At-home test for infected ticks could improve Lyme Disease diagnosis
At-home test for infected ticks could improve Lyme Disease diagnosis
家用蜱虫检测技术有望改善莱姆病的诊断
Of the estimated 899 species of ticks worldwide, about 90 are found in the continental U.S.; however, only four species are responsible for most of the infections found in the U.S. today. Research shows that more than 31 million Americans—or nearly one in ten people—experience a tick bite every year. While some tick bites can be harmless, these parasitic arachnids that feed on both animals and people can transmit dozens of diseases in as little as 36 to 48 hours, including anaplasmosis, babesiosis, Rocky Mountain spotted fever, alpha-gal syndrome and Lyme disease.
在全球估计的 899 种蜱虫中，约有 90 种存在于美国大陆；然而，目前美国大多数感染病例是由其中四种蜱虫引起的。研究表明，每年有超过 3100 万美国人（即近十分之一的人口）遭遇蜱虫叮咬。虽然有些蜱虫叮咬可能无害，但这些以动物和人类为食的寄生蛛形纲动物可在短短 36 到 48 小时内传播数十种疾病，包括无形体病、巴贝西虫病、落基山斑疹热、α-半乳糖综合征和莱姆病。
This spring, the Centers for Disease Control and Prevention (CDC) reported a spike in tick-borne-illness-related emergency room visits, with Lyme disease being the most common diagnosis. An estimated 476,000 patients are treated each year for Lyme disease, concentrated in the Northeast, Mid-Atlantic and Upper Midwest, thanks to the prevalence of its carrier: blacklegged ticks.
今年春天，美国疾病控制与预防中心（CDC）报告称，与蜱虫传播疾病相关的急诊就诊人数激增，其中莱姆病是最常见的诊断结果。据估计，每年有 476,000 名患者接受莱姆病治疗，病例主要集中在东北部、中大西洋地区和中西部北部，这主要归因于其携带者——黑腿蜱虫的广泛分布。
Erin Dawicki is no stranger to the increase in tick-borne illnesses, especially in New England where she resides. For the past few years, the pediatric physician associate in Boston has experienced a steady uptick in kids showing up in her office with “huge swollen joints and zero trauma,” she says—symptoms that signal Lyme arthritis, a condition that develops anywhere from one to a few months after an untreated tick bite.
Erin Dawicki 对蜱虫传播疾病的增加并不陌生，尤其是在她居住的新英格兰地区。过去几年里，这位波士顿的儿科医师助理发现，来到她诊所就诊的孩子中，出现“关节严重肿胀且无外伤”的情况稳步增加。她说，这些症状预示着莱姆关节炎，这是一种在蜱虫叮咬后若未及时治疗，可能会在数周至数月内出现的疾病。
Lyme disease is easiest to treat during its early, or acute, stage, which makes quick tick identification critical for treatment. Most experience a “bull’s-eye” rash at the site of the bite, along with other symptoms, including fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes, and neck stiffness. While the most common treatment is a 10- to 14-day course of antibiotics, the CDC also recommends a single 200-milligram dose of doxycycline within a 72-hour prophylactic window, if the tick had been attached for 36 hours, in areas where Lyme disease reports are high.
莱姆病在早期（急性期）最容易治疗，因此快速识别蜱虫对于治疗至关重要。大多数患者在叮咬部位会出现“牛眼状”皮疹，并伴有其他症状，包括发烧、寒战、头痛、疲劳、肌肉和关节疼痛、淋巴结肿大以及颈部僵硬。虽然最常见的治疗方法是进行 10 到 14 天的抗生素疗程，但 CDC 也建议，在莱姆病高发地区，如果蜱虫叮咬时间已达 36 小时，可在 72 小时的预防窗口期内服用单剂 200 毫克的强力霉素。
Unfortunately, even treated, some people experience post-treatment Lyme disease syndrome, previously known as “chronic Lyme disease.” This diagnosis comes with persistent fatigue, musculoskeletal pain or cognitive difficulties months after completing the appropriate antibiotic treatment. According to the CDC, time, and not additional antibiotics, is needed to overcome the syndrome.
遗憾的是，即使经过治疗，有些人仍会经历“治疗后莱姆病综合征”（此前被称为“慢性莱姆病”）。这种诊断意味着在完成适当的抗生素治疗数月后，患者仍会感到持续的疲劳、肌肉骨骼疼痛或认知困难。据 CDC 称，克服这种综合征需要时间，而非额外的抗生素。
Because early treatment is critical for recovery, Dawicki’s mode of course is to complete a blood test while also prescribing antibiotics before even obtaining an official Lyme disease diagnosis. It bothers her that she has to “blanket prescribe because the risk of Lyme is so high,” she says, thus contributing to the growing antibiotic resistance health crisis within the United States.
由于早期治疗对康复至关重要，Dawicki 的做法是在获得莱姆病正式诊断之前，就先进行血液检查并开具抗生素处方。她说，她很苦恼必须进行“全面开药，因为莱姆病的风险太高了”，这加剧了美国日益严重的抗生素耐药性健康危机。
Dawicki’s “aha moment” came during a health care entrepreneurship course she took as a MIT Sloan fellow during her MBA program in 2024. Students selected one of three innovation tracks—Lyme disease, pharmaceuticals or Parkinson’s disease—to develop and pitch an original idea. From there, classmates formed collaborative teams to advance the strongest concepts. “I joined the class late and was assigned Lyme disease,” explains Dawicki. “Initially, my plan was to just check the box on the course, but the morning the pitches were due, an idea popped into my head.”
Dawicki 的“顿悟时刻”出现在 2024 年她攻读 MBA 期间，作为麻省理工学院斯隆管理学院的研究员，她参加了一门医疗保健创业课程。学生们需要从莱姆病、制药或帕金森病这三个创新方向中选择一个，开发并推介一个原创想法。随后，同学们组成合作团队来推进最具潜力的概念。“我加入课程比较晚，被分配到了莱姆病方向，”Dawicki 解释道，“起初，我只是打算应付一下课程，但在提交方案的当天早上，一个想法突然出现在我的脑海里。”
So often her patients call her to report they have found a tick on their child. They’re worried and want to know the best course of action, but they can’t afford to come in for an office visit. As a medical professional, Dawicki understands the variables in health care accessibility, having patients concerned about the cost of care or taking time off work for an appointment, especially when the tick in question may not even be disease-carrying. “So, I thought, wouldn’t it be cool if they could just test the tick at home, and then they know immediately if it’s Lyme-infected?” Dawicki says.
她的患者经常打电话给她，说在孩子身上发现了蜱虫。他们很担心，想知道最好的处理方法，但又负担不起去诊所就诊的费用。作为一名医疗专业人员，Dawicki 理解医疗可及性中的各种变量，患者往往担心护理成本或请假看病的麻烦，尤其是当那只蜱虫可能根本不携带病菌时。“所以我想，如果他们能在家里直接检测蜱虫，并立即知道它是否携带莱姆病病毒，那该多好啊？”Dawicki 说道。
Fun fact: The U.S. National Tick Collection is the largest continuously curated collection of ticks in the world. More than one million tick specimens are housed at Georgia Southern University in Statesboro, Georgia. The collection, on loan from the Smithsonian’s National Museum of Natural History, is an important resource for researchers studying the transmission of tick-borne illnesses.
趣闻：美国国家蜱虫收藏馆是世界上规模最大、持续维护的蜱虫收藏馆。超过一百万份蜱虫标本保存在佐治亚州斯泰茨伯勒的佐治亚南方大学。该收藏馆的标本由史密森尼国家自然历史博物馆借出，是研究人员研究蜱虫传播疾病的重要资源。
Why the uptick in ticks?
为什么蜱虫数量会增加？
Of the estimated 899 species of ticks worldwide, about 90 are found in the continental U.S.; however, only four species are responsible for most of the infections found in the U.S. today. Found across the Northeast, Mid-Atlantic, Upper Midwest and Southeast, the blacklegged tick, Ixodes scapularis, is the most widespread of the tick species. It carries Lyme disease, anaplasmosis, babesiosis, Powassan virus and Borrelia miyamotoi disease.
在全球估计的 899 种蜱虫中，约有 90 种存在于美国大陆；然而，目前美国大多数感染病例是由其中四种蜱虫引起的。黑腿蜱（学名：Ixodes scapularis）分布于东北部、中大西洋、中西部北部和东南部，是分布最广的蜱虫种类。它携带莱姆病、无形体病、巴贝西虫病、波瓦桑病毒和宫本疏螺旋体病。
The western blacklegged tick, Ixodes pacificus, is found along the Pacific Coast, congregating mainly in California, Oregon and Washington, and it also carries Lyme disease and anaplasmosis. The lone star tick, Amblyomma americanum, originated in the Southeast but has recently spread across the Midwest, Mid-Atlantic and Northeast, carrying ehrlichiosis, Heartland virus, STARI and alpha-gal syndrome. Lastly, the American dog tick, Dermacentor variabilis, in the eastern U.S. as well as parts of the West, can carry Rocky Mountain spotted fever and tularemia. While other prevalent species include the Gulf Coast tick, Rocky Mountain wood tick and brown dog tick, they account for fewer human infections than the main four.
西部黑腿蜱（学名：Ixodes pacificus）分布于太平洋沿岸，主要聚集在加利福尼亚州、俄勒冈州和华盛顿州，它也携带莱姆病和无形体病。孤星蜱（学名：Amblyomma americanum）起源于东南部，但最近已扩散到中西部、中大西洋和东北部，携带埃立克体病、哈特兰病毒、STARI 和 α-半乳糖综合征。最后，美国犬蜱（学名：Dermacentor variabilis）分布于美国东部以及西部部分地区，可携带落基山斑疹热和兔热病。虽然其他常见的蜱虫还包括墨西哥湾沿岸蜱、落基山木蜱和褐犬蜱，但它们引起的人类感染病例比上述四种主要蜱虫要少。
“Thirty years ago, there were only two reports ever of the Ixodes ticks that can transmit Lyme disease, and those were both on one coyote in Kentucky,” says Brian Stevenson, a microbiologist at the University of Kentucky’s College of Medicine. He studies the Lyme disease bacterium Borrelia burgdorferi and how it infects hosts and transitions between ticks and mammals. “Today, there are many, many other places where the range of the tick is expanding; therefore, the incidence…”
“三十年前，关于能传播莱姆病的硬蜱（Ixodes）仅有过两份报告，而且都是在肯塔基州的一只郊狼身上发现的，”肯塔基大学医学院的微生物学家 Brian Stevenson 说。他研究莱姆病细菌——伯氏疏螺旋体（Borrelia burgdorferi），以及它是如何感染宿主并在蜱虫和哺乳动物之间传播的。“今天，蜱虫的活动范围正在许多其他地方不断扩大；因此，发病率……”