# DOD Efforts in Tick Surveillance and 

# Preventing Tick- Borne Disease in

the US
Ellen Stromdahl Entomological Science Program 

# U.S. Army Public Health Command

UNCLASSIFIED

# Tick- borne Disease is an Occupational Health Risk for Military Personnel

2 UNCLASSIFIED Tick- Borne Disease Laboratory

# Deer on Military Installations

3 UNCLASSIFIED Tick- Borne Disease Laboratory4 UNCLASSIFIED Tick- Borne Disease Laboratory 

# • 

# Tick and Tick- Borne Disease 

# Surveillance

• Tick Taxonomy / Imaging

• Tick Repellents

# Ticks are collected by a variety of methods 

# Tick Drag, CO2 trap Small, medium, large mammals SAMPLE INFORMATION TEST ORGANISM Coll’n method Sample

type Bb

#/D/%D Ec

#/D/%D Ee

#/D/%D Ap

#/D/%D Babesia

#/D/%D Rickettsia

#/D/%D Drag A. americanum Non vector 82/1/1% 82/4/5% Non -vector Non -vector 82/0/0% Drag D. variabilis Non vector Non vector Non vector Non -vector Non -vector 33/0/0% Drag I. scapularis 1/0/0% Non vector Non vector 1/0/0% 1/0/0% Non -vector Drag A. maculatum Non vector Non vector Non vector Non -vector Non -vector 2/1/50% 1 Coyote A. maculatum Non vector Non vector Non vector Non -vector Non -vector 2/1/50% 1 Drag I. affinis 2 3/1/33% Non vector Non vector 3/0/0% 3/2/67%3 Non -vector

1 Rickettsia parkerii positive causative agent of Tidewater Fever 2 5 collected 3 tested 2 submitted to US National Tick Collection as voucher 3 Babesia canis 

# PHC Region - North

# Threatmap with Proposed Tick Control

# Laboratory identification and PCR analysis during the Jamboree to determine the infection rate of ticks
TICK INFORMATION TEST RESULTS TICK ID # TICKS

TESTED HME

#D (%D) EE

#D (%D) Rr

#D (%D) Ap

#D (%D) LD

#D (%D) Babesia

#D (%D) A. americanum 124 1 3 (2%) 7 (6%) Non -vector Non -vector Non -vector Non -vector D. variabilis 161 2 Non -vector Non -vector 0 (0%) Non -vector Non -vector Non -vector I. scapularis 3 Non -vector Non -vector Non -vector 0 (0%) 0 (0%) 0 (0%) TOTAL 288 

# Scouts’ ticks tested at the Jamboree PHC Region - North

# DOD Human Tick Test Kit Program Clinical support for health 

# care providers and their tick- bite patients Tick I.D. and analysis

• Lyme disease
• Human granulocytic anaplasmosis
• Babesiosis


# • Human monocytic ehrlichiosis
• Ewingii ehrlichiosis
• R. parkeri rickettsiosis

• Rocky Mountain spotted fever 9 UNCLASSIFIED Tick- Borne Disease Laboratory

# Locations of Tick Test Kit Program Participants

10 UNCLASSIFIED Tick- Borne Disease Laboratory11 UNCLASSIFIED Tick- Borne Disease Laboratory

# Publications – ticks and tick - borne pathogens

• Sardelis MR, Neidhardt K, Perich MJ, Milstrey EG, Harlan HJ, Boobar LR. Reduction of the Amblyomma americanum ( acari:Ixodidae ) population at Fort A.P. Hill, Virginia by aerial application of diazinon granules: correlation of percentage control with received dose. J Med Entomol. 1989 26:494. 

## • Evans SR, Korch GW Jr , Lawson MA. Comparative field evaluation of permethrin and deet - treated military uniforms for personal protection against ticks ( Acari ). J Med Entomol. 1990 27:829 - 34. 

## • Kardatzke , JT, Neidhardt , K, Dzuban , DP Sanchez, JL,et al. Cluster of tick - borne infections at Fort Chaffee, AR: rickettsiae and Borrelia burgdorferi in Ixodid ticks. J Med Entomol 1992; 29:669–72. 

## • Amerasinghe FP, Breisch NL, Azad AF, Gimpel WF, Greco M, Neidhardt K, Pagac B, Piesman J, Sandt J, Scott TW, et al. Distribution, density, and Lyme disease spirochete infection in Ixodes dammini ( Acari:Ixodidae ) on white - tailed deer in Maryland. J Med Entomol. 1992 29:54 - 61. 

## • Solberg VB, Neidhardt K, Sardelis MR, Hildebrandt C, Hoffmann FJ, Boobar LR. Quantitative evaluation of sampling methods for Ixodes dammini and Amblyomma americanum (Acari:Ixodidae ) . J Med Entomol. 1992 29:451 - 6. 

