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Background: Northward expansion of the tick Ixodes scapularis is driving Lyme disease (LD) emergence in Canada. Information on mechanisms involved is needed to enhance surveillance and identify where LD risk is emerging. Objectives: We used passive and active surveillance and phylogeographic analysis of Borrelia burgdorferi to investigate LD risk emergence in Quebec. Methods: In active surveillance, we collected ticks from the environment and from captured rodents. B. burgdorferi transmission was detected by serological analysis of rodents and by polymerase chain reaction assays of ticks. Spatiotemporal trends in passive surveillance data assisted interpretation of active surveillance. Multilocus sequence typing (MLST) of B. burgdorferi in ticks identified likely source locations of B. burgdorferi. Results: In active surveillance, we found I. scapularis at 55% of sites, and we were more likely to find them at sites with a warmer climate. B. burgdorferi was identified at 13 I. scapularis–positive sites, but infection prevalence in ticks and animal hosts was low. Low infection prevalence in ticks submitted in passive surveillance after 2004—from the tick-positive regions identified in active surveillance—coincided with an exponential increase in tick submissions during this time. MLST analysis suggested recent introduction of B. burgdorferi from the northeastern United States. Conclusions: These data are consistent with I. scapularis ticks dispersed from the United States by migratory birds, founding populations where the climate is warmest, and then establishment of B. burgdorferi from the United States several years after I. scapularis have established. These observations provide vital information for public health to minimize the impact of LD in Canada.

Widespread circulation of SARS-CoV-2 in humans raises the theoretical risk of reverse zoonosis events with wildlife, reintroductions of SARS-CoV-2 into permissive nondomesticated animals. Here we report that North American deer mice ( Peromyscus maniculatus ) are susceptible to SARS-CoV-2 infection following intranasal exposure to a human isolate, resulting in viral replication in the upper and lower respiratory tract with little or no signs of disease. Further, shed infectious virus is detectable in nasal washes, oropharyngeal and rectal swabs, and viral RNA is detectable in feces and occasionally urine. We further show that deer mice are capable of transmitting SARS-CoV-2 to naïve deer mice through direct contact. The extent to which these observations may translate to wild deer mouse populations remains unclear, and the risk of reverse zoonosis and/or the potential for the establishment of Peromyscus rodents as a North American reservoir for SARS-CoV-2 remains unknown. Deer mice are natural hosts for a number of human pathogens. Here, Griffin et al. report that intranasal exposure of the North American deer mouse to SARS-CoV-2 results in virus replication and shedding, despite causing only mild or asymptomatic illness. Additionally, infected deer mice can transmit SARS-CoV-2 to naïve deer mice.

Ixodes scapularis ticks are expanding their range in parts of northeastern North America, bringing with them pathogens of public health concern. While rodents like the white-footed mouse, Peromyscus leucopus , are considered the primary reservoir of many emerging tick-borne pathogens, the contribution of birds, as alternative hosts and reservoirs, to local transmission cycles has not yet been firmly established. From 2016 to 2018, we collected host-seeking ticks and examined rodent and bird hosts for ticks at 48 sites in a park where blacklegged ticks are established in Quebec, Canada, in order to characterize the distribution of pathogens in ticks and mammalian and avian hosts. We found nearly one third of captured birds (n = 849) and 70% of small mammals (n = 694) were infested with I . scapularis . Five bird and three mammal species transmitted Borrelia burgdorferi to feeding larvae (n larvae tested = 2257) and we estimated that about one fifth of the B . burgdorferi -infected questing nymphs in the park acquired their infection from birds, the remaining being attributable to mice. Ground-foraging bird species were more parasitized than other birds, and species that inhabited open habitat were more frequently infested and were more likely to transmit B . burgdorferi to larval ticks feeding upon them. Female birds were more likely to transmit infection than males, without age differentiation, whereas in mice, adult males were more likely to transmit infection than juveniles and females. We also detected Borrelia miyamotoi in larvae collected from birds, and Anaplasma phagocytophilum from a larva collected from a white-footed mouse. This study highlights the importance of characterising the reservoir potential of alternative reservoir hosts and to quantify their contribution to transmission dynamics in different species assemblages. This information is key to identifying the most effective host-targeted risk mitigation actions.

