Opposing Patterns of Spatial Synchrony in Lyme Disease Incidence.

Incidence of Lyme disease, a tick-borne illness prevalent in the US, is increasing in endemic regions and regions with no previous history of the disease, significantly impacting public health. We examined space-time patterns of Lyme disease incidence and the influence of ecological and social factors on spatial synchrony, i.e., correlated incidence fluctuations across US counties. Specifically, we addressed these questions: Does Lyme disease incidence exhibit spatial synchrony? If so, what geographic patterns does Lyme disease synchrony exhibit? Are geographic patterns of disease synchrony related to weather, land cover, access to health care, or tick-borne disease awareness? How do effects of these variables on Lyme disease synchrony differ geographically? We used network analysis and matrix regression to examine geographical patterns of Lyme disease synchrony and their potential mechanisms in 399 counties in the eastern and Midwestern US. We found two distinct regions of synchrony in Northeast and upper Midwest regions exhibiting opposing temporal fluctuations in incidence. Spatial patterns of Lyme disease synchrony were partly explained by land cover, weather, poverty, and awareness of tick-borne illness, with significant predictive variables changing regionally. However, the two regions may have become more synchronous over time, potentially leading to higher-amplitude nation-wide fluctuations in disease incidence.

Cascading impacts of overstory structure in managed forests on understory structure, microclimate conditions, and Ixodes scapularis (Acari: Ixodidae) densities.

Forest management practices designed to meet varied landowner objectives affect wildlife habitat and may interrupt the life-cycle stages of disease vectors, including the black-legged tick, Ixodes scapularis Say (Acari: Ixodidae). Ixodes scapularis transmits multiple pathogens including Borrelia burgdorferi, the causative agent of Lyme disease, which is the most common tick-borne disease in the United States. There is evidence that a range of active forest management practices (e.g., invasive plant removal, prescribed burning) can alter tick densities and pathogen transmission. However, few studies have investigated relationships between forest stand structural variables commonly manipulated by timber harvesting and tick ecology. Foresters may harvest timber to create certain forest structural conditions like the mean number of trees, or basal area, per hectare. This study used a spatially replicated experiment in a blocked design to compare forest stands with a range of overstory structures and document variations in the midstory, understory, and forest floor, as well as microclimate conditions within tick off-host habitat. Greater numbers of trees or basal area per hectare correlated with greater canopy closure but less understory cover, stabilized microclimate temperature, higher microclimate humidity, and greater I. scapularis nymph densities. A random forest model identified understory forest structure as the strongest predictor of nymph densities. There was no relationship between the number of trees or basal area per hectare and daily deer (Odocoileus virginianus Zimmermann) activity or nymphal infection prevalence. These findings provide a deeper understanding of tick-habitat associations within a forest stand and have the potential to inform forest management decisions.

Ticks' attraction to electrically charged hosts.

Ticks are blood-feeding parasites with limited locomotion, known for transmitting multiple pathogens to vertebrates. England et al. suggest that ticks can be easily pulled, via electrostatic induction, toward charged hosts with fluffy coats that are prone to accumulate higher electrostatic potentials. Thus, static electricity may influence ticks' ecology and management.

Red Breast Syndrome and Acellular Dermal Matrix.

Increasingly popular for use in breast reconstruction, acellular dermal matrix (ADM) can provide support and protection to implants. However, use of ADM may be associated with infection and complications, including red breast syndrome (RBS). RBS is an inflammatory event that typically presents with cutaneous erythema over the domain where the ADM is surgically implanted. As ADM use increases, presumably, more cases of RBS will occur. Thus, techniques and tools to mitigate or manage RBS are needed to improve patient outcomes. Here, we describe a case where RBS was diagnosed and interestingly resolved after exchange for a different brand of dermal matrix. This surgical resolution maintained excellent reconstructive results with no recurrent erythema over a follow-up period of 7 months. Although we cannot rule out RBS due to other variables, RBS due to patient hypersensitivity to certain ADMs has been documented in the literature. In this instance, our results suggest that revision with an alternate ADM brand may serve as a potential solution.

Epidemic spread on patch networks with community structure.

