Publications

epidemic and spatial dynamics of lyme disease in new york state, 1990-2000.	lyme disease (ld) occurrence in new york state (nys) has not only increased over time but also spread throughout the state from the original disease focus in southeastern nys. few studies have investigated this epidemic and spatial dynamic in great detail. using data from the nys department of health lyme registry surveillance system, we summarized epidemic and spatial characteristics of ld in nys for the 11-yr time period from 1990 through 2000. new epidemiological trends associated with age, s ...	2005	16363174
detection of antibodies to borrelia burgdorferi in naturally infected horses in the usa by enzyme-linked immunosorbent assay using whole-cell and recombinant antigens.	blood samples were collected from 98 horses suspected of having borreliosis or granulocytic ehrlichiosis in connecticut and new york state, usa during 1985, 1995, and 1996. serum antibodies to borrelia burgdorferi were detected by an enzyme-linked immunosorbent assay (elisa), based on whole-cell and recombinant antigens, in 82 (84%) horses. of the 181 sera tested, 59% were positive, using whole-cell antigens, compared to 48% with protein (p)37 and 35% with vlse antigens. an elisa containing eith ...	2005	15924926
distribution of borreliae among ticks collected from eastern states.	lyme disease is the most commonly reported vector-borne disease in the united states and is transmitted by borrelia burgdorferi-infected ixodes species. the disease is typically characterized by an erythema migrans (em) rash at the site of tick feeding. em rashes have also been associated with feeding by amblyomma americanum ticks despite evidence suggesting that they are incompetent vectors for lyme disease. in 1996, a borrelia organism only recently cultivated in the laboratory was described i ...	2005	16417434
microbiologic evaluation of patients from missouri with erythema migrans.	borrelia lonestari infects amblyomma americanum, the tick species that is the most common cause of tick bites in southeast and south-central united states, and this spirochete has been detected in an erythema migrans (em)-like skin rash in 1 patient. therefore, b. lonestari is considered to be a leading candidate for the etiologic agent of em in this region.	2005	15668867
prospective clinical evaluation of patients from missouri and new york with erythema migrans-like skin lesions.	the most common and most recognizable feature of borrelia burgdorferi infection (lyme disease) is the skin lesion erythema migrans (em). an illness associated with an em-like skin lesion, but which is not caused by b. burgdorferi, occurs in many southern states in the united states (southern tick-associated rash illness [stari], also known as masters disease).	2005	16142659
serologic evaluation of patients from missouri with erythema migrans-like skin lesions with the c6 lyme test.	southern tick-associated rash illness (stari), also known as masters disease, affects people predominantly in the southeast and south central united states. these patients exhibit skin lesions that resemble erythema migrans (em), the characteristic skin lesion in early lyme disease. the etiology of stari remains unknown, and no serologic test is available to aid in its diagnosis. the c6 lyme enzyme-linked immunosorbent assay was used to evaluate coded serum specimens from patients with stari at ...	2006	17028220
strategies for reducing the risk of lyme borreliosis in north america.	the incidence of lyme borreliosis continues to increase in the united states. in 1991, when lyme borreliosis first became a nationally reportable disease to the centers for disease control and prevention (cdc), a total of 9470 cases were reported; in contrast, by 2002 a total of 23,763 cases were reported, >2.5x the total in 1991. area-wide acaricides can be highly effective in killing nymphal ixodes scapularis, with >95% of nymphs killed in studies using cyfluthrin, deltamethrin, or carbaryl. t ...	2006	16524769
molecular analysis of microbial communities identified in different developmental stages of ixodes scapularis ticks from westchester and dutchess counties, new york.	ixodes scapularis ticks play an important role in the transmission of a wide variety of pathogens between various mammalian species, including humans. pathogens transmitted by ticks include borrelia, anaplasma and babesia. although ticks may harbour both pathogenic and non-pathogenic microflora, little is known about how the diversity of the microflora within ticks may influence the transmission of pathogens. to begin addressing this question, we examined the composition of bacterial communities ...	2006	16623735
