Linking human tick bite risk with tick abundance in the environment: a novel approach to quantify tick bite risk using orienteers in Scotland

The rate that people are bitten by ticks is critical in determining the risk of tick-borne infections but is rarely quantified accurately. Often tick abundance in the environment is used as a proxy for tick bite risk, but the relationship with risk is poorly understood. We used a novel citizen science approach to measure tick bite rate in orienteers, to assess the relationship between tick abundance and tick bite risk and to identify risk factors for tick bites. Eleven orienteering events were attended in Scotland between August 2018 and September 2019. The number of tick bites in orienteers, and the time and distance of activity were collected using an online questionnaire. Tick abundance in the same areas used for the orienteering events was estimated by surveying ticks on ground vegetation using blanket drags. Among orienteers, mean incidence was 409 tick bites per 1,000 person-hours. Tick abundance and tick bite rate were strongly correlated, indicating that data from questing tick surveys is a useful proxy for the risk of human tick bites. Tick bite rate was better explained by the activity duration than distance covered and was higher in orienteers that ran earlier in the day, exposed to higher temperatures and in woodland habitats. This study highlights the value of the citizen science approach used, which crucially included submission of activity reports both with and without ticks, to generate robust data on tick bite rate. Accurately measuring tick bite rate and understanding environmental factors that influence it are essential in mitigating the risk of tick-borne diseases

Predicting tick-borne disease risk: improving the distribution mapping of ticks and tick bite risk in Scotland

Maps of Ixodes ricinus distribution and maps depicting tick bite risk are essential for government and health organisations to target prevention and control strategies for tick-borne diseases. However, researchers often lack robust long-term and geographically extensive tick distribution data, and information about human exposure to ticks to measure risk. Citizen science projects, through the collective effort of many volunteers, have the potential to provide valuable data on tick bite risk and tick distribution, but are often based on opportunistic submission of reports. The overarching aim of this study was to assess methodologies to improve public health decision-making through distribution mapping of ticks and tick bite risk for Scotland. Research was undertaken to: compare the quality and robustness of predictive mapping with the three types of tick data most often used for predictive mapping; use statistical approaches to improve the quality of predictions of the distribution of I. ricinus in Scotland, including the predicted uncertainty; assess whether questing tick surveys reflect human-tick encounter risk; and finally, test the feasibility of a new citizen science approach to assess human risk of tick encounters. Analysis of the three existing datasets with I. ricinus distribution in Scotland showed that whereas data from questing tick surveys generate detailed predictive maps at local scale, at the country level, predictions were affected by poor data coverage. Additionally, dissimilarities in the predicted distribution pattern of I. ricinus between data from passive submission and from questing tick surveys were identified. This suggests the need for data from public submissions to gather information on absences and to account for volunteer effort. A predictive map of I. ricinus distribution in Scotland developed with a sophisticated Bayesian statistical technique (the stochastic partial differential equation (SPDE)) which accounted for several sources of variation was successful in improving the predictions in areas with poor data coverage, and the associated uncertainty. The relationship between questing tick surveys and human tick bite rate was then assessed. Questing tick surveys were carried out whilst collecting contemporaneous data on tick encounters from orienteers running the same areas in 11 events at world, national, regional and local orienteering events. This novel approach found that questing tick surveys are a good indicator of tick bite risk. Also, the number of people multiplied by the hours of exposure is the most meaningful denominator for human exposure to tick bites (correlation coefficient with questing tick abundance of 0.8, p=0.0052). From 340 reports from orienteers recorded across all events, a mean incidence of 409 tick bites per 1,000 person-hours exposure was recorded. Significant correlations were found between tick bite rate and temperature on the event day, the proportion of pastures around the track used by orienteers and the start time of the activity. A citizen science project was implemented in Scotland between May and November 2018 and again between March and November 2019. The project used a novel approach that included collection of denominator data (number of people exposed, and time spent) and additionally asked people to report both when they did, and importantly, when they did not encounter ticks. Tick bite and tick encounter rates calculated from participant reports were compared with predictions of questing tick abundance in two study areas, Lochaber and the Cairngorms using data collected from questing tick surveys. A total of 1,914 reports from 65 volunteers were received, with 231 and 118 reports received, respectively, from the Cairngorms and Lochaber areas. On average, the Cairngorms area registered 0.083 tick bites per person per hour of activity and 0.268 tick encounters per person per hour. Lochaber area registered 0.018 tick bites and 0.028 tick encounters per person per hour. Tick bite and tick encounter rates in the Cairngorms correlated better with predicted tick abundance in the area (correlation coefficient of 0.27 and 0.31, respectively) compared to Lochaber (correlation coefficient of 0.15 in both cases). Tick bite and tick encounter rates were found to depend both on questing tick abundance, and on factors related to human activity and behaviour. Type of human activity explained more variation in tick bite rate than questing tick abundance. Tick bite and tick encounter rates were quantified by activity type. These findings are valuable in identifying high risk activities and targeting public health messages. This study resulted in new methodologies to improve predictive mapping of ticks, and better understanding of tick bite risk and the factors that drive it, with the overall aim of improving control and prevention of tick-borne diseases

J Med Entomol

Tick-borne diseases are increasing in North America. Knowledge of which tick species and associated human pathogens are present locally can inform the public and medical community about the acarological risk for tick bites and tick-borne infections. Citizen science (also called community-based monitoring, volunteer monitoring, or participatory science) is emerging as a potential approach to complement traditional tick record data gathering where all aspects of the work is done by researchers or public health professionals. One key question is how citizen science can best be used to generate high-quality data to fill knowledge gaps that are difficult to address using traditional data gathering approaches. Citizen science is particularly useful to generate information on human-tick encounters and may also contribute to geographical tick records to help define species distributions across large areas. Previous citizen science projects have utilized three distinct tick record data gathering methods including submission of: 1) physical tick specimens for identification by professional entomologists, 2) digital images of ticks for identification by professional entomologists, and 3) data where the tick species and life stage were identified by the citizen scientist. We explore the benefits and drawbacks of citizen science, relative to the traditional scientific approach, to generate data on tick records, with special emphasis on data quality for species identification and tick encounter locations. We recognize the value of citizen science to tick research but caution that the generated information must be interpreted cautiously with data quality limitations firmly in mind to avoid misleading conclusions.20212021-04-20T00:00:00ZCC999999/ImCDC/Intramural CDC HHS/United States32772108PMC80562871061

Innovation in citizen science – perspectives on science-policy advances

Citizen science is growing as a field of research with contributions from diverse disciplines, promoting innovation in science, society, and policy. Inter- and transdisciplinary discussions and critical analyses are needed to use the current momentum to evaluate, demonstrate, and build on the advances that have been made in the past few years. This paper synthesizes results of discussions at the first international citizen science conference of the European Citizen Science Association (ECSA) in 2016 in Berlin, Germany, and distills major points of the discourse into key recommendations. To enhance innovation in science, citizen science needs to clearly demonstrate its scientific benefit, branch out across disciplines, and foster active networking and new formats of collaboration, including true co-design with participants. For fostering policy advances, it is important to embrace opportunities for policy-relevant monitoring and policy development and to work with science funders to find adequate avenues and evaluation tools to support citizen science. From a society angle it is crucial to engage with societal actors in various formats that suit participants and to evaluate two-way learning outcomes as well as to develop the transformative role of science communication. We hope that these key perspectives will promote citizen science progress at the science-society-policy interface

Dog bites: Perception and Prevention

Traditional approaches to studying dog bites have predominantly used epidemiological methodology to understand risk factors and prevention centred on education about dogs’ body language. Instead, in this project dog bites are explored from the perspective of those directly affected, as a victim or a dog owner. The objectives of this study included understanding how dog bites are perceived and experienced and how the context of individual lived experiences influences these perceptions and practices around dogs. The project also aimed to learn how impact of bites could be reduced. The project used a mixed research methods approach: a) qualitative methods (in-depth interviews, participant-observations, focus group discussions, and analysis of documents and comments) were used to explore individual experiences and perceptions; b) Statistical analysis of a health and safety database was used to explore patterns of dog bites and remedial actions within occupational contexts. This research highlights that victims or dog owners (but rarely dogs) were blamed for bites and felt stigmatised due to their experience, which hindered prevention by impacting on their motivation to seek help. Two most common scenarios in which bites at work occurred were: entering or delivering a parcel to a property, or handling dogs in a veterinary practice or dog shelter. In many occupational bite scenarios, dogs were not seen before a bite. Risk in interactions with dogs was identified and managed by drawing on three overlapping strategies: through routines and procedures; emotions and intuition; and trust and sense of responsibility for the dog. At work, the formal, co-dependent procedures for risk management were modified in response to individual experience and relations with colleagues and dogs. Trust was used as a proxy for risk identification, but also paradoxically, led to taking risk in interactions with some dogs. Trustworthiness was assessed by scrutinising a dog’s reputation, character or appearance (including breed), performance, and the dog’s owner. Most participants believed that the emotional contagion between humans and dogs was a risk as well as a tool for negotiating safety. Risk management was consequently discussed in terms of ability to regulate emotions, and in so doing, controlling one’s own body and bodies of dogs. Prevention required practical skills to control dogs, which owners often lacked. Dog bites often had a long-lasting impact on individual physical and mental health. This research indicates that dog bite prevention requires more than knowledge of dog behaviour: it was embedded within social relations and necessitated co-operation with colleagues or family, and it was shaped by the physical environment in which the interaction took place, social norms, and perceptions of dogs and possibility of preventing bites. While dog bites cannot always be prevented, their impact could be feasibly reduced through provision of muzzles as well as return to work policies, mental health care and social support which could reduce the long-term damage to the injured person. More broadly, dog bite prevention can be improved by expanding efforts to be more ‘system-wide’ so that there are multiple opportunities for intervention

