Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Peter J. Krause

Abstract

Background: Salivary proteins from insect bites result in a wide array of complex immune interactions within a bitten host. In the case of the deer tick, Ixodes scapularis, previous research has demonstrated that tick-induced hypersensitivity reactions may interfere with the transmission of Lyme disease. There are no prospective studies in humans regarding the spectrum of hypersensitivity reactions that occur with I. scapularis bites.

Methods: We analyzed data obtained from a prospective enrollment of the first 102 individuals who reported tick bite to a medical practice in Mansfield, Connecticut from 2005-2008. Clinical responses were recorded and subject based diaries were utilized to classify and analyze whether certain reactions reduced tick-borne pathogen transmission.

Results: No subjects developed serious clinical manifestations or systemic reactions. The most common localized reactions were local erythema (88%), swelling (64%), itch (48%), and a delayed type hypersensitivity reaction (27%). None of these responses were associated with the presence or absence of a previous episode of Lyme disease.

Conclusion: Hypersensitivity reactions to I. scapularis bites generally are mild. Although they may help to prevent tick-borne infection, we did not observe an association between tick-bite reaction and the presence or absence of Lyme disease. An expanded and modified surveillance study is needed to determine if there is an association between hypersensitivity reactions and the development of tick-borne infection.

Comments

This is an Open Access Thesis.

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