Predicting and preparing for the trajectory of disease epidemics relies on a knowledge of environmental and socioeconomic factors that affect transmission rates on local and global spatial scales. This article discusses the simulation of epidemic outbreaks on human metapopulation networks with community structure, such as cities within national boundaries, for which infection rates vary both within and between communities. We demonstrate mathematically, through next-generation matrices, that the structures of these communities, setting aside all other considerations such as disease virulence and human decision-making, have a profound effect on the reproduction rate of the disease throughout the network. In high modularity networks, with high levels of separation between neighboring communities, disease epidemics tend to spread rapidly in high-risk communities and very slowly in others, whereas in low modularity networks, the epidemic spreads throughout the entire network as a steady pace, with little regard for variations in infection rate. The correlation between network modularity and effective reproduction number is stronger in population with high rates of human movement. This implies that the community structure, human diffusion rate, and disease reproduction number are all intertwined, and the relationships between them can be affected by mitigation strategies such as restricting movement between and within high-risk communities. We then test through numerical simulation the effectiveness of movement restriction and vaccination strategies in reducing the peak prevalence and spread area of outbreaks. Our results show that the effectiveness of these strategies depends on the structure of the network and the properties of the disease. For example, vaccination strategies are most effective in networks with high rates of diffusion, whereas movement restriction strategies are most effective in networks with high modularity and high infection rates. Finally, we offer guidance to epidemic modelers as to the ideal spatial resolution to balance accuracy and data collection costs.

A citizen science approach to investigate the distribution, abundance, and pathogen infection of vector ticks through active surveillance.

Tick-borne disease poses a growing public health burden in the United States and understanding the patterns of presence and density of infected vector ticks is key to developing and implementing effective public health management strategies. Citizen science has emerged as a highly effective means to generate data sets on the geographical distribution of tick species. But to date, nearly all citizen science studies of ticks are 'passive surveillance' programs in which researchers accept reports of ticks, together with either physical specimens or digital images, found opportunistically on people, pets, and livestock from community members for species identification and in some cases also tick-borne pathogen detection. These studies are limited because data are not collected systematically, making comparisons among locations and over time challenging, and introducing considerable reporting bias. In this study, we engaged citizen scientists in 'active surveillance' of host-seeking ticks, training volunteers to actively collect ticks on their woodland properties in an emergent region of tick-borne disease in the state of Maine, USA. We developed volunteer recruitment strategies, materials to train volunteers in data collection methods, field data collection protocols based on techniques used by professional scientists, and a variety of incentives to promote volunteer retention and satisfaction with their experiences, and we communicated research findings to participants. A total of 125 volunteers in 2020 and 181 volunteers in 2021 collected 7,246 ticks in southern and coastal Maine, including the American dog tick (Dermacentor variabilis, 4,023 specimens), the blacklegged tick (Ixodes scapularis, 3,092 specimens), and the rabbit tick (Haemaphysalis leporispalustris, 102 specimens). We demonstrated the feasibility of citizen scientists collecting ticks using active surveillance methods and found that volunteers were motivated to participate largely by their interest in the scientific problem and a desire to learn about ticks on their properties.

Perceived vulnerability for Lyme disease questionnaire: A social science tool for understanding tick-borne disease attitudes.

Lyme disease has emerged as a growing epidemic across the U.S., with tick populations spreading north because of a plethora of human-induced factors. As the scope of this problem grows, there is a need to understand how vulnerable the public perceives themselves to be and how perceived vulnerability as a psychological construct influences public behavior. A growing body of literature has explored individual risk perceptions and individual preventative behaviors toward Lyme disease, but there remains a notable research gap regarding the concept of vulnerability. This empirical study establishes the first questionnaire for perceived vulnerability towards Lyme disease, modified from pre-existing infectious disease literature. This novel instrument was tested and compared with individual factors relating to preventative behaviors and source credibility of major information sources about Lyme disease in the state of Maine. Recent increases in black-legged tick (Ixodes scapularis) populations have affected the state of Maine in dramatic ways. This research specifically surveyed homeowners to explore their perceived vulnerability, source credibility, and individual protective intentions related to ticks and Lyme disease in Maine. Results from this study validate a modified perceived vulnerability scale for Lyme disease and highlight how understanding the relationships between these perceptions of vulnerability, individual behaviors, and sources of information can improve outreach and communication efforts about tick-borne diseases.

