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<p>More than 15 tick-borne diseases have been recognized in the United States (US) (Eisen (2020). Collectively, TBDs have been linked to seven different tick species in the US. Climate change, urbanization, and host migration exacerbate the threat of increasing TBD incidence and the expanding geographic distribution of ticks. Furthermore, data suggests that less than a tenth of the reportable TBDs were reported to the CDC annually. Studies from a national survey and high incidence states for Lyme disease provided evidence that healthcare providers have knowledge gaps about TBD epidemiology and diagnostics, which has yet to be examined in Indiana to our knowledge.</p><p></p><p>An anonymous survey of 597 Indiana healthcare providers was conducted between February 28^th and April 10^th,2020 to assess knowledge about ticks and tick-borne diseases (TBDs). The survey comprised 22 discrete and ordinal questions and one open-ended question. The study revealed that 92% of the respondents reported Doctor of Medicine (MD) (71%), Doctor of Osteopathic Medicine (DO) (8%), Physician Assistant (PA) (12%) and Registered nurse (RN) (1%) as their highest level of training and practiced in a diversity of settings including Primary care office (28%), Specialty care office (23%) and Hospital (inpatient) (20%). Analyses revealed that 39% of respondents had practiced for more than 25 years, consulted between 1-25 patients with confirmed or suspected TBD per year, and predominantly served both rural and urban communities (62% respondents). Seventy percent of respondents recognized the clinical signs and symptoms of TBDs endemic to Indiana and 96% of DOs, 94% of PAs, and 91% of MDs were aware of the limitations of the erythema migrans (EM) rash as a diagnostic criteria for Lyme disease (LD), the most common TBD in Indiana and the U.S. The majority of respondents (75%) reported using fine tip tweezers, considered best practice for the removal of an attached tick. Among respondents who used online resources to obtain information regarding diagnostic and treatment guidelines, 25-45% visited federal (CDC) and state (Indiana Department of Health, IDOH) websites. </p><p>Survey data revealed several potential knowledge gaps among Indiana state providers. Respondents reported that they were unsure about the following topics: (1) the tick species capable of disease transmission in IN (47% unsure), (2) the geographic distribution of the black legged tick, <i>Ixodes scapularis, </i>the vector of LD in the U.S. (56% unsure), (3) northwest Indiana as the region of the state associated with highest LD risk (49% unsure), and (4) May-July as the months considered highest risk for TBD transmission (48% unsure or answered incorrectly). These findings provided evidence to support the hypothesis under investigation in the present study that Indiana healthcare providers lack knowledge of tick vectors and TBDs risks specific to the state. </p>Qualitative analysis was conducted for open-ended question (Q23) and resulted in coding of 597 responses into six major categories (Healthcare provider, Healthcare system, Patient Knowledge, Disagreement, Education and Not applicable) and 15 associated subcategories. Coding analyses revealed that healthcare providers are aware of their shortcomings and are receptive to online interventions. Here we present the first focused study to assess provider knowledge of ticks and TBD in Indiana. Taken together, the survey findings provide information to guide development of region-specific educational material and guidelines about ticks and TBDs for healthcare providers. We provide evidence to suggest that a continued provider education program may improve diagnosis and treatment of TBDs.