prevalence of borrelia burgdorferi in small mammals in new york state.	intensive small mammal trapping was conducted in 12 counties in new york state during 1998-2000 to investigate the prevalence and site specificity of the lyme disease spirochete, borrelia burgdorferi in, and presence of the blacklegged tick, ixodes scapularis say on, the wild mice peromyscus leucopus rafinesque and peromyscus maniculatus wagner and other small mammal species. previously captured mice (1992-1997) from throughout new york state also were recruited into the study, providing a total ...	2006	17017230
spatiotemporal bayesian analysis of lyme disease in new york state, 1990-2000.	mapping ordinarily increases our understanding of nontrivial spatial and temporal heterogeneities in disease rates. however, the large number of parameters required by the corresponding statistical models often complicates detailed analysis. this study investigates the feasibility of a fully bayesian hierarchical regression approach to the problem and identifies how it outperforms two more popular methods: crude rate estimates (cre) and empirical bayes standardization (ebs). in particular, we ap ...	2006	16892639
a new view on lyme disease: rodents hold the key to annual risk.		2006	20076583
efficacy of an ospa vaccine preparation for prevention of lyme disease in new york state.	a multicenter, double-blinded, placebo-controlled study was done comparing a 30-microgram dose of a single protein recombinant ospa vaccine preparation with a saline placebo for efficacy in prevention of lyme disease in humans. the ospa vaccine (30-microgram dose) or saline placebo was given intramuscularly at day 0, 1 month later, and 12 months later. cases of possible lyme disease were evaluated clinically and using culture, polymerase chain reaction and immunoblot assays. safety data are bein ...	2007	9717677
an evaluation of a lyme disease prevention program in a working population.	lyme disease vaccine was offered to new york state department of health employees considered at risk for lyme disease because of their job duties. this evaluation was conducted to assess (1) attitudes that affected employees' decisions to accept or decline the vaccine, (2) preventive behaviors among employees who received the vaccine, and (3) effectiveness of the educational modalities offered in improving knowledge of lyme disease and lyme disease vaccine.	2007	16871815
lyme disease--united states, 2003-2005.	lyme disease is caused by the spirochete borrelia burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks (ixodes spp.). early manifestations of infection include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. left untreated, late manifestations involving the joints, heart, and nervous system can occur. a healthy people 2010 objective (14-8) is to reduce the annual incidence of lyme disease to 9.7 new cases per 100,000 population in 1 ...	2007	17568368
the role of lizards in the ecology of lyme disease in two endemic zones of the northeastern united states.	we examined the role of lizards in the ecology of lyme disease in new york and maryland. we collected data on vector tick infestations, measured lizard "realized" reservoir competence for the lyme disease spirochete borrelia burgdorferi, and estimated lizard population density. these data were incorporated into a model that predicts a host's ability to influence the prevalence of b. burgdorferi in the tick population, a primary risk factor in the epidemiology of lyme disease. published data on o ...	2007	17626342
conspicuous impacts of inconspicuous hosts on the lyme disease epidemic.	emerging zoonotic pathogens are a constant threat to human health throughout the world. control strategies to protect public health regularly fail, due in part to the tendency to focus on a single host species assumed to be the primary reservoir for a pathogen. here, we present evidence that a diverse set of species can play an important role in determining disease risk to humans using lyme disease as a model. host-targeted public health strategies to control the lyme disease epidemic in north a ...	2008	18029304
borrelia burgdorferi sensu stricto is clonal in patients with early lyme borreliosis.	lyme borreliosis, the most commonly reported vector-borne disease in north america, is caused by the spirochete borrelia burgdorferi. given the extensive genetic polymorphism of b. burgdorferi, elucidation of the population genetic structure of the bacterium in clinical samples may be relevant for understanding disease pathogenesis and may have applicability for the development of diagnostic tests and vaccine preparations. in this investigation, the genetic polymorphism of the 16s-23s rrna (rrs- ...	2008	18539816
