How Lyme Disease Spreads

Lyme Disease

Key points

• Lyme disease bacteria causing human infection in the United States are spread to people by blacklegged (Ixodes) ticks.
• In general, infected ticks must be attached for more than 24 hours to transmit infection; prompt tick removal can prevent transmission.
• Infected ticks are found most commonly in forested areas in the northeastern, north-central, and mid-Atlantic states, and in smaller areas within Pacific Coast states.

How it spreads

The bacteria that cause Lyme disease in the United States, Borrelia burgdorferi and, rarely, B. mayonii, are spread to people through the bites of infected ticks. The blacklegged tick (or deer tick, lxodes scapularis) transmits infection in the northeastern, mid-Atlantic, and north-central United States. The western blacklegged tick (lxodes pacificus) transmits infection in areas along the Pacific Coast. Lyme disease can be prevented by avoiding tick bites and promptly removing ticks.

The percentage of ticks that are infected ranges from none to over 50%, depending on the area and life stage. Blacklegged ticks found in most areas of the southeastern United States are almost never infected.

Blacklegged ticks have a 2-to-3-year life cycle. During this time, they go through four life stages: egg, larva, nymph, and adult. After the egg hatches, the larva and nymph each must take a blood meal to develop to the next life stage, and the female needs blood to produce eggs.

• Larval and nymphal ticks can become infected with Lyme disease bacteria when feeding on an infected wildlife host, usually a rodent. The bacteria are passed along to the next life stage. Nymphs or adult females can then spread the bacteria during their next blood meal.
• Female ticks infected with Lyme disease bacteria do not pass the infection to their offspring.
• Deer are a source of blood for ticks and important to tick survival and movement to new areas. However, deer are not infected with Lyme disease bacteria and do not infect ticks.

About other modes of transmission

• There is no credible scientific evidence that Lyme disease is spread through touching, kissing, or sexual contact. Published studies in animals do not support sexual transmission (Moody 1991; Woodrum 1999), and the biology of the Lyme disease spirochete is not compatible this route of exposure (Porcella 2001).
• Untreated Lyme disease during pregnancy can lead to infection of the placenta; spread from mother to fetus is possible but extremely rare. Fortunately, with appropriate antibiotic treatment, there is no increased risk of adverse birth outcomes. There are no published studies assessing developmental outcomes of children whose mothers acquired Lyme disease during pregnancy.
• There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic that’s safe for use when breastfeeding.
• Although no cases of Lyme disease have been linked to blood transfusion, scientists have found that the Lyme disease bacteria can live in blood that is stored for donation. Individuals being treated for Lyme disease with an antibiotic should not donate blood. Individuals who have completed antibiotic treatment for Lyme disease may be considered as potential blood donors. Information on the current criteria for blood donation is available on the Red Cross website.
• Although dogs and cats can get Lyme disease, there is no evidence that they spread the infection directly to their owners. However, pets can bring infected ticks into your home or yard. Consider protecting your pet through the use of tick and tickborne disease prevention products for animals.
• You will not get Lyme disease from eating game meat, but in keeping with general food safety principles, always cook meat thoroughly. Note that hunting and dressing game animals may bring you into close contact with infected ticks.
• There is no credible evidence that Lyme disease bacteria can be transmitted through air, food, water, or from the bites of mosquitoes, flies, fleas, or lice.
• Lone star ticks (Amblyomma americanum), the American dog tick (Dermacentor variabilis), the Rocky Mountain wood tick (D. andersoni), and the brown dog tick (Rhipicephalus sanguineus) are not able to transmit Lyme disease bacteria, however, they can transmit bacteria, parasites, and viruses that cause other tickborne diseases.

Website: International Conference on Infectious Diseases.

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New insights reveal how house dust mites trigger allergic asthma by activating immune system

New research from the University of Pittsburgh uncovers how inhaled house dust mites, a common trigger of allergic asthma, activate the immune system and drive this disease in mice.

The findings, published recently in Nature Immunology, offer important insights into how seemingly harmless substances such as dust mites, pet dander and pollen can overcome the immune system to trigger allergic reactions and could eventually pave the way for identifying new therapeutics to treat and manage allergic asthma.

"We often think of the immune system as an army that fights the bad guys," said senior author Amanda C. Poholek, Ph.D., director of the Health Sciences Sequencing Core and assistant professor in the Department of Immunology at Pitt's School of Medicine.