Patterns and Ecological Mechanisms of Tick-Borne Disease Exposure Risk in Acadia National Park, Mount Desert Island, Maine, United States.

National parks are unique and significant vector-borne pathogen transmission settings, engaging over 300 million people in outdoor recreation per year. In this study, we integrated vector surveys and ecological habitat feature data in spatial models to characterize tick-borne disease exposure risk in Acadia National Park (ANP), Maine. To determine the broad-scale patterns of blacklegged tick Ixodes scapularis Say (Acari: Ixodidae) densities in ANP, we conducted host-seeking tick collections at 114 sites across the park over two years. Using these tick survey data and geospatial landscape feature data (i.e., land cover, elevation, forest patch size, and aspect) we developed a random forest model of nymphal tick density. We found that host-seeking tick density varies significantly across the park and is particularly high in areas characterized by deciduous forest cover and relatively low elevation. To explore potential fine-scale ecological drivers of tick density spatial patterns, we quantified microclimate conditions, host activity, and vegetation characteristics at a subset of 19 sites. We identified significant differences in microclimate conditions but not host activity or vegetation metrics across broad-scale landscape feature classes. Mean temperature and mean humidity were correlated to nymphal densities and therefore may provide a mechanistic link between landscape features and blacklegged tick densities. Finally, we detected multiple tick-borne pathogens in both ticks and small mammals sampled in ANP, including Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum. Our findings demonstrate the value of using ecological metrics to estimate vector-borne disease exposure risk and provide insight into habitat characteristics that may drive tick-borne disease exposure risk.

Collaborative Modeling of the Tick-Borne Disease Social-Ecological System: A Conceptual Framework.

Hard-bodied ticks have become a major concern in temperate regions because they transmit a variety of pathogens of medical significance. Ticks and pathogens interact with hosts in a complex social-ecological system (SES) that influences human exposure to tick-borne diseases (TBD). We argue that addressing the urgent public health threat posed by TBD requires an understanding of the integrated processes in the forest ecosystem that influence tick density and infection prevalence, transmission among ticks, animal hosts, and ultimately disease prevalence in humans. We argue that collaborative modeling of the human-tick SES is required to understand the system dynamics as well as move science toward policy action. Recent studies in human health have shown the importance of stakeholder participation in understanding the factors that contribute to human exposure to zoonotic diseases. We discuss how collaborative modeling can be applied to understand the impacts of forest management practices on ticks and TBD. We discuss the potential of collaborative modeling for encouraging participation of diverse stakeholders in discussing the implications of managing forest ticks in the absence of large-scale control policy.

Ethical funding for trustworthy AI: proposals to address the responsibilities of funders to ensure that projects adhere to trustworthy AI practice.

AI systems that demonstrate significant bias or lower than claimed accuracy, and resulting in individual and societal harms, continue to be reported. Such reports beg the question as to why such systems continue to be funded, developed and deployed despite the many published ethical AI principles. This paper focusses on the funding processes for AI research grants which we have identified as a gap in the current range of ethical AI solutions such as AI procurement guidelines, AI impact assessments and AI audit frameworks. We highlight the responsibilities of funding bodies to ensure investment is channelled towards trustworthy and safe AI systems and provides case studies as to how other ethical funding principles are managed. We offer a first sight of two proposals for funding bodies to consider regarding procedures they can employ. The first proposal is for the inclusion of a Trustworthy AI Statement' section in the grant application form and offers an example of the associated guidance. The second proposal outlines the wider management requirements of a funding body for the ethical review and monitoring of funded projects to ensure adherence to the proposed ethical strategies in the applicants Trustworthy AI Statement. The anticipated outcome for such proposals being employed would be to create a 'stop and think' section during the project planning and application procedure requiring applicants to implement the methods for the ethically aligned design of AI. In essence it asks funders to send the message "if you want the money, then build trustworthy AI!".