effect of borrelia burgdorferi genotype on the sensitivity of c6 and 2-tier testing in north american patients with culture-confirmed lyme disease.	a potential concern with any serologic test to detect antibodies to borrelia burgdorferi is whether the epitopes incorporated in the test provide sufficient cross-reactivity to detect infection with all of the pathogenic strains of the species. this is a particular concern for the c6 test, which is based on reactivity to a single peptide.	2008	18724824
borrelia burgdorferi genotype predicts the capacity for hematogenous dissemination during early lyme disease.	lyme disease, the most common tickborne disease in the united states, is caused exclusively by borrelia burgdorferi sensu stricto in north america. the present study evaluated the genotypes of >400 clinical isolates of b. burgdorferi recovered from patients from suburban new york city with early lyme disease associated with erythema migrans; it is the largest number of borrelial strains from north america ever to be investigated.	2008	18781866
surveillance for lyme disease--united states, 1992-2006.	lyme disease is a multisystem disease that occurs in north america, europe, and asia. in the united states, the etiologic agent is borrelia burgdorferi sensu stricto, a spirochete transmitted to humans by infected ixodes scapularis and i. pacificus ticks. the majority of patients with lyme disease develop a characteristic rash, erythema migrans (em), accompanied by symptoms of fever, malaise, fatigue, headache, myalgia, or arthralgia. other manifestations of infection can include arthritis, card ...	2008	18830214
impact of host community composition on lyme disease risk.	the drivers of variable disease risk in complex multi-host disease systems have proved very difficult to identify. here we test a model that explains the entomological risk of lyme disease (ld) in terms of host community composition. the model was parameterized in a continuous forest tract at the cary institute of ecosystem studies (formerly the institute of ecosystem studies) in new york state, u.s.a. we report the results of continuing longitudinal observations (10 years) at the cary institute ...	2008	18959321
the united states department of agriculture northeast area-wide tick control project: history and protocol.	the northeast area-wide tick control project (neatcp) was funded by the united states department of agriculture (usda) as a large-scale cooperative demonstration project of the usda-agricultural research service (ars)-patented 4-poster tick control technology (pound et al. 1994) involving the usda-ars and a consortium of universities, state agencies, and a consulting firm at research locations in the five states of connecticut (ct), maryland (md), new jersey (nj), new york (ny), and rhode island ...	2009	19650730
acaricidal treatment of white-tailed deer to control ixodes scapularis (acari: ixodidae) in a new york lyme disease-endemic community.	the efficacy of topically treating white-tailed deer with an acaricide was evaluated in a lyme disease-endemic community of southern new york state. twenty-four 4-poster feeders were placed in a 5.2 km(2) treatment area in bedford, ny, while a site in lewisboro, ny, 4.8 km distant, served as control. treatment periods ran from 15 september to 15 december each fall from 1997 to 2001, and from 15 march to 15 may each spring from 1998 to 2002. corn consumption averaged 15,779 kg in fall sessions an ...	2009	19650732
diluting the dilution effect: a spatial lyme model provides evidence for the importance of habitat fragmentation with regard to the risk of infection.	this paper aims to construct a spatially-explicit model of ixodes scapularis infection in the state of new york, usa, based on climate traits, high-resolution landscape features and patch-connectivity according to graph theory. the degree of risk for infection is calculated based on empirical data of host abundance, previous studies on host infectivity rates and tick preferences towards a given host. the outcome signifies what is called the "recruitment of infection", i.e. an index representing ...	2009	19440959
lyme disease surveillance in the united states, 1983-1986.	during 1983-1986, 5,016 cases of lyme disease were reported to the centers for disease control. cases were acquired in 31 states; however, 86% of the cases were acquired in seven states: massachusetts, rhode island, connecticut, new york, new jersey, wisconsin, and minnesota. for 63% of patients the disease began in summer; 52% recalled a tick bite. erythema chronicum migrans (ecm) occurred in 91% of the patients; arthritis, in 57%; neurologic complications, in 18%; and cardiac manifestations, i ...	2009	2682955
