First Recognized Human Bite in the United States by the Asian Longhorned Tick, Haemaphysalis longicornis.

We present the case summary of the first human recognized to have been bitten by the Haemaphysalis longicornis tick in the United States, which occurred in New York State. Subsequent field studies confirmed that this tick was present in multiple geographic locations near the patient's residence, including on manicured lawns.

Multistate Infestation with the Exotic Disease-Vector Tick Haemaphysalis longicornis - United States, August 2017-September 2018.

Haemaphysalis longicornis is a tick indigenous to eastern Asia and an important vector of human and animal disease agents, resulting in such outcomes as human hemorrhagic fever and reduction of production in dairy cattle by 25%. H. longicornis was discovered on a sheep in New Jersey in August 2017 (1). This was the first detection in the United States outside of quarantine. In the spring of 2018, the tick was again detected at the index site, and later, in other counties in New Jersey, in seven other states in the eastern United States, and in Arkansas. The hosts included six species of domestic animals, six species of wildlife, and humans. To forestall adverse consequences in humans, pets, livestock, and wildlife, several critical actions are indicated, including expanded surveillance to determine the evolving distribution of H. longicornis, detection of pathogens that H. longicornis currently harbors, determination of the capacity of H. longicornis to serve as a vector for a range of potential pathogens, and evaluation of effective agents and methods for the control of H. longicornis.

First record of Ixodes keiransi (Acari: Ixodidae) in New Jersey, USA.

The hard tick, Ixodes keiransi Beati, Nava, Venzal, & Guglielmone, formerly the North American lineage of Ixodes affinis Neumann, is expanding its range northward along the US East Coast. In July 2023, we collected I. keiransi adult female and nymph in a single sampling event, suggesting its range now includes southern New Jersey. In this area, I. keiransi is sympatric with northern populations of Ixodes scapularis Say (Acari: Ixodidae), the primary vector of Lyme disease. Given its status as an enzootic vector of spirochaetes in the Borrelia burgdorferi sensu lato complex, proper differentiation of these 2 species will be critical for accurate estimates of entomological risk. Targeted surveillance should be implemented to monitor further I. keiransi expansion and to elucidate the phenology and enzootic role of this and other understudied Ixodes spp. in the northeastern United States.

Detection of multiple tick-borne pathogens in Ixodes scapularis from Hunterdon County, NJ, USA.

Several human pathogens vectored by the blacklegged tick (Ixodes scapularis Say; Acari: Ixodidae) are endemic in the state of New Jersey. Disease incidence data suggest that these conditions occur disproportionately in the northwestern portion of the state, including in the county of Hunterdon. We conducted active surveillance at three forested sites in Hunterdon County during 2020 and 2021, collecting 662 nymphal and adult I. scapularis. Ticks were tested for five pathogens by qPCR/qRT-PCR: Anaplasma phagocytophilum, Babesia microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan virus (POWV) lineage 2. Over 2 years, 25.4% of nymphs and 58.4% of adults were found infected with at least one pathogen, with 10.6% of all ticks infected with more than one pathogen. We report substantial spatial and temporal variability of A. phagocytophilum and B. burgdorferi, with high relative abundance of the human-infective A. phagocytophilum variant Ap-ha. Notably, POWV was detected for the first time in Hunterdon, a county where human cases have not been reported. Based on comparisons with active surveillance initiatives in nearby counties, further investigation of non-entomological factors potentially influencing rates of tick-borne illness in Hunterdon is recommended.

The Gulf Coast Tick, Amblyomma maculatum (Ixodida: Ixodidae), and Spotted Fever Group Rickettsia in the Highly Urbanized Northeastern United States.

We report the multi-year collection of the Gulf Coast tick, Amblyomma maculatum Koch (Acaridae: Ixodida: Ixodidae) in Staten Island, New York City (NYC) as well as their detection in Brooklyn, NYC, and in Atlantic and Cumberland counties in southern New Jersey, USA. The first and most common detections were of adults, however in Freshkills Park on Staten Island larvae were also collected in a following year. The presence of larvae indicates that adults are successfully finding hosts in Staten Island. While it is still unknown how A. americanum reached Staten Island, immatures of this species often parasitize migratory birds, which are now often seen in Freshkills Park. We describe the landscape features of the area in Staten Island where populations were highest and larvae were detected, which could have facilitated the establishment of A. maculatum. Notably, we also report the presence of human pathogens Rickettsia parkeri in 5/10 (50%) of adults tested and R. felis in 1/24 (4.17%) of larvae tested. In addition to established populations in Staten Island we found evidence of A. maculatum in NJ and other NYC boroughs, suggesting current or future establishment is possible. The failure thus far to detect established populations in these areas may be due to inherent difficulties in detecting low density, spatially heterogeneous incipient populations, which could require targeted surveillance efforts for this species. We discuss the consequences to public health of the establishment of A. maculatum and detection of two additional rickettsial pathogens in the densely populated northeastern United States.