Microclimate conditions alter Ixodes scapularis (Acari: Ixodidae) overwinter survival across climate gradients in Maine, United States.

The incidence and geographic range of vector-borne diseases have been expanding in recent decades, attributed in part to global climate change. Blacklegged ticks (Ixodes scapularis), the primary vector for multiple tick-borne pathogens in North America, are spreading rapidly beyond their historic post-colonial range and are thought to be constrained mainly by winter temperature at northern latitudes. Our research explored whether winter climate currently limits the distribution of blacklegged ticks and the pathogens they transmit in Maine, U.S.A., by contributing to overwinter mortality of nymphs. We experimentally tested tick overwinter survival across large-scale temperature and snowfall gradients and assessed factors contributing to winter mortality in locations where blacklegged tick populations are currently established and locations where the blacklegged tick has not yet been detected. We also tested the hypothesis that insulation in the tick microhabitat (i.e., by leaf litter and snowpack) can facilitate winter survival of blacklegged tick nymphs despite inhospitable ambient conditions. Overwinter survival was not significantly different in coastal southern compared to coastal and inland northern Maine, most likely due to sufficient snowpack that protected against low ambient temperatures at high latitudes. Snow cover and leaf litter contributed significantly to overwinter survival at sites in both southern and northern Maine. To further assess whether the current distribution of blacklegged ticks in Maine aligns with patterns of overwinter survival, we systematically searched for and collected ticks at seven sites along latitudinal and coastal-inland climate gradients across the state. We found higher densities of blacklegged ticks in coastal southern Maine (90.2 ticks/1000 m2) than inland central Maine (17.8 ticks/1000 m2) and no blacklegged ticks in inland northern Maine. Our results suggest that overwinter survival is not the sole constraint on the blacklegged tick distribution even under extremely cold ambient conditions and additional mechanisms may limit the continued northward expansion of ticks.

Active Forest Management Reduces Blacklegged Tick and Tick-Borne Pathogen Exposure Risk.

In the northeastern USA, active forest management can include timber harvests designed to meet silvicultural objectives (i.e., harvesting trees that meet certain maturity, height, age, or quality criteria). Timber harvesting is an important tool in enhancing regeneration and maintaining forest health. It also has considerable potential to influence transmission dynamics of tick-borne pathogens, which are deeply embedded in the forest ecosystem. We conducted a 2-year study to test the hypotheses that recent timber harvesting impacts blacklegged tick density and infection prevalence in managed nonindustrial forests. We found that (1) recent harvesting reduces the presence of nymphal and density of adult blacklegged ticks, (2) recently harvested stands are characterized by understory microclimate conditions that may inhibit tick survival and host-seeking behavior, (3) capture rates of small mammal species frequently parasitized by immature ticks are lower in recently harvested stands compared to control stands with no recent harvest history. In addition, a 1-year pilot study suggests that harvesting does not affect nymphal infection prevalence. Collectively, our results demonstrate that forest structure and understory conditions may impact ticks and the pathogens they transmit via a range of mechanistic pathways, and moreover, active forest management may offer sustainable tools to inhibit entomological risk of exposure to tick-borne pathogens in the landscape.

Interactions between sympatric invasive European fire ants (Myrmica rubra) and blacklegged ticks (Ixodes scapularis).

The blacklegged tick (Ixodes scapularis) and the invasive European fire ant (Myrmica rubra) are both expanding throughout their sympatric range in coastal New England. Ixodes scapularis is the primary vector of the bacterium Borrelia burgdorferi, which is the causative agent of Lyme disease, and Mount Desert Island, Maine, home to Acadia National Park, currently is affected by a high Lyme disease burden. Ticks have many natural predators, including ants, although no previous studies have investigated interactions between these two species. To test the hypothesis that the presence of M. rubra alters I. scapularis abundance, we collected ticks by drag-sampling at eight ant-infested sites and eight uninfested control sites in Acadia National Park. We found that nymph density was significantly higher at ant-infested sites, while larval density was significantly higher at control sites. In addition, we conducted a laboratory bioassay to measure M. rubra aggression against I. scapularis larvae, nymphs, and adults and Dermacentor variabilis adults, and found that ant aggression was significantly higher against D. variabilis adults than I. scapularis adults. Our findings support the hypothesis that M. rubra has divergent effects across I. scapularis life stages, and we discuss possible ecological mechanisms, including optimal microclimate and predation, that could promote density of nymphs while inhibiting density of larvae.

