Kerry A. Padgett

A meta-analysis suggesting that the relationship between biodiversity and risk of zoonotic pathogen transmission is idiosyncratic.

Abstract Zoonotic pathogens are significant burdens on global public health. Because they are transmitted to humans from non‐human animals, the transmission dynamics of zoonoses are necessarily influenced by the ecology of their animal hosts and vectors. The ‘dilution effect’ proposes that increased species diversity reduces disease risk, suggesting that conservation and public health initiatives can work synergistically to improve human health and wildlife biodiversity. However, the meta‐analysis that we present here indicates a weak and highly heterogeneous relationship between host biodiversity and disease. Our results suggest that disease risk is more likely a local phenomenon that relies on the specific composition of reservoir hosts and vectors, and their ecology, rather than patterns of species biodiversity.

Large Scale Spatial Risk and Comparative Prevalence of Borrelia miyamotoi and Borrelia burgdorferi Sensu Lato in Ixodes pacificus

Borrelia miyamotoi is a newly described emerging pathogen transmitted to people by Ixodes species ticks and found in temperate regions of North America, Europe, and Asia. There is limited understanding of large scale entomological risk patterns of B. miyamotoi and of Borreila burgdorferi sensu stricto (ss), the agent of Lyme disease, in western North America. In this study, B. miyamotoi, a relapsing fever spirochete, was detected in adult (n = 70) and nymphal (n = 36) Ixodes pacificus ticks collected from 24 of 48 California counties that were surveyed over a 13 year period. Statewide prevalence of B. burgdorferi sensu lato (sl), which includes B. burgdorferi ss, and B. miyamotoi were similar in adult I. pacificus (0.6% and 0.8%, respectively). In contrast, the prevalence of B. burgdorferi sl was almost 2.5 times higher than B. miyamotoi in nymphal I. pacificus (3.2% versus 1.4%). These results suggest similar risk of exposure to B. burgdorferi sl and B. miyamotoi from adult I. pacificus tick bites in California, but a higher risk of contracting B. burgdorferi sl than B. miyamotoi from nymphal tick bites. While regional risk of exposure to these two spirochetes varies, the highest risk for both species is found in north and central coastal California and the Sierra Nevada foothill region, and the lowest risk is in southern California; nevertheless, tick-bite avoidance measures should be implemented in all regions of California. This is the first study to comprehensively evaluate entomologic risk for B. miyamotoi and B. burgdorferi for both adult and nymphal I. pacificus, an important human biting tick in western North America.

Rickettsia spp. 364D causing a cluster of eschar-associated illness, California.

We describe the clinical course of the first 3 pediatric cases infected with Rickettsia spp. 364D. Although the pathogen was identified in California ticks decades ago, only recently have human cases been documented. Clinical features are generally mild, characterized by eschar, fever, headache, malaise and lymphadenopathy. Antigenic similarity among rickettsiae leads to cross-reactive antibody responses; definitive diagnosis requires molecular methods.

Early warning system for West Nile virus risk areas, California, USA.

TOC Summary: This system effectively identified high-risk human population areas.

The Eco-epidemiology of Pacific Coast Tick Fever in California

Rickettsia philipii (type strain “Rickettsia 364D”), the etiologic agent of Pacific Coast tick fever (PCTF), is transmitted to people by the Pacific Coast tick, Dermacentor occidentalis. Following the first confirmed human case of PCTF in 2008, 13 additional human cases have been reported in California, more than half of which were pediatric cases. The most common features of PCTF are the presence of at least one necrotic lesion known as an eschar (100%), fever (85%), and headache (79%); four case-patients required hospitalization and four had multiple eschars. Findings presented here implicate the nymphal or larval stages of D. occidentalis as the primary vectors of R. philipii to people. Peak transmission risk from ticks to people occurs in late summer. Rickettsia philipii DNA was detected in D. occidentalis ticks from 15 of 37 California counties. Similarly, non-pathogenic Rickettsia rhipicephali DNA was detected in D. occidentalis in 29 of 38 counties with an average prevalence of 12.0% in adult ticks. In total, 5,601 ticks tested from 2009 through 2015 yielded an overall R. philipii infection prevalence of 2.1% in adults, 0.9% in nymphs and a minimum infection prevalence of 0.4% in larval pools. Although most human cases of PCTF have been reported from northern California, acarological surveillance suggests that R. philipii may occur throughout the distribution range of D. occidentalis.

