1. Ticks and Tick-borne Diseases in Fairfax County, VA Joshua Smith, M.S. Environmental Health Specialist Fairfax County Health Department

2. Fairfax County Suburban/peri-urbanSuburban/peri-urban ~ 1,000,000 residents ~ 1,000,000 residents ~ 400 square miles ~ 400 square miles

3. What are we doing about Lyme disease and other tick-borne diseases in Fairfax County? Tick and pathogen surveillanceTick and pathogen surveillance Community outreach and educationCommunity outreach and education Finding out what people knowFinding out what people know

4. Tick Surveillance 2006-082006-08 –Lyme disease focus 2009-102009-10 –Expanded and more robust –Other ticks and tick-borne pathogens

5. Tick Sampling CO 2 trap (year-round)CO 2 trap (year-round) DragDrag FlagFlag Host examinationHost examination –Small mammal –White-tailed deer Veterinary clinics and animal shelterVeterinary clinics and animal shelter Tick ID serviceTick ID service

6. Species ID Service (n= 228) Trapping (n=5,302) Vet & Shelter* (n=583) Amblyomma americanum 69.390.047.0 Dermacentor variablis 13.62.013.0 Ixodes scapularis 16.78.040.0 * Does not include June collections Summary of % of Selected Ticks Collected, 2010

7. Ix. scapularis tested, B. burgdorferi positive, all stages, 2010 Week # ticks

8. Tick Species Pathogen Infection Rate Ix. scapularis Deer Tick Deer Tick B. burgdorferi B. burgdorferi 24.3 A. phagocytophilum 0.56 Am. americanum Lone Star Tick Lone Star Tick E. chaffensis 6.3 B. lonestari 2.1 R. amblyommii 26.6 Am. maculatum Gulf Coast Tick Gulf Coast Tick R. parkeri 40.8 R. amblyommii 1.2 R. andeane 0.6 De. variabilis De. variabilis Dog Tick Dog Tick R. parkeri 0.3 R. montanensis 0.97 Frequency of Tick Pathogens* in the County, 2010 *No R. ricketsii detected

9. Community Outreach and Education Efforts

10. Annual Lyme Disease Awareness Month Proclamation

11. Educational Materials ~50,000 >400,000

12. Books, tattoos, calendars

13. Outreach Events

14. How are we measuring impact? Ticks and pathogens presentTicks and pathogens present –Compare data –Vector and disease ecology Educational materialsEducational materials –? Community outreachCommunity outreach –?

15. KAP Study K nowledgeK nowledge –Understanding of topic A ttitudesA ttitudes –Feelings towards subject –Preconceived ideas on subject P racticesP ractices –Demonstration of knowledge and attitudes through action

16. KAP Study Use to measure response to specific intervention (e.g., outreach and education)Use to measure response to specific intervention (e.g., outreach and education) Track changes in KAPTrack changes in KAP Tailor activitiesTailor activities Pre- and post-intervention surveysPre- and post-intervention surveys –Baseline –Follow-up: Impact?

17. 2007 Lyme Disease KAP Study OverallOverall –Most heard of Lyme disease –Most knew how transmitted Hispanic subsetHispanic subset –Interview in English or Spanish –Lack of awareness of Lyme disease and ticks in Spanish- speaking community

19. Summary Surveillance CreativityCommunication PositiveImpact

21. THANK YOU