to foster greater coordination on surveillance , research , education , and prevention of tickborne diseases , cdc established ticknet during 2007 .
ticknet is a public health network that includes partners from state health departments and academic institutions collaborating through the emerging infections program ( eip ) , staff of state and local health departments collaborating through the epidemiology and laboratory capacity ( elc ) cooperative agreement , and cdc staff in the division of vector - borne diseases and the division of parasitic diseases and malaria .
ticknet provides funding to state and local health departments through the elc cooperative agreement to help sustain and enhance routine surveillance for tickborne diseases .
approximately 18 state and local health departments are funded annually for lyme disease surveillance , with priority given to states with a reported incidence of lyme disease greater than the national average and to bordering states where the disease may be spreading . during 2014 , an additional 7 state and local health departments received elc funding to support surveillance for other tickborne diseases . together with elc funding for program support , funding through eip has allowed ticknet partners in maryland , minnesota , and new york to undertake special studies to quantify underreported tickborne diseases .
these studies include a review of patient charts and codes from the international classification of diseases , ninth edition , and provide insights into the use of electronic medical records for public health surveillance .
other studies in massachusetts , minnesota , and new york are examining ways to streamline the evaluation of positive laboratory reports by using random sampling methods .
, ticknet partners at eip sites in connecticut , maryland , minnesota , and new york conducted a survey of commercial , clinical , and state laboratories to evaluate practices and volume of testing for 5 leading tickborne diseases . collectively , 7 large commercial laboratories reported testing 2.4 million patient specimens for evidence of b. burgdorferi infection during 2008 , at an estimated cost of $ 492 million . after correcting for test sensitivity , specificity , and stage of illness ,
the overall frequency of infection among patients for whom samples were tested was estimated at 12% .
applied to the total number of specimens , this percentage yielded an estimated 288,000 true b. burgdorferi infections ( range 240,000444,000 ) among source patients during 2008 ( 18 ) .
results of this study will be compared with results of other ongoing cdc studies to estimate the overall frequency of lyme disease and other tickborne infections in the united states .
to better quantify the public health burden of tickborne diseases , ticknet eip partners in connecticut , maryland , minnesota , and new york have undertaken a study to quantify current costs associated with individual cases of lyme disease . begun during 2014 ,
the cost of lyme disease study uses a prospective survey design to capture individual and societal costs of lyme disease , including out - of - pocket medical costs , nonmedical costs , and productivity losses , as well as total direct medical costs to society by using billing codes from enrolled patients providers .
this estimate will be used to guide impact assessments of current and future prevention methods . as an adjunct to personal protective measures such as use of insect repellents ,
several yard - based interventions have been proposed to reduce tick abundance in the home environment . to assess the efficacy of such interventions in preventing human illness , ticknet sites have instituted a series of studies to evaluate the efficacy of novel and commercially available prevention strategies .
one study , a randomized , blinded , placebo - controlled , multistate trial assessing the effectiveness of acaricide barrier sprays , will cover 2,700 households in 3 states , with outcomes measures including tick density on acaricide - treated properties , the number of tick  human encounters , and the number of tickborne diseases in humans .
a second study , begun in connecticut during 2012 , uses a similar design to evaluate the effectiveness of bait boxes that apply fipronil to rodents that are the reservoirs of b. burgdorferi
. used by veterinarians to prevent flea and tick infestations on dogs , fipronil kills ticks on the rodents for several weeks and may potentially interrupt the local transmission cycle of b. burgdorferi .
recent experience indicates that additional tickborne pathogens are waiting to be discovered . in collaboration with the tennessee and minnesota health departments , the mayo clinic , and vanderbilt university ,
ticknet has recently initiated a study to identify novel agents of tickborne disease . over the next 3 years ,
> 30,000 clinical specimens from us patients with suspected tickborne diseases will be screened by using high - throughput molecular methods designed to detect bacteria , followed by use of genomic sequencing to characterize detected pathogens .
the ultimate goal is to better describe the epidemiologic and laboratory features associated with recognized and novel tickborne pathogens and to guide the development of new diagnostic methods .
although sometimes overlooked , tickborne diseases pose an increasing threat to public health . factors driving the emergence of tickborne diseases are poorly defined , but current prevention methods are clearly inadequate . addressing this problem
requires a multidisciplinary approach with input of entomologists , epidemiologists , educators , and infectious disease and communications specialists .
built on the pillars of the eip and the elc cooperative agreements , ticknet provides a collaborative network that brings together these resources at the federal and state levels to enhance surveillance , improve prevention , and identify new tickborne diseases .
 ticknet , a public health network , was created in 2007 to foster greater collaboration between state health departments , academic centers , and the centers for disease control and prevention on surveillance and prevention of tickborne diseases . 
 research activities are conducted through the emerging infections program and include laboratory surveys , high - quality prevention trials , and pathogen discovery . 