Exploring the Tick-borne and Zoonotic Diseases of Arizona
Hayley Yaglom, MS, MPH Senior Vector-borne & Zoonotic Disease Epidemiologist
April 26, 2018
Morbidity Case Count (2017)
Rocky Mountain spotted fever 27
Rickettsia parkeri 4
Tick-borne relapsing fever 3
Plague 1
Tularemia 1
Hantavirus 2
Animal rabies 155 Rhipacephalus Amblyomma Ornithodoros Cases of tick-borne disease peaked in August and September during 2016.
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0 Jan Apr Jul Oct
Note: This graph excludes cases where tick exposure was outside Arizona, such as Lyme disease.
Rabid Animals in Arizona: 2002–2018*
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Rabid Animals in Arizona: 2008–2017 300 Other 250 Fox Skunk 200 Bat
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0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Arizona Department of Health Services: Laboratory & Zoonotic Disease Team • Offer no-cost rabies testing for animals • Perform rabies risk assessments and assist with post-exposure prophylaxis guidelines • Track animal rabies cases and human exposures
Rabies Risk Assessment Form • Must be approved by ADHS-VBZD • Electronic version • Must accompany animal/head • Completeness is key!
• Then….ship to ASPHL for testing! Ongoing Projects
• Continued Rocky Mountain spotted fever prevention • Field surveillance for Amblyomma maculatum • Coyotes as potential reservoir for Onchocerca lupi Resources
• ADHS Vectorborne & Zoonotic Disease Team: [email protected] or 602-364-3676/602-364-3199 (fax) • Arizona Manual for Rabies Control & Bite Management available online • Website updates coming in the next few months azhealth.gov/rabies VBZD Team
Heather Venkat, DVM, MPH CDC Career Epidemiology Field Officer Vector-borne and Zoonotic Disease Program Manager Acting State Public Health Veterinarian 602-542-8960 [email protected] T. Michael Fink, MA (602) 364-3853 [email protected] Hayley D. Belisle-Yaglom, MS, MPH Senior Vector-borne & Zoonotic Disease Epidemiologist 602-542-2521 [email protected] Kara Tarter, MPH Vector-borne & Zoonotic Disease Epidemiologist 602-364-0661 [email protected] Questions?
Doxycycline? All About Them Arbos Arizona Arboviral Update April 26, 2018
Kara Tarter, MPH Vector-borne & Zoonotic Disease Epidemiologist Office of Infectious Disease Services West Nile Virus
Culex tarsalis. Image by CDC
West Nile Virus St. Louis encephalitis virus
Culex tarsalis. Image by CDC During 2017, over 150 mosquito pools tested positive for St. Louis encephalitis virus. A total of 6 human cases were reported from 2 counties: La Paz and Maricopa. Zika Dengue Chikungunya
Aedes aegypti. Image by CDC Between 2016 and 2017, Zika virus cases reported from the U.S. Territories decreased by 98%.
36,512
653 Between 2016 and 2017, Zika virus cases reported from the U.S. Territories decreased by 98%.
36,512
Zika virus cases in the U.S. States fell 92%, to under 500 cases.
5,168
653 432
While the number of individuals tested for Zika virus at the Arizona State Public Health Lab was generally increasing through July 2017, the number of individuals positive for Zika virus sharply decreased towards the end of 2016. 6
30 ADHS updates testing 5 recommendations.
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0 0 1 7 13 19 25 31 37 43 49 3 9 15 21 27 33 39 45 51 2016 2017 Since the emergence of chikungunya, dengue, and Zika in the Americas, Arizona has seen cases associated with travel to Mexico during most years.
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0 0 0 2010 2011 2012 2013 2014 2015 2016 2010 2011 2012 2013 2014 2015 2016 2017 2010 2011 2012 2013 2014 2015 2016 2017 In 2014, nearly 90% of total dengue cases had travel history to Mexico. In general, approximately 30% of cases of chikungunya, , and have travel history to Mexico. dengue Zika 100 100 100
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0 0 0 2010 2011 2012 2013 2014 2015 2016 2017 2010 2011 2012 2013 2014 2015 2016 2017 2010 2011 2012 2013 2014 2015 2016 2017 Image by markgranitz/CC-BY-NC-ND 2.0 Kara Tarter, MPH [email protected] | [email protected] azhealth.gov/mosquito Dengue, Chikungunya and Zika in Mexico Update April 26, 2018
Presenting To 2018 AZ Vector conference | Phoenix
Mariana Casal MD MPH MBA | BIDS officer • Dengue approaching the 2013 border Mexico Timeline
• Chikungunya arrival 2014 • Dengue outbreak Yuma/SLRC
• Chikungunya outbreak 2015 • Zika arrival
2016 • Zika outbreak
• Dengue 2017 • Chikungunya • Zika
3 diseases, end of 2016 Confirmed cases by week, MX, 2015-2017* 2017 Mexico Mexico dengue cases by week
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4,000
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0
National 2017 week only probable National 2017 week only confirmed National 2016 week only probable National 2016 week only confirmed 2016-2017 Chikungunya Mexico
Mexico Chikungunya Cases by Week 70
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2017 Mexico confirmed 30 2016 Mexico confirmed
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-10 2016-2017 Zika Mexico Mexico Zika Cases by Week
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400 2017 Mexico confirmed 2016 Mexico confirmed 300
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Arbovirus cases in Sonora
Year Dengue Chikungunya Zika total confirmed cases in Sonora, 2012 575 2012 - 2017 Zika 2013 699 Chikungunya 1% 2014 3908 4% 2015 3300 359 2016 202 10 43 2017 158 0 64 Total 8842 369 107
Dengue 95% Dengue in Sonora. 2007 - 2015 4500 25
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15 2500 Cases 2000 Deaths 10
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0 0 2007 2008 2009 2010 2011 2012 2013 2014 2015
Fiebre por Dengue Fiebre Hemorrágica por Dengue Defunciones Dengue Fever Hemorrhagic Dengue Fever Deaths Source: DGPROSPE/UIEES/SEVE ETV 2016-2017 Sonora dengue cases Sonora dengue cases by week 90
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Sonora 2017 week only probable Sonora 2017 week only confirmed Sonora 2016 week only probable Sonora 2016 week only confirmed Native dengue cases locations
SLRC
Rocky Caborca Nogales Agua Point Prieta 2016-2017 Sonora Chikungunya
Sonora Chikungunya Cases by Week 2.5
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2016 sonora confirmed 2017 sonora confirmed 1
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0 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031323334353637383940414243444546474849505152 2016-2017 Sonora Zika Cases
Sonora Zika Cases by Week
11 10 9 8 7 2017 Sonora confirmed 6 2016 Sonora confirmed 5 4 3 2 1 0 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 3363 pregnant women 1526 pregnant women
Ovitraps in Sonora • 1,569 Ovitraps • Different municipalities of the 3 Border Health Jurisdictions • Higher positive results in: – Hermosillo, Cajeme y Navojoa. • Using the federal level methodology following the “Guía Metodológica para la Viglancia Entomológica con Ovitrampas.” Source: Denica Cruz-Loustaunau, MD Secretariat of Public Health, Sonora, Mexico
• Identify 10 block in a neighborhood • 4 ovitraps per block • 1 per inhabited house (patio) • At least 50 mts (160 ft.) apart • The study unit is the block with 4 ovitraps • Checked weekly Ovitraps Sonora, 2016. % of Positive Results and Average of Eggs Per Block Information from the state
Information from border and each municipality Chikungunya
Dengue
West Nile Virus
RMSF leptospirosis
Plague
Rabies
Tularemia
Zika