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Chapter 12 : A Convergence of Tick-Transmitted Diseases within the Lyme Disease Transmission Cycle
Category: Clinical Microbiology
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This chapter provides a description of the three zoonotic diseases now known to be transmissible to humans by the deer tick, Ixodes scapularis (also known as Ixodes dammini). The convergence of these and other organisms within the Lyme disease transmission cycle may represent a clinical challenge as well as a scientific opportunity to study the immunologic interactions of pathogens in a naturally occurring model of coinfection and cotransmission. Because the three infections may require different approaches to therapeutic management, development of an understanding of the natural history of infection with Babesia and Ehrlichia spp. may become critical to understanding their importance in the Lyme disease transmission cycle. Application of broad-range PCR and other pathogen discovery techniques has the potential to expand the litany of pathogens known to be transmitted by deer ticks, with the ultimate goal of clarifying the role of the known and perhaps soon-to-be-known cold-zone pathogens within the transmission cycle of Lyme disease. White-footed mice appear to be a reservoir for all three of these known human pathogens (Borrelia, Ehrlichia, and Babesia) and are commonly coinfected themselves. Further research is necessary to define the full complement of microbial agents involved in the Lyme disease transmission cycle and to elucidate further the possible immunologic interactions of these pathogens.