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Arthropod-Borne Diseases: The Camper’s Uninvited Guests

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  • Author: Gregory Juckett1
  • Editor: David Schlossberg2
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: West Virginia University School of Medicine, Morgantown, WV 26506; 2: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
  • Received 25 November 2014 Accepted 06 February 2015 Published 31 July 2015
  • Gregory Juckett, gjuckett@hsc.wvu.edu
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  • Abstract:

    Arthropod-borne diseases are a major problem whenever outdoor activities bring arthropods and people into contact. The arthropods discussed here include arachnids (ticks) and insects. Most arthropod bites and stings are minor, with the notable exception being bee-sting anaphylaxis. Ticks cause the most disease transmission. Key hard tick vectors include black-legged (), dog (), and lone star () ticks, which transmit Lyme and various rickettsial diseases. Insect repellents, permethrin sprays, and proper tick inspection reduce this risk significantly. Lyme disease and the milder southern-tick-associated rash illness (STARI) are characterized by the erythema migrans rash followed, in the case of Lyme disease, by early, disseminated, and late systemic symptoms. Treatment is with doxycycline or ceftriaxone. Indefinite treatment of “chronic Lyme disease” based on subjective symptoms is not beneficial. Rickettsial diseases include ehrlichiosis, anaplasmosis, and Rocky Mountain spotted fever, which are characterized by fever, headache, and possible rash and should be empirically treated with doxycycline while awaiting laboratory confirmation. Tularemia is a bacterial disease () spread by ticks and rabbits and characterized by fever and adenopathy. Treatment is with gentamicin or streptomycin. Babesiosis is a protozoal disease, mimicking malaria, that causes a self-limited flu-like disease in healthy hosts but can be life threatening with immune compromise. Treatment is with atovaquone and azithromycin. Other tick-related conditions include viral diseases (Powassan, Colorado tick fever, heartland virus), tick-borne relapsing fever (), and tick paralysis (toxin). Mosquitoes, lice, fleas, and mites are notable for their annoying bites but are increasingly significant disease vectors even in the United States.

  • Citation: Juckett G. 2015. Arthropod-Borne Diseases: The Camper’s Uninvited Guests. Microbiol Spectrum 3(4):IOL5-0001-2014. doi:10.1128/microbiolspec.IOL5-0001-2014.

Key Concept Ranking

Eastern Equine Encephalitis
0.58027476
Infectious Diseases
0.5653412
Human Lyme Disease
0.5442656
Rocky Mountain Spotted Fever
0.51119447
0.58027476

References

1. Bratton RL, Whiteside JW, Hovan MJ, Engle RL, Edwards FD. 2008. Diagnosis and treatment of Lyme disease. Mayo Clin Proc 83:566–571. [PubMed][CrossRef]
2. Clark RP, Hu LT. 2008. Prevention of Lyme disease and other tick-borne infections. Infect Dis Clin North Am 22:381–396, vii. [PubMed][CrossRef]
3. Dana AN. 2009. Diagnosis and treatment of tick infestation and tick-borne diseases with cutaneous manifestations. Dermatol Ther 22:293–326. [PubMed][CrossRef]
4. Dept. of Health and Human Services CDC. 2014. Tickborne Diseases of the United States: A Reference Manual for Health Care Providers, 2nd ed. http://www.cdc.gov/lyme/resources/TickborneDiseases.pdf.
5. Feder HM, Johnson BJ, O’Connell S, Shapiro ED, Steere AC, Wormser GP, Agger WA, Artsob H, Auwaerter P, Dumler JS, Bakken JS, Bockenstedt LK, Green J, Dattwyler RJ, Munoz J, Nadelman RB, Schwartz I, Draper T, McSweegan E, Halperin JJ, Klempner MS, Krause PJ, Mead P, Morshed M, Porwancher R, Radolf JD, Smith RP, Sood S, Weinstein A, Wong SJ, Zemel L, Group AHILD. 2007. A critical appraisal of “chronic Lyme disease.” N Engl J Med 357:1422–1430. [PubMed][CrossRef]
6. Harik NS. 2013. Tularemia: epidemiology, diagnosis, and treatment. Pediatr Ann 42:288–292. [PubMed][CrossRef]
7. Jin H, Wei F, Liu Q, Qian J. 2012. Epidemiology and control of human granulocytic anaplasmosis: a systematic review. Vector Borne Zoonotic Dis 12:269–274. [PubMed][CrossRef]
8. Juckett G. 2013. Arthropod bites. Am Fam Physician 88:841–847. [PubMed]
9. Vannier E, Krause PJ. 2012. Human babesiosis. N Engl J Med 366:2397–2407. [PubMed][CrossRef]
10. Woods CR. 2013. Rocky Mountain spotted fever in children. Pediatr Clin North Am 60:455–470. [PubMed][CrossRef]
11. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelman RB. 2006. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 43:1089–1134. [PubMed][CrossRef]
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2015-07-31
2017-08-19

