title: Tick-Borne Zoonoses in the United States: Persistent and Emerging Threats to Human Health.
abstract: In the United States, ticks transmit the greatest diversity of arthropod-borne pathogens and are responsible for the most cases of all vector-borne diseases. In recent decades, the number of reported cases of notifiable tick-borne diseases has steadily increased, geographic distributions of many ticks and tick-borne diseases have expanded, and new tick-borne disease agents have been recognized. In this review, we (1) describe the known disease agents associated with the most commonly human-biting ixodid ticks, (2) review the natural histories of these ticks and their associated pathogens, (3) highlight spatial and temporal changes in vector tick distributions and tick-borne disease occurrence in recent decades, and (4) identify knowledge gaps and barriers to more effective prevention of tick-borne diseases. We describe 12 major tick-borne diseases caused by 15 distinct disease agents that are transmitted by the 8 most commonly human-biting ixodid ticks in the United States. Notably, 40% of these pathogens were described within the last two decades. Our assessment highlights the importance of animal studies to elucidate how tick-borne pathogens are maintained in nature, as well as advances in molecular detection of pathogens which has led to the discovery of several new tick-borne disease agents.
authors.affiliation: Rebecca J. Eisen, PhD, is a Research Biologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Kiersten J. Kugeler, PhD, is an Epidemiologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Lars Eisen, PhD, is a Research Entomologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Charles B. Beard, PhD, is a Branch Chief in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Christopher D. Paddock, MD, is a Medical Officer/Pathologist in the Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Atlanta, Georgia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Eisen
authors.affiliation: Rebecca J. Eisen, PhD, is a Research Biologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Kiersten J. Kugeler, PhD, is an Epidemiologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Lars Eisen, PhD, is a Research Entomologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Charles B. Beard, PhD, is a Branch Chief in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Christopher D. Paddock, MD, is a Medical Officer/Pathologist in the Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Atlanta, Georgia.
authors.forename: Kiersten J
authors.initials: KJ
authors.lastname: Kugeler
authors.affiliation: Rebecca J. Eisen, PhD, is a Research Biologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Kiersten J. Kugeler, PhD, is an Epidemiologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Lars Eisen, PhD, is a Research Entomologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Charles B. Beard, PhD, is a Branch Chief in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Christopher D. Paddock, MD, is a Medical Officer/Pathologist in the Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Atlanta, Georgia.
authors.forename: Lars
authors.initials: L
authors.lastname: Eisen
authors.affiliation: Rebecca J. Eisen, PhD, is a Research Biologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Kiersten J. Kugeler, PhD, is an Epidemiologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Lars Eisen, PhD, is a Research Entomologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Charles B. Beard, PhD, is a Branch Chief in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Christopher D. Paddock, MD, is a Medical Officer/Pathologist in the Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Atlanta, Georgia.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Beard
authors.affiliation: Rebecca J. Eisen, PhD, is a Research Biologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Kiersten J. Kugeler, PhD, is an Epidemiologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Lars Eisen, PhD, is a Research Entomologist in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Charles B. Beard, PhD, is a Branch Chief in the Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Fort Collins, Colorado. Christopher D. Paddock, MD, is a Medical Officer/Pathologist in the Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention in Atlanta, Georgia.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Paddock
mesh_terms: D000818:Animals; D006801:Humans; D017282:Tick-Borne Diseases / Q000453:epidemiology*; D013987:Ticks / Q000469:parasitology*; D014481:United States / Q000453:epidemiology; D015047:Zoonoses / Q000453:epidemiology*