
• Department of Health and Mental Hygiene
– Katherine Feldman, DVM, MPH
– Erin Jones, MS
– SB Wee, MHS
– Heather Rutz, MCRP, MHS
– Kimberly Mitchell, MPH
– Mary Armolt
Questions?
References
•
Bhate, Chinmoy and Schwartz, Robert A. Lyme Disease Part I. Advances and Perspectives. J Am Acad
Dermatol. 2011;64:619-36.
•
Heymann, David L. Control of Communicable Diseases Manual. Washington, D.C.: Association of Public Health,
2008.
•
Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene.
Available at: http://ideha.dhmh.md.gov/OIDEOR/CZVBD/SitePages/lyme-disease.aspx. Assessed May 4, 2012.
•
Killilea, ME, Swei A, Lane RS, et al. Spatial Dynamics of Lyme Disease: A Review. EcoHealth. 2008; 5:167-195.
•
Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene.
Available at: http://ideha.dhmh.md.gov/OIDEOR/CZVBD/Shared%20Documents/2000-2010_LymeDisease.pdf.
Assessed May 1, 2012.
•
Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene.
Available at:
http://ideha.dhmh.maryland.gov/IDEHASharedDocuments/counts_rates/2010Summary_PrintCriteria_Counts_FIN
AL.pdf. Assessed May 5, 2012.
•
Bacon RM, Kugeler KJ, Mead PS, et al. WMMR Surveillance Summary. Surveillance for Lyme disease -- United
States, 1992 – 2006. 2008;57(10): 1-9.
•
Centers for Disease Control and Prevention. http://www.cdc.gov/anaplasmosis/. Assessed May 5, 2012.
References
•
Infectious Disease and Environmental Health Administration, Maryland Department of Health and Mental Hygiene. Available
at: http://ideha.dhmh.md.gov/IDEHASharedDocuments/Ehrlich_Anapl_FactSheet.pdf. Assessed May 5, 2011..
•
Centers for Disease Control and Prevention. Ticks: Geographic Distribution.
http://www.cdc.gov/ticks/geographic_distribution.html. Assessed May 5, 2011.
•
Glass, G.E., et al., Predicting Ixodes scapularis abundance on white-tailed deer using geographic information systems. Am J
Trop Med Hyg, 1994. 51(5): p. 538-44.
•
Zhang, X., et al., Economic impact of Lyme disease. Emerg Infect Dis, 2006. 12(4): p. 653-60.
•
Sarwari, A.R., et al., Tick exposure and Lyme disease at a summer camp in Maryland. W V Med J, 2005. 101(3): p. 126-30.
•
Malouin R, Winch P, Leontsin E, et al. Longitudinal Evaluation of an Educational Intervention for Preventing Tick Bites in an
Area with Endemic Lyme Disease in Baltimore County, Maryland. Am J Epidemiol, 2003. 157(11): 1039-51.
•
Armstrong PM, Brunet LR, Spielman A et al. Risk of Lyme Disease: Perceptions of Residents of a Lone Star Tick-infested
Community. Bull World Health Organ, 2001. 79 (10): 916-25.
•
Caroll JF and Kramer M. Winter Activity of Ixodes scapularis (Acari: Ixodidae) and the Operation of Deer-Targeted Tick
Control Devices in Maryland. J Med Entomol, 2003. 40(2):238-44.
•
Carroll JF. A Survey for Nymphs of Host-seeking Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) on Tree
Trunks in Deciduous Forests. J Med Entomol, 2002. 39(1): 237-40.