The threat of tick-borne disease in vulnerable West Virginia

In 2022, the U.S. Centers for Disease Control designated West Virginia as a high incidence state for tick-borne disease, supported by rapidly increasing rates of Lyme disease. However, this disease is transmitted by a single species of ixodid (Acari: Ixodidae) tick: Ixodes scapularis. Meanwhile, populations of other species, such as Haemaphysalis longicornis and Amblyomma americanum, appear to be on the rise. These species are quickly establishing themselves in West Virginia and are capable of transmitting a wide range of diseases. Based on trends seen in reported Lyme disease cases combined with the state’s weak healthcare infrastructure and high poverty rates, we hypothesize that the state of West Virginia is not adequately prepared for a potential explosion of new tick species and tick-borne diseases. In order to evaluate the state’s vulnerability, U.S. Census and American Community Survey data were used to compare areas with different levels of healthcare access, classified by hospital location, median income, educational attainment, poverty rate, and insurance status. Social Vulnerability Index scores were also assessed. Our results indicate that West Virginia’s vulnerability is impacted by lack of access to major medical centers, lack of insurance, and poverty indicators. In the future, it will be important to conduct proper research, surveillance, and outreach in West Virginia in order to minimize the impact of tick-borne illnesses.