assessment of polymicrobial infections in ticks in new york state.	ixodes scapularis ticks are clinically important hematophagous vectors. a single tick bite can lead to a polymicrobial infection. we determined the prevalence of polymicrobial infection with borrelia burgdorferi, anaplasma phagocytophilum, babesia microti, borrelia miyamotoi, and powassan virus in 286 adult ticks from the two counties in new york state where lyme disease is endemic, utilizing a masstag multiplex polymerase chain reaction assay. seventy-one percent of the ticks harbored at least ...	2010	19725770
babesiosis in lower hudson valley, new york, usa.	although lyme disease has been endemic to parts of the lower hudson valley of new york, united states, for >2 decades, babesiosis has emerged there only since 2001. the number of lower hudson valley residents in whom babesiosis was diagnosed increased 20-fold, from 6 to 119 cases per year during 2001-2008, compared with an ≈1.6-fold increase for the rest of new york. during 2002-2009, a total of 19 patients with babesiosis were hospitalized on 22 occasions at the regional tertiary care center. c ...	2011	21529393
agents of human anaplasmosis and lyme disease at camp ripley, minnesota.	the transmission dynamics of anaplasma phagocytophilum (ap) and borrelia burgdorferi (bb) among ixodes scapularis (is) and mammalian hosts was investigated at camp ripley, an area representative of central minnesota. prevalence of white-footed mouse infection with ap and bb were 20% and 42%, respectively, with a coinfection level of 14%. peak levels of infection with both agents occurred in may. the average levels of seropositivity to ap and bb were 29.3% and 48%, respectively. of the mice infec ...	2011	21867420
comparison of erythema migrans caused by borrelia burgdorferi and borrelia garinii.	abstract background: a comparison of patients with erythema migrans due to borrelia garinii versus borrelia burgdorferi has not been reported. patients and methods: one hundred nineteen patients from new york state with erythema migrans caused by b. burgdorferi were compared with 116 patients from slovenia with erythema migrans due to b. garinii infection. results: patients with b. garinii infection were older, more often reported a tick bite, and developed larger lesions (median largest diamete ...	2011	21612533
Southern Tick-Associated Rash Illness (STARI) in the North: STARI following a tick bite in Long Island, New York.	The most common clinical manifestation of Lyme disease is the characteristic rash, erythema migrans (EM). In the 1980s EM-like eruptions were reported in Missouri and other southeastern states. The EM-like eruptions, which were of unknown etiology, often followed the bite of the Lone Star tick (Amblyomma americanum) and the rash is called STARI (southern tick-associated rash illness). Although the Lone Star tick is found in the Lyme disease-endemic areas of New England and Mid-Atlantic regions o ...	2011	21940418
Molting success of Ixodes scapularis varies among individual blood meal hosts and species.	The blacklegged tick (Ixodes scapularis) is an important vector of emerging human pathogens. It has three blood-feeding stages, as follows: larva, nymph, and adult. Owing to inefficient transovarial transmission, at least for the Lyme disease agent (Borrelia burgdorferi), larval ticks rarely hatch infected, but they can acquire infection during their larval blood meal. Nymphal ticks are primarily responsible for transmitting pathogens to hosts, including humans. The transition from uninfected ho ...	2011	21845946
deer, predators, and the emergence of lyme disease.	lyme disease is the most prevalent vector-borne disease in north america, and both the annual incidence and geographic range are increasing. the emergence of lyme disease has been attributed to a century-long recovery of deer, an important reproductive host for adult ticks. however, a growing body of evidence suggests that lyme disease risk may now be more dynamically linked to fluctuations in the abundance of small-mammal hosts that are thought to infect the majority of ticks. the continuing an ...	2012	22711825
serum antibodies to whole-cell and recombinant antigens of borrelia burgdorferi in cottontail rabbits.	archived serum samples, from 95 eastern cottontail rabbits (sylvilagus floridanus) captured in new york, new york, usa and millbrook, new york, usa, during 1985-86, were analyzed in solid-phase enzyme-linked immunosorbent assays (elisa) for total and class-specific immunoglobulin (ig) m antibodies to whole-cell or recombinant antigens of borrelia burgdorferi sensu stricto. using a polyvalent conjugate, rabbit sera contained antibodies to whole-cell and recombinant antigens (protein [p]35, p37, o ...	2012	22247369
