PubMed Health⌕ Search

Biomedical subjects

R C Falco

Publications and source records attributed to R C Falco.

At least 19 recordsLinked to original sources
PubMed2001

Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite.

BACKGROUND: It is unclear whether antimicrobial treatment after an Ixodes scapularis tick bite will prevent Lyme disease. METHODS: In an area of New York where Lyme disease is hyperendemic we conducted a randomized, double-blind, placebo-controlled trial of treatment with a single 200-mg dose of doxycycline in 482 subjects who had removed attached I. scapularis ticks from their bodies within the previous 72 hours. At base line, three weeks, and six weeks, subjects were interviewed and examined, and serum antibody tests were performed, along with blood cultures for Borrelia burgdorferi. Entomologists confirmed the species of the ticks and classified them according to sex, stage, and degree of engorgement. RESULTS: Erythema migrans developed at the site of the tick bite in a significantly smaller proportion of the subjects in the doxycycline group than of those in the placebo group (1 of 235 subjects [0.4 percent] vs. 8 of 247 subjects [3.2 percent], P<0.04). The efficacy of treatment was 87 percent (95 percent confidence interval, 25 to 98 percent). Objective extracutaneous signs of Lyme disease did not develop in any subject, and there were no asymptomatic seroconversions. Treatment with doxycycline was associated with more frequent adverse effects (in 30.1 percent of subjects, as compared with 11.1 percent of those assigned to placebo; P<0.001), primarily nausea (15.4 percent vs. 2.6 percent) and vomiting (5.8 percent vs. 1.3 percent). Erythema migrans developed more frequently after untreated bites from nymphal ticks than after bites from adult female ticks (8 of 142 bites [5.6 percent] vs. 0 of 97 bites [0 percent], P=0.02) and particularly after bites from nymphal ticks that were at least partially engorged with blood (8 of 81 bites [9.9 percent], as compared with 0 of 59 bites from unfed, or flat, nymphal ticks [0 percent]; P=0.02). CONCLUSIONS: A single 200-mg dose of doxycycline given within 72 hours after an I. scapularis tick bite can prevent the development of Lyme disease.

Adolescent↗
PubMed2000

Estimating population size and drag sampling efficiency for the blacklegged tick (Acari: Ixodidae).

Estimates of absolute density were determined over a 5-yr period (1990-1994) for a population of Ixodes scapularis Say located in Westchester County, NY, by mark-release-recapture (nymphs and adults) and removal (larvae) methods. Density estimates for larvae ranged from 5.2 to 16.5/m2 and averaged 11.5/m2. Values for nymphs varied as much as fourfold among successive years, ranging from 0.5 to 2.3/m2 and averaging 1.2/m2, whereas adult density ranged from 0.3 to 0.4/m2, averaging 0.33/m2. Natural mortality of nymphs and adults was measured in experimental cages during population estimation periods, and indicated that survival declined linearly over the short-term and did not significantly influence estimates. Drag sampling efficiency, the proportion of the estimated population obtained in a single sample, averaged 6.3% among all stages. Efficiency was not significantly different among stages and was independent of tick density within a given life stage. The population estimation techniques employed in this study are well suited for use with I. scapularis and can provide data that offer insights into mortality patterns in individual populations.

Animals↗
PubMed2000

Lyme disease.

Lyme borreliosis, the most common vector-borne disease in the northern hemisphere, is caused by bacteria belonging to the Borrelia burgdorferi complex. The disease is multisystemic, affecting mainly the skin, nervous system, heart and joints. In Europe, the vector of the disease is the tick Ixodes ricinus, whereas in the United States of America, two primary tick vectors exist, namely: I. scapularis in the north-eastern and mid-western regions and I. pacificus on the west coast. Several species of small and medium-sized mammals and ground-feeding birds serve as reservoirs for the bacteria in endemic areas. The prognosis for patients with Lyme borreliosis is excellent, particularly when diagnosed and treated early in the course of infection. Prevention of Lyme borreliosis can be achieved using two approaches, either prevention of infection by immunisation, or prevention of tick bites through avoidance, personal protection and tick control.

Animals↗
PubMed1999

Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans.

Understanding the role that nymphal and female ticks, Ixodes scapularis, have in the epidemiology of Lyme disease is essential to the development of successful prevention programs. In this study, the authors sought to evaluate the seasonal and annual relations between tick densities and patients > or = 16 years of age diagnosed with erythema migrans (EM), the rash associated with early Lyme disease. Ticks were collected weekly by drag sampling throughout most of the year from 1991 to 1996 in Westchester County, New York. The number of EM cases was based on patients diagnosed at the Westchester County Medical Center using Centers for Disease Control and Prevention (CDC) criteria. No patients with EM were diagnosed from January through April, when only adult ticks were active. Correlation analysis between monthly tick densities and EM incidence was significant for nymphs (r = 0.87, p < 0.01), but not for adult ticks (r = -0.57, p > 0.05). There was a strong, although not significant, correlation between peak annual number of patients with EM and peak nymphal tick abundance (r = 0.76, p = 0.08). These data indicate that bites from adult I. scapularis only rarely result in Lyme disease, and that annual nymphal tick abundance determines exposure. This suggests that annual fluctuations in Lyme disease case numbers are largely due to natural changes in tick abundance and, therefore, that control of nymphal I. scapularis should be a major component of Lyme disease prevention efforts.