Connectivity, reproduction number, and mobility interact to determine communities' epidemiological superspreader potential in a metapopulation network.

Disease epidemic outbreaks on human metapopulation networks are often driven by a small number of superspreader nodes, which are primarily responsible for spreading the disease throughout the network. Superspreader nodes typically are characterized either by their locations within the network, by their degree of connectivity and centrality, or by their habitat suitability for the disease, described by their reproduction number (R). Here we introduce a model that considers simultaneously the effects of network properties and R on superspreaders, as opposed to previous research which considered each factor separately. This type of model is applicable to diseases for which habitat suitability varies by climate or land cover, and for direct transmitted diseases for which population density and mitigation practices influences R. We present analytical models that quantify the superspreader capacity of a population node by two measures: probability-dependent superspreader capacity, the expected number of neighboring nodes to which the node in consideration will randomly spread the disease per epidemic generation, and time-dependent superspreader capacity, the rate at which the node spreads the disease to each of its neighbors. We validate our analytical models with a Monte Carlo analysis of repeated stochastic Susceptible-Infected-Recovered (SIR) simulations on randomly generated human population networks, and we use a random forest statistical model to relate superspreader risk to connectivity, R, centrality, clustering, and diffusion. We demonstrate that either degree of connectivity or R above a certain threshold are sufficient conditions for a node to have a moderate superspreader risk factor, but both are necessary for a node to have a high-risk factor. The statistical model presented in this article can be used to predict the location of superspreader events in future epidemics, and to predict the effectiveness of mitigation strategies that seek to reduce the value of R, alter host movements, or both.

A Generalized Additive Model Correlating Blacklegged Ticks With White-Tailed Deer Density, Temperature, and Humidity in Maine, USA, 1990-2013.

Geographical range expansions of blacklegged tick [Ixodes scapularis Say (Acari: Ixodidae)] populations over time in the United States have been attributed to a mosaic of factors including 20th century reforestation followed by suburbanization, burgeoning populations of the white-tailed deer [Odocoileus virginianus Zimmerman (Artiodactyla: Cervidae)], and, at the northern edge of I. scapularis' range, climate change. Maine, a high Lyme disease incidence state, has been experiencing warmer and shorter winter seasons, and relatively more so in its northern tier. Maine served as a case study to investigate the interacting impacts of deer and seasonal climatology on the spatial and temporal distribution of I. scapularis. A passive tick surveillance dataset indexed abundance of I. scapularis nymphs for the state, 1990-2013. With Maine's wildlife management districts as the spatial unit, we used a generalized additive model to assess linear and nonlinear relationships between I. scapularis nymph abundance and predictors. Nymph submission rate increased with increasing deer densities up to ~5 deer/km2 (13 deer/mi2), but beyond this threshold did not vary with deer density. This corroborated the idea of a saturating relationship between I. scapularis and deer density. Nymphs also were associated with warmer minimum winter temperatures, earlier degree-day accumulation, and higher relative humidity. However, nymph abundance only increased with warmer winters and degree-day accumulation where deer density exceeded ~2 deer/km2 (~6/mi2). Anticipated increases in I. scapularis in the northern tier could be partially mitigated through deer herd management.

Landscape features predict the current and forecast the future geographic spread of Lyme disease.