"And while that's true, most of the time your immune system is not encountering pathogens but dealing with dust and pollen that you breathe in, plants and animals that you eat, and things that you touch in the environment. A big question that motivates my research is: How does our immune system know to respond to pathogens and not to self and the environment?"

When the immune system does this job correctly, it's known as immune tolerance. But when tolerance breaks down, typically harmless environmental allergens can activate T Helper 2 (TH2) cells, which are a type of immune cell that drives inflammation in allergic asthma and other allergic diseases.

Allergic asthma is the most common form of asthma, characterized by symptoms such as coughing, chest tightness, shortness of breath and wheezing. This debilitating condition is on the rise worldwide and places a substantial burden on the health care system, according to Poholek.

To learn more about how allergens activate TH2 cells and cause allergic asthma, Poholek and her team used a mouse model of the disease triggered by inhalation of house dust mites. This model is a more accurate representation of how humans encounter allergens compared to studies that used under-the-skin or systemic injections of allergen.

Using new tools that allowed them to track TH2 cells and see exactly when they get activated and where they went, the researchers found that in response to inhaled house dust mite, a specific molecular pathway involving a protein called BLIMP1 was needed to generate TH2 cells in the lymph node. These cells then move to the lung and drive disease. In contrast, when house dust mite is injected, that molecular pathway is not needed.

They also found that two signaling molecules, or cytokines, called IL2 and IL10 were required for expression of BLIMP1.

"IL10 is normally thought of as an anti-inflammatory cytokine, which dampens immune responses, so we were really surprised to find that it was actually promoting inflammation," said Poholek. "This finding opens that door to therapeutic options targeting IL10, which hadn't previously been considered, particularly for newly diagnosed patients."

According to Poholek, most patients with allergic asthma receive steroids, which treat the symptoms but not the root of the disease. There is a huge need for new treatments that allow early intervention before allergic asthma causes long-term damage to the airways.

When the researchers mapped the location of TH2 activation in the lymph node, they were also surprised to find hotspots of IL2 activity.

"IL2 is a very prominent cytokine, so we expected that it would be dispersed throughout the lymph node," said Poholek. "Instead, we discovered that IL2 was localized to certain regions. Now, we have a lot more work to figure out how these regions form and whether disrupting these regions could disrupt the formation of TH2 cells, halting allergic asthma."

Website: International Conference on Infectious Diseases.

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Teen Hospitalized in First Human Bird Flu Case in Canada

Bird Flu

A teenager in British Columbia has become the first person in Canada to test positive for bird flu, authorities said Saturday.

This person is receiving treatment in a children's hospital for H5 avian flu, the provincial health department said.

The source of contagion and any possible contacts are being investigated.

Officials said the infection probably came from a bird or animal.

"This is a rare event," British Columbia Health Officer Bonnie Henry said.

"We are conducting a thorough investigation to fully understand the source of exposure here in B.C."

Bird flu is most commonly found in wild birds and poultry, but has more recently been detected in mammals, with an outbreak in cattle seen across the United States this year.

It can occasionally infect humans through close contact or contaminated environments.

hey fear a high rate of transmission could facilitate a mutation of the virus, which could enable it to be passed from one human to another.

In September, officials said a person in Missouri became the first in the United States to test positive for bird flu without a known exposure to infected animals.

All previous bird flu cases in the United States have been among farmworkers, including the very first, in 2022.

In the decades since H5 has been found in humans, there have been rare cases where an animal source cannot be identified.

But there has so far not been evidence of sustained human-to-human transmission, which would significantly increase the threat level.

Website: International Conference on Infectious Diseases.

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HIV and AIDS: The Basics

What is HIV and AIDS?

HIV stands for human immunodeficiency virus, which is the virus that causes HIV infection. The abbreviation “HIV” can refer to the virus or to HIV infection.

AIDS stands for acquired immunodeficiency syndrome. AIDS is the most advanced stage of HIV infection.

HIV attacks and destroys the infection-fighting CD4 cells (CD4 T lymphocyte) of the immune system. The loss of CD4 cells makes it difficult for the body to fight off infections, illnesses, and certain cancers. Without treatment, HIV can gradually destroy the immune system, causing health decline and the onset of AIDS. With treatment, the immune system can recover.

How is HIV transmitted?

