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

总结/摘要 人感染莱姆病的病原体伯氏疏螺旋体（Bb）和其他蜱传疾病 在美国，病原体是主要的和新出现的健康威胁。蜱虫媒介的地理范围 正在美国境内扩张，新的蜱虫物种正在引入，包括长角血蜱 (the亚洲长角蜱），一种入侵物种，是几种人类感染的媒介。虽然许多 州和地方一级的司法管辖区都有蜱虫监测计划，这些计划的必要性涵盖了大 地理区域导致费用增加和效率低下。因此， 蜱传疾病的流行病学仍然不清楚;目前还没有方法来识别和 目标是蜱传疾病传播风险最高的物理位置。因此，研究 这里提出的是针对理解人类户外活动之间的联系的关键方面， 活动和蜱虫种群，以制定更有针对性的健康监测计划。首先，我们将招收 我们会评估感染蜱传疾病的风险因素， 感染然后，我们将使用地理信息系统捕获并比较两组中的人员流动模式。 定位系统（GPS）数据记录器;这些数据将用于确定存在重大风险的地点。第二、 我们将在所有高风险或低风险的地点进行全面的蜱虫调查， 丰度和地点之间的病原体流行率，以确认空间分析的结果。我们的研究结果 将极大地扩展我们的能力，直接和有效地针对监测和干预，以解决 一个非常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.