Questions and Answers
What percentage of people will develop a bull's eye rash after being bitten by an infected Ixodes tick?
How many hours of attachment are required for the transmission of Borrelia from an Ixodes tick to a host?
What is the primary method of diagnosis for early localized Lyme disease?
Which of the following is NOT a recommended treatment for early localized Lyme disease?
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What is the recommended duration of treatment for neurological disease caused by Lyme disease?
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What is the primary vector responsible for transmitting Lyme disease in Southern Canada?
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What is the purpose of serology in the diagnosis of Lyme disease?
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Why should serology NOT be used for asymptomatic individuals?
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Which of the following is NOT a characteristic of vector-borne diseases?
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What is the causative agent of Q Fever?
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What is the purpose of prophylaxis in Lyme disease?
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Which of the following tick species is found on the west coast of Canada and is important for transmitting disease there?
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Which of the following is a characteristic of Lyme disease?
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What is the name of the tick species that requires a blood meal at each stage of maturation for females?
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What is the stage of the tick lifecycle involved in transmission of Borrelia?
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Which of the following is a potential route of transmission for vector-borne diseases?
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What is the name of the disease caused by the bacterium Borrelia burgdorferi?
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Which of the following is NOT a disease that has been diagnosed in Nova Scotia?
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What is the primary goal of controlling the vector in vector-borne diseases?
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Which of the following is an example of a disease that is well established in Nova Scotia?
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What is the primary reservoir for Babesia that infects ticks?
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How long does it take for Babesia transmission to occur through tick attachment?
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Which of the following is NOT a common characteristic of Babesiosis?
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What is the primary method of diagnosing Babesiosis?
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Which of the following is NOT a characteristic of Anaplasma phagocytophilum?
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What is the primary vector for transmitting Anaplasma phagocytophilum?
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Which of the following is a rare method of transmitting Babesia?
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What is the primary region where Babesiosis is commonly found?
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What is the severe complication that can occur in Babesiosis?
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Which of the following is used for screening blood donations for Babesiosis?
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Study Notes
Vector Borne Infections
- Vector borne diseases are transmitted by live agents, usually arthropods or insects, which can be mechanical (passively carrying organisms) or biological (where the organism lives within the vector).
- Transmission can also occur through rare routes, such as blood transfusions or organ transplants.
- The areas where these diseases are prevalent are restricted by the presence of the vector.
- Control of the vector can allow for control of the disease, but local suppression may be more achievable.
Importance to Nova Scotia
- Some vector borne infections, such as Lyme disease, are well established in Nova Scotia.
- Others, like Anaplasma and Babesia, have been diagnosed infrequently, but their vectors exist in the province.
- Some vectors, like those that could transmit Rocky Mountain Spotted Fever (RMSF) and West Nile Virus (WNV), exist in Nova Scotia, but the infections have not been diagnosed yet.
Ixodes scapularis
- Ixodes scapularis, also known as the black-legged tick (BLT), is a key vector that requires a blood meal at each stage of maturation for females.
- Found throughout the Southern Maritimes and Southern Canada, as well as on the west coast (Ixodes pacificus).
Lyme Disease
- Caused by Borrelia burgdorferi, a gram-negative spirochete, which undergoes antigenic changes when transmitted by Ixodes ticks.
- Transmission requires 24-36 hours of tick attachment, and nymphs and adults are involved in transmission.
- First described in Lyme, Connecticut in 1975, and now common in Nova Scotia, other parts of southern Canada, and the northeastern United States.
Clinical Presentations of Lyme Disease
- Early Localized disease: develops 3-30 days after the bite, with 80% of cases presenting with a bulls-eye rash (erythema migrans) and flu-like symptoms.
- Early Disseminated disease: multiple erythema migrans lesions, neurological or cardiac disease.
- Late disease: arthritis, especially affecting the knee, and neurological symptoms.
Diagnosis of Lyme Disease
- Early localized disease is diagnosed clinically based on erythema migrans and flu-like symptoms.
- Serology is positive after several weeks, using enzyme immunoassay or Western Blot, or 2 sequential rapid tests.
- Testing is insensitive when only erythema migrans is present, and should not be used for asymptomatic people or those with non-specific symptoms.
Treatment of Lyme Disease
- Prophylaxis with doxycycline is used by some practitioners after tick bites in high-prevalence areas.
- Early disease is treated with amoxicillin, doxycycline, or cefuroxime for up to 3 weeks.
- Neurological disease is treated with ceftriaxone, penicillin, or doxycycline for up to 28 days.
- Long courses of treatment are not beneficial, and additional antimicrobials are not useful.
Babesiosis
- Caused by the Apicomplexa parasite Babesia, which is related to Plasmodium (malaria), and transmitted by Ixodes ticks.
- Babesia infects mice as the reservoir that infects ticks, and takes 24-36 hours of attachment for transmission.
- Found in New England, New Jersey, and Minnesota, with different species found in Europe and elsewhere.
- Rarely transmitted through blood or transplanted organs.
Clinical and Diagnosis of Babesiosis
- Infection causes symptoms ranging from asymptomatic to severe, including anemia, fever, and hemolysis.
- Diagnosis is made through blood smear, detection of parasite DNA by PCR, and serology, which tends to be after the acute phase of infection.
Anaplasma
- Caused by Anaplasma phagocytophilum, a gram-negative obligate intracellular bacteria, related to Rickettsia.
- Transmitted by Ixodes ticks, and rarely through blood transfusion or organ transplant.
- Seen in the northeastern United States, north-central United States, and Nova Scotia.
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Description
Learn about vector borne diseases, their transmission routes, and control methods. Explore how these diseases are restricted to areas with vectors and how controlling the vector can control the disease.
