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Tick-borne diseases, which afflict humans and other animals, are caused by infectious agents transmitted by tick bites. Tick-borne illnesses are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa. Because individual ticks can harbor more than one disease-causing agent, patients can be infected with more than one pathogen at the same time, compounding the difficulty in diagnosis and treatment. As of 2016, 16 tick-borne diseases of humans are known (four discovered since 2013).
In epidemiology, a disease vector is any agent who carries and transmits an infectious pathogen into another living organism; most agents regarded as vectors are organisms, such as intermediate parasites or microbes, but it could be an inanimate medium of infection such as dust particles.
Ticks are small arachnids, typically 3 to 5 mm long, part of the order Parasitiformes. Along with mites, they constitute the subclass Acari. Ticks are ectoparasites, living by feeding on the blood of mammals, birds, and sometimes reptiles and amphibians. Ticks had evolved by the Cretaceous period, the most common form of fossilisation being immersed in amber. Ticks are widely distributed around the world, especially in warm, humid climates.
In biology, a pathogen, in the oldest and broadest sense, is anything that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ.
As the incidence of tick-borne illnesses increases and the geographic areas in which they are found expand, health workers increasingly must be able to distinguish the diverse, and often overlapping, clinical presentations of these diseases.
In general, specific laboratory tests are not available to rapidly diagnose tick-borne diseases. Due to their seriousness, antibiotic treatment is often justified based on clinical presentation alone.
An antibiotic is a type of antimicrobial substance active against bacteria and is the most important type of antibacterial agent for fighting bacterial infections. Antibiotic medications are widely used in the treatment and prevention of such infections. They may either kill or inhibit the growth of bacteria. A limited number of antibiotics also possess antiprotozoal activity. Antibiotics are not effective against viruses such as the common cold or influenza; drugs which inhibit viruses are termed antiviral drugs or antivirals rather than antibiotics.
Ticks tend to be more active during warmer months, though this varies by geographic region and climate. Areas with woods, bushes, high grass, or leaf litter are likely to have more ticks. Those bitten commonly experience symptoms such as body aches, fever, fatigue, joint pain, or rashes. People can limit their exposure to tick bites by wearing light-colored clothing (including pants and long sleeves), using insect repellent with 20%–30% DEET, tucking their pants legs into their socks, checking for ticks frequently, and washing and drying their clothing (in a hot dryer).
Fever, also known as pyrexia and febrile response, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between 37.5 and 38.3 °C. The increase in set point triggers increased muscle contractions and causes a feeling of cold. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure. This is more common in young children. Fevers do not typically go higher than 41 to 42 °C.
A rash is a change of the human skin which affects its color, appearance, or texture.
An insect repellent is a substance applied to skin, clothing, or other surfaces which discourages insects from landing or climbing on that surface. Insect repellents help prevent and control the outbreak of insect-borne diseases such as malaria, Lyme disease, dengue fever, bubonic plague, river blindness and West Nile fever. Pest animals commonly serving as vectors for disease include insects such as flea, fly, and mosquito; and the arachnid tick.
For a person or companion animal to acquire a tick-borne disease requires that that individual gets bitten by a tick and that that tick feeds for a sufficient period of time. The feeding time required to transmit pathogens differs for different ticks and different pathogens. Transmission of the bacterium that causes Lyme disease is well understood to require a substantial feeding period.
Lyme disease, also known as Lyme borreliosis, is an infectious disease caused by a bacterium named Borrelia spread by ticks. The most common sign of infection is an expanding area of redness on the skin, known as erythema migrans, that appears at the site of the tick bite about a week after it occurred. The rash is typically neither itchy nor painful. Approximately 70–80% of infected people develop a rash. Other early symptoms may include fever, headache and tiredness. If untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness, or heart palpitations, among others. Months to years later, repeated episodes of joint pain and swelling may occur. Occasionally, people develop shooting pains or tingling in their arms and legs. Despite appropriate treatment, about 10 to 20% of people develop joint pains, memory problems, and tiredness for at least six months.