HIV can be transmitted from one person to another when certain bodily fluids are shared between people. Bodily fluids that can transmit HIV include blood, semen (“cum”), pre-seminal fluid (“pre-cum”), vaginal fluids, rectal fluids, and breastmilk. HIV can be transmitted during vaginal or anal sex, through sharing needles for injecting drugs or tattooing, by getting stuck with a needle that has the blood of someone with HIV on it, through pregnancy, and through breastfeeding.

The transmission of HIV from a birthing parent with HIV to their child during pregnancy, childbirth, or breastfeeding is called perinatal transmission of HIV. For more information on perinatal transmission, read the HIVinfo fact sheet on Preventing Perinatal Transmission of HIV.

You cannot get HIV by shaking hands or hugging a person who has HIV. You also cannot get HIV from contact with objects, such as dishes, toilet seats, or doorknobs, used by a person with HIV. HIV is not spread through the air or water or by mosquitoes, ticks, or other insects. Use the HIVinfo You Can Safely Share…With Someone With HIV infographic to spread this message.

What is the treatment for HIV?

Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. People on ART take a combination of HIV medicines (called an HIV treatment regimen) every day (pills) or by schedule (injections). In many cases oral medicines may be combined into a single pill or capsule. There are newer long-acting medicines given by an injection every 2 months that may be used in some people.

ART is recommended for everyone who has HIV. ART prevents HIV from multiplying, which reduces the amount of HIV in the body (called the viral load). Having less HIV in the body protects the immune system and prevents HIV infection from advancing to AIDS. ART cannot cure HIV, but HIV medicines can help people with HIV live long, healthy lives.

How can a person reduce the risk of transmitting HIV?

ART reduces the risk of HIV transmission. ART can reduce a person’s viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have no risk of transmitting HIV to their HIV-negative partner through sex.

HIV medicines taken during pregnancy, childbirth, and breastfeeding can also reduce the risk of perinatal (parent to infant) transmission of HIV. Previously, replacement feeding (properly prepared formula or pasteurized donor human milk from a milk bank) was recommended instead of breastfeeding since the risk of HIV transmission was considered high. Now, there is evidence that the risk of transmission through the breastmilk of someone consistently using ART and maintaining an undetectable viral load is low (less than 1%). Pregnant people with HIV can speak with their health care provider to determine what method of feeding their baby is right for them.

How can a person reduce the risk of getting HIV?

For people without HIV, there are several ways to reduce the risk of acquiring (getting) HIV infection. Using condoms correctly with every sexual encounter, particularly with partners that are HIV positive with a detectable viral load or with partners whose HIV status is unknown, can reduce the risk of acquiring HIV. Reducing HIV risk also involves limiting and reducing sexual partners, and avoiding sharing needles.

Persons who do not have HIV should talk to their health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who do not have HIV but who are at risk of becoming infected with HIV. PrEP involves taking a specific HIV medicine every day or a long-acting injection. For more information, read the HIVinfo fact sheet on Pre-exposure Prophylaxis (PrEP).

Persons who do not have HIV, but may have been exposed to HIV, should talk to their health care provider about post-exposure prophylaxis (PEP) within 72 hours after a possible exposure. For more information, read the HIVinfo fact sheet on Post-Exposure Prophylaxis (PEP).

To learn more about reducing the risk of HIV transmission, read the HIVinfo fact sheet The Basics of HIV Prevention.

What are the symptoms of HIV and AIDS?


Within 2 to 4 weeks after infection with HIV, some people may have flu-like symptoms, such as fever, chills, or rash. The symptoms may last for a few days to several weeks. Other possible symptoms of HIV include night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers. Having these symptoms does not mean you have HIV. Other illnesses can cause the same symptoms. Some people may not feel sick during early HIV infection (called acute HIV). During this earliest stage of HIV infection, the virus multiplies rapidly. After the initial stage of infection, HIV continues to multiply but at lower levels.

More severe symptoms of HIV infection for persons not on ART may not appear for many years until HIV has developed into AIDS. People with AIDS have weakened immune systems that make them prone to opportunistic infections. Opportunistic infections are infections and infection-related cancers that occur more frequently or are more severe in people with weakened immune systems than in people with healthy immune systems.

Without treatment, HIV transmission is possible at any stage of HIV infection—even if a person with HIV has no symptoms of HIV.

How is AIDS diagnosed?