International malaria control initiatives such as the Roll Back Malaria Initiative (RBM) and the Medicines for Malaria Venture (MMV) mobilize resources and spur research aimed at vector control as well as the treatment and eventual eradication of the disease. These efforts have managed to reduce incidence of malaria by an estimated 37% worldwide since 2000. However, despite the promising success of control efforts such as these, the World Health Organization reports a staggering 438,000 deaths from malaria in 2015. The continuing high death toll of malaria as well as emerging insecticide and antimalarial drug resistance suggests that while encouraging, success in reducing malaria incidence may be tenuous. Current vector control strategies are often complicated by ecological and behavioral heterogeneity of vector mosquito populations. As an additional obstruction, mosquito genomes are highly plastic as evidenced by the wealth or chromosomal inversions that have occurred in this genus. Chromosomal inversions have been correlated with differences in adaptation to aridity, insecticide resistance, and differences in resting behavior. However, a good understanding of the molecular mechanisms for inversion generation is still lacking. One possible contributor to inversion formation in Anopheles mosquitoes includes repetitive DNA such as transposable elements (TEs), tandem repeats (TRs) and inverted repeats (IRs). This dissertation provides physical maps for two important malaria vectors, An. stephensi and An. albimanus (Ch.2 and Ch. 3) and then applies those maps to the identification of inversion breakpoints in malaria mosquitoes. Repeat content of each chromosomal arm and the molecular characterization of lineage specific breakpoints is also investigated (Ch. 2 and Ch.4). Our study reveals differences in patterns of chromosomal evolution of Anopheles mosquitoes vs. Drosophila. First, mosquito chromosomes tend to shuffle as intact elements via whole arm translocations and do not under fissions or fusions as seen in fruitflies. Second, the mosquito sex chromosome is changing at a much higher rate relative to the autosomes in malaria mosquitoes than in fruit flies. Third, our molecular characterization of inversion breakpoints indicates that TEs and TRs may participate in inversion genesis in an arm specific manner. / Ph. D. / Malaria is a complex and devastating disease vectored by the bite of a female Anopheles mosquito. This disease claimed an estimated 438,000 lives in 2015. The mobilization of funding and resources as part of global malaria eradication initiatives have reduced the global incidence of malaria by 37% in the last 15 years. Deaths from malaria are also 60% lower vs. the year 2000. These promising gains are threatened by the ability of Anopheles mosquitoes to adapt in the face of malaria control efforts. Anopheles mosquito chromosomes are known to be highly plastic, as evidenced by numerous chromosomal inversions. Recent years have seen increases in insecticide resistance, and behavioral change in mosquito populations that allow them to avoid insecticides and remain prolific vectors of disease. This ability of mosquito vectors to adapt threatens to unravel recent progress towards a malaria free world. The projects presented in this dissertation explore mechanisms of chromosomal evolution, specifically the potential role of repetitive DNA in the generation of chromosomal inversions. The exploration of chromosomal inversions was facilitated by the creation of physical maps for Anopheles species. Prominent malaria vectors An. stephensi andAn. albimanus were physically mapped in Chapter 2 and Chapter 3 respectively. In chapter 1 and chapter 3 physical maps are utilized for the identification of chromosomal inversion breakpoints using 2 species (Ch. 2) and many species (Ch. 4). Repeat content was quantified along each chromosomal arm (Ch 2,4) and in inversion breakpoint regions (Ch 3). This dissertation presents physical maps for two important malaria species that have been applied to the study of chromosomal evolution and will also serve as community tools for further study of malaria mosquitoes. Our work on chromosomal evolution has revealed the Anopheles chromosomes tend to undergo translocations as intact elements and do not under fissions and fusions as seen in fruitflies. We also find that the malaria mosquito sex chromosome changes much more rapidly relative to the autosomes than in fruitflies. Additionally, repetitive DNA including transposable elements (TEs) and tandem repeats (TRs) may be encouraging chromosomal inversions but with differing roles on different chromosomal arms.

Every year three million deaths are attributed to malaria, of which one-third are of children. Malaria is a vector-borne disease, where a mosquito acts as the vector that transmits the disease. In the last few years, computer simulation based models have been used effectively to study the vector population dynamics and control strategies of vector-borne diseases. Typically, these models use ordinary differential equations to simulate the spread of malaria. Although these models provide a powerful mechanism to study the spread of malaria, they have several shortcomings. The research in this thesis focuses on creating a simulation model based on the framework of cellular automata, which addresses many shortcomings of previous models. Cellular automata are dynamical systems, which are discrete in time and space. The implementation of the model proposed can easily be integrated with EpiSims/TRANSIMS. EpiSims is an epidemiological modeling tool for studying the spread of infectious diseases; it uses social contact network from TRANSIMS (A Transport Analysis and Simulation System). Simulation results from the prototype implementation showed qualitatively correct results for vector densities, diffusion and epidemiological curves. / Master of Science