For an individual to acquire infection, the feeding tick must also be infected. Not all ticks are infected. In most places in the US, 30-50% of deer ticks will be infected with Borrelia burgdorferi (the agent of Lyme disease). Other pathogens are much more rare. Ticks can be tested for infection using a highly specific and sensitive qPCR procedure. Several commercial labs provide this service to individuals for a fee. The Laboratory of Medical Zoology (LMZ), a nonprofit lab at the University of Massachusetts, provides a comprehensive TickReportfor a variety of human pathogens and makes the data available to the public. Those wishing to know the incidence of tick-borne diseases in their town or state can search the LMZ surveillance database.
Borrelia burgdorferi is a bacterial species of the spirochete class of the genus Borrelia. B. burgdorferi exists in North America and Europe and until 2016 was the only known cause of Lyme disease in North America. Borrelia species are considered diderm (double-membrane) bacteria rather than Gram-positive or negative.
The University of Massachusetts is the five-campus public university system and the only public research system in the Commonwealth of Massachusetts. The University system includes five campuses, and a satellite campus, with system administration in Boston and Shrewsbury. The system is accredited by the New England Association of Schools and Colleges and across its campuses enrolls 73,000 students.
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Major tick-borne diseases include:
Lyme disease, or borreliosis, is caused by spirochetal bacteria from the genus Borrelia, which has 52 known species. Three main species are the main causative agents of the disease in humans, while a number of others have been implicated as possibly pathogenic. Borrelia species in the species complex known to cause Lyme disease are collectively called Borrelia burgdorferisensu lato (s.l.) not to be confused with the single species in that complex Borrelia burgdorferi sensu stricto which is responsible for all cases of Lyme disease in North America.
Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types other organs are also affected. Onset can be gradual or sudden.
Erythema migrans refers to a rash often seen in the early stage of Lyme disease, and can also be caused by southern tick-associated rash illness (STARI). It can appear anywhere from one day to one month after a tick bite. This rash does not represent an allergic reaction to the bite, but rather an actual skin infection of one of the Lyme bacteria species from the genus Borrelia.
Rickettsia rickettsii is a gram-negative, intracellular, coccobacillus bacterium that is around 0.8 to 2.0 micrometers long. R. rickettsi is the causative agent of Rocky Mountain spotted fever. R. rickettsii is one of the most pathogenic Rickettsia strains. It affects a large majority of the Western Hemisphere and small portions of the Eastern Hemisphere.
Bartonella is a genus of Gram-negative bacteria. It is the only genus in the family Bartonellaceae. Facultative intracellular parasites, Bartonella species can infect healthy people, but are considered especially important as opportunistic pathogens. Bartonella species are transmitted by vectors such as ticks, fleas, sand flies, and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.
An emerging infectious disease (EID) is an infectious disease whose incidence has increased in the past 20 years and could increase in the near future. Emerging infections account for at least 12% of all human pathogens. EIDs are caused by newly identified species or strains that may have evolved from a known infection or spread to a new population or to an area undergoing ecologic transformation, or be reemerging infections, like drug resistant tuberculosis. Nosocomial (hospital-acquired) infections, such as methicillin-resistant Staphylococcus aureus are emerging in hospitals, and extremely problematic in that they are resistant to many antibiotics. Of growing concern are adverse synergistic interactions between emerging diseases and other infectious and non-infectious conditions leading to the development of novel syndemics. Many emerging diseases are zoonotic - an animal reservoir incubates the organism, with only occasional transmission into human populations.
Dermacentor variabilis, also known as the American dog tick or wood tick, is a species of tick that is known to carry bacteria responsible for several diseases in humans, including Rocky Mountain spotted fever and tularemia. It is one of the most well-known hard ticks. Diseases are spread when it sucks blood from the host, which could take several days for the host to experience some symptoms.
