Geographic Variation in the Relationship between Human Lyme Disease Incidence and Density of Infected Host-Seeking Ixodes scapularis Nymphs in the Eastern United States
Geographic Variation in the Relationship between Human Lyme Disease Incidence and Density of Infected Host-Seeking Ixodes scapularis Nymphs in the Eastern United States
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DOI：
10.4269/ajtmh.2012.11-0630
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发表时间：
2012-06-01
影响因子：
3.3
通讯作者：
Diuk-Wasser, Maria A.
中科院分区：
文献类型：
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作者：
Pepin, Kim M.;Eisen, Rebecca J.;Diuk-Wasser, Maria A.
莱姆病的预防和控制十分困难，因为该病原体（伯氏疏螺旋体）载体（肩胛硬蜱）具有复杂的生物学特性，并且具有不同程度的能力的多个储存宿主。经济有效地实施针对蜱和宿主的控制方法需要了解若虫病原体流行率、若虫丰度和莱姆病人类病例发病率之间的关系。我们使用县级人类病例数据和来自 36 个东部州实地估计的若虫流行率数据，量化了估计的螨虫风险与人类发病率之间的关系。受感染若虫的估计密度 (mDIN) 与人类发病率显着相关 (r = 0.69)。这种关系在高流行地区最为强烈，但因地区和州而异，部分原因是伯氏疏螺旋体基因型的分布。在将 DIN 用于成本效益分析之前，需要在几个高流行州提供更多信息。
Prevention and control of Lyme disease is difficult because of the complex biology of the pathogen's (Borrelia burgdorferi) vector (Ixocles scapularis) and multiple reservoir hosts with varying degrees of competence. Cost-effective implementation of tick- and host-targeted control methods requires an understanding of the relationship between pathogen prevalence in nymphs, nymph abundance, and incidence of human cases of Lyme disease. We quantified the relationship between estimated acarological risk and human incidence using county-level human case data and nymphal prevalence data from field-derived estimates in 36 eastern states. The estimated density of infected nymphs (mDIN) was significantly correlated with human incidence (r = 0.69). The relationship was strongest in high-prevalence areas, but it varied by region and state, partly because of the distribution of B. burgdorferi genotypes. More information is needed in several high-prevalence states before DIN can be used for cost-effectiveness analyses.