Summary 1. Over the past two decades, Ixodes scapularis, the primary tick vector of the Lyme disease pathogen Borrelia burgdorferi in North America has expanded its range northward from the USA to colonize new regions in southern Canada. We have previously projected range increases for I. scapularis based on temperature suitability, but to what extent this is matched by actual tick range expansion is unknown. 2. Since 1990, I. scapularis ticks have been collected across Canada offering a unique opportunity to track the range expansion of an arthropod vector. We used these data to model time‐to‐establishment for tick populations across Canada to identify factors influencing the rate of spread. 3. Our results point to both long‐distance dispersal of ticks by migratory birds and local dispersal by resident hosts as important potential mechanisms underlying patterns of tick range expansion. 4. Temperature (accumulated degree days > 0 °C) was the most important determinant of environmental suitability for tick population establishment, suggesting that climate warming may facilitate range expansion. 5. Model projections suggest that I. scapularis range will expand c. 46 km year−1 in the coming decade, with climate warming expected to increase the rate of spread. This expansion is likely to result in a substantial increase in human Lyme disease risk, with the proportion of the human population of eastern Canada inhabiting areas with established tick populations increasing from 18% in 2010 to over 80% by 2020. 6. This first empirical model of I. scapularis invasion supports theoretical range projections based on climate suitability and provides a unique data‐driven estimate of the speed of northward range expansion for I. scapularis at the continental scale. 7. Synthesis and applications. By tracking I. scapularis invasion in Canada over the past two decades, we show that I. scapularis is rapidly expanding its range and is likely to colonize the most densely populated areas of southern Canada in the coming decade. These projections suggest that prompt action is necessary to prepare the Canadian public for a likely epidemic of Lyme disease, with emphasis on focusing surveillance activities to confirm the locations of emerging Lyme disease risk. By tracking I. scapularis invasion in Canada over the past two decades, we show that I. scapularis is rapidly expanding its range and is likely to colonize the most densely populated areas of southern Canada in the coming decade. These projections suggest that prompt action is necessary to prepare the Canadian public for a likely epidemic of Lyme disease, with emphasis on focusing surveillance activities to confirm the locations of emerging Lyme disease risk.

Climate change is driving emergence and establishment of Ixodes scapularis, the main vector of Lyme disease in Québec, Canada. As for the black-legged tick, I. scapularis Say, global warming may also favor northward expansion of other species of medically important ticks. The aims of this study were to determine (1) current diversity and abundance of ticks of public health significance other than I. scapularis, (2) sex and age of the human population bitten by these ticks (3), and the seasonal and geographic pattern of their occurrence. From 2007 to 2015, twelve tick species other than I. scapularis were submitted in the Québec passive tick surveillance program. Of these 9243 ticks, 91.2% were Ixodes cookei, 4.1% were Dermacentor variabilis, 4.0% were Rhipicephalus sanguineus and 0.7% were Amblyomma americanum. The combined annual proportion of submitted I. cookei, D. variabilis, R. sanguineus and A. americanum ticks in passive surveillance rose from 6.1% in 2007 to 16.0% in 2015 and an annual growing trend was observed for each tick species. The number of municipalities where I. cookei ticks were acquired rose from 104 to 197 during the same period. Of the 862 people bitten by these ticks, 43.3% were I. cookei ticks removed from children aged < 10 years. These findings demonstrate the need for surveillance of all the tick species of medical importance in Québec, particularly because climate may increase their abundance and geographic ranges, increasing the risk to the public of the diseases they transmit.

