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Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith May 4, 2018 All Creatures Great and Small: Bites by Small Creatures with Potentially Great Consequences As we are now beginning to see real summer weather, this recent publication highlights some things to be concerned about. Date: Tue 1 May 2018 Source: New York Times [edited] < The number of people who get diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States in recent years, federal health officials reported on [Tue 1 May 2018]. Since 2004, at least 9 such diseases have been newly discovered or introduced into the United States. Warmer weather is an important cause of the surge in cases reported to the Centers for Disease Control and Prevention (CDC). The author states that “the numbers on some of these diseases have gone to astronomical levels." While the CDC did not suggest that Americans drop plans for playing outdoors or lying in hammocks this summer, Dr. Redfield emphasized that everyone especially children needed to protect themselves against tick and mosquito bites. Between 2004 and 2016, about 643,000 cases of 16 insect and tick-borne illnesses were reported to the CDC – 27,000 a year in 2004, rising to 96,000 by 2016. The real case numbers were undoubtedly far larger. For example, the CDC estimates that about 300,000 Americans get Lyme disease each Public Health Brief Richard O. Johnson, M.D., MPH Nichole Williamson Public Health Officer HHS Director Office: [PHONE REDACTED], Ext 249 Office: [PHONE REDACTED] e-mail: [EMAIL REDACTED] 24/7/365 Emergency Contact Numbers Dr. Johnson’s cell: (760) 914-0496 Dispatch: [PHONE REDACTED], Ext 330 ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith year, but only about 35,000 diagnoses are reported. The increase was probably caused by many factors, including 2 related to weather: Ticks thriving in regions previously too cold for them, and hot spells triggering outbreaks of mosquito-borne diseases. Other factors include expanded human travel, suburban reforestation and a lack of new vaccines to stop outbreaks. More jet travel from the tropics means that previously obscure viruses like dengue and Zika are moving long distances rapidly in human blood. (By contrast, malaria and yellow fever are thought to have reached the Americas on slave ships 3 centuries ago.) A good example was chikungunya, which causes joint pain so severe that it is called "bending-up disease." In late 2013, a Southeast Asian strain arrived on the Dutch Caribbean island of St. Maarten, its 1st appearance in this hemisphere. Within one year, local transmission had occurred everywhere in the Americas except Canada, Chile, Peru and Bolivia. Warm weather helps mosquitoes and ticks breed and transmit disease faster. But after a certain point, the hotter and drier it gets, the more quickly the pests die. Disease transmission to humans peaks somewhere between mildly warm and hellishly hot weather. Tickborne diseases are rising steadily in the Northeast, the Upper Midwest and California. Ticks spread Lyme disease, anaplasmosis, babesiosis, Rocky Mountain spotted fever, rabbit fever, Powassan virus and other ills, some of them only recently discovered. Tick diseases are expanding as summers lengthen, and malaria is becoming more common in the northern reaches of Australia. Ticks need deer or rodents as their main blood hosts, and those have increased as forests in suburbs have gotten thicker, deer hunting has waned, and rodent predators like foxes have disappeared. (A century ago, the Northeast had fewer trees than it now does; forests made a comeback as farming shifted west and firewood for heating was replaced by coal, oil and gas.) Most disease outbreaks related to mosquitoes since 2004 have been in Puerto Rico, the Virgin Islands and American Samoa. But West Nile virus, which arrived in 1999, now appears unpredictably across the country; Dallas, for example, saw a big outbreak in 2012. For most of these diseases, there are no vaccines and no treatment, so the only way to stop outbreaks is through mosquito control, which is expensive and rarely stops outbreaks. Miami, for instance, was the only city in the Western Hemisphere to halt a Zika outbreak with pesticides. The only flea-borne disease in the report is plague [caused by _Yersinia pestis_], the bacterium ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith responsible for the medieval Black Death. It remains rare but persistent: Between 2 and 17 cases were reported from 2004 to 2016, mostly in the Southwest. The infection can be cured with antibiotics. The study can be found at: http://dx.doi.org/10.15585/mmwr.mm6717e1 What is the risk in the Eastern Sierra? For Zika, dengue, chikungunya, malaria, and yellow fever, the risk is zero, as we do not have the right kind of mosquito - so far! See: and-Aedes-albopictus-mosquitoes.aspx 54255b For West Nile virus, we do have the right kind of mosquito, the right kind of birds, and the presence of the virus has been documented locally. Cases have been documented in the area, so protection from mosquito bites is important. See: http://www.westnile.ca.gov/ Don’t forget to get your horse vaccinated!! For tick bites, we have good evidence of cases of tick-borne relapsing fever (from the bite of soft ticks). However, locally acquired disease from hard ticks – the ones you can see – is rare, but possible. Locally, we have plenty of dog ticks, which can carry disease, but not Lyme disease. I challenge you to bring me the right kind of tick from Alpine County that is known to carry Lyme disease, the ixodes Pacificus! Your risk is travel – usually to the northern California Coast, the west side Sierra foothills, the upper Midwest, and the Northeast. See: For flea bites, there is a very small risk of plague, since we certainly do have evidence almost every year of current or previous infection in squirrels and chipmunks. See: ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith b3 And of course, I can’t fail to mention those cute mice – the deer mouse – that can carry and transmit hantavirus! See: 2194de What can I do to protect myself and my family? Hey Doc, I’ve Been Bitten by A Tick – What Do I Do Now? nByATick.pdf Repellent Use Information in Spanish: http://westnile.ca.gov/news.php?id=64 Your Guide to Insect Repellents – English and Spanish: Tick-Borne Diseases – Occupational Risk Toolkit: Hantavirus – Reduce Your Risk of Exposure (video): Hantavirus – Reducing Your Risk of Occupational Exposure Toolkit: Facts About Plague in California: CA.pdf The Vector-Borne Disease Section of the California Department of Public Health Website has many more resources for your research and interest: ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith