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Anaplasma phagocytophilum Human Agent Variant Detected in Asian Longhorned Ticks

Longhorned Ticks. Photo by James Occi, (PhD cand.) LDA Scientific & Professional Advisory Board
Longhorned Ticks. Photo by James Occi, (PhD cand.) LDA Scientific & Professional Advisory Board

In a newly published US study, Anaplasma phagocytophilum–human agent variant has been detected for the first time in the highly invasive Asian longhorned tick (Haemaphysalis longicornis). Active tick surveillance was conducted throughout Pennsylvania during the time period of May 1st through September 6th, 2019. Researchers  tested 265 ticks for rickettsial pathogens through PCR testing and 1.5% of these ticks were positive for A. phagocytophilum. Two were confirmed positive as A. phagocytophilum–human agent variant through sequence analysis of the 16S rRNA gene. 

Access to the full text article can be found here

Additional LDA articles on Asian longhorned tick pathogens can be found here




NEW Discovery for Antibiotic Resistance

A new University of Copenhagen study reports a previously unknown hiding place for the genes that make bacteria resistant to antibiotics. The prevailing belief that resistant bacteria will lose their resistance genes during a break from antibiotic use has been challenged by the findings of this new study. 

This study shows that resistance genes have the ability to hide in inactive bacteria, where they form a hidden reserve of resistance that bacteria can rely on, even in the absence of antibiotics. The new study shows that biofilms contribute to antibiotic resistance of bacteria where inactive bacteria layered deep in the biofilm maintain their resistance even when dormant. These findings are important to understanding how bacterial antibiotic resistance takes place, as resistance genes have been found to persist longer than previously believed.  

Read the full University of Copenhagen News Article here

Read the full text Danish study article here

Read more LDA articles on bacteria persistence here




Southeastern US: Ixodes scapularis-Lizard Associations

A recent article published in the Journal of Medical Entomology, describes host associations of larval and nymphal Ixodes scapularis (blacklegged ticks) collected from eight lizard species. Researchers collected from 2 to 3 sampling arrays at 5 field sites in the southeastern US, including North Carolina, Tennessee, South Carolina, Alabama, and Florida. Samples were collected at each site every third week in 2011 and 2012.

As questing behavior and host associations of immature blacklegged ticks in the NE are known to differ from ticks in the SE, researchers attempt to shed light on this observation. Findings of this study show that immature ticks (larvae and nymphs) attached in greater numbers to larger lizards than to smaller lizards. They also found different levels of attachment with different lizard species, with the highest numbers of larvae and nymphs attached to skinks of the genus Plestiodon and substantially lower numbers on anoles, fence lizards, and racerunners. There remains a question as to whether these findings are due to behavioral host preferences or if  ecological factors such as timing or microhabitat distributions of tick questing and host activity may have influence. 

Read full article here

Read additional LDA articles on Southeastern ticks here

 




New Tool from Johns Hopkins: Lyme & TBD Dashboard

In a recent article, Johns Hopkins presents its newly developed tool, the Lyme and Tickborne Disease (TBD) Dashboard which tracks tickborne diseases at a global scale and displays maps and spatial data sets utilizing unique geographic context and  includes a search function to find out what the incidence is in your US county.

This initiative was led by the Johns Hopkins Spatial Science for Public Health Center, in collaboration with the Johns Hopkins Medicine Lyme Disease Research Center and the Johns Hopkins Lyme and Tickborne Diseases Research and Education Institute. 

The dashboard was primarily designed for researchers. However, this tool is both accessible and useful for use in the public health sector, policymakers, advocacy groups, and the general public. 

The article describes how this novel tool can be used to raise awareness of TBDs and encourage both research and collaboration in science representing a One Health approach. Authors describe the experience of Johns Hopkins developers in designing and implementing the dashboard modeled after their COVID-19 dashboard and the main features of the Lyme & TBD dashboard. The article also presents discussion of the current limitations and future directions of this tool.

Read the full article here

View the Johns Hopkins Lyme & TBD Dashboard here

Read additional LDA articles on Lyme & TBD distribution here




Borrelia miyamotoi in the US

CDC Figure. Borrelia miyamotoi positivity rates in human-biting Ixodes scapularis and I. pacificus ticks, United States, 2013–2019. Gray shading indicates states in which B. miyamotoi was detected in human-biting ticks.

In a recent article published by the Centers for Disease Control (CDC), authors detected Borrelia miyamotoi in ticks from 19 states in the US. Investigators tested 39,198 ticks for B. miyamotoi that were submitted to the public tick testing program at the University of Massachusetts during May 2013–December 2019. All ticks tested were found on humans.

In Oregon and California, B. miyamotoi was found in Ixodes pacificus ticks. Throughout the Northeastern and Midwestern US, B. miyamotoi was detected in Ixodes scapularis ticks. No ticks carrying B. miyamotoi were detected south of Virginia. It was also found that Lyme disease bacterium was 19 times more prevalent than B. miyamotoi in the I. scapularis ticks. Of note, almost 60% of B. miyamotoi–positive I. scapularis ticks had concurrent infections.

Read the full article here

Read additional LDA articles on B. miyamotoi here




COVID Impacts on Lyme Disease Reporting

In a new study published by the CDC, Effects of COVID-19 Pandemic on Reported Lyme Disease, United States, 2020, authors describe how the impacts of COVID-19 might have influenced Lyme disease case reporting in 2020. Investigators explored 4 data sources to assess how the COVID-19 pandemic may have influenced reporting of Lyme disease cases in 2020. Surveys that were conducted indicate that residents in the United States spent more time in the outdoors in 2020 than in 2019, but that reports of tick bite–related ER visits and Lyme disease laboratory tests were fewer. Authors indicate that although outdoor exposures were higher, case reporting for Lyme disease in 2020 may have been “artificially reduced” due to changes in people’s medical care seeking behavior in response to the COVID-19 pandemic. Additionally, many health departments were limited in resources to investigate Lyme disease case reports in 2020 due to the increased workload created by the COVID-19 pandemic. 

Read the full text article here

Read more LDA articles on COVID here

 




COVID in White-tailed Deer?

In a recent study conducted by the U.S. Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) serum samples were analyzed from free-ranging white-tailed deer for SARS-CoV-2 antibodies.
Researchers found that a cohort of white-tailed deer populations from Illinois, Michigan, New York, and Pennsylvania were exposed to SARS-CoV-2. The USDA-APHIS has published an informational brief that addresses both questions and answers regarding these findings. USDA-APHIS also expresses the need for more research on the significance of the finding of SARS-CoV-2 antibodies in free-ranging white-tailed deer,  as well as what, if any, potential impacts this may have on overall deer populations, other wildlife species, and humans.

Read the full publication here

Read more LDA Articles on COVID here




Ehrlichiosis Infection Following Organ Donation

In a recent article, investigators describe multiple cases of organ transplant derived Ehrlichiosis infections in donor recipients. Two cases of ehrlichiosis were reported to the Organ Procurement and Transplantation Network (OPTN) and the Centers for Disease Control and Prevention (CDC) for investigation in 2020. These two kidney recipients from a common donor developed fatal ehrlichiosis-induced hemophagocytic lymphocytic histiocytosis (HLH). Additionally, two kidney recipients and a liver recipient from another common donor developed ehrlichiosis, and  were all treated successfully. Investigators suggest that donor-derived ehrlichiosis should be considered by clinicians when evaluating recipients with fever early after transplantation after more common causes are ruled out, and cases that are suspected for Ehrlichiosis should be reported to the organ procurement organization (OPO) and the OPTN for further investigation.

Access to full article here.

Read more LDA articles on Ehrlichiosis here.




A Board of Education Member on Lyme in Schools

Lyme Disease in the Schools: From a Board Perspective

By: Pat Smith, President, Lyme Disease Association

January 20, 2006 – Twelve years on the Board of Education in my community in New Jersey taught me one thing:  board members do not know, cannot know and should not know everything that happens in a school district.  Their job, by and large, at least in New Jersey, is to ensure that the superintendent runs the district well and administers board policy.

Parents can use the board in the process of obtaining a proper education for their child, especially one who is classified with an IEP or is under a 504 plan. However, there are things you need to know first, and steps you need to take before you consider approaching the board.  I am familiar with the legal process governing school districts in New Jersey, NJSA Title 18A.  Each state has its own set of statutes to govern the operation of school districts and boards of education, which can probably be found online if you need to refer to them.

Before you approach your board, get a list of procedures that the may district have in place for parents who want to complain about an issue, and also get the “chain of command.”  It tells you who is supervised by whom. Follow it before taking other actions.  For example, if your complaint is with the teacher, your first step should be to sit down with the teacher and try to work things out.  Explain to him/her in a non-confrontational way the problems your child is having in school due to Lyme disease.  If the issue is not resolved with the teacher in a face-to-face, write a letter.  Always document complaints in writing.  Next step up is usually the building principal  A personal meeting is good, then put complaint in writing if not resolved. At this stage, you should also be copying any communications to the person in the special services department who is the case manager if your child has an IEP (Individualized Educational Program) or to the 504 coordinator if your child is covered under 504.  Every district in the country must have one. Ask for a parental rights booklet, NJ has one and most other states do, too.

If your problem is with the child study team/504 coordinator, then you meet with them to discuss the issue.  If it is not resolved at the table, your complaint should be put in writing and copy whoever oversees the child study team, e.g.,  a special services director, an assistant superintendent, or in small districts, the superintendent  him/herself or your state’s equivalent (chief school administrator, CSA).

Explore help options from other entities. Check if there is a parent teacher organization specifically for students with special needs.  They may be able to guide you.  If there is not one in your school, check the other schools in the district.  Also check to see if you have a county office of education, or perhaps your state has another governmental jurisdiction (e.g. parish) which may have jurisdiction over the district and it may be able to help you. Call them to see what they can do.  Copy them on correspondence from this point forward. Sometimes they will step in and investigate a district’s special education department if the complaint is serious enough, or if others have similar complaints. Write to and/or call the office of the State Commissioner of Education at your state department of education. 

If your issue is with board policy─the policy is interfering with your child’s ability to get accommodations─ask for the written policy, do not accept the district’s word there is a policy. Make sure the policy applies to special educations students, sometimes there are separate policies for them.  If it appears your student is covered under a district policy and you feel it is discriminatory because of your child’s condition, write to the board and state that. Find out how to get school policies changed.

Your next option might be to go to the elected or appointed board of education.  If time is not a factor, you might want to sit in on a few board meetings to see how they operate.   Check out the board committees.  There may be a special education committee or policy committee who can help you.  Remember that board members are people like you, members of your community who are trying to make sure children get a proper education. An elected board will probably be more responsive than an appointed one, since they answer to you and to your neighbors.

Most, if not all states, have privacy laws, so boards cannot discuss your child’s case publicly.  You can first try to call some of the board members (districts have listings of members) and explain your problem to see if you can find a sympathetic ear.  If that does not work, see if you can attend a committee meeting.  If not, you may want to go to a meeting of the board and during the public comment time, stand up, and speak generally about your child’s problem.  Some districts require you to state name and address for the record. Ask if that can be waived for privacy reasons, but you may have to give it. Remember this does expose your child to public scrutiny, although you are not giving your child’s name, so you need to weigh the pros and cons. Often however, when you begin to speak and say that you feel your child’s rights are being violated, or the district is not providing appropriate services to your child, the board will immediately say it cannot discuss this issue in public, and it will often direct the CSA to set up a private meeting with you.  Now you are in a stronger position, because the board is aware there is a problem and it is going to want to hear from the CSA that the issue has been favorably resolved.   You have put them on notice that you are not afraid to confront them about the issue in public, and they do not want you to come back publicly again.

Contacting the press is sometimes a last resort parents use when they feel they have exhausted all other possibilities and still cannot get their child’s situation resolved. Districts do not like adverse press.  Children with problems who are not being helped make a great story for them. Again, there are privacy issues involved so before even considering this action, assess those factors and the impact on your child.

Remember, every state has an address for appeal of 504 cases, since this is federal legislation. Under an IEP, many states have an appeal or mediation process you can go through. Use it. Bottom line, if things go totally awry, you can consider taking the district to court.  Districts do not like to go that route because of expense and their fear of precedence.  Often they will settle out of court.

The choice is yours to make, no one can recommend or say which of these actions, if any, will bring positive results, but inaction or allowing an uncooperative district to control your child’s fate will not get the services your child is entitled to and needs.  “The squeaky wheel gets the grease” is a truism in the educational world.