dogs and horses with antibodies to outer-surface protein c as on-time sentinels for ticks infected with borrelia burgdorferi in new york state in 2011.	reported cases of lyme disease (a chronic disease caused by infection with borrelia burgdorferi) in humans increased more than two-fold between 1992 and 2006 in the united states. recently, the annual number of reported human lyme disease cases stabilized (according to the center for disease control and prevention) but the geographic distribution seemed to increase. in new york (ny) state, usa, a spread from the original lyme disease focus in southeastern parts of the state has occurred. we dete ...	2012	22841496
epidemiologic features of lyme disease in new york.	during 1982, surveillance identified 207 cases of lyme disease in new york state. cases were clustered in two geographic areas, eastern long island and northern westchester counties. symptoms and signs of lyme disease in cases were consistent with previous reports, with erythema chronicum migrans (ecm) being the most frequently (77 percent) reported sign of disease. facial palsy was reported in a surprisingly high 18 percent of cases. of 160 cases whose sera were submitted for lyme spirochete sp ...	2013	6334940
three sudden cardiac deaths associated with lyme carditis - united states, november 2012-july 2013.	lyme disease is a multisystem illness caused by borrelia burgdorferi, a spirochete transmitted by certain species of ixodes ticks. approximately 30,000 confirmed and probable cases of lyme disease were reported in the united states in 2012, primarily from high-incidence states in the northeast (connecticut, delaware, maine, maryland, massachusetts, new hampshire, new jersey, new york, pennsylvania, rhode island, and vermont) and upper midwest (minnesota and wisconsin). common manifestations incl ...	2013	24336130
detection of borrelia burgdorferi outer surface protein antibodies in wild white-tailed deer (odocoileus virginianus) in new york and pennsylvania, usa.	borrelia burgdorferi differentially exhibits outer surface proteins (osp) on its outer membrane, and detection of particular osp antibodies in mammals is suggestive of the infection stage. for example, ospf is typically associated with chronic infection, whereas ospc suggests early infection. a fluorescent bead-based multiplex assay was used to test sera from new york and pennsylvania white-tailed deer (odocoileus virginianus) for the presence of antibodies to ospa, ospc, and ospf. ospf seroprev ...	2013	23507438
potential role of deer tick virus in powassan encephalitis cases in lyme disease-endemic areas of new york, u.s.a.	powassan virus, a member of the tick-borne encephalitis group of flaviviruses, encompasses 2 lineages with separate enzootic cycles. the prototype lineage of powassan virus (powv) is principally maintained between ixodes cookei ticks and the groundhog (marmota momax) or striped skunk (mephitis mephitis), whereas the deer tick virus (dtv) lineage is believed to be maintained between ixodes scapularis ticks and the white-footed mouse (peromyscus leucopus). we report 14 cases of powassan encephalit ...	2013	24274334
the prevalence of zoonotic tick-borne pathogens in ixodes scapularis collected in the hudson valley, new york state.	ixodes scapularis, the blacklegged tick, is capable of transmitting the pathogens that cause lyme disease (borrelia burgdorferi), babesiosis (babesia microti), anaplasmosis (anaplasma phagocytophilum), and to a lesser extent powassan encephalitis (deer tick virus [dtv]). these pathogens represent significant public health problems, but little is known about the occurrence and co-infection prevalence of these pathogens in i. scapularis. here, we used standard pcr and pathogen-specific primers to ...	2014	24689680
prevalence of borrelia burgdorferi (spirochaetales: spirochaetaceae), anaplasma phagocytophilum (rickettsiales: anaplasmataceae), and babesia microti (piroplasmida: babesiidae) in ixodes scapularis (acari: ixodidae) collected from recreational lands in the hudson valley region, new york state.	abstract blacklegged ticks, ixodes scapularis say, were collected from 27 sites in eight new york state counties from 2003 to 2006 to determine the prevalence and distribution of tick-borne pathogens in public-use areas over a 4-yr period. in total, 11,204 i. scapularis (3,300 nymphs and 7,904 adults) were individually analyzed using polymerase chain reaction to detect the presence of borrelia burgdorferi (causative agent of lyme disease), anaplasma phagocytophilum (formerly ehrlichia phagocytop ...	2014	24605473
disparities in reportable communicable disease incidence by census tract-level poverty, new york city, 2006-2013.	we described disparities in selected communicable disease incidence across area-based poverty levels in new york city, an area with more than 8 million residents and pronounced household income inequality.	2015	26180961