Symptoms such as fever, weakness, and weight loss may be a sign that a person’s HIV has advanced to AIDS. However, a diagnosis of AIDS is based on the following criteria:A drop in CD4 count to less than 200 cells/mm3. A CD4 count measures the number of CD4 cells (CD4 T lymphocyte) in a sample of blood.
OR
The presence of certain opportunistic infections.

Although an AIDS diagnosis indicates severe damage to the immune system, HIV medicines can still help people at this stage of HIV infection.

Website: International Conference on Infectious Diseases.

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Measles cases surge 20 percent, global study shows

Measles

GENEVA: Measles infections soared by a fifth last year to over 10 million cases globally, revealing alarming gaps in vaccine coverage, a study showed Thursday.

Worldwide, there were an estimated 10.3 million measles cases in 2023, according to a joint publication by the World Health Organization and the US Centers for Disease Control and Prevention (CDC).
That marked a 20-percent increase from 2022, the study showed, saying that “inadequate immunization coverage globally is driving the surge in cases.”

Measles is one of the world’s most infectious diseases. At least 95-percent coverage with two doses of the measles/rubella vaccine is needed to prevent outbreaks.
But in 2023, only 83 percent of children worldwide received their first dose of the measles vaccine through routine health services — the same level as in 2022 but down from 86 percent before the pandemic.
Only 74 percent received their second dose last year, the study showed.
“Measles vaccine has saved more lives than any other vaccine in the past 50 years,” WHO chief Tedros Adhanom Ghebreyesus said in a joint statement.

“To save even more lives and stop this deadly virus from harming the most vulnerable, we must invest in immunization for every person, no matter where they live.”
CDC director Mandy Cohen said: “The measles vaccine is our best protection against the virus, and we must continue to invest in efforts to increase access.”

As a result of global gaps in vaccination coverage, 57 countries experienced large and disruptive measles outbreaks in 2023, up from 36 countries a year earlier, the study showed.
All regions except the Americas were impacted, it said, with nearly half of all large and disruptive outbreaks occurring in the African region.
The virus that can cause a rash, fever and flu-like symptoms but also particularly severe complications in young children is estimated to have killed 107,500 people in 2023, most of them under the age of five.

This marks an eight-percent decrease from the previous year.
The agencies explained that the decline was mainly due to the fact that the surge in cases occurred in countries and regions where children with measles were less likely to die, due to better nutritional status and access to health services.

“Far too many children are still dying from this preventable disease,” they said.
The agencies cautioned that a global target of eliminating measles as an endemic threat by 2030 was “under threat.”
By the end of last year, 82 countries had achieved or maintained measles elimination.
After Brazil this week reverified having eliminated measles, WHO’s Americas region is once again considered free of endemic measles.
All regions, with the exception of Africa, meanwhile count at least one country that has eliminated the disease.

The agencies called for urgent and targeted efforts to ensure all children are reached with two vaccine doses, especially in the African and Eastern Mediterranean regions and in fragile and conflict-affected areas.
“This requires achieving and maintaining high-performing routine immunization programs and delivering high-quality, high-coverage campaigns when those programs are not yet sufficient to protect every child,” they said.

Website: International Conference on Infectious Diseases.

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Infectious disease control in the microbial functional genomics era

The continuing advances in the high-throughput and deep sequencing technologies and the bioinformatics tools used to analyse, interpret, and share sequencing data have revolutionised infectious disease microbiology. The emergence of varied “omics” or “omes” technologies have advanced the transition to sequence-based characterisation of infectious diseases.

The microbial genomics characterised by high resolution have allowed for tracking the transmission of infectious agents, establishing accurate evolutionary relationships among circulating pathogens and predicating associated phenotypes (e.g. serotype, pathogenicity, and antimicrobial resistance(AMR)). Therefore, microbial genomics have been extremely useful in investigating outbreaks, detecting the emergence of atypical and novel variants, and tracking the dissemination of AMR.

Currently the size of archived microbial sequences is doubled every two years and, with hundreds of thousands of bacterial and viral samples being sequenced annually, it is likely to grow at an increasing pace. However, this huge volume of microbial sequences has not yet reflected an advance in our understanding of the “functionality” of microbial genes (microbial gene function).