Dengue viruses are responsible for over 100 million infections a year worldwide and are a public health concern in Bangladesh. Although risk of transmission is high, data on vector population characteristics are scanty in Bangladesh; therefore, a comprehensive prediction of the patterns of local virus transmission is not possible. Recognizing these gaps, multi-year entomological surveys were carried out in Dhaka, where the disease is most frequently reported. The specific objectives of the present study are threefold: i) to determine the risk factors for the presence of Aedes mosquitoes; ii) to identify the types of most productive and key containers; and iii) to estimate the effects of climatic factors on Aedes abundance in the city of Dhaka, Bangladesh. Entomological surveys were conducted in 12 out of 90 wards in Dhaka. These wards were selected using a probability proportional sampling procedure during the monsoon seasons in 2011, 2012 and 2013 and in the dry season in 2012. All containers inside and around sampled households were inspected for mosquito larvae and pupae, and containers were classified according to their relative size, use pattern, and materials of construction. During the study period (2011-2013), 12,680 larvae and pupae were collected. About 82% of the identified immature mosquitoes were Aedes aegypti, while the remainder were Ae. albopictus and other mosquito species. The largest number of immature mosquitoes was collected from tires and refrigerator trays during 2011 and 2012 monsoon seasons. Conversely, plastic drums were the most productive during the 2012 dry and 2013 monsoon season. Vehicle parts and discarded construction materials were the most efficient producers of Aedes mosquitoes in all surveys. The presence of Aedes mosquitoes was significantly (p < 0.05) higher in low socio-economic zones of Dhaka. Container location, presence of vegetation, and availability of shade for containers were also significantly associated with finding immature Aedes mosquitoes, based on multivariable analysis after confounder adjustment. Rainfall, temperature, and relative humidity also significantly affected the mean abundance of mosquitoes. Proper use, disposal, and recycling of the containers that effectively produce large numbers of Aedes vector mosquitoes may decrease the risk of arboviral transmission.

The invasion of the blacklegged tick, Ixodes scapularis into Ontario, Canada poses a significant risk to public health because it is a vector for numerous pathogens, including Borrelia burgdorferi sensu stricto, the causative agent of Lyme disease. Baseline field sampling in 2014 and 2015 detected I. scapularis and B. burgdorferi at sites across southern, eastern and central Ontario, including a hot spot in eastern Ontario. A \"speed of spread\" model for I. scapularis developed by Leighton and colleagues (2012) estimated that the tick's range was expanding northward at 46 km/year. In 2016, we revisited a subset of sites sampled in 2014 and 2015 to understand the changing nature of risk, and assess whether the rate of tick invasion is consistent with the speed of spread estimate. Ticks were collected via tick dragging at 17 out of 36 sites, 5 of which were new sites for I. scapularis. Samples were positive for B. burgdorferi at 8 sites. No other I. scapularis-borne pathogens were detected. Centrographic statistics revealed an increase in the dispersion of I. scapularis positive sites in eastern Ontario. Field data for each site were then compared to the model's predicted year of establishment for each census subdivision. Our findings illustrate that the range expansion of I. scapularis and the emergence of B. burgdorferi is ongoing, and provide short timescale evidence of the processes associated with I. scapularis spread. The range front appears to be moving at a rate of ~46 km/year, with colonization of the tick behind this range front occurring at a slower and heterogeneous rate. Assessment of site-level ecological factors did not provide any insight into the underlying processes that may be influencing the colonization of I. scapularis in specific areas. Ongoing field sampling is needed to monitor this dynamic process. This study highlights the current geographic risk associated with Lyme disease, which can be used to target public health interventions to the areas of greatest risk.

Lyme disease (LD), caused by bacteria of the Borrelia burgdorferi sensu lato species complex, is the most common vector-borne disease in North America and Europe. A systematic review (SR) was conducted to summarize the global literature on adverse birth outcomes associated with gestational LD in humans. The SR followed an a priori protocol of pretested screening, risk of bias, and data extraction forms. Data were summarized descriptively and random effects meta-analysis (MA) was used where appropriate. The SR identified 45 relevant studies, 29 describing 59 cases reported as gestational LD in the United States, Europe, and Asia (1969-2017). Adverse birth outcomes included spontaneous miscarriage or fetal death (n = 12), newborn death (n = 8), and newborns with an abnormal outcome (e.g. hyperbilirubinemia, respiratory distress and syndactyly) at birth (n = 16). Only one report provided a full case description (clinical manifestations in the mother, negative outcome for the child, and laboratory detection of B. burgdorferi in the child) that provides some evidence for vertical transmission of B. burgdorferi that has negative consequences for the fetus. The results of 17 epidemiological studies are included in this SR. Prevalence of adverse birth outcomes in an exposed population (defined by the authors as: gestational LD, history of LD, tick bites or residence in an endemic area) was compared to that in an unexposed population in eight studies and no difference was reported. A meta-analysis of nine studies showed significantly fewer adverse birth outcomes in women reported to have been treated for gestational LD (11%, 95%CI 7-16) compared to those who were not treated during pregnancy (50%, 95%CI 30-70) providing indirect evidence of an association between gestational LD and adverse birth outcomes. Other risk factors investigated; trimester of exposure, length of LD during pregnancy, acute vs. disseminated LD at diagnosis, and symptomatic LD vs. seropositive women with no LD symptoms during pregnancy were not significantly associated with adverse birth outcomes. This SR summarizes evidence from case studies that provide some limited evidence for transplacental transmission of B. burgdorferi. There was inconsistent evidence for adverse birth outcomes of gestational LD in the epidemiological research, and uncommon adverse outcomes for the fetus may occur as a consequence of gestational LD. The global evidence does not fully characterize the potential impact of gestational LD, and future research that addresses the knowledge gaps may change the findings in this SR. Given the current evidence; prompt diagnosis and treatment of LD during pregnancy is recommended.