seasonal activity, density, and collection efficiency of the blacklegged tick (ixodes scapularis) (acari: ixodidae) in mid-western pennsylvania.	although pennsylvania has recently reported the greatest number of lyme disease cases in the united states, with the largest increase for pa occurring in its western region, the population biology of the blacklegged tick (ixodes scapularis say) has not been adequately characterized in western pa. we studied the seasonal activity of host-seeking i. scapularis larvae, nymphs, and adults in mid-western pa over the course of a year, including a severe winter, and determined their absolute densities ...	2015	26336271
variation in the microbiota of ixodes ticks with regard to geography, species, and sex.	ixodes scapularis is the principal vector of lyme disease on the east coast and in the upper midwest regions of the united states, yet the tick is also present in the southeast, where lyme disease is absent or rare. a closely related species, i. affinis, also carries the pathogen in the south but does not seem to transmit it to humans. in order to better understand the geographic diversity of the tick, we analyzed the microbiota of 104 adult i. scapularis and 13 adult i. affinis ticks captured i ...	2015	26150449
abundance and infection rates of ixodes scapularis nymphs collected from residential properties in lyme disease-endemic areas of connecticut, maryland, and new york.		2015	26047204
lyme disease surveillance using sampling estimation: evaluation of an alternative methodology in new york state.	in the 14-year period from 1993 to 2006, new york state (nys) accounted for over one-quarter (27.1%) of all confirmed lyme disease (ld) cases in the united states. during that time period, a nine-county area in south-east nys accounted for 90.6% of the reported ld cases in the state. based on concerns related to diminishing resources at both the state and local level and the increasing burden of traditional ld surveillance, the nys department of health (doh) sought to develop an alternative to t ...	2016	26924579
lyme disease surveillance in new york state: an assessment of case underreporting.	despite the mandatory nature of lyme disease (ld) reporting in new york state (nys), it is believed that only a fraction of the ld cases diagnosed annually are reported to public health authorities. lack of complete ld case reporting generally stems from (i) lack of report of provider-diagnosed cases where supportive laboratory testing is not ordered or results are negative (i.e. provider underreporting) and (ii) incomplete case information (clinical laboratory reporting only with no accompanyin ...	2016	27612955
health survey of free-ranging raccoons (procyon lotor) in central park, new york, new york, usa: implications for human and domestic animal health.	we conducted health assessments on 113 free-ranging raccoons ( procyon lotor ) in central park, new york city, us, in february 2010, september 2010, and november 2011 in conjunction with a trap-vaccinate-release program to control a raccoon rabies epizootic. five individuals were sampled at two time points for 118 raccoon examinations in total. we tested 13 of 13 and 8 of 13 euthanized raccoons for rabies and canine distemper virus (cdv), respectively, by antigen testing on brain tissue; all wer ...	2017	28135131
impact of white-tailed deer on the spread of borrelia burgdorferi.	there is a public perception that the white-tailed deer odocoileus virginianus (artiodactyla: cervidae) is the main reservoir supporting the maintenance and spread of the causative agent of lyme disease, borrelia burgdorferi. this study examines the pathogen prevalence rate of borrelia in adult ixodes scapularis (ixodida: ixodidae), the black-legged tick, collected from white-tailed deer and compares it with pathogen prevalence rates in adult ticks gathered by dragging vegetation in two contiguo ...	2017	27699814
detection of borrelia miyamotoi and other tick-borne pathogens in human clinical specimens and ixodes scapularis ticks in new york state, 2012-2015.	borrelia miyamotoi (bm) is a recently emerging bacterial agent transmitted by several species of ixodid ticks. diagnosis of bm infection can be challenging, as the organism is not easily cultivable. we have developed and validated a multiplex real-time pcr to simultaneously identify bm infection and the agents causing human granulocytic anaplasmosis and human monocytic ehrlichiosis, anaplasma phagocytophilum and ehrlichia chaffeensis, respectively. the assay is 100% specific; highly sensitive, d ...	2017	28131594