Adult↗
PubMed1998

Geographic risk for lyme disease and human granulocytic ehrlichiosis in southern New York state.

Ixodes scapularis, the tick vector of Lyme disease and human granulocytic ehrlichiosis (HGE), is prevalent in much of southern New York state. The distribution of this species has increased, as have reported cases of both Lyme disease and HGE. The unreliability of case reports, however, demonstrates the need for tick and pathogen surveillance in order to accurately define areas of high risk. In this study, a total of 89,550 m2 at 34 study sites was drag sampled in 1995 and a total of 51,540 m2 at 40 sites was sampled in 1996 to determine tick and pathogen distribution in southern New York state. I. scapularis was collected from 90% of the sites sampled, and regionally, a 2.5-fold increase in nymphal abundance occurred from 1995 to 1996. I. scapularis individuals from all sites were infected with Borrelia burgdorferi in 1995, while an examination of ticks for both B. burgdorferi and the agent of HGE in 1996 confirmed that these organisms were present in all counties; the average coinfection rate was 1.9%. No correlation was found between estimated risk and reported cases of Lyme disease. The geographic disparity of risk observed among sites in this study underscores the need for vector and pathogen surveillance on a regional level. An entomologic risk index can help identify sites for targeted tick control efforts.

Animals↗
PubMed1996

Duration of tick bites in a Lyme disease-endemic area.

Regression equations, based on scutal index (body length/scutal width), were developed to determine the duration of attachment for nymphal and adult female lxodes scapularis ticks. Feeding times were calculated for 444 nymphal and 300 female ticks submitted by bite victims between 1985 and 1989 in Westchester County, New York, an area where Lyme disease is highly endemic. Nymphs were attached for a mean of 34.7 hours, with 26.8% removed after 48 hours, the critical time for transmission of Borrelia burgdorferi. Attachment times increased with victim age class (Kruskal-Wallis test, p < 0.05). Mean duration of attachment for female ticks (28.7 hours) was significantly less (Kruskal-Wallis test, p < 0.05) than that for nymphs, with 23.3% attached for more than 48 hours. The 0- to 9-year age class had the highest proportion (37.1%) of females attached for more than 48 hours. Nymphs remain attached to adult tick-bite victims longer than they remain attached to children. However, children have a high risk of acquiring Lyme disease because they receive more nymphal bites and also because they are less likely to have female ticks removed in time to prevent transmission.

Adolescent↗
PubMed1996

Timing of Ixodes scapularis (Acari: Ixodidae) oviposition and larval activity in southern New York.

Timing of oviposition and larval eclosion for fall- and spring-fed female blacklegged tick, Ixodes scapularis Say, and effect of temperature on those events in southern New York state, where Lyme disease is endemic, were determined in the field. We also examined seasonal pattern of larval host-seeking activity, as well as rate of survival for overwintering, unfed larvae. Totals of 9 and 8 replete female I. scapularis were released in fall 1988 and spring 1989, respectively. For the 10 females that oviposited, egg laying began in mid-to-late May, regardless of when ticks had fed. Likewise, larval eclosion was synchronized in July for all egg masses. Microhabitat temperatures experienced by females were not reliable indicators of female reproductive success, in terms of either presence or absence of eggs, or numbers of larvae recovered. However, average body size was significantly greater for females that oviposited successfully than for those that did not. The percentage of unfed larvae surviving the 8-mo overwintering period from late August to early May ranged from 1.9 to 31.4, with a mean survival rate of 10.4%. Concurrent drag sampling through the year indicated a bimodal pattern of larval abundance marked by a relatively small early peak of activity in late May that extended into early July. Because the first peak of larval activity occurred during the period of oviposition, 8 wk before onset of larval eclosion, it appears that bimodality represents activity of 2 consecutive cohorts, with the early peak composed of overwintering survivors. These data imply variation in timing of reproduction and larval activity from 1 geographic area to another. Efforts to devise a comprehensive scheme for the life cycle of I. scapularis must consider that population differences may exist.

Animals↗
PubMed1995

Increase in abundance of immature Ixodes scapularis (Acari: Ixodidae) in an emergent Lyme disease endemic area.

