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1. Comparing
results
and
predic2ons
of
different
surveillance
approaches
for
Lyme
borreliosis
Canine
seroprevalence
in
New
Brunswick
as
a
case
study
Dr. Vett Lloyd
Mt. Allison University

2. Faculty/Presenter
Disclosure
• Faculty:
Ve3
Lloyd
• Rela2onships
with
commercial
interests:
– Grants/Research
Support:
NSERC
– Speakers
Bureau/Honoraria:
Academic
only
– Consul2ng
Fees:
None
– Other:
Employee
of
Mt.
Allison
University

3. Disclosure
of
Commercial
Support
• This
program
has
received
financial
support
from
NSERC
in
the
form
of
Discovery
Grant,
MITACS
grant.
• Poten2al
for
conflict(s)
of
interest:
•
None

4. MiHgaHng
PotenHal
Bias
• NSERC
does
not
dictate
or
prescribe
research
results.

5. Content:
1. Different
surveillance
approaches
and
the
role
of
canine
seroprevalence
studies
2. Canine
seroprevalence
in
New
Brunswick
.
Surveillance
of
Hcks
in
New
Brunswick,
2012-­‐1015.
Julie
Lewis,
Ve3
Lloyd.
Unpublished.
Lyme
disease
risk
in
Dogs
in
New
Brunswick
Natalie
K.
Bjurman1,
Gina
Bradet2,
Ve3
K.
Lloyd1,3
CVJ,
in
press

6. Surveillance
for
2cks
and
2ck-­‐vectored
diseases
November
3rd
2014
AcHve
Hck
surveillance
Canine
seroprevalence
Passive
Hck
surveillance
Human
case
reports
Labour
intensive
and
expensive
Low
sensiHvity
Under-­‐reporHng
Used
extensively
in
US,
Europe
and
Asia
Limited
use
in
Canada
PaHcularly
useful
in
areas
of
emerging
risk

7. h3p://www.express.co.uk/news/nature/
439432/Mystery-­‐of-­‐killer-­‐canine-­‐
disease-­‐spreading-­‐from-­‐the-­‐New-­‐Forest
Why
this
works:
h3p://www.dog-­‐care-­‐
knowledge.com/dog-­‐Hck-­‐
removal.html
h3p://www.wellcomeimageawards.org/2014/
Hck-­‐sucking-­‐blood-­‐from-­‐human-­‐leg
Humans
and
dogs
get
Lyme
disease
in
the
same
way

8. Advantages
–informaHon
on
canine
Lyme
is
rouHnely
collected
by
veterinary
clinics
using
standardized
and
validated
methodologies.
It
is
freely
available
on
line
which
is
valuable
for
public
awareness
and
educaHon.
Pet
Disease
Report
-­‐
IDEXX
h3p://www.petdiseasereport.com/content/
prevmap.aspx?currentprev=LS

9. New
Brunswick
as
a
case
study
on
the
use
of
canine
seroprevalence
as
a
predictor
of
human
Lyme
disease
risk

10. Why
New
Brunswick?
Leiske,
D
and
V.
Lloyd
–
in
review
Surveillance
of
Hcks
in
New
Brunswick,
2012-­‐1015.
Julie
Lewis,
Ve3
Lloyd.
Unpublished.

11. Why
• Live
with
humans
• Robust
immune
response
• When
ill,
similar
clinical
manifestaHons
of
disease
(symptoms)
ie
arthriHs,
lameness,
and
neurological
disease
• InfecHon
detected
with
commercial
kits
Methods
nutrasilver.com
How
• Recruitment
of
veterinary
clinics
• 100
canine
blood
samples
for
each
of
the
7
NB
health
districts
• Tested
699
samples
using
IDEXX
Snap4Dx+C6
ELISA
and
immunoblot
• Risk
factor
correlaHon
Borrelia
infec2on
(Lyme
disease
risk)
in
Dogs
in
New
Brunswick
Natalie
K.
Bjurman1,
Gina
Bradet2,
Ve3
K.
Lloyd1,3

12. Results
Rapid
recent
increase
in
canine
seroposi2vity
(6
fold
in
6
years)
Western
blohng
results
were
generally
consistent
with
C6
ELISAs
but
both
tests
had
false
posiHves
and
possibly
false
negaHves
There
is
no
accepted
algorithm
for
interpretaHon
of
western
blots
and
posiHve/negaHve
calls
varied
by
algorithm

14. So
what
does
this
mean
for
humans?
1:6
raHo
of
human:dog
infecHons
6,475
humans
with
Lyme
New
Brunswick
Public
Health
5

