![]() ![]() ![]() Despite widespread education initiatives in tick-endemic regions, numerous studies have shown that overall public perception and knowledge surrounding tick identification, tickborne disease risk, and proper disease prevention strategies is low ( Herrington 2004, Bayles et al. There is a constant need for improved strategies capable of bolstering TBD prevention behaviors given that the ranges of tick species and their associated diseases are changing, creating the increased potential for human risk in locations where there was recently little to none ( Springer et al. 2019), and overall improvements in disease diagnosis, surveillance, and reporting ( Beard et al. ![]() 2018), changes in human behavior resulting in enhanced exposure risks ( Zeimes et al. 2018), an increase in deer and other wildlife populations overlapping with human-inhabited space ( Ginsberg and Zhioua 1999, Rand et al. 2013, Ostfeld and Brunner 2015, Salkeld et al. The factors contributing to more cases of TBDs and vector range expansion are complex and include broad ecological changes like changes in climate and land use patterns ( Guerra et al. Aside from direct healthcare costs, the uptick in these illnesses is also having indirect impacts, including increased TBD mortalities, such as a rise in babesia-infected blood bank reserves that have resulted in ~30% fatality rates in transfusion patients receiving contaminated blood products ( Lobo et al. In addition to Lyme disease, reports of other tickborne diseases (TBDs) such as babesiosis, anaplasmosis, ehrlichiosis, Rocky Mountain Spotted Fever, and various encephalitic viruses have doubled and tripled over the past decade ( Springer et al. healthcare system alone is between $712 million and $1.3 billion annually ( Adrion et al. Health economists estimate that the current cost of Lyme disease to the U.S. 2012, CDC 2020), it is still the most common vector-borne disease in the country, currently comprising 82% of all reported tickborne disease cases ( Rosenberg et al. Research suggests that there are more than 300,000 new cases of Lyme disease each year, and although 95% of cases are reported from only 14 states ( Diuk-Wasser et al. Incidence of tickborne disease has increased steadily across the United States in the past decade, with the number of reported cases of tickborne diseases doubling ( Rosenberg et al. Tick, public health entomology, surveillance These findings provide targets for future educational efforts and underscore the value of photograph-based tick surveillance to elucidate these knowledge gaps. State and region of residence and season of submission did not contribute significantly to the optimal model. Ticks reported on pets were more likely to be identified correctly than those found on humans (OR = 1.07, 95% CI: 1.01–2.04, P < 0.001), and ticks feeding for 2.5 d or longer were more likely to be misidentified than those having fed for one day or less (OR = 0.43, 95% CI: 0.29–0.65, P < 0.001). Logistic regression generalized linear models suggested that participants were significantly more likely to misidentify nymph-stage ticks than adult ticks (odds ratio = 0.40, 95% confidence interval : 0.23, 0.68, P < 0.001). More than one quarter of participants (26.3%) submitted photographs of ticks that had been feeding for at least 2.5 d, suggesting heightened risk. Of the top four most commonly submitted tick species, western blacklegged ticks ( Ixodes pacificus Cooley & Kohls ) had the largest proportion of unidentified or misidentified submissions (87.7% incorrectly identified to species), followed by lone star ticks ( Amblyomma americanum Linneaus 86.8% incorrect), American dog ticks ( Dermacentor variabilis Say 80.7% incorrect), and blacklegged ticks ( Ixodes scapularis Say 77.1% incorrect). Data from the University of Rhode Island’s TickEncounter Resource Center’s photo-based surveillance system, TickSpotters, indicate that users incorrectly identified their submitted specimen 83% of the time. Tick identification is critical for assessing disease risk from a tick bite and for determining requisite treatment. ![]()
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