Changes in the abundance of immature Ixodes scapularis Say, the primary vector of Lyme disease, were assessed over a 7-yr period in Westchester County, New York, where the disease is endemic. In total, 4,000 m2 were drag sampled at each of 6 study sites in June and July of 1984 and 1991. The abundance of nymphs collected from all sites was 2.6-fold greater in 1991 than in 1984. Four of the 6 sites had significantly more nymphs in 1991, with increases ranging from 1.1- to 46.5-fold. The abundance of larvae collected from all sites was 34.2-fold higher in 1991 than in 1984. Five of the sites sampled had significantly more larvae in 1991, with increases ranging from 2.7- to 681-fold. These data demonstrate that populations of immature I. scapularis in Westchester County have, overall, increased during the 7-yr period from 1984 to 1991. However, the magnitude of increase is not uniform from site to site.

Animals↗
PubMed1993

The distribution of canine exposure to Borrelia burgdorferi in a Lyme-Disease endemic area.

OBJECTIVES: A serosurvey of canine exposure to Borrelia burgdorferi, the causative agent of human Lyme disease, was conducted in Westchester County, New York, to determine the distribution of exposure in an area endemic for Lyme disease. METHODS: A total of 1446 blood samples was collected from resident dogs and tested by modified enzyme-linked immunosorbent assay. Equivocal samples were further tested by immunoblot. A mean number of 57.8 samples was collected from each of 25 towns and cities. RESULTS: Seroprevalence rates for municipalities ranged from 6.5% to 85.2%. County seroprevalence was 49.2%. There was a significant difference among the rates for the northern (67.3%), central (45.2%), and southern (17.3%) regions. Multiple range analysis indicated homogeneity between the southern and central regions and the central and northern regions. CONCLUSIONS: Canine exposure to B burgdorferi increases in a south to north gradient within the county. Intensity of exposure, measured by enzyme-linked immunosorbent assay titers, indicates a similar pattern. The close association between dogs and humans suggests that human risk of acquiring Lyme disease within Westchester County is equally disparate and is inversely related to the degree of urbanization.

Animals↗
PubMed1992

A comparison of methods for sampling the deer tick, Ixodes dammini, in a Lyme disease endemic area.

The purpose of this study was to compare the trapping and examining of mice, drag sampling, and CO2-baited traps for their ability to detect the presence and abundance of immature deer ticks, Ixodes dammini, in a Lyme disease endemic area in southern New York State. Eight study sites were sampled 14 times between 28 May and 31 August by setting 49 live-traps, four CO2-baited traps, and drag sampling 500 m2. A total of 1540 nymphs and 3079 larvae was collected during the study. Drag sampling collected the most nymphs (705), while more larvae were recovered from CO2-baited traps (1105). Comparisons among the methods showed a significant difference in the numbers of both larval and nymphal ticks collected (P less than 0.01). There was a positive correlation between the numbers of nymphs collected by drag sampling and CO2-baited tick traps (rs = 0.83, P less than 0.05), and between the numbers of larvae collected by drag sampling and mouse trapping (rs = 0.75, P less than 0.05). These results suggest that drag sampling would be the single most reliable method for quantitatively sampling immature I. dammini populations in a Lyme disease endemic area.

Analysis of Variance↗
PubMed1991

Evaluation of host-targeted acaricide for reducing risk of Lyme disease in southern New York state.

A 2-yr evaluation of a commercial product designed to reduce the risk of Lyme disease by delivering permethrin-treated cotton to white-footed mice (Peromyscus leucopus) was conducted at three sites in Westchester County, N.Y., an area where Lyme disease is endemic. We examined the numbers of host-seeking nymphal Ixodes dammini Spielman, Clifford, Piesman & Corwin, the numbers of larval I. dammini infesting mice, and the proportion of nymphs infected with Borrelia burgdorferi, the causative agent of Lyme disease. The density of nymphs collected by drag sampling did not differ between treatment and control areas in the first year for either a woodland or recreational site. In the second year, no significant decrease in the density of nymphs was observed in the treatment areas compared with the control areas. Numbers of larvae on 67 mice captured on treatment and control grids did not differ for woodland and recreational sites, but significantly fewer larvae were found on mice captured at the residential treatment site. The percentage of host-seeking ticks infected with spirochetes did not differ between treatment and control sites in any habitat for either year. The use of permethrin-treated cotton did not measurably reduce the numbers of I. dammini or the proportion of ticks infected with spirochetes at our study sites.

Animals↗
PubMed1991

Horizontal movement of adult Ixodes dammini (Acari: Ixodidae) attracted to CO2-baited traps.