Bacterial functional genomics technologies can have tremendous impact on this knowledge gap because they can assay every gene in the bacterial genome simultaneously to discern genotype-phenotype associations, and they can identify functional signatures of individual bacterial species and/or bacterial populations within specific niches. These included Microbial functional genomics, Transposon Insertion Sequencing (TIS), Transposon Directed Insertion-site Sequencing (TraDIS), Transposon Sequencing (IN-Seq, Tn-Seq), Whole transcriptome, shotgun megtagenomics, microbial genome-wide association studies (mGWAS), Antimicrobial Resistant bacteria, microbe-host interactions, ecological niches, high-throughput phenotype, bacterial knock-out

The specific themes of this Research Topic include (but are not limited to):

1. Identification of the molecular basis of bacterial emergence, pathogenesis and infection biology (infections within in vivo environments)

2. Survival mechanisms (and metabolic pathways) employed by bacterial species to resist multiple antimicrobial drugs, tolerate environmental stress, evade host immune responses, and evade bacteriophage killing mechanisms

3. Microbiomics analysis to identify the dynamics of AMR bacteria and ARGs within different hosts and/or varied environments (ecological niches)

4. Translational microbiology involving the identification of bacterial targets for novel therapeutics and preventive interventions

Website: International Conference on Infectious Diseases.

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5 actions for a malaria-free world

Every day over 1,200 children die from malaria, a disease that is both preventable and treatable.

Malaria is caused by parasites transmitted through the bite of an infected female anopheles mosquito. It is one of the leading killers of children under five and disproportionately affects vulnerable communities. Malaria also has severe economic ramifications for families, causing an estimated $12 billion in productivity losses annually, as parents are forced to take time off work for treatment and care.

1. Life-saving malaria vaccines

Malaria vaccines represent a breakthrough in protecting the most vulnerable children from severe forms of malaria and even death. With support from UNICEF, 22 countries are preparing to, or are alraedy rolling out these life-saving vaccines.

Two malaria vaccines, RTS,S/AS01 and R21/Matrix-M, are considered highly effective, reducing clinical malaria by about 75 per cent when administered seasonally in high transmission areas.As the leading global vaccine provider, UNICEF has been at the forefront of this work. In Ghana, Kenya and Malawi, where the malaria vaccines were first piloted, millions of children were reached and all-cause child mortality fell by 13 per cent, a remarkable breakthrough in child health and child survival.

2. Mosquito bed nets

Sleeping under insecticide-treated bed nets is one of the most effective ways to prevent malaria transmission. These nets create a protective barrier against mosquito bites during the night, saving countless lives, especially among young children, pregnant women and families living in areas with high rates of transmission.

For decades, UNICEF has worked to get mosquito nets to those most at risk—providing more than 500 million mosquito nets in over 50 countries, including 13 million in 2023 alone.

3. Early malaria diagnosis and treatment

Ensuring access to early malaria diagnosis and effective treatments is critical to child survival, especially in hard-to-reach areas where access to care is challenging.

UNICEF collaborates with governments to provide diagnostic tests and antimalarial medications as part of integrated health care programmes that identify and address a range of childhood illnesses, including malaria, diarrhoea and pneumonia, which are the three top causes of child deaths globally.No child should survive malaria only to die of pneumonia, diarrhoea or another illness. By strengthening health systems to identify, manage and monitor malaria and other diseases, UNICEF is contributing to improving child survival in even the most remote communities.

4. Community awareness and empowerment

Community awareness and social behaviour change is an essential part of malaria prevention and control.

UNICEF works with local leaders and health workers, as well as trusted networks of women, youth, faith groups and schools, to spread awareness about malaria prevention and control: understanding symptoms, seeking early diagnosis and treatment and adopting preventive interventions. Additionally, we work to debunk myths and combat misinformation by sharing correct information across communities.Through engaging campaigns and local partnerships, UNICEF empowers communities with the knowledge needed to protect themselves from malaria.

5. Partnering for scale, innovation and impact

UNICEF collaborates with other organizations, national governments, local partners and other stakeholders to enhance malaria control efforts. These partnerships enable the sharing of resources, expertise and innovative solutions, like the introduction and scale-up of malaria vaccines. By working together, we can maximize our impact, driving down malaria cases and improving health outcomes for children on a global scale.

UNICEF, together with partners, is promoting a comprehensive and innovative approach to combating malaria. By increasing country capacities in prevention, diagnosis and treatment, we can achieve a malaria-free world where every child has the possibility to survive and thrive.



Website: International Conference on Infectious Diseases.

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