Paul Mead, MD MPH

Centers for Disease Control and Prevention

Division of Vector-borne Diseases

Fort Collins Colorado

TickNet 

Lyme and Other Tickborne Diseases 

Prevention Study 
TickNet

 Established in 2007 to foster coordination 

among public health officials on surveillance, 

research, education, and prevention of 

tickborne diseases

 Collaborators: state & local health 

departments, CDC DVBD, DPDM & Emerging 

Infections Program (EIP)

 Current extramural program goals: 

 Support and enhance surveillance (ELC)*

 Applied research (EIP)

*Epidemiology and Laboratory Capacity Cooperative Agreement 
TickNet Extramural Funding 2010

$1,876,346

Tier 1 ELC

EIP site

Tier 2 ELC

Epidemiology and Laboratory Capacity cooperative agreement (ELC) Emerging Infections Program (EIP)
Current TickNet Research Projects

 Laboratory Survey (CT, MD, MN, NY)

Two stage survey to evaluate national testing 

volumes, test type, and rate of positivity among 

commercial, clinical and state laboratories for 5 

tickborne diseases 
Current TickNet Research Projects

 Laboratory Survey (CT, MD, MN, NY)

 Underreporting Study (MD, MN, NY)

Quantify underreporting of physician-diagnosed 

Lyme disease and assess medical record coding 

practices
Current TickNet Research Projects

 Laboratory Survey (CT, MD, MN, NY)

 Underreporting Study (MD, MN, NY)

 Active Surveillance for RMSF and Erythema

Migrans in Western Tennessee (TN)

Active surveillance to better define epidemiology 

and clinical features of spotted fever group 

rickettsioses and EM in four west-central Tennessee 

counties 
Current TickNet Research Projects

 Laboratory Survey (CT, MD, MN, NY)

 Underreporting Study (MD, MN, NY)

 Active Surveillance for RMSF and Lyme-like 

Illness in Western Tennessee (TN)

 Lyme and Other Tickborne Diseases 

Prevention Study (CT, MD, NY)
Lyme and Other Tickborne Diseases 

Prevention Study

 Not a pesticide or IPM trial 

 Randomized, blinded, placebo-controlled 

trial to assess the efficacy of a targeted, 

single, springtime application of a 

commercially available acaricide

 Primary outcome measure is prevention of 

human illness due to tickborne diseases
Pesticides Kill Ticks

 Single application of granular deltamethrin

reduced nymphal I. scapularis 95% at 9 

days1

 Single spray application of bifenthrin 

(Talstar) significantly reduced I. scapularis

nymphs, larvae, and adults up to 41 weeks 

post spray2

1. Schultze et al. Ent Soc Am 2001

2. Rand et al. J Med Ent 2010
Substantial Minority of Households Use 

Chemical Pesticides to Kill Ticks

 29% of 2,400 Connecticut households 

used within the previous year1

 7% of 900 New England/Mid Atlantic 

households used currently2

 Applications up to 4 times per year

1. Gould et al. Vector-Borne Zoo Dis 2007

2. CDC Unpublished data
The Problem

Residential acaricide use has not been shown 

to reduce tickborne disease in humans 

 If it doesn’t work, people shouldn’t use it 

 If it does work... 

 evidence to promote greater usage

 data need for cost/benefit analysis

 impetus for finding safer acaricides or 

other methods of yard-based control
LTDPS Methods I

 ~1600 households in 3 states (NY, CT, MD)

 Recruited through fliers, advertisements, 

and targeted mailings to county residents

 Inclusion criteria

 Households with >2 residents

 Freestanding, private property, 

 Lot size 1⁄2 to 5 acres 

 Not within 100 feet of water bodies

 Not treated in previous year
Study Locations

New York 

 Dutchess

Connecticut

 Fairfield

Maryland 

 Baltimore

 Howard

 Harford
LTDPS Methods II

 Houses randomized to receive single 

application of water or bifenthrin

 Applications between May 1 and June 15 

using backpack sprayer

 Applied to ecotone 10 feet into lawn and 

20 feet into brush or wooded areas

 Post-treatment tick collection and 

pathogen testing for 10% of properties
67%

Where the wild ticks are

22%

2%

Stafford, CAES, 2007
Outcome measures

 Monthly surveys to ascertain tick bites and 

ticks found on participants and pets

 Self-reported tickborne disease during study 

period

 Medical record review to validate reported 

illness
Timeline 2011

 Mar - Apr Enroll and survey

 May - June Randomize and treat

 June - Sept Monthly surveys

 Oct - Nov Final survey, chart review
Acknowledgments

Connecticut Emerging Infections Program

Connecticut Department of Public Health

School of Public Health at Yale University

James Meek Julie Ray Neeta Connally

Maryland Emerging Infections Program

Maryland Department of Health and Mental Hygiene

Katherine Feldman Erin Jones 

Patricia Ryan S.B. Wee

New York State Emerging Infections Program

New York Department of Health

Bryon Backenson Jennifer Hallisey 

Gary Lukacik Mark VanDeusen
Acknowledgments

Division of Vector-Borne Diseases

Alison Hinckley Ashley Kay

Kiersten Kugeler Jennifer McQuiston

Anna Perea Joe Piesman

Mark Dolan Emily Zielinski-Gutierrez

Division of Parasitic Diseases and Malaria

Barbara Herwaldt

CDC

Disclaimer: The findings and conclusions in this presentation are those of the authors and do 

not necessarily represent the views of the Centers for Disease Control and Prevention.
For more information visit:

www.betickfree.com