Lyme disease, the most prevalent vector-borne disease in North America, is increasing in incidence and geographic distribution as the tick vector, Ixodes scapularis, spreads to new regions. We re-construct the spatial-temporal invasion of the tick and human disease in the Midwestern US, a major focus of Lyme disease transmission, from 1967 to 2018, to analyse the influence of spatial factors on the geographic spread. A regression model indicates that three spatial factors-proximity to a previously invaded county, forest cover and adjacency to a river-collectively predict tick occurrence. Validation of the predictive capability of this model correctly predicts counties invaded or uninvaded with 90.6% and 98.5% accuracy, respectively. Reported incidence increases in counties after the first report of the tick; based on this modelled relationship, we identify 31 counties where we suspect I. scapularis already occurs yet remains undetected. Finally, we apply the model to forecast tick establishment by 2021 and predict 42 additional counties where I. scapularis will probably be detected based upon historical drivers of geographic spread. Our findings leverage resources dedicated to tick and human disease reporting and provide the opportunity to take proactive steps (e.g. educational efforts) to prevent and limit transmission in areas of future geographic spread.

Production of Culex pipiens in Stormwater and Combined Sewer Catch Basins.

Man-made stormwater and sewage infrastructure, particularly roadside catch basins, provides widespread habitats for immature mosquitoes in urban and suburban environments. Historically, throughout much of the USA, stormwater, sewage, and industrial wastewater were conducted together through "combined" sewer systems, discharging a combination of stormwater and wastewater into streams. Within recent decades, many cities have replaced these combined sewers with "stormwater only" systems that separate stormwater from wastewater. The objective of this research was to evaluate the implications of this infrastructure conversion for production of Culex pipiens, a primary vector for West Nile virus. On a weekly basis over 14 wk, 20 catch basins (10 combined sewer and 10 stormwater only) were sampled for mosquito larvae and emerging adults using the dipping collection method and floating emergence traps. Abundance of larval Cx. pipiens was higher in combined sewer compared with stormwater-only catch basins, while to the contrary, abundance of adult Cx. pipiens was lower in combined sewer compared with stormwater-only catch basins. This study is the first to reveal that habitat attractiveness and quality for Cx. pipiens may vary between combined sewer and stormwater-only catch basins, and our results contribute to a growing body of research to inform vector management and urban planning efforts as municipalities consider the environmental and public health implications of conversion from combined sewage management to separation of stormwater and wastewater.

Fatal attraction: lone star ticks (Amblyomma americanum) exhibit preference for human female breath over male breath.

Ticks use a variety of chemical cues to locate hosts, the main cue being carbon dioxide, which is exhaled by hosts. This study sought to experimentally determine whether ticks exhibit preference among human hosts based on host sex, as the chemical components of human male and female breath have been shown to differ. We focused on the lone star tick, Amblyomma americanum, due to its importance as a disease vector in the United States and its active host-seeking behavior. To test the hypothesis that ticks exhibit preference based upon host sex, we conducted a binary choice behavioral bioassay. Male and female human volunteers (n = 20 pairs) breathed into opposite sides of a secured polycarbonate tube containing 10 adult A. americanum and the proportion of ticks that exhibited a host preference was recorded. We found that under controlled conditions, human females attract a significantly larger proportion of ticks than males. Possible mechanisms to explain these results include that (1) female breath contains components that ticks find attractive, and/or (2) male breath contains a repellent chemical component.

Container Size Alters the Outcome of Interspecific Competition Between Aedes aegypti (Diptera: Culicidae) and Aedes albopictus.

Aedes aegypti L. and Aedes albopictus Skuse co-occur in a variety of water-filled containers where they compete for resources. Larvae of Ae. albopictus Skuse often outcompete those of Ae. aegypti L., but variation in biotic and abiotic parameters can modify the outcome of this interspecific competition. We tested whether container size can alter the magnitude and direction of intra- and interspecific competition by rearing three Ae. aegypti and Ae. albopictus larval combinations (100:0, 50:50 and 0:100) in three container sizes (small, medium, and large). For both mosquito species, individuals raised in small- and medium-sized containers had shorter development time to adulthood, higher survival to adulthood, and larger adult body size compared to individuals from large containers. For Ae. aegypti but not Ae. albopictus, survival to adulthood was significantly influenced by a two-way interaction between container size and larval competition. The negative effect of interspecific competition was stronger in the small and medium containers and the negative effect of intraspecific competition was stronger in large containers. Our results show that container size can affect the outcome of intra- and interspecific competition between Ae. aegypti and Ae. albopictus and may help account for the observed patterns of both competitive exclusion and coexistence documented in the field for these two medically important mosquito species.