Editor’s note: Ms. Smith is a former 12 year member of the board of education in her community and former board president.  She was an officer in the Monmouth County School Boards Association, active in the NJ School Boards Association committees and at the federal level. She also sat on the [NJ] Governor’s Lyme Disease Advisory Council when it worked on the NJ Lyme disease curriculum, Making a Difference: Lyme Disease Prevention and Education Guide, which was adopted statewide by the NJ State Department of Education. It is the only statewide curriculum in the country for Lyme disease.  Former presidents of the LDANJ, Kerry Fordyce, and of the NJ Lyme Disease Coalition, Peggy Sturmfels, were instrumental in this process.

The Lyme Disease Association of New Jersey, now LDA, was successful in having the following laws adopted in New Jersey.
New Jersey Statutes Annotated 18A

18A:35-5.1.    Lyme Disease curriculum guidelines 
   1.     The Commissioner of Education, in consultation with the Commissioner of Health, shall develop curriculum guidelines for the teaching of information on the prevention of Lyme Disease within the public school health curriculum. The guidelines shall emphasize disease prevention and sensitivity for victims of the disease.  The Commissioner of Education shall periodically review and update the guidelines to insure that the curriculum reflects the most current information available.    L.1991,c.488,s.1. 

18A:35-5.2.    Availability of guidelines 
   2.     The commissioner shall make the curriculum guidelines available to all school districts in the State and shall encourage their adoption by those districts which are located in areas of the State which have a high incidence of Lyme Disease.    L.1991,c.488,s.2. 

18A:35-5.3.    Guidelines for, training of teachers instructing infected students 
   3.     The Commissioner of Education, in consultation with the Commissioner of Health, shall also provide curriculum guidelines for the training of all teachers who instruct students with Lyme disease which emphasizes the special needs and problems of students with the disease, in order to provide information about how best to teach those students.  Each school district shall annually provide training to all teachers who instruct students with Lyme disease, based upon the guidelines.   L.1991,c.488,s.3. 

 

 

 

 




Tick-Borne Disease Working Group Reports (2018 – 2020)

The Tick-Borne Disease Working Group (TBDWG) was established by the 21st Century Cures Act to improve federal coordination of efforts related to tick-borne diseases.  The TBDWG’s purpose is to review federal activities and research related to all tick-borne diseases and provide a summary of its findings and any recommendations regarding changes or improvements to such findings to the HHS Secretary and Congress every two years.

To date:

  • The first report was submitted to Congress in November 2018; the second report was submitted in January 2021, both authored by the TBDWG members.
  • Subcommittee Reports were also written in 2018 and 2020, some coauthored by Working Group member and LDA President, Pat Smith.
    • Each subcommittee of the Working Group identified priorities and developed a report to the TBDWG that described current efforts, gaps in research, and potentials actions relevant to their topic.
  • Topic development briefs were also developed by the first term Working Group 

See HHS -TBDWG webpage for all of the reports or click below

2020 TBDWG Report to Congress

2018 TBDWG Report to Congress

 


2020 Subcommittee Reports:

2020 Alpha-Gal Syndrome Subcommittee Report to the Tick-Borne Disease Working Group

2020 Babesiosis and Tick-Borne Pathogens Report to the Tick-Borne Disease Working Group

2020 Clinical Aspects of Lyme Disease Report to the Tick-Borne Disease Working Group

2020 Ehrlichiosis and Anaplasmosis Subcommittee Report to the Tick-Borne Disease Working Group

2020 Pathogenesis and Pathophysiology of Lyme Disease Subcommittee Report to the Tick-Borne Disease Working Group

2020 Rickettsiosis Subcommittee Report to the Tick-Borne Disease Working Group

2020 Tick Biology, Ecology, and Control Subcommittee Report to the Tick-Borne Disease Working Group

2020 Training, Education, Access to Care, and Reimbursement Subcommittee Report to the Tick-Borne Disease Working Group


2018 Subcommittee Reports:

Report of the Access to Care Services and Support to Patients Subcommittee

Report of the Disease Vectors, Surveillance, and Prevention Subcommittee

Report of the Other Tick-Borne Diseases and Co-Infections Subcommittee

Report of the Pathogenesis, Transmission and Treatment Subcommittee

Report of the Testing and Diagnostics Subcommittee

Report of the Vaccine and Therapeutics Subcommittee


2019 Topic Development Briefs

Increases in Tick-Borne Diseases

Diagnostic Tests for Tick-Borne Diseases

Persistent Symptoms of Lyme Disease