Bacterial Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO.
Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
J Med Entomol. 2021 Jul 16;58(4):1490-1502. doi: 10.1093/jme/tjaa087.
In recent decades, tickborne disease (TBD) cases and established populations of medically important ticks have been reported over expanding geographic areas, and an increasing number of tickborne bacteria, viruses, and protozoans have been recognized as human pathogens, collectively contributing to an increasing burden of TBDs in the United States. The prevention and diagnosis of TBDs depend greatly on an accurate understanding by the public and healthcare providers of when and where persons are at risk for exposure to human-biting ticks and to the pathogens these ticks transmit. However, national maps showing the distributions of medically important ticks and the presence or prevalence of tickborne pathogens are often incomplete, outdated, or lacking entirely. Similar deficiencies exist regarding geographic variability in host-seeking tick abundance. Efforts to accurately depict acarological risk are hampered by lack of systematic and routine surveillance for medically important ticks and their associated human pathogens. In this review, we: 1) outline the public health importance of tick surveillance; 2) identify gaps in knowledge regarding the distributions and abundance of medically important ticks in the United States and the presence and prevalence of their associated pathogens; 3) describe key objectives for tick surveillance and review methods appropriate for addressing those goals; and 4) assess current capacity and barriers to implementation and sustainability of tick surveillance programs.
在最近几十年中，已报告称在不断扩大的地理区域内出现了蜱传疾病（TBD）病例和具有重要医学意义的蜱虫定殖种群，越来越多的蜱传细菌、病毒和原生动物已被确认为人类病原体，这些病原体共同导致美国 TBD 的负担不断增加。TBD 的预防和诊断在很大程度上取决于公众和医疗保健提供者是否准确了解在何处以及何时存在人员接触到叮咬人类的蜱虫以及这些蜱虫传播的病原体的风险。然而，显示具有重要医学意义的蜱虫分布情况以及蜱传病原体存在或流行情况的全国性地图往往是不完整、过时的，或者完全缺乏。关于宿主寻找蜱虫丰度的地理变异性也存在类似的缺陷。由于缺乏对具有重要医学意义的蜱虫及其相关人类病原体的系统和常规监测，因此难以准确描绘节肢动物学风险。在这篇综述中，我们：1）概述蜱虫监测对公共卫生的重要性；2）确定了关于美国具有重要医学意义的蜱虫分布和丰度以及与它们相关的病原体存在和流行情况的知识差距；3）描述了蜱虫监测的主要目标，并回顾了适用于解决这些目标的方法；4）评估了实施和可持续性的当前能力和障碍。
