Age- and Sex-Specific Differences in Lyme Disease Health-Related Behaviors, Ontario, Canada, 2015-2022.

We investigated differences in risk factors and preventive behaviors by age and sex among persons with reported Lyme disease in Ontario, Canada, during 2015-2022. Incidence rates peaked among children 5-9 and adults 50-79 years of age. Median age was higher for female than male case-patients (54 vs.

Pathogen prospecting of museums: Reconstructing malaria epidemiology.

Malaria is a disease of global significance. Ongoing changes to the earth's climate, antimalarial resistance, insecticide resistance, and socioeconomic decline test the resilience of malaria prevention programs. Museum insect specimens present an untapped resource for studying vector-borne pathogens, spurring the question: Do historical mosquito collections contain DNA, and, if so, can museum specimens be used to reconstruct the historical epidemiology of malaria? In this Perspective, we explore molecular techniques practical to pathogen prospecting, which, more broadly, we define as the science of screening entomological museum specimens for human, animal, or plant pathogens.

Rurality, Socioeconomic Status, and Residence in Environmental Risk Areas Associated with Increased Lyme Disease Incidence in Ontario, Canada: A Case-Control Study.

Lyme disease (LD) is the most common tick-borne illness in North America. LD is acquired through exposure to the tick vector, , known as the blacklegged tick. In Canada, LD is rapidly emerging, with the establishment of in many newly endemic regions posing a growing risk to local communities.

American dog ticks along their expanding range edge in Ontario, Canada.

The American dog tick, Dermacentor variabilis, is a tick of public and veterinary health importance in North America. Using passive tick surveillance data, we document distribution changes for the American dog tick in Ontario, Canada, from 2010 through 2018. Dermacentor variabilis submissions from the public were geocoded and aggregated-from large to small administrative geographies-by health region, public health unit (PHU) and Forward Sortation Area (FSA).

Surveillance for Lyme disease in Canada, 2009-2019.

Background: Lyme disease (LD) is a multisystem infection that can affect the skin, heart, joints and nervous system. In Canada, the incidence of LD cases has increased over the past decade making this a disease of public health concern. The objective of this study is to summarize the epidemiology of LD cases reported in Canada from 2009 through 2019.

A Computer Vision Approach to Identifying Ticks Related to Lyme Disease.

Lyme disease (caused by ) is an infectious disease transmitted to humans by a bite from infected blacklegged ticks () in eastern North America. Lyme disease can be prevented if antibiotic prophylaxis is given to a patient within 72 hours of a blacklegged tick bite. Therefore, recognizing a blacklegged tick could facilitate the management of Lyme disease.

Monitoring the patterns of submission and presence of tick-borne pathogens in Ixodes scapularis collected from humans and companion animals in Ontario, Canada (2011-2017).

Background: The universal nature of the human-companion animal relationship and their shared ticks and tick-borne pathogens offers an opportunity for improving public and veterinary health surveillance. With this in mind, we describe the spatiotemporal trends for blacklegged tick (Ixodes scapularis) submissions from humans and companion animals in Ontario, along with pathogen prevalence.

Methods: We tested tick samples submitted through passive surveillance (2011-2017) from humans and companion animals for Borrelia burgdorferi, Borrelia miyamotoi, Anaplasma phagocytophilum and Babesia microti.

Assessing human exposure to spotted fever and typhus group rickettsiae in Ontario, Canada (2013-2018): a retrospective, cross-sectional study.

Background: Assessing the burden of rickettsial infections in Ontario, Canada, is challenging since rickettsial infections are not reportable to public health. In the absence of reportable disease data, we assessed the burden of rickettsial infections by examining patient serological data and clinical information.

Methods: Our retrospective, cross-sectional study included patients who had Rickettsia serological testing ordered by their physician, in Ontario, from 2013 to 2018.

An apparent, locally acquired case of rickettsialpox () in Ontario, Canada.

Rickettsialpox, caused by , is a spotted fever group rickettsiae transmitted to humans through the bite of the house mouse mite (). Worldwide, rickettsialpox is most commonly associated with exposure to rodents in urban environments. Here, we present the case of a 47-year-old woman from Brantford, Ontario, with fever, eschar on the right leg, expanding erythema, and right groin lymphadenopathy.

The direct healthcare costs attributable to West Nile virus illness in Ontario, Canada: a population-based cohort study using laboratory and health administrative data.

Background: West Nile virus (WNV) is a mosquito-borne flavivirus, first detected in the Western Hemisphere in 1999 and spread across North America over the next decade. Though endemic in the most populous areas of North America, few studies have estimated the healthcare costs associated with WNV. The objective of this study was to determine direct healthcare costs attributable to WNV illness in Ontario, Canada.

Detection of municipalities at-risk of Lyme disease using passive surveillance of Ixodes scapularis as an early signal: A province-specific indicator in Canada.