First Record of Carios kelleyi (Acari: Ixodida: Argasidae) in New Jersey, United States and Implications for Public Health.

The soft tick Carios kelleyi (Cooley and Kohls), a parasite of bats known to occur in at least 29 of the 48 conterminous U.S. states, is here reported from New Jersey for the first time, based on larvae collected from big brown bats, Eptesicus fuscus. Although thought to be widespread in North America, the ecology of C. kelleyi is not well understood, despite reports of this species feeding on humans and its consequent potential as a disease vector. The association of C. kelleyi with bat species that regularly roost in human-made structures, such as attics and barns, and recent isolations from this tick of pathogens capable of infecting humans, companion animals, and livestock underscore the need for further studies of these bat ectoparasites.

Comparative hologenomics of two Ixodes scapularis tick populations in New Jersey.

Tick-borne diseases, such as those transmitted by the blacklegged tick Ixodes scapularis, are a significant and growing public health problem in the US. There is mounting evidence that co-occurring non-pathogenic microbes can also impact tick-borne disease transmission. Shotgun metagenome sequencing enables sampling of the complete tick hologenome-the collective genomes of the tick and all of the microbial species contained therein, whether pathogenic, commensal or symbiotic. This approach simultaneously uncovers taxonomic composition and allows the detection of intraspecific genetic variation, making it a useful tool to compare spatial differences across tick populations. We evaluated this approach by comparing hologenome data from two tick samples (N = 6 ticks per location) collected at a relatively fine spatial scale, approximately 23 km apart, within a single US county. Several intriguing variants in the data between the two sites were detected, including polymorphisms in both in the tick's own mitochondrial DNA and that of a rickettsial endosymbiont. The two samples were broadly similar in terms of the microbial species present, including multiple known tick-borne pathogens (Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum), filarial nematodes, and Wolbachia and Babesia species. We assembled the complete genome of the rickettsial endosymbiont (most likely Rickettsia buchneri) from both populations. Our results provide further evidence for the use of shotgun metagenome sequencing as a tool to compare tick hologenomes and differentiate tick populations across localized spatial scales.

New Jersey-Wide Survey of Spotted Fever Group Rickettsia (Proteobacteria: Rickettsiaceae) in Dermacentor variabilis and Amblyomma americanum (Acari: Ixodida: Ixodidae).

For the last decade, the New Jersey (NJ) Department of Health has reported between 42 and 144 new cases each year of "spotted fever group rickettsiosis" (SFGR), a statistic that reflects uncertainty regarding which rickettsial agents (Proteobacteria: Rickettsiaceae: Rickettsia) are infecting NJ residents. To identify the Rickettsia circulating in NJ ticks, we used a combination of conventional and real time PCR approaches to screen 560 Dermacentor variabilis Say and 245 Amblyomma americanum L. obtained from a 1-day state-wide surveillance in May 2018 and an additional 394 D. variabilis collected across NJ in 2013-2018. We found zero D. variabilis infected with Rickettsia rickettsii, the agent of Rocky Mountain spotted fever and, on average, 1.3% infected with presumed nonpathogenic Rickettsia montanensis. We also found zero A. americanum infected with R. rickettsii, and 20% infected with Rickettsia amblyommatis, a prevalence somewhat lower than in more southern states. Overall, we conclude that it is unlikely that R. rickettsii vectored by D. variabilis is a primary cause of SFGR cases in NJ and discuss our findings in the context of known facts and current limitations. We conclude that understanding the causes of SFGR east of the Mississippi will require collaboration among medical doctors, public health authorities, and medical entomologists to follow up presumptive human cases of SFGR with detailed histories of exposure, species-specific molecular assays, and active surveillance of putative vectors and the pathogens they may carry.

Leveraging the Expertise of the New Jersey Mosquito Control Community to Jump Start Standardized Tick Surveillance.

Despite the rising incidence of tick-borne diseases (TBD) in the northeastern United States (US), information and expertise needed to assess risk, inform the public and respond proactively is highly variable across states. Standardized and well-designed tick surveillance by trained personnel can facilitate the development of useful risk maps and help target resources, but requires nontrivial start-up costs. To address this challenge, we tested whether existing personnel in New Jersey's 21 county mosquito control agencies could be trained and interested to participate in a one-day collection of American dog ticks (Dermacentor variabilis), a presumably widespread species never before surveyed in this state. A workshop was held offering training in basic tick biology, identification, and standard operating procedures (SOPs) for surveillance, followed by a one-day simultaneous collection of D. variabilis across the state (the "NJ Tick Blitz"). In total, 498 D. variabilis were collected from 21 counties and follow-up participant surveys demonstrated an increase in knowledge and interest in ticks: 41.7% of respondents reported collecting ticks outside the Tick Blitz. We hope that the success of this initiative may provide a template for researchers and officials in other states with tick-borne disease concerns to obtain baseline tick surveillance data by training and partnering with existing personnel.