Globally emphasis has been given to identify emerging and re-emerging pathogens. Rapid urban expansion creates a problem which is two-fold. Firstly, increasing slum living conditions due to inadequate rate of infrastructure development results in an increased reliance on natural resources, including the capture and consumption of surrounding wildlife to subsist, thereby facilitating the transfer of emergent zoonotic pathogens. Secondly, through activities such as pollution or alien species introductions, the rapid transformation of once pristine environments, alters natural systems, potentially exposing these environments to new bacterial pathogens. Therefore, the main aim of this study was to assess overlooked bacterial species harboured by four host species (Bathyergus suillus, Georychus capensis, Cryptomys hottentotus hottentotus and Fukomys damarensis) belonging to the subterranean rodent family Bathyergidae, which inhabit an environment well-suited for an array of bacterial species, and which varied in their exposure to human settlements. Bacterial prevalence and diversity was initially evaluated using broad-range PCR techniques in combination with nucleotide sequencing. This revealed high levels of bacterial prevalence (82.91%) and mixed infections (22.60%) in bathyergid species. Two bacterial groups, the Bacillus cereus complex (a group of soil-dwelling bacterial strains with pathogenic potential with an overall prevalence of 8.55%) and haemotropic Mycoplasma strains (vector-borne bacterial strains of zoonotic potential with an overall prevalence of 1.28%) were subsequently selected for further genetic analysis with genus and species-specific PCRs. Bacillus molecular screening and phylogenetic analyses was achieved by targeting four gene regions with seven published primer assays and two novel PCR assays. This enabled identification of two B. cereus complex strains in bathyergid lungs and revealed an overall B. cereus complex prevalence of 17.95% for the 234 bathyergid lung samples screened. Bacillus genome prevalence was significantly higher in B. suillus individuals (45.35%), sampled in a peri-urban environment, compared to the other bathyergid species sampled from pristine habitats (ranging from 0% - 4.44%). Anthropogenic activities in the area where B. suillus was sampled could, at least partially, attribute to the perceived difference between urban and naturally sampled bathyergid species, highlighting the role of B. suillus to act as both a reservoir of potentially zoonotic pathogens and as a sentinel for anthropogenic soiling. Mycoplasma molecular screening using three different PCR assays, all targeting the 16S rRNA gene region, confirmed an overall haemotropic Mycoplasma prevalence of 24.13% in the 286 bathyergid organs (lung, spleen and liver) screened. A significantly higher prevalence and diversity of haemotropic Mycoplasma strains was found in B. suillus lungs (41.86%) compared to its naturally occurring relatives (ranging from 0%-36%). Phylogenetic analyses identified six novel haemotropic Mycoplasma strains, all grouping within a discrete monophyletic cluster, sister to Mycoplasma coccoides, and comprising two well-supported sub-clusters. The human introduction of commensal rodents harbouring Mycoplasma strains transferred through cosmopolitan arthropod vectors to indigenous bathyergids, likely underlies the higher prevalence in urban areas, although other biotic and abiotic factors affecting ectoparasite load also merit consideration. The data generated by the current study indicate the need to identify largely overlooked and potentially zoonotic bacterial pathogens in subterranean mammals and emphasises the importance of monitoring anthropogenically-introduced, opportunistic pathogens and the threats they pose to vulnerable communities and co-occurring, free-living animal species / Dissertation (MSc)--University of Pretoria, 2017. / Airports Company of South Africa (ACSA) / National Research Foundation (NRF) / Zoology and Entomology / MSc / Unrestricted

Climate change will likely have impacts on disease vector distribution. Posing a significant health threat in the 21st century, risk of tick-borne diseases may increase with higher annual mean temperatures and changes in precipitation. We modeled the current and future potential distribution of the Ixodes ricinus tick species in Europe. The Genetic Algorithm for Rule-set Prediction (GARP) was utilized to predict potential distributions of I. ricinus based on current (1990-2010 averages) and future (2040-2060 averages) environmental variables. A ten model best subset was created out of a possible 200 models based on omission and commission criteria. Our results show that under the A2 climate change scenario the potential habitat range for the I. ricinus tick in Europe will expand into higher elevations and latitudes (e.g., Scandinavia, the Baltics, and Belarus), while contracting in other areas (e.g., Alps, Pyrenees, interior Italy, and northwestern Poland). Overall, a potential habitat expansion of 3.8% in all of Europe is possible. Our results may be used to inform climate change adaptation efforts in Europe.

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2 pp. / Warm temperatures increase the risk for food-borne illness which can spoil cook-outs and picnics. This article provides information about the necessary precautions to take in order to assure the food you serve is safe to eat.

1p. / Keeping food safe to eat is as simple as keeping hot foods hot, cold foods cold, and all foods clean. This article outlines particular options for keeping coolers cold.

1p. / Most of the "bad food" reported illnesses are due to bacterial contamination. Nearly all of these cases can be linked to improper food handling, both in our homes and in restaurants. This article briefly discusses the causes of food contamination and how to handle food safely.