The incidence of tickborne diseases in the United States is increasing; reported cases more than doubled from >22,000 in 2004 to >48,000 in 2016 (1). Ticks are responsible for approximately 95% of all locally acquired vectorborne diseases reported by states and the District of Columbia, with Lyme disease accounting for >80% of those cases (2). After a tick bite, persons might seek care at an emergency department (ED) for tick removal and to receive postexposure prophylaxis, which has been shown to effectively prevent Lyme disease when taken within 72 hours of a high-risk bite (3). Using data from CDC's National Syndromic Surveillance Program (NSSP), investigators examined ED tick bite visits during January 2017-December 2019 by sex, age group, U.S. region, and seasonality. During this 36-month period, 149,364 ED tick bite visits were identified. Mean cumulative incidence was 49 ED tick bite visits per 100,000 ED visits overall; incidence was highest in the Northeast (110 per 100,000 ED visits). The seasonal distribution of ED tick bite visits was bimodal: the larger peak occurred during the spring and early summer, and the smaller peak occurred in the fall. This pattern aligns with the seasonality of a known and abundant human-biter, the blacklegged tick, Ixodes scapularis (4). Compared with other age groups, pediatric patients aged 0-9 years accounted for the highest number and incidence of ED tick bite visits; incidence was higher among male patients than among females. Tick bites are not monitored by current surveillance systems because a tick bite is an event that in and of itself is not a reportable condition to health departments. Syndromic surveillance of ED tick bite visits can provide timely information that might predict temporal and geographic risk for exposure to tickborne diseases and guide actionable public health messaging such as avoiding tick habitats, wearing repellent consistently when outdoors, and performing regular tick checks during times of increased tick bite risk.

中文翻译：

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2017年1月至2019年12月，美国急诊部探视ick虫叮咬。

在美国，壁虱传播疾病的发病率正在上升。报告的病例从2004年的> 22,000增加到2016年的> 48,000（1）的两倍以上。在各州和哥伦比亚特区报告的所有本地传播的媒介传播疾病中，壁虱大约占95％，莱姆病占这些病例的80％以上（2）。a虫叮咬后，人们可能会去急诊室（ED）寻求护理，以去除tick虫并接受暴露后预防，这已被证明有效地预防了高风险叮咬后72小时内的莱姆病（3）。研究人员使用CDC国家综合症状监测计划（NSSP）的数据，按性别，年龄段，美国地区和季节性检查了2017年1月至2019年12月间ED tick叮咬的访问。在这36个月的时间内149，确定了364次ED tick叮咬访视。平均累计发病率为每100,000 ED访视49次ED tick叮咬访视；东北地区的发病率最高（每10万例ED就诊110次）。ED tick叮咬探访的季节性分布是双峰的：较大的高峰发生在春季和初夏，而较小的高峰发生在秋季。这种模式与已知的丰富人类咬人黑脚tickIxodes scapularis的季节性相吻合（4）。与其他年龄段相比，0-9岁的儿科患者占ED tick叮咬访视的次数和发生率最高。男性患者的发病率高于女性。当前的监视系统不监视虫叮咬，因为a虫叮咬本身是对卫生部门不可报告的事件。