Analyses of Tick-Borne Diseases Using Multimodal Databases: Identifying Opportunities to Improve Surveillance of Human Disease Risk (Preprint)

BACKGROUND The extent of tick-borne disease (TBD) risk in the United States is generally unknown. Active surveillance using entomological measures, such as presence and density of infected nymphal I. scapularis ticks, have served as indicators for assessing human risk, but results have been inconsistent. Passive surveillance via the public health system suggests TBDs are underreported. OBJECTIVE The aim of our study was to geographically overlay electronic patient survey data of human tick bite encounters (TBEs) and concomitant reports of tick-borne disease with multimodal data sources, such as canine serological reports, to assess the use of various human TBD- risk proxies. METHODS This study employs a mixed-method research strategy, drawing on multiple data sources to provide insights into various aspects of human disease risk from tick-bite encounters (TBEs) and tick-borne diseases (TBDs) in the United States. TBEs among patients diagnosed with Lyme disease (LD) were analyzed at the county level and compared to Ixodes scapularis and Ixodes pacificus tick presence, human cases identified by the Centers for Disease Control and Prevention (CDC), and canine serological data. Engaging a One Health spatial approach, analyses employed multi-layer thematic mapping. RESULTS Results revealed spatial matching at the county level among patient survey reports of TBEs and disease risk indicators from official sources. The results included one-for-one county-level matching of reported TBEs with at least one official source of human disease risk (i.e., positive canine serological tests, CDC-reported LD, or known tick presence) as demonstrated by thematic mapping. CONCLUSIONS Use of triangulation methods that integrate electronic patient data on tick bite encounter recall with established canine serological reports, tick presence, and official human disease information offers clinicians and public health officials with more granular, county-level information regarding tick-borne disease risk. Data other than official public health sources may serve as robust proxies for tick-borne disease risk among humans. CLINICALTRIAL Not applicable