1. Identifying invading tick populations provides early warning for emerging tickborne diseases that are expanding their geographic range. But how fast do tickborne pathogens invade after ticks become established? 2. Surveillance data for the tick Ixodes scapularis and the agent of Lyme disease Borrelia burgdorferi in southern Canada, an area where these species currently are invading, revealed a space-time cluster of ticks of low B. burgdorferi infection prevalence in southern Quebec signalling the location where tick populations became established beginning in 2004. The cluster disappeared in 2009, indicating a 5-year gap between tick and B. burgdorferi invasion. 3. Simulations of a model of I. scapularis populations and B. burgdorferi transmission identified numbers of immigrating ticks, rather than host density and diversity, as key determinants of the speed of pathogen invasion after ticks become established. 4. Greater numbers of immigrating infected nymphs would be expected in Central compared with Eastern Canada because nymphal and larval ticks in source populations in Midwestern USA are active in spring when migratory birds can carry ticks north. Whereas in northeastern USA, tick populations that are sources for immigrating ticks for Eastern Canada have active nymphs, but few larvae are active in spring. Consequently, we hypothesized that a 5-year gap would occur between tick and B. burgdorferi invasion in Eastern Canada, but a much shorter gap would occur in Central Canada. 5. Consistent with this hypothesis, analysis of surveillance data revealed clusters of ticks with low infection prevalence of ≥ 5 years duration in locations in Eastern Canada where I. scapularis is invading, but a nonsignificant cluster of only 3-year duration in regions of Central Canada where I. scapularis is invading. 6. Synthesis and applications. We have identified the speed at which the pathogen Borrelia burgdorferi invades following the invasion of the tick Ixodes scapularis, and that the synchrony of larval and nymphal tick activity in spring is a key factor determining the gap between tick and pathogen invasion. This has immediate application in interpreting imminence of Lyme disease risk when surveillance identifies emerging tick populations in Canada. It also has general application in predicting of the speed of invasion of emerging tickborne pathogens elsewhere in the world.

Lyme disease is emerging in southern Canada due to range expansion of the tick vector, followed by invasion of the agent of Lyme disease Borrelia burgdorferi sensu stricto. Strain diversity, as determined by Multi Locus Sequence Typing, occurs in this zone of emergence, and this may have its origins in adaptation to ecological niches, and have phenotypic consequences for pathogenicity and serological test performance. Sixty-four unique strains were cultured from ticks collected in southern Canada and the genomes sequenced using the Illumina MiSeq platform. A maximum likelihood phylogenetic tree of the chromosome revealed two large clades with multiple subclades. Consistent with previous studies on this species, the clades were not geographically defined, and some Canadian strains were highly divergent from previously sequenced US strains. There was evidence for recombination in the chromosome but this did not affect the phylogeny. Analysis of chromosomal genes indicated that these are under intense purifying selection. Phylogenies of the accessory genome and chromosome were congruent. Therefore strain differences identified in the phylogeny of chromosomal genes likely act as a proxy for genetic determinants of phenotypic differences amongst strains that are harboured in the accessory genome. Further studies on health implications of strain diversity are needed.