Abstract:

Arthropod-borne diseases are a major problem whenever outdoor activities bring arthropods and people into contact. The arthropods discussed here include arachnids (ticks) and insects. Most arthropod bites and stings are minor, with the notable exception being bee-sting anaphylaxis. Ticks cause the most disease transmission. Key hard tick vectors include black-legged (), dog (), and lone star () ticks, which transmit Lyme and various rickettsial diseases. Insect repellents, permethrin sprays, and proper tick inspection reduce this risk significantly. Lyme disease and the milder southern-tick-associated rash illness (STARI) are characterized by the erythema migrans rash followed, in the case of Lyme disease, by early, disseminated, and late systemic symptoms. Treatment is with doxycycline or ceftriaxone. Indefinite treatment of “chronic Lyme disease” based on subjective symptoms is not beneficial. Rickettsial diseases include ehrlichiosis, anaplasmosis, and Rocky Mountain spotted fever, which are characterized by fever, headache, and possible rash and should be empirically treated with doxycycline while awaiting laboratory confirmation. Tularemia is a bacterial disease () spread by ticks and rabbits and characterized by fever and adenopathy. Treatment is with gentamicin or streptomycin. Babesiosis is a protozoal disease, mimicking malaria, that causes a self-limited flu-like disease in healthy hosts but can be life threatening with immune compromise. Treatment is with atovaquone and azithromycin. Other tick-related conditions include viral diseases (Powassan, Colorado tick fever, heartland virus), tick-borne relapsing fever (), and tick paralysis (toxin). Mosquitoes, lice, fleas, and mites are notable for their annoying bites but are increasingly significant disease vectors even in the United States.

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Figures

Image of FIGURE 1
FIGURE 1

Tick Identification “Relative sizes of several ticks at different life stages.” Courtesy of United States Centers for Disease Control and Prevention. doi:10.1128/microbiolspec.IOL5-0001-2014.f1

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Image of FIGURE 2
FIGURE 2

Map of Lyme disease distribution: “Reported cases of Lyme disease – 2013.” Courtesy of United States Centers for Disease Control and Prevention. doi:10.1128/microbiolspec.IOL5-0001-2014.f2

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Image of FIGURE 3
FIGURE 3

Erythema migrans “bull’s-eye” rash. Courtesy of CDC/James Gathany (CDC-PHIL ID#9875). doi:10.1128/microbiolspec.IOL5-0001-2014.f3

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Image of FIGURE 4
FIGURE 4

Child’s right hand and wrist displaying the characteristic spotted rash of Rocky Mountain spotted fever. Courtesy of CDC (CDC-PHIL ID #1962). doi:10.1128/microbiolspec.IOL5-0001-2014.f4

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Image of FIGURE 5
FIGURE 5

A tularemia lesion on the dorsal skin of the right hand. Courtesy of CDC/ Dr. Brachman (CDC PHIL ID # 2037). doi:10.1128/microbiolspec.IOL5-0001-2014.f5

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Image of FIGURE 6
FIGURE 6

Babesia blood smear with ring forms and Maltese cross. (From Rogers W. 2011. and , p 2091-2112. Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), . ASM Press, Washington, DC.) doi:10.1128/microbiolspec.IOL5-0001-2014.f6

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Image of FIGURE 7
FIGURE 7

mosquito. Courtesy of CDC/James Gathany (CDC-PHIL ID #9181). doi:10.1128/microbiolspec.IOL5-0001-2014.f7

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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Tables

Generic image for table
TABLE 1

Major clinical manifestations of Lyme disease

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
Generic image for table
TABLE 2

Comparison of HME and HGA symptoms

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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TABLE 3

Common forms of tularemia

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014
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TABLE 4

Mosquito-borne infections in the United States

Source: microbiolspec July 2015 vol. 3 no. 4 doi:10.1128/microbiolspec.IOL5-0001-2014

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