Ecology of Borrelia burgdorferi sensu lato and epidemiology of borrelial infections in Cumbria

Borrelia burgdorferi sensu lato (s.l.) is the causative agent of the tick-borne zoonotic disease Lyme borreliosis (LB), of which around 2-3000 cases are reported annually in the UK. This project took a “One Health” approach to studying Borrelia burgdorferi s.l. in southern Cumbria exploring its medical and veterinary importance and quantifying the environmental hazard it presents in the region. Under a “One Health” umbrella, this project comprised of three discrete studies: (1) a longitudinal study of tick population dynamics, and B. burgdorferi s.l. transmission dynamics in these ticks, was carried out between June 2013 and September 2017 in three separate but closely located woodlands, (2) the role of grey squirrels (Sciurus carolinensis) in the natural maintenance of B. burgdorferi s.l. was assessed, and (3) a veterinarian-based survey of ticks infesting companion animals was completed. The most noteworthy findings in these studies were: (1) the phenologies of the three questing tick populations studied were similar, but there was consistent and significant variation in tick abundance between the three populations. Overall tick abundance rose during the study. B. burgdorferi s.l. circulated in all three tick populations, but at significantly different prevalences. The annual density of infected ticks varied significantly at all three sites but this variation was asynchronous. Four Borrelia genospecies were encountered in the study, but the relative contribution of each to the borrelial community varied markedly between populations and but stayed constant through time. (2) Grey squirrels were susceptible to B. burgdorferi s.l. (prevalence 19.74%) and infection with all four Borrelia genospecies was encountered. The prevalence of infections in ticks feeding on squirrels was almost 11.57% significantly higher than that in local questing tick populations (3.69%). (3) Three Ixodes species parasitized companion animals, with I. ricinus being the most common. Parasitism peaked in July. Infection rate in companion animal-associated I. ricinus ticks was 1.29%, was significantly lower than that observed in questing ticks. This thesis provides an insight into tick phenology and what species of ticks bite companion animals in the area. Although the peak in tick bites on companion animals did not coincide with the peak in questing ticks from the longitudinal study this can be explained by behaviour and species of ticks. Regarding B. burgdorferi s.l. infections in questing ticks tend to fluctuate throughout the year with cases of temporary absence at some sites. Infection prevalence in ticks from companion animals was lower than that found in questing ticks and grey squirrels had a high prevalence of infection particularly B. afzelii and B. garinii. Both of which dominated sites during the longitudinal study. This holistic approach to disease ecology shows that B. burgdorferi should not only be discussed in regard to human disease but to explore the wider concept to gain a better insight into the spirochetes place in the world

Exposing multiple malarias: A photo-ethnography of young people's malaria-related health practice in the Philippines

This thesis explores malaria in the municipality of Bataraza in the Philippines. It shows how multiple versions of malaria exist inside (and in between) various bodies. These malarias are situated in both time and space, emerge interrelationally and are enacted through embodied practice. It focuses on young people in this context and shows how their identity is similarly enacted through practice. With this in mind, the thesis critically examines how photovoice, a participatory action research method can be used to both depict young people’s malaria-related health practice as well as potentially alter it. During a 15-week photovoice project, 44 school-going children took photographs of their lived experience of different malarias and worked in groups to identify possible changes they might make. As a result of engaging in the photovoice process, young people’s interactions with each other and their families appeared to change as well as their role in promoting health in relation to others. However, in contrast to the literature that highlights the ability of approaches like photovoice to ‘empower’ individuals to make changes to their lives by generating critical consciousness, this thesis makes a unique theoretical contribution by suggesting that photovoice might be effective precisely because it directly operates at and therefore interacts with the level of situated, relational and embodied practice. Taking seriously the context-specific, situated, relational and embodied nature of practice is a key message of this thesis, with important implications for behaviour change initiatives