Relapsing fever is a vector-borne disease caused by infection with certain bacteria in the genus Borrelia, which are transmitted through the bites of lice or soft-bodied ticks.
A canine vector-borne disease (CVBD) is one of "a group of globally distributed and rapidly spreading illnesses that are caused by a range of pathogens transmitted by arthropods including ticks, fleas, mosquitoes and phlebotomine sandflies." CVBDs are important in the fields of veterinary medicine, animal welfare, and public health. Some CVBDs are of zoonotic concern.
Powassan virus is a flavivirus transmitted by ticks, found in North America and in the Russian Far East. It is named after the town of Powassan, Ontario, where it was identified in a young boy who eventually died from it. It can cause encephalitis, an infection of the brain. No vaccine or antiviral drug exists. Prevention of tick bites is the best precaution.
Andrew Spielman, Sc.D. was a prominent American public health entomologist and Professor of Tropical Public Health in the Department of Immunology and Infectious Disease at the Harvard School of Public Health (HSPH).
Ixodes scapularis is commonly known as the deer tick or black-legged tick, and in some parts of the US as the bear tick. It is a hard-bodied tick of the eastern and northern Midwestern United States and southeastern Canada. It is a vector for several diseases of animals, including humans and is known as the deer tick owing to its habit of parasitizing the white-tailed deer. It is also known to parasitize mice, lizards, migratory birds, etc. especially while the tick is in the larval or nymphal stage.
Jorge Benach is a medical researcher at the Stony Brook University in New York state. Benach is the chair of the Department of Molecular Genetics and Microbiology. Benach's main area of research is the tick-borne spirochete Borrelia burgdorferi which is the causative agent of Lyme disease.
Powassan encephalitis, caused by the Powassan virus (POWV), a flavivirus also known as the deer tick virus, is a form of arbovirus infection that results from tick bites. It can occur as a co-infection with Lyme disease since both are transmitted to humans by the same species of tick. There has been a surge in the number of cases and geographic range in the last decade. In the United States, cases have been recorded in the northeast. The disease was first isolated from the brain of a boy who died of encephalitis in Powassan, Ontario, in 1958. The disease is a zoonosis, an animal disease, usually found in rodents and ticks, with spillover transmission to humans. The virus is antigenically related to the Far Eastern tick-borne encephalitis viruses.
Southern tick-associated rash illness (STARI) or Masters' disease is an emerging infectious disease related to Lyme disease that occurs in southeastern and south-central United States. It is spread by tick bites, but the organism that causes the infection is unknown.
Human granulocytic anaplasmosis (HGA) is a tick-borne, infectious disease caused by Anaplasma phagocytophilum, an obligate intracellular bacterium that is typically transmitted to humans by ticks of the Ixodes ricinus species complex, including Ixodes scapularis and Ixodes pacificus in North America. These ticks also transmit Lyme disease and other tick-borne diseases.
Deer tick virus (DTV) is a flavivirus causing tick-borne encephalitis.
The Baggio–Yoshinari syndrome, formerly known as the Brazilian Lyme-like disease and Brazilian human borreliosis, is a disease transmitted by the Amblyomma cajennense tick, but the organism that causes the infection is still unknown. Clinical features resemble those of Lyme disease (LD).
Tibovirus Is term is often used to describe viruses that are transmitted by tick vectors. The word tibovirus is an acronym. This falls within the superorder arthropod thus tibovirus is classified under Arthropod Borne virus (Arborvirus). For a person to acquire infection the tick must bite and feed for a sufficient period of time. The tiboviruses that affect humans are limited to within 3 families: Flaviviridae, Reoviridae, and Bunyaviridae.
Borrelia mayonii is a gram-negative, host-associated spirochete that is capable of causing Lyme disease. This organism can infect various vertebrate and invertebrate hosts such as humans and ticks, primarily Ixodes scapularis. Migratory songbirds play a role in the dispersal of the tick vector, Ixodes scapularis, across long distances, indirectly dispersing Borrelia mayonii as well.