## • Solberg VB, Neidhardt K, Sardelis MR, Hoffmann FJ, Stevenson R, Boobar LR, Harlan HJ. Field evaluation of two formulations of cyfluthrin for control of Ixodes dammini and Amblyomma americanum (Acari : Ixodidae ). J Med Entomol. 1992 29:634 - 8. 

## • Amerasinghe FP, Breisch NL, Neidhardt K, Pagac B, Scott TW. Increasing density and Borrelia burgdorferi infection of deer- infesting Ixodes dammini (Acari : Ixodidae ) in Maryland. J Med Entomol. 1993 30:858 - 64. 

## • Stromdahl, EY, Randolph, MP, O'Brien, JJ, Gutierrez, AG.. Ehrlichia chaffeensis ( Rickettsiales : Ehrlichieae ) infection in Amblyomma americanum (Acari : Ixodidae ) at Aberdeen Proving Ground, Maryland. J Med Entomol 2000 37:349 - 356. 

## • Stromdahl, EY, Evans, SR, O'Brien, JJ, Gutierrez, AG. Prevalence of infection in ticks submitted to the human tick test kit p rog ram of the U.S. Army Center for Health Promotion and Preventive Medicine. J Med Entomol 2001; 38:67 - 74. 

## • Stromdahl, EY, Williamson, PC, Kollars , TM Jr , Evans, SR, et al. Evidence of Borrelia lonestari DNA in Amblyomma americanum (Acari : Ixodidae ) removed from humans. J Clin Microbiol 2003; 41:5557 - 5562. 

## • Sumner, JW, Durden , LA, Goddard, J, Stromdahl, EY, Clark, KL, Reeves, WK and Paddock, CD. A survey of gulf coast ticks (Amblyomma maculatum) for Rickettsia parkeri in the United States. Emerg Infect Dis. 2007 13:751 - 3 

## • Loftis, AD, Mixson, TR, Stromdahl , EY, Yabsley , M J, Garrison, LE, Williamson, PC, Fitak , R R , Fuerst , PA and Blount K.B. Geographic distribution and genetic diversity of the Ehrlichia sp. from Panola Mountain . BMC Infect Dis 2008; 8:54 

## • Stromdahl, EY, Vince, MA, Billingsley, PM, Dobbs, NA, et al. Rickettsia amblyommii infecting Amblyomma americanum larvae. Vector Borne Zoonotic Dis 2008; 8: 15 - 24. 

## • Jiang, J, Yarina , T Melissa K. Miller, Ellen Y. Stromdahl, Allen L. Richards. Molecular detection of Rickettsia amblyommii in Amblyomma americanum parasitizing humans . Vector Borne Zoonotic Dis 2010 10:329 - 40. 

## • Ellen Y. Stromdahl, Ju Jiang , Mary Vince and Allen L. Richards. Infrequency of Rickettsia rickettsii in Dermacentor variabilis Removed from Humans. Vector Borne Zoonotic Dis 2010 ( Epub ahead of print) 

## • Eremeeva, ME, Stromdahl, EY. New spotted fever group Rickettsia in a Rhipicephalus turanicus tick removed from a child in eastern Sicily, Italy. Am J Trop Med Hyg . 2011 84:99 - 101

# Field - portable macro imaging device for arthropod identification http://phc.amedd.army.mil/PHC%20Resource%20Library/MacroimagingPortfolio.pdf

# TickMap

• www.tickmap.org • Downloadable collection form • >50,000 records • New website (requires Silverlight): www.vectormap.org

# Relate vector distribution to collection records

# How to contribute collection records

Collection forms Excel Mapper

# www.afhsc.mil/msmr

# Defense Medical Epidemiology

Database: http://www.afhsc.mil/aboutDmed1,330,000 1,340,000 1,350,000 1,360,000 1,370,000 1,380,000 1,390,000 1,400,000 1,410,000 1,420,000

0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Number of trrops by year Number of cases (not population adjusted) 

# Reported cases of various vector- borne diseases in the military 2000 -2009 (source AFHSC's DMED website)

Malaria (hospital) All arthropod - borne diseases Leishmaniasis (ambulatory) Arboviruses (hospitalized) Troop population

# DEVELOPMENT OF MOLECULAR ASSAYS FOR 

# DETECTING TICK- BORNE PATHOGENS

## qPCR assays for detection of Rickettsia in ticks Rickettsia genus assay - Rick17b tick-borne spotted fever group assay - Trick species specific assays:



# R. rickettsii
- Rrick R.parkeri - Rpark Candidatus R. andeanae - Rande R.felis - Rfelis R. montanensis - Rmont 

# R.amblyommii- Rambl R.conorii - Rcono R.africa - Rafri R.raoultii - Rraou R.slovaca - Rslov R.aeschlimannii - Raesc qPCR assays avalible for detection of other tick- borne pathogens 