15. Re-­‐assessment
approach
ProporHon
of
infected
Hcks
(I)
Number
of
infected
humans
X
X
=
x
x
x
x
x
x
x
x
ProporHon
engorging
on
humans(F)
Number
of
Hck
bites
(T)

16. X
X
=
x
x
x
x
x
x
x
x
ProporHon
of
infected
Hcks
(I)
ProporHon
engorging
on
dogs
(F)
Number
of
Hck
bites
(T)
Number
of
infected
dogs

17. Propor2on
of
infected
2cks
-­‐
I
I
=
0.123
(NML
low
value
.068,
high
value
.159)
Ogden
et
al.
2006
Dibernardo
et
al
2014
Lewis
and
Lloyd
(in
prep)
1990-­‐2003
2012
2014
151
364
536
15.9%
6.8%
12.3%
year
Number
tested
%
infecHon

18. Propor2on
of
fed
2cks
-­‐
F
F
=
0.614
/0.08
(humans)
or
0.974/.60
(dogs)
0
1
2
3
4
5
6
7
8
9
10
0
2
4
6
8
10
BL/SL
ra2o
BW/SW
ra2o
NB
2014
Hcks
Literature
Tick
size
vs
2me
feeding
72hrs
0-­‐24h
19
1-­‐2
days
1
2-­‐3
days
3
3+
days
2
0-­‐24h
25
1-­‐2
days
18
2-­‐3
days
97
3+
days
208
humans
dogs

19. x
x
x
x
x
x
x
x
Number
of
2ck
bites
-­‐
T
2014
-­‐
111,677
dogs
in
NB
-­‐
6,700
(6%)
Borrelia
seroposiHve
Ipsos-­‐Forward
on
behalf
of
the
Canadian
Animal
Health
InsHtute
(
h3p://www.cahi-­‐icsa.ca/companion-­‐
animal-­‐health/
and
StaHsHcs
Canada
To
produce
6,700
Borrelia
seroposiHve
dogs
with
a
Hck
infecHon
rate
of
12.3%
and
with
60%
fed
3+
days
gives
an
esHmated
90,786
2ck
bites
Adjustments:
Average
1.33
Hcks/dogs
(so
more
Hck
bites)
Not
all
Hcks
found
by
dog
owners
(so
more
Hck
bites)
Tick
infecHon
rate
can
reflect
infecHon
acquired
from
host
so
infecHon
rate
could
really
be
11.56%
–
so
more
Hck
bites
Part
1.
Dogs

20. Part
2.
Extrapola2ng
dog
to
human
2ck
bites:
Number
of
2ck
bites
-­‐
T
To
what
extent
does
a
Hck
prefer
a
dog
to
a
human?
This
can
be
esHmated
from
return
rates
from
passive
surveillance
programmes
or
from
the
literature.
h3p://www.feathersandfleece.com/
gpage13.htmlfgfr
NB
Hcks
from
humans
NB
Hcks
from
dogs
Dibernardo
et
al
(2014)
123
187
Lewis
and
Lloyd
(in
prep)
25
429
148
616
19.4%
of
Hcks
on
humans
vs
dogs
Lindenmeyer
et
al
1991
:human:dog
Hck
raHo
of
1:6
(14.3%)
This
gives
us
an
esHmate
of
19.4%
x
90786
dog
Hck
bites
17,612
human
2ck
bites
(T).

21. So
what
does
this
mean
for
humans?
Lindenmeyer
et
al
1991
6,475
humans
with
Lyme
5
New
Brunswick
Public
Health
LB
=
I
x
F
x
T(h)
MulHplied
by
the
infecHon
rate
(I)
of
12.3%
and
probability
of
a
Hck
on
a
human
having
fed
3+
days
(F),
8%
173
predicted
human
infecHons
in
NB
in
2014.
(ConservaHve
esHmate)

22. Discrepancies:
TesHng
at
the
Hme
of
Hck
bite
Lyme
diagnosis
not
considered
Under-­‐reporHng
Single
Her
vs
two
Hered
tesHng
SensiHvity
of
tesHng
Perdurance
of
canine
seroposiHvity
IDEXX
tech
notes

23. Conclusions
Canine
seroposi2vity
surveillance
is
a
powerful
complement
to
2ck
surveillance
approaches
• Inexpensive
(as
it
is
already
being
done)
• Standardized
methodologies
• NaHonal
infrastructure
in
place
• Directly
relevant
to
humans
• InsensiHve
to
problems
with
Hck
endemnicity