Spatial case-control studies to target the human ecology of tick-borne infections

摘要/摘要 人类感染莱姆病的病原体伯氏疏螺旋体(Bb)和其他由壁虱传播的 病原体在美国是主要的和正在出现的健康威胁。刻度向量的地理范围 正在美国境内扩张，新的扁虱物种正在被引入，包括长角血蜱 (亚洲长角蜱)，一种入侵物种，是几种人类感染的媒介。虽然很多人 州和地方级的司法管辖区都有扁虱监测项目，这些项目必然覆盖很大范围 地理区域导致费用增加和效率低下。因此，从根本上讲 壁虱传播疾病的流行病学仍然不清楚；目前还没有方法来确定和 以具有最高森林传播疾病风险的物理位置为目标。因此，这些研究 这里提出的建议旨在了解人类户外活动之间的联系的关键方面 开展更有针对性的健康监测项目。首先，我们将招收 已确诊患有硬蜱传播疾病的人和未确诊的人，我们将评估风险因素 感染。然后，我们将使用地理位置捕获并比较两组人群中的人类活动模式 定位系统(GPS)数据记录器；这些数据将用于识别存在重大风险的位置。第二， 我们将在所有高风险或低风险的地点进行全面的滴答调查，并将比较滴答 不同地点之间的丰度和病原菌流行情况，以确认空间分析的结果。我们的发现 将极大地扩展我们直接和有效地针对要解决的监测和干预措施的能力 一个极其重要的公共卫生问题。

SUMMARY/ABSTRACT Human infections with Borrelia burgdorferi (Bb) the causative agent of Lyme disease, and other tick-borne pathogens are major and emerging health threats in the United States. The geographic range of tick vectors is expanding within the US, and new tick species are being introduced including Haemaphysalis longicornis (the Asian longhorned tick), an invasive species which is a vector for several human infections. While many state- and local-level jurisdictions have tick surveillance programs, these by necessity cover large geographic areas leading to increased expense and inefficiency. As a consequence, fundamental aspects of the epidemiology of tick-borne diseases remain obscure; and no methods currently exist to identify and target physical locations with highest risk for tick-borne disease transmission. Therefore, the studies proposed here are directed to understanding key aspects of the connections between human outdoor activities and tick populations to develop more targeted health surveillance programs. First, we will enroll both persons with confirmed tick- borne disease and those without, and we will assess risk factors for infection. We will then capture and compare human mobility patterns in both groups using geographic position system (GPS) data loggers; these data will be used to identify locations of significant risk. Secondly, we will perform comprehensive tick surveys at all locations with either high or low risk, and will compare tick abundance and pathogen prevalence between sites to confirm results from the spatial analysis. Our findings will dramatically expand our ability to directly and efficiently target surveillance and interventions to address a critically important public health problem.