# Borrelia lonestari 

# Borrelia burgdorferi Ehrlichia chaffeensis E. canis Anaplasma phagocytophilum Coxiella burnetii qPCR assays avalible for identification of tick species 

# Amblyomma americanum Dermacentor variabilis 

# Ixodes scapularis Ixodes pacificus 

# Quantitative real - time PCR(qPCR) assays

Multilocus Sequencing Typing (MLST) Primers are designed to amplify the well known genes for characterization of Rickettsia : 16s rRNA gene, 17 kDa antigen gene, gltA, ompA,ompB, and sca4

## • Stromdahl EY, Jiang J, Vince M, Richards AL. Infrequency of Rickettsia rickettsii in Dermacentor variabilis

removed from humans, with comments on the role of other human -biting ticks associated with spotted fever group rickettsiae in the United States. Vector Borne Zoonotic Dis 2010 (Epub ahead of print) • Smith MP, Ponnusamy L, Jiang J, Ayyash LA, Richards AL, Apperson CS. Bacterial pathogens in ixodid ticks from a Piedmont County in North Carolina: prevalence of rickettsial organisms. Vector Borne Zoonotic Dis. 2010 Dec;10(10):939 - 52 • Jiang J, Yarina T, Miller MK, Stromdahl EY, Richards AL. Molecular Detection of Rickettsia amblyommii in 

## Amblyomma americanum Parasitizing Humans. Vector Borne Zoonotic Dis 2010 May;10(4):329 - 40. • Whitman TJ, Richards AL, Paddock CD, Tamminga CL, Sniezek PJ, Jiang J, Byers DK, Sanders JW. Rickettsia parkeri infection after tick bite, Virginia. Emerg Infect Dis 2007;13(2):334 - 6. • Wright CL, Nadolny RM, Jiang J, Richards AL, Sonenshine DE, Gaff HD, Hynes WL. R. parkeri found in A. maculatum from VA. Emerg Infect Dis 2011 • Jiang J, Stromdahl EY, Richards AL. Detection of Rickettsia parkeri and Candidatus Rickettsia andeanae in Amblyomma maculatum Gulf Coast Ticks Collected from Humans in the United States. Vector Borne Zoonotic Dis (submitted) • Rozmajzl PJ, Flyer JG, Jiang J, Stromdahl EY, and Richards AL. Development of a Quantitative Real - time Polymerase Chain Reaction (qPCR) Assay for the Detection of Rickettsia montanensis Validated with Dermacentor variabilis Collected from Humans. Am J Trop Med Hyg . 2011 (submitted) 

## • Truong M, Jiang J; Yarina T, Evans H, Turner J, Miller M, Christensen TP, Richards AL. Rickettsia parkeri and Ehrlichia chaffeensis Detected in Ixodidae Ticks from Fort Eustis, Virginia. Am J Trop Med Hyg . 2011 (submitted) 

# Publications - detection of tick - borne pathogens

# Prevalence and Clinical Characteristics of 

# Infection Caused by the Newly Emerging Pathogen, Rickettsia parkeri, in Adults and Children Presenting to Clinics and 

# Emergency Departments with Acute

Febrile Illness. Todd Myers, PhD 

# Naval Medical Research Center Silver Spring MD

# TICK TESTING & 

# HUMAN DIAGNOSTICS 

# +

# LITERATURE RETRIEVAL SYSTEM



# ARMED FORCES PEST MANAGEMENT BOARD 

# www.afpmb.org

DVD ON TICK IDENTIFICATION

# IMAGE LIBRARY

Dr. Henry Hoogstraal



# ARMED FORCES PEST MANAGEMENT BOARD 

# www.afpmb.org

# DoD Insect Repellent System DoD Insect Repellent System 

# =

# 0.5% PERMETHRIN Aerosol Spray Can NSN 6840- 01 - 278 - 1336 Military Commercial

29 UNCLASSIFIED Tick- Borne Disease Laboratory

# PERMETHRIN Impregnation (IDA) Kit NSN 6840 - 01 - 345 - 0237

# PERMETHRIN Application using 2 - Gallon Sprayer

# USDA ARS CMAVE has developed a test procedure to ensure military uniforms are correctly treated to protect troops from arthropod bites.

Deployed War- Fighter Protection (DWFP) is a DOD - sponsored research program administered by the Armed Forces Pest Management Board

(AFPMB).

# Permethrin Factory-Treated Flame Resistant



# Army Combat Uniforms (FRACU - P)

# Permethrin Factory-Treated Flame Resistant



# MultiCam Uniforms (Afghanistan)

# U.S. Army Public Health Command

Ellen Stromdahl Tick- Borne Disease Laboratory The views expressed in this article are those of 

# the author and do not reflect the official policy or position of the Department of the Army, Department of Defense or the U.S. Government.

37 UNCLASSIFIED