Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.

North Carolina (NC) experiences some of the highest incidence rates of spotted fever rickettsiosis (SFR) and ehrlichiosis in the United States (US). Due to the non-specific nature of clinical symptoms, minimal utilization of molecular methods when appropriate, and limitations of sero-diagnostic meth...

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Main Authors: Lauryn Ursery, Odai Mansour, Haley Abernathy, Emily Wichmann, Allie Yackley, Alexis Siegler, Dana Giandomenico, Carl Williams, Alexis Barbarin, Michael H Reiskind, Ross M Boyce
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0320361
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author Lauryn Ursery
Odai Mansour
Haley Abernathy
Emily Wichmann
Allie Yackley
Alexis Siegler
Dana Giandomenico
Carl Williams
Alexis Barbarin
Michael H Reiskind
Ross M Boyce
author_facet Lauryn Ursery
Odai Mansour
Haley Abernathy
Emily Wichmann
Allie Yackley
Alexis Siegler
Dana Giandomenico
Carl Williams
Alexis Barbarin
Michael H Reiskind
Ross M Boyce
author_sort Lauryn Ursery
collection DOAJ
description North Carolina (NC) experiences some of the highest incidence rates of spotted fever rickettsiosis (SFR) and ehrlichiosis in the United States (US). Due to the non-specific nature of clinical symptoms, minimal utilization of molecular methods when appropriate, and limitations of sero-diagnostic methods, accurate case identification and subsequent public health reporting is challenging. Herein we detail the protocol and early enrollment results for an enhanced surveillance project aiming to generate more accurate estimates of tick-borne disease incidence in NC. Secondary outcomes of interest include: (i) increasing the obtainment rate of convalescent samples (ii) defining demographic and socioeconomic, behavioral/knowledge, entomologic, and environmental risk factors for disease, and (iii) describing the spectrum and clinical course of disease among cases of SFR and ehrlichiosis up to 90 days after symptom onset. In addition, we will collect remnant serum to establish a biorepository of well characterized samples that we intend to make available to researchers. Of the 150 participants enrolled, highlighted results include 49.5% of participants reported being exposed in their own home compared to 43.2% being exposed due to work or travel showing the importance of tick control and education. We also reported more confirmed cases of SFR and ehrlichiosis (15 and 20 respectively) where the North Carolina State Health Department only reported 14 and 11 confirmed cases in the entire state in 2022. Findings from the project will be reported in subsequent publications.
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spelling doaj-art-696849306afa49e6875ebe3ebb856d182025-08-20T02:33:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01205e032036110.1371/journal.pone.0320361Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.Lauryn UrseryOdai MansourHaley AbernathyEmily WichmannAllie YackleyAlexis SieglerDana GiandomenicoCarl WilliamsAlexis BarbarinMichael H ReiskindRoss M BoyceNorth Carolina (NC) experiences some of the highest incidence rates of spotted fever rickettsiosis (SFR) and ehrlichiosis in the United States (US). Due to the non-specific nature of clinical symptoms, minimal utilization of molecular methods when appropriate, and limitations of sero-diagnostic methods, accurate case identification and subsequent public health reporting is challenging. Herein we detail the protocol and early enrollment results for an enhanced surveillance project aiming to generate more accurate estimates of tick-borne disease incidence in NC. Secondary outcomes of interest include: (i) increasing the obtainment rate of convalescent samples (ii) defining demographic and socioeconomic, behavioral/knowledge, entomologic, and environmental risk factors for disease, and (iii) describing the spectrum and clinical course of disease among cases of SFR and ehrlichiosis up to 90 days after symptom onset. In addition, we will collect remnant serum to establish a biorepository of well characterized samples that we intend to make available to researchers. Of the 150 participants enrolled, highlighted results include 49.5% of participants reported being exposed in their own home compared to 43.2% being exposed due to work or travel showing the importance of tick control and education. We also reported more confirmed cases of SFR and ehrlichiosis (15 and 20 respectively) where the North Carolina State Health Department only reported 14 and 11 confirmed cases in the entire state in 2022. Findings from the project will be reported in subsequent publications.https://doi.org/10.1371/journal.pone.0320361
spellingShingle Lauryn Ursery
Odai Mansour
Haley Abernathy
Emily Wichmann
Allie Yackley
Alexis Siegler
Dana Giandomenico
Carl Williams
Alexis Barbarin
Michael H Reiskind
Ross M Boyce
Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.
PLoS ONE
title Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.
title_full Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.
title_fullStr Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.
title_full_unstemmed Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.
title_short Enhanced surveillance for tick-borne rickettsiosis and ehrlichiosis in North Carolina: Protocol and preliminary results.
title_sort enhanced surveillance for tick borne rickettsiosis and ehrlichiosis in north carolina protocol and preliminary results
url https://doi.org/10.1371/journal.pone.0320361
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