At-home test for infected ticks could improve Lyme Disease diagnosis

家庭感染蜱虫检测可能改善莱姆病诊断

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. 全球估计有 899 种蜱虫，其中约 90 种发现于美国本土；然而，只有四种蜱虫导致了当今美国发现的大多数感染。

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. 研究表明，每年有超过 3100 万美国人——或者说近十分之一的人——会遭遇蜱虫叮咬。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，只需 36 到 48 小时就能传播数十种疾病，包括无形体病、巴贝西虫病、落基山斑点热、alpha-gal 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室就诊人数激增，其中莱姆病是最常见的诊断结果。估计每年有 476,000 名患者接受莱姆病治疗，主要集中在东北部、中大西洋地区和上中西部，这得益于其携带者——黑腿蜱的普遍存在。

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 New England 地区。这位波士顿的儿科医师助理表示，过去几年里，她诊所里出现“关节巨大肿胀且无外伤”的儿童数量稳步上升——这些症状预示着莱姆关节炎，这是一种在未治疗的蜱虫叮咬后一到几个月内发生的状况。

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. 莱姆病在早期或急性期最容易治疗，这使得快速识别蜱虫对治疗至关重要。大多数人在叮咬部位会出现“靶形”皮疹，并伴有其他症状，包括发烧、发冷、头痛、疲劳、肌肉和关节疼痛、淋巴结肿大以及颈部僵硬。虽然最常见的治疗是 10 到 14 天的抗生素疗程，但 CDC 也建议在莱姆病报告率高的地区，如果蜱虫附着超过 36 小时，可在 72 小时的预防窗口期内单次服用 200 毫克多西环素。

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. 不幸的是，即使经过治疗，有些人也会经历治疗后莱姆病综合征，以前被称为“慢性莱姆病”。在完成适当的抗生素治疗后数月，这种诊断伴随着持续的疲劳、肌肉骨骼疼痛或认知困难。根据 CDC 的说法，克服这种综合征需要时间，而不是额外的抗生素。

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 的常规做法是在完成血液检测的同时，甚至在获得官方莱姆病诊断之前就开具抗生素。她说，不得不“因为莱姆病风险太高而普遍开具处方”让她感到困扰，从而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 年她作为麻省理工学院斯隆研究员攻读 MBA 期间选修的一门医疗保健创业课程中。学生们从三个创新轨道——莱姆病、制药或帕金森病——中选择一个，来开发和推介原创想法。随后，同学们组成合作团队，推进最强的概念。“我加入课程较晚，被分配到了莱姆病，”Dawicki 解释道。“起初，我的计划只是完成课程要求，但在推介截止的早晨，一个想法跳进了我的脑海。”

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. 她的病人经常打电话给她，报告说在孩子的身体上发现了蜱虫。他们很担心，想知道最好的行动方案，但他们负担不起来诊所就诊的费用。作为一名医疗专业人员，Dawicki 理解医疗保健可及性中的变量，患者担心护理成本或请假就诊，尤其是当相关的蜱虫甚至可能不携带疾病时。

“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. “所以，我想，如果他们能在家里测试蜱虫，然后立即知道它是否感染了莱姆病，那不是很酷吗？”Dawicki 说。

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. 趣味事实：美国国家蜱虫收藏是世界上最大的持续策展蜱虫收藏。超过一百万个蜱虫标本存放在佐治亚州 Statesboro 的佐治亚南方大学。该收藏由史密森尼国家自然历史博物馆出借，是研究蜱虫传播疾病传播的研究人员的重要资源。

Why the uptick in ticks? 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. 为什么蜱虫数量增加了？全球估计有 899 种蜱虫，其中约 90 种发现于美国本土；然而，只有四种蜱虫导致了当今美国发现的大多数感染。

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. 分布于东北部、中大西洋地区、上中西部和东南部，黑腿蜱（Ixodes scapularis）是分布最广的蜱虫物种。它携带莱姆病、无形体病、巴贝西虫病、波瓦桑病毒和宫下伯氏疏螺旋体病。

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. 西部黑腿蜱（Ixodes pacificus）发现于太平洋沿岸，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。

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. 孤星蜱（Amblyomma americanum）起源于东南部，但最近已蔓延至中西部、中大西洋地区和东北部，携带埃立克体病、Heartland 病毒、STARI 和 alpha-gal 综合征。

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. 最后，美洲狗蜱（Dermacentor variabilis）分布在美国东部以及西部部分地区，可能携带落基山斑点热和兔热病。

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. 虽然其他常见物种包括墨西哥湾蜱、落基山木蜱和棕色狗蜱，但它们导致的人类感染少于主要的四种。

“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. “三十年前，只有两份关于可传播莱姆病的 Ixodes 蜱虫的报告，而且都在肯塔基州的一只郊狼身上，”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以及它如何感染宿主并在蜱虫和哺乳动物之间转换。

“Today, there are many, many other places where the range of the tick is expanding; therefore, the inciden “今天，有许多许多其他地方蜱虫的活动范围正在扩大；因此，发病率”（注：原文此处截断）