Lyme disease, the most commonly reported vector-borne disease in North America, is caused by the spirochete Borrelia burgdorferi sensu stricto, which is transmitted by Ixodes scapularis in eastern Canada and Ixodes pacificus in western Canada. Recently, the northward range expansion of I. scapularis ticks, in south-eastern Canada, has resulted in a dramatic increase in the incidence of human Lyme disease.

Estimating direct healthcare costs attributable to laboratory-confirmed Lyme disease in Ontario, Canada: A population-based matched cohort study using health administrative data.

The objective of this study was to determine healthcare costs attributable to laboratory-confirmed Lyme disease (LD) from the healthcare payer perspective in Ontario, Canada. A cost-of-illness study was conducted for incident LD subjects from 1 January 2006 through 31 December 2013 ascertained from provincial laboratory and reportable disease databases, linked to health administrative data. All LD subjects included were laboratory-confirmed, according to provincial case definitions.

Evaluating the impact of Aedes japonicus invasion on the mosquito community in the Greater Golden Horseshoe region (Ontario, Canada).

Background: Aedes japonicus was first documented in Ontario, Canada, in 2001. The objective of this study was to determine the effect of Ae. japonicus establishment on the abundance of other mosquitoes in the Greater Golden Horseshoe (GGH) region of Ontario.

Occurrence and distribution of Ambylomma americanum as determined by passive surveillance in Ontario, Canada (1999-2016).

The lone star tick, Amblyomma americanum, is spreading northward from its historical stronghold in the southeastern United States. As a vector and biting pest, public and veterinary health officials must remain vigilant of the lone star tick's expanding range. We use ticks submitted to Public Health Ontario Laboratory (1999-2016) to describe the spatial and temporal dynamics of A.

Distribution of in Northwestern Ontario: Results from Active and Passive Surveillance Activities in the Northwestern Health Unit Catchment Area.

The range of is expanding in Ontario, increasing the risk of Lyme disease. As an effective public health response requires accurate information on disease distribution and areas of risk, this study aims to establish the geographic distribution of and its associated pathogen, , in northwestern Ontario. We assessed five years of active and passive tick surveillance data in northwestern Ontario.

Characterizing the health and information-seeking behaviours of Ontarians in response to the Zika virus outbreak.

Objectives: The purpose of this study is to describe the impact of the 2016 Zika virus (ZIKV) outbreak on the health-seeking and information-seeking behaviours of Ontarians.

Methods: A timeline that included events and announcements from health agencies was constructed to describe the unfolding of the ZIKV outbreak between January 1 and September 30, 2016. In order to gain an understanding of the information and health-seeking behaviours of Ontarians, data from the following sources were collected and analyzed descriptively over time in 1-week intervals: trends in web searches, calls to a provincial telemedicine advice line, test submissions to the provincial laboratory and Zika-related media coverage.

Clinical manifestations of reported Lyme disease cases in Ontario, Canada: 2005-2014.

Lyme disease (LD) is the most common vector-borne disease in Ontario, Canada. We describe the epidemiology and clinical manifestations of LD in Ontario and examine trends in the incidence of non-disseminated and disseminated LD. LD surveillance data from the integrated Public Health Information System (iPHIS) from 2005-2014 were mapped to symptoms according to syndrome groups (erythema migrans (EM), flu-like, cardiac, neurologic or arthritic) and disease stages (early localized, early disseminated or late disseminated).

Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review.

Background: Clinical syndromes associated with West Nile virus (WNV) infection range from fever to neuroinvasive disease. Understanding WNV epidemiology and disease history is important for guiding patient care and healthcare decision-making. The objective of this review was to characterize the existing body of peer-reviewed and surveillance literature on WNV syndromes and summarize epidemiologic and clinical parameters.

Zika Virus in Ontario: Evaluating a Rapid Risk Assessment Tool for Emerging Infectious Disease Threats.

To determine the Ontario-specific risk of local and travel-related Zika virus transmission in the context of a public health emergency of international concern, Public Health Ontario (PHO) completed a rapid risk assessment (RRA) on January 29, 2016, using a newly developed RRA guidance tool. The RRA concluded that risk of local mosquito-borne transmission was low, with a high risk of imported cases through travel. The RRA was updated 3 times based on predetermined triggers.

Human pathogens associated with the blacklegged tick Ixodes scapularis: a systematic review.

Background: The blacklegged tick Ixodes scapularis transmits Borrelia burgdorferi (sensu stricto) in eastern North America; however, the agent of Lyme disease is not the sole pathogen harbored by the blacklegged tick. The blacklegged tick is expanding its range into areas of southern Canada such as Ontario, an area where exposure to blacklegged tick bites and tick-borne pathogens is increasing. We performed a systematic review to evaluate the public health risks posed by expanding blacklegged tick populations and their associated pathogens.