Chapter 120 of the 2023 Virginia Acts of Assembly tasked the Virginia Department of Health (VDH) with convening a “work group composed of representatives of health care providers, public health experts, organizations representing individuals living with or impacted by tick-borne diseases, and other appropriate stakeholders to study and make recommendations for reducing the occurrence and impact of tick-borne diseases in the Commonwealth." The work group was instructed to address increasing both public and healthcare provider awareness of tick-borne diseases, improving public health surveillance of tick-borne diseases and developing strategies to control tick populations. VDH sponsored five meetings from May through August of 2023 to address the four items specified in the chapter. The work group was instructed to report its findings and recommendations to the Governor and the General Assembly by November 1, 2023.

RECOMMENDATIONS AND DISCUSSION

Major recommendations associated with each item listed in Chapter 120 of the 2023 Virginia Acts of Assembly are listed below. Additional recommendations can be found in the body of the report.

1. Increasing public awareness of tick-borne diseases and strategies for preventing tick-borne diseases:

a. In addition to continuing tick prevention work that VDH is already engaged in, VDH should work with stakeholders, such as the Virginia Department of Education (DOE), the Virginia Council for Private Education (VCPE), Virginia Farm Bureau, Virginia Cooperative Extension, Virginia Department of Conservation and Recreation (DCR), National Capital Lyme Disease Association (NatCapLyme), and youth associations as appropriate (e.g., Boy & Girl Scouts of America), to create tick awareness and tick-borne disease prevention educational programs for K-12 students.

b. In collaboration with the DOE, VDH should create lesson plans and educational materials to enhance Science, Health and/or Physical Education curricula and produce educational content about tick bite prevention and tick-borne diseases.

2. Educating health care providers and the public about the importance of and need for early diagnosis and treatment of tick-borne diseases:

a. Virginia medical associations that offer continuing education are strongly encouraged to routinely offer continuing education including content pertaining to the clinical presentation, diagnosis, and treatment of tick-borne diseases found in Virginia.

b. Institutions offering graduate-level clinical health professions programs in Virginia are encouraged to:

i. Offer comprehensive instruction about the diagnosis and treatment of tick-borne diseases found in Virginia, including information about variations in clinical presentation, which can inform treatment considerations.

ii. Facilitate the research, development, implementation, and evaluation of practices and interventions to improve health literacy about tick-borne diseases.

c. The work group discussed the need for additional funding to support researchers at Virginia universities and colleges who are engaged in clinical studies on the diagnosis and treatment of tick-borne diseases.

3. Improving public health surveillance and data collection related to tick-borne diseases:

VDH should continue to:

a. modernize and improve visualizations of public health data associated with tick-borne disease.

b. implement new data modernization strategies to improve tick-borne disease data collection, case investigations, and data quality assurance and control measures.

c. strengthen and support local health department personnel with training and consultations concerning best practices for tickborne disease surveillance, case investigations, and data collection.

d. engage with healthcare providers to better understand the most effective methods to communicate public health entomology and tick-borne disease information with providers.

e. work with federal agencies, academic partners, and other stakeholders that are involved in public health entomology for tick surveillance and testing.

4. Developing and implementing strategies to reduce tick populations and reduce the risk of exposure to and transmission of tick-borne diseases in the Commonwealth:

a. VDH and academic partners should continue tick surveillance to understand where human illness risk lies in the environment and to inform education of healthcare providers and members of the public about the need for personal protective measures and early detection of common and emerging tick-borne diseases.

b. VDH and other state agencies focused on public education about the environment and human disease prevention should continue to highlight best practices in landscape management to reduce tick abundance around homes and public areas.

c. The work group discussed the need for additional funding to support institutions of higher education in Virginia engaged in public health entomology research focused on the environmental control of ticks, tick surveillance, and tick testing.