The ability of male and female deer ticks, Ixodes dammini Spielman, Clifford, Piesman, & Corwin, to move horizontally was evaluated by performing a mark-recapture study. In each of two experiments, 120 ticks were marked with fluorescent powder and released at predetermined distances from a CO2-baited trap. The mean recruitment distance was 1.8 m after 6 d of trap operation. This distance is appreciably lower than those calculated from previous studies of several other species of ixodid ticks, including Amblyomma americanum (9.9 m for 48 h) and Dermacentor andersoni (6.3 m for 48 h). Both the number of ticks attracted and the distance traveled to the trap were dependent upon the duration of trap operation (P less than 0.001 for both cases).

Animals↗
PubMed1989

Seasonal activity and survival of adult Ixodes dammini (Acari: Ixodidae) in southern New York State.

Mark-recapture studies demonstrated that adult Ixodes dammini Spielman, Clifford, Piesman, and Corwin in southern New York successfully overwinter and resume active host-seeking in the spring. Thus, the resulting bimodal peak in autumn and spring appears to reflect temperature-induced activity of the same cohort and not different generations. Adult tick abundance in the field was monitored by counting the number of ticks collected by a domestic dog on routine walks and correcting for the effects of temperature on tick activity. It is suggested that adult abundance, measured independently of ambient temperature, may be an accurate indicator of survival. The field tick abundance curve was negatively exponential (y = e(4.26-0.12x] and significantly different from the survival curve for ticks maintained in the laboratory, which displayed a constant mortality rate (y = -3.7x + 105.5). Body size influenced male survival during the winter, whereas female survival was independent of body size. Greater male mortality in fall and winter resulted in a lower sex ratio in spring.

Animals↗
PubMed1989

Potential for exposure to tick bites in recreational parks in a Lyme disease endemic area.

Eight recreational parks located in a Lyme disease endemic area of southern New York State were surveyed for the presence of ticks during the summer of 1985 by drag sampling. Ixodes dammini, the primary vector of Lyme disease in the northeast, was found in all but one park and accounted for 580 (91.8 per cent) of the 632 ticks collected. Of these, 18 per cent were larvae, 80 per cent were nymphs, and 2 per cent were adults. An I. dammini encounter distance, defined as the mean number of meters traveled before encountering a nymphal or adult I. dammini on a drag cloth, ranged from 36 m in high-risk parks, to infinity (no tick encounters). Generally, areas of high use presented higher encounter distances (lower risk) than those of the entire park. Two of the three parks with the highest annual attendance also had the highest I. dammini population indices as projected from our sampling regimen. These results indicate that recreational parks in Lyme disease endemic areas represent a substantial human risk for tick bites and Lyme disease.

Animals↗
PubMed1988

Prevalence of Ixodes dammini near the homes of Lyme disease patients in Westchester County, New York.

Cases of Lyme disease that occurred in Westchester County, an affluent suburb north of New York City, in 1983 were investigated in 1983 and 1984 to determine the presence of Ixodes dammini (Acari: Ixodidae) in the vicinity of the patients' homes. Small mammal trapping, drag cloth, and carbon dioxide-baited tick traps were used to sample ticks. In all but one of 11 cases investigated, I. dammini was found on or near well-maintained lawns in the immediate vicinity of the residences. A mark-release-recapture experiment to determine tick abundance in one 700 m2 lawn resulted in an estimate of 6800 adult ticks (approximately 1 per m2). Dark-field microscopic examination of tick midgut tissues revealed that 33% of nymphs and 55% of adult ticks from this lawn contained spirochetes. These data suggest that many cases of Lyme disease in Westchester County, New York, may be acquired at home as a result of activities on the lawn.

Animals↗
PubMed1988

Ticks parasitizing humans in a Lyme disease endemic area of southern New York State.

A total of 126 tick specimens were submitted by tick bite victims to the Westchester County Department of Health, White Plains, New York, and to the New York Medical College, Medical Entomology Laboratory, Armonk, New York, during 1985. These included 96 (76.2%) Ixodes dammini, 26 (20.6%) Dermacentor variabilis, and two (1.6%) Amblyomma americanum. I. dammini parasitism was reported during all months of the year except December and February and involved all life stages. Only D. variabilis adults parasitized humans, with all cases occurring in the spring and summer. The mean age of I. dammini victims was 24.5 years, with 39.0% under age 10 years. This age group also accounted for 52.0% of all D. variabilis victims (mean age, 16.8 years). The majority of I. dammini and D. variabilis were though to be acquired in the victims' yards (68.6 and 64.7%, respectively). Attachment sites for these species were significantly different, with I. dammini nymphs found most frequently on the lower extremities and I. dammini adults and D. variabilis adults found primarily on the head. Prophylactic antibiotic treatment was prescribed by a physician for 40.8% of I. dammini victims, compared with 4.5% of the D. variabilis victims. Lyme disease was reported by two patients during the course of the study. Neither had received prophylactic therapy at the time of the reported tick bite.

Adolescent↗