Emerging infectious diseases

Emerging Infectious Diseases is providing access to these abstracts on behalf of the ICEID 2008 program committee, which performed peer review. Emerging Infectious Diseases has not edited or proofread these materials and is not responsible for inaccuracies or omissions. All information is subject to change.Comments and corrections should be brought to the attention of the authors.Slide Sessions -- Foodborne & waterborne diseases I -- Influenza I -- Surveillance: International -- Zoonotic & animal diseases I -- Methicillin-resistant stapylococcal infections -- Vectorborne diseases -- Foodborne & waterborne diseases II -- Influenza II -- Surveillance: Domestic -- Zoonotic & animal diseases II -- Noscomial infections -- Respiratory diseases -- Health communications -- Blood, organ, & tissue safety -- Tropical diseases -- New rapid diagnostics -- Mobile populations & infectious diseases -- Vaccine-preventable diseases -- Tuberculosis -- Sexually transmitted diseases -- -- Poster Abstracts -- Vaccines & vaccine-preventable diseases -- Antimicrobial resistance -- Climate changes -- Foodborne & waterborne infections -- Health communication -- Infectious causes of chronic diseases -- Influenza -- New or rapid diagnostics -- Nosocomial infections -- Outbreak investigation: Lab & epi response -- Sexually transmitted diseases -- Surveillance: International & new strategies -- Travelers' health & disease importation -- Tropical infections & parasitic diseases -- Vector-borne diseases -- Women, gender, sexual minorities & infectious diseases -- Zoonotic & animal diseases -- Vaccines & vaccine-preventable diseases -- Antimicrobial resistance -- Emerging aspects of HIV -- Foodborne & waterborne infections -- Health communication -- Molecular epidemiology -- Outbreak investigation: Lab & epi response -- Poverty & infectious diseases -- Surveillance: International & new strategies -- Tropical infections & parasitic diseases -- Vector-borne diseases -- Zoonotic & animal diseases -- Vaccines & vaccine-preventable diseases -- Antimicrobial resistance -- Blood, organ, & other tissue safety -- Foodborne & waterborne infections -- Host & microbial genetics -- Influenza -- Molecular epidemiology -- New or rapid diagnostics -- Outbreak investigation: Lab & epi response -- Prevention effectiveness, cost effectiveness, & cost studies -- Surveillance: International & new strategies -- Vector-borne diseases -- Zoonotic & animal diseases -- Vaccines & vaccine-preventable diseases -- Antimicrobial resistance -- Bioterrorism preparedness -- Emerging opportunistic infections -- Foodborne & waterborne infections -- Healthcare worker safety -- Influenza -- Laboratory proficiency testing/quality assurance -- Modeling -- Nosocomial infections -- Outbreak investigation: Lab & epi response -- Vector-borne diseases -- Viral hepatitis -- Zoonotic & animal diseases -- Vaccines & vaccine-preventable diseases -- Antimicrobial resistance -- Emerging opportunistic infections -- Foodborne & waterborne infections -- Influenza -- New or rapid diagnostics -- Nosocomial infections -- Outbreak investigation: Lab & epi response -- Social determinants of infectious disease disparities -- Surveillance: International & new strategies -- Tuberculosis -- Vector-borne diseases -- Zoonotic & animal diseases -- -- Additional Poster Abstracts.Abstracts published in advance of the conference

Ultrasensitive detection of toxocara canis excretory-secretory antigens by a nanobody electrochemical magnetosensor assay.

peer reviewedHuman Toxocariasis (HT) is a zoonotic disease caused by the migration of the larval stage of the roundworm Toxocara canis in the human host. Despite of being the most cosmopolitan helminthiasis worldwide, its diagnosis is elusive. Currently, the detection of specific immunoglobulins IgG against the Toxocara Excretory-Secretory Antigens (TES), combined with clinical and epidemiological criteria is the only strategy to diagnose HT. Cross-reactivity with other parasites and the inability to distinguish between past and active infections are the main limitations of this approach. Here, we present a sensitive and specific novel strategy to detect and quantify TES, aiming to identify active cases of HT. High specificity is achieved by making use of nanobodies (Nbs), recombinant single variable domain antibodies obtained from camelids, that due to their small molecular size (15kDa) can recognize hidden epitopes not accessible to conventional antibodies. High sensitivity is attained by the design of an electrochemical magnetosensor with an amperometric readout with all components of the assay mixed in one single step. Through this strategy, 10-fold higher sensitivity than a conventional sandwich ELISA was achieved. The assay reached a limit of detection of 2 and15 pg/ml in PBST20 0.05% or serum, spiked with TES, respectively. These limits of detection are sufficient to detect clinically relevant toxocaral infections. Furthermore, our nanobodies showed no cross-reactivity with antigens from Ascaris lumbricoides or Ascaris suum. This is to our knowledge, the most sensitive method to detect and quantify TES so far, and has great potential to significantly improve diagnosis of HT. Moreover, the characteristics of our electrochemical assay are promising for the development of point of care diagnostic systems using nanobodies as a versatile and innovative alternative to antibodies. The next step will be the validation of the assay in clinical and epidemiological contexts