Annotated List of the Hard Ticks (Acari: Ixodida: Ixodidae) of New Jersey.

Standardized tick surveillance requires an understanding of which species may be present. After a thorough review of the scientific literature, as well as government documents, and careful evaluation of existing accessioned tick collections (vouchers) in museums and other repositories, we have determined that the verifiable hard tick fauna of New Jersey (NJ) currently comprises 11 species. Nine are indigenous to North America and two are invasive, including the recently identified Asian longhorned tick, Haemaphysalis longicornis (Neumann, 1901). For each of the 11 species, we summarize NJ collection details and review their known public health and veterinary importance and available information on seasonality. Separately considered are seven additional species that may be present in the state or become established in the future but whose presence is not currently confirmed with NJ vouchers. We compare our list of hard ticks in NJ with those from neighboring states (Connecticut, New York, Pennsylvania, Delaware, and Maryland), discuss the importance of vouchers in tick research and surveillance, and examine the likelihood and public health consequences of additional hard tick species becoming established in NJ.

A pictorial key to differentiate the recently detected exotic Haemaphysalislongicornis Neumann, 1901 (Acari, Ixodidae) from native congeners in North America.

Until recently, only two haemaphysaline species, Haemaphysalischordeilis (Packard, 1869) and Haemaphysalisleporispalustris (Packard, 1869), were known to occur in the United States, and neither was considered to be of significant medical or veterinary importance. In 2017-2018 established populations of the Asian longhorned tick, Haemaphysalislongicornis Neumann, 1901, were detected in the eastern US for the first time. Haemaphysalislongicornis has the potential to be a significant threat to human and animal health, and the urgent need to determine the full extent of its distribution and host range requires availability of a straightforward and practical guide to differentiate it from native species. We created a pictorial dichotomous key to all stages of Haemaphysalis spp. known to occur in North America with scanning electron photomicrographs of all H.longicornis life stages, including rarely seen males, to aid researchers in differentiating these species. The largely Neotropical species Haemaphysalisjuxtakochi Cooley, 1946, with established populations in Mexico and sporadic detections in the US on migrating birds is also included.

Patients as Patches: Ecology and Epidemiology in Healthcare Environments.

The modern healthcare system involves complex interactions among microbes, patients, providers, and the built environment. It represents a unique and challenging setting for control of the emergence and spread of infectious diseases. We examine an extension of the perspectives and methods from ecology (and especially urban ecology) to address these unique issues, and we outline 3 examples: (1) viewing patients as individual microbial ecosystems; (2) the altered ecology of infectious diseases specifically within hospitals; and (3) ecosystem management perspectives for infection surveillance and control. In each of these cases, we explore the accuracy and relevance of analogies to existing urban ecological perspectives, and we demonstrate a few of the potential direct uses of this perspective for altering research into the control of healthcare-associated infections. Infect Control Hosp Epidemiol. 2016;1507-1512.

Diverse host feeding on nesting birds may limit early-season West Nile virus amplification.

Arboviral activity tracks vector availability, which in temperate regions means that transmission ceases during the winter and must be restarted each spring. In the northeastern United States, Culex restuans Theobald resumes its activity earlier than Culex pipiens L. and is thought to be important in restarting West Nile virus (WNV) transmission. Its role in WNV amplification, however, is unclear, because viral levels commonly remain low until the rise of Cx. pipiens later in the season. Because a vector's feeding habits can reveal key information about disease transmission, we identified early-season (April-June) blood meals from Cx. restuans collected throughout New Jersey, and compared them to published datasets from later in the season and also from other parts of the country. We found significantly higher avian diversity, including poor WNV hosts, and fewer blood meals derived from American Robins (17% versus over 40% found in later season). Critically, we identified blood meals from significantly more female than male birds in species where females are the incubating sex, suggesting that Cx. restuans is able to feed on such a wide variety of hosts in early spring because incubating birds are easy targets. Because WNV amplification depends on virus consistently reaching competent hosts, our results indicate that Cx. restuans is unlikely to be an amplifying vector of WNV in the early season. As the season progresses, however, changes in the availability of nesting birds may make it just as capable as Cx. pipiens, although at somewhat lower abundance as the summer progresses.