1. Scott White, DVM, MPH

2.  Clinical Disease in Pets ◦ Anaplasmosis ◦ Lyme  Pets and Human Risk  Preventive Measures  Nantucket Experience

3. Horses  Anaplasmosis (formerly Ehrlichia equi) ◦ Fever most common symptom ◦ Lymphadenopathy & vasculitis (swollen legs) less common ◦ Doxycycline or tetracycline  Lyme -- ?? ◦ Most cases likely were anaplasmosis ◦ Overdiagnosed Cats -- ??

4. Dogs -- Lyme and anaplasmosis  Acute cases: classic symptoms are similar ◦ Fever ◦ Joint pain or swelling ◦ Lymphadenopathy ◦ Often just mild, flu-like symptoms that resolve ◦ Vomiting with anaplasmosis ◦ More severe if co-infected ◦ Rare but severe thrombocytopenia (low platelets) with anaplasmosis ◦ Disease is mostly mild to moderate & very responsive to doxycycline ◦ Diagnosis & treatment straightforward

5. Dogs  Asymptomatic but Sero-Positive on Routine Screening Tests ◦ Persistent Infection or Residual Antibodies ?? ◦ Disease Risks ?? ◦ Doxycycline ??  Anaplasmosis ◦ Consider treatment if recent sero-conversion ◦ Additional blood tests invariably normal ◦ General consensus not to treat  Lyme ◦ Consider treatment if recent sero-conversion ◦ Suspected increased risk of kidney disease in chronic infections ◦ Unlikely to prove infection with laboratory tests ◦ Evidence of kidney disease by testing for elevated protein in urine ◦ Treat or monitor based on results

6.  Bring ticks to us ◦ Petting or grooming ◦ Living spaces ◦ Car  Activities with pets in infested areas ◦ Walks or rides ◦ Hunting ◦ Getting the “tennis ball” for the dog YES – Pets increase our risk of exposure to TBDs !!

7.  Similar steps for preventing exposure to ourselves ◦ Avoid likely infested areas ◦ Tick checks ◦ Landscaping and spraying yard  Pet specific measures ◦ Topical products for dogs and cats  monthly, year-round  not repellants  fipronil? ◦ Vaccination and routing screening tests for dogs

8.  Ticks can be… ◦ anywhere ◦ very focal  S easonal owners and pets from non-endemic areas ◦ Unaware of risks and preventive measures ◦ Vaccinations/testing not available from regular veterinarian ◦ Onset of disease when return home ‣ Sero-positive rates in dogs are high ◦ N=100 Neg/Neg: 40 An: 38 L: 3 An/L: 19 ◦ 60% positive for Anaplamosis, Lyme or both ◦ Anaplasmosis > Lyme @ 3:1 ◦ present year-round (adults) ◦ “suddenly” around homes