Detection of Rickettsia Species in Fleas Collected from Cats in Regions Endemic and Nonendemic for Flea-Borne Rickettsioses in California

Rickettsia typhi, transmitted by rat fleas, causes most human flea-borne rickettsioses worldwide. Another rickettsia, Rickettsia felis, found in cat fleas, Ctenocephalides felis, has also been implicated as a potential human pathogen. In the continental United States, human cases of flea-borne rickettsioses are reported primarily from the southern regions of Texas and California where the cat flea is considered the principal vector. In California, more than 90% of locally acquired human cases are reported from suburban communities within Los Angeles and Orange counties despite the almost ubiquitous presence of cat fleas and their hosts throughout the state. The objective of this study is to assess the presence and infection rate of Rickettsia species in cat fleas from selected endemic and nonendemic regions of California. Cat fleas were collected from cats in Los Angeles County (endemic region) and Sacramento and Contra Costa counties (nonendemic region). Sequencing of 17 amplicons confirmed the presence of R. felis in both the endemic and non-endemic regions with a calculated maximum likelihood estimation of 131 and 234 per 1000 fleas, respectively. R. typhi was not detected in any flea pools. Two R. felis-like genotypes were also detected in fleas from Los Angeles County; Genotype 1 was detected in 1 flea pool and Genotype 2 was found in 10 flea pools. Genotype 1 was also detected in a single flea pool from Sacramento County. Results from this study show that R. felis is widespread in cat flea populations in both flea-borne rickettsioses endemic and nonendemic regions of California, suggesting that a high prevalence of this bacterium in cat fleas does not predispose to increased risk of human infection. Further studies are needed to elucidate the role of R. felis and the two R. felis-like organisms as etiologic agents of human flea-borne rickettsioses in California.

Seasonal activity patterns of the western black-legged tick, Ixodes pacificus, in relation to onset of human Lyme disease in northwestern California

Seasonal activity patterns of questing western black-legged ticks, Ixodes pacificus were investigated in northwestern California. Adult I. pacificus became active in the fall (late October/early November) and their appearance was associated with the first rain of the season. Following a peak in January, the abundance of adult ticks declined such that they were rare or absent by June/July. The nymphal tick activity season occurred from January through October, and larval activity occurred from April to June, but sometimes extended into October. Thus, potentially infectious ticks (nymphs and adults) present a year-round risk of Lyme disease transmission in northwestern California. The seasonality of Lyme disease cases in humans, based on the onset of erythema migrans, mirrored tick activity patterns and was year-round in cases infected in California. Peak incidence in humans occurs from May through July, and indicates that most disease transmission is from nymphal ticks. This study demonstrates that tick activity patterns are more extended than previously recognized in northwestern California.

Novel exposure sites for nymphal Ixodes pacificus within picnic areas

Risk of exposure to nymphal Ixodes pacificus Cooley and Kohls ticks was investigated at 7 picnic areas in Tilden Regional Park, a heavily used recreation area of over 2000 acres in northwestern California, east of San Francisco Bay. Wooden picnic tables, tree trunks, logs, leaf litter, surrounding vegetation, and rock walls were checked for ticks using standard 1-m(2) flannel tick flags at biweekly intervals from March to August 2008. Results indicate that nymphal I. pacificus were commonly found on wooden picnic tables and other wooden materials, such as tree trunks and logs, at an equal proportion to those found in leaf litter. Nymphal I. pacificus in picnic areas peaked in April, with a secondary peak in early June. Five of 170 (2.9%) nymphal I. pacificus collected at picnic sites were positive for Borrelia spirochetes, of which 3 (1.8%) were identified as B. burgdorferi sensu stricto using molecular techniques. In addition, a nymphal I. auritulus collected from a rock wall in a picnic area tested positive for a mixture of B. burgdorferi and B. bissettii; this tick species feeds exclusively on birds. This study indicates a moderate risk of acquiring a nymphal tick at Tilden Park picnic areas, but due to the low B. burgdorferi infection prevalence, the risk of acquiring Lyme disease appears to be low.

Public Health Response to Aedes aegypti and Ae. albopictus Mosquitoes Invading California, USA

Aedes aegypti and Ae. albopictus mosquitoes, primary vectors of dengue and chikungunya viruses, were recently detected in California, USA. The threat of potential local transmission of these viruses increases as more infected travelers arrive from affected areas. Public health response has included enhanced human and mosquito surveillance, education, and intensive mosquito control.

Survival analysis of dogs diagnosed with canine peritoneal larval cestodiasis (Mesocestoides spp.).

Canine peritoneal larval cestodiasis (CPLC) is a poorly understood disease of dogs caused by asexual multiplication of larval Mesocestoides spp. tapeworms. In this study, we examined the descriptive statistics and survival characteristics of 60 dogs diagnosed with CPLC from 1989 to 2009. Clinically affected dogs presented with ascites (60%), anorexia/weight loss (42%), vomiting (23%), diarrhea (9%) and tachypnea (9%), while subclinical infections (22%) were incidentally detected, typically during ovariohysterectomy or neuter. Survival at 6 months and 1 year post-diagnosis were 72.3% and 60.5%, respectively, and survival was not affected by sex or age. Using Cox proportional hazard analyses, we determined that the most significant factors influencing survival were the severity of clinical signs at the time of diagnosis and application of an aggressive treatment strategy after diagnosis. Dogs that were not treated aggressively were >5 times more likely to die than dogs that were treated with a combination of surgery/lavage and high doses of fenbendazole.