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Morozov A, Tischenkov A, Silaghi C, Proka A, Toderas I, Movila A, Frickmann H, Poppert S. Prevalence of Bacterial and Protozoan Pathogens in Ticks Collected from Birds in the Republic of Moldova. Microorganisms 2022; 10:microorganisms10061111. [PMID: 35744630 PMCID: PMC9227923 DOI: 10.3390/microorganisms10061111] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
Epidemiological knowledge on pathogens in ticks feeding on birds in Moldova is scarce. To reduce this gap of information, a total of 640 migrating and native birds of 40 species were caught from 2012 to 2015 and examined for the presence of ticks in the Republic of Moldova. Altogether, 262 ticks belonging to five tick species (Ixodes ricunus n = 245, Ixodes frontalis n = 12, Haemaphysalis punctata n = 2, Hyalomma marginatum n = 2 (only males), Dermacentor marginatus n = 1) were collected from 93 birds. Of these ticks, 250 (96%) were at the stage of a nymph and 9 at the stage of a larva (3%). One imago of I. frontalis and two imagoes of Hy. marginatum were found. Generally, ticks infested 14.1% of the assessed birds belonging to 12 species. DNA was extracted from individual ticks with subsequent PCR targeting Rickettsia spp., Borrelia spp. in general, as well as relapsing fever-associated Borrelia spp., in particular, Anaplasma phagocytophilum, Neoehrlichia mikurensis, Babesia spp. and Coxiella burnetii. The bird species Turdus merula showed the heaviest infestation with ticks and the highest incidence of infected ticks. Altogether, 32.8% of the assessed ticks (n = 86) were positive for one of the pathogens. DNA of Borrelia spp. was found in 15.2% (40/262) of the investigated ticks; in 7.6% of ticks (20/262), DNA of rickettsiae was detected; 6.9% (18/262) of the ticks were positive for A. phagocytophilum DNA; in 1.5% of the ticks (4/262), DNA of Neoehrlichia mikurensis was detected, followed by 1.5% (4/262) Babesia microti and 1.5% (4/262) Borrelia miyamotoi. Within the B. burgdorferi complex, B. garinii (n = 36) was largely predominant, followed by B. valaisiana (n = 2) and B. lusitaniae (n = 2). Among the detected Rickettsia spp., R. monacensis (n = 16), R. helvetica (n = 2) and R. slovaca (n = 1) were identified. In conclusion, the study provided some new information on the prevalence of ticks on birds in Moldova, as well as the presence of DNA of pathogens in the ticks. By doing so, it provided an additional piece in the puzzle of the global epidemiology of tick-transmitted infectious diseases from a geographic side from where respective surveillance data are scarce.
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Affiliation(s)
- Alexandr Morozov
- Center of Research of Biological Invasions, Institute of Zoology, MD-2012 Chisinau, Moldova; (A.P.); (I.T.); (A.M.)
- Correspondence: (A.M.); (S.P.)
| | - Alexei Tischenkov
- Natural Geography Department, Shevchenko Transnistria State University, MD-3300 Tiraspol, Moldova;
| | - Cornelia Silaghi
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany;
- Institute of Infectology, Friedrich-Loeffler-Institute, 17493 Greifswald, Germany
| | - Andrei Proka
- Center of Research of Biological Invasions, Institute of Zoology, MD-2012 Chisinau, Moldova; (A.P.); (I.T.); (A.M.)
| | - Ion Toderas
- Center of Research of Biological Invasions, Institute of Zoology, MD-2012 Chisinau, Moldova; (A.P.); (I.T.); (A.M.)
| | - Alexandru Movila
- Center of Research of Biological Invasions, Institute of Zoology, MD-2012 Chisinau, Moldova; (A.P.); (I.T.); (A.M.)
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN 46202, USA
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany;
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany
| | - Sven Poppert
- Bernhard Nocht Institute for Tropical Medicine Hamburg, 20359 Hamburg, Germany
- Correspondence: (A.M.); (S.P.)
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2
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Henningsson AJ, Aase A, Bavelaar H, Flottorp S, Forsberg P, Kirkehei I, Lövmar M, Nilsson K, Nyman D, Ornstein K, Sjöwall J, Skogman BH, Tjernberg I, Aaberge I. Laboratory Methods for Detection of Infectious Agents and Serological Response in Humans With Tick-Borne Infections: A Systematic Review of Evaluations Based on Clinical Patient Samples. Front Public Health 2021; 9:580102. [PMID: 34616701 PMCID: PMC8488432 DOI: 10.3389/fpubh.2021.580102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/20/2021] [Indexed: 01/08/2023] Open
Abstract
Background: For the most important and well-known infections spread by Ixodes ticks, Lyme borreliosis (LB) and tick-borne encephalitis (TBE), there are recommendations for diagnosis and management available from several health authorities and professional medical networks. However, other tick-borne microorganisms with potential to cause human disease are less known and clear recommendations on diagnosis and management are scarce. Therefore, we performed a systematic review of published studies and reviews focusing on evaluation of laboratory methods for clinical diagnosis of human tick-borne diseases (TBDs), other than acute LB and TBE. The specific aim was to evaluate the scientific support for laboratory diagnosis of human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis, babesiosis, hard tick relapsing fever, tularemia and bartonellosis, as well as tick-borne co-infections and persistent LB in spite of recommended standard antibiotic treatment. Methods: We performed a systematic literature search in 11 databases for research published from 2007 through 2017, and categorized potentially relevant references according to the predefined infections and study design. An expert group assessed the relevance and eligibility and reviewed the articles according to the QUADAS (diagnostic studies) or AMSTAR (systematic reviews) protocols, respectively. Clinical evaluations of one or several diagnostic tests and systematic reviews were included. Case reports, non-human studies and articles published in other languages than English were excluded. Results: A total of 48 studies fulfilled the inclusion criteria for evaluation. The majority of these studies were based on small sample sizes. There were no eligible studies for evaluation of tick-borne co-infections or for persistent LB after antibiotic treatment. Conclusions: Our findings highlight the need for larger evaluations of laboratory tests using clinical samples from well-defined cases taken at different time-points during the course of the diseases. Since the diseases occur at a relatively low frequency, single-center cross-sectional studies are practically not feasible, but multi-center case control studies could be a way forward.
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Affiliation(s)
- Anna J Henningsson
- Division of Clinical Microbiology, Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.,Division of Clinical Microbiology, Region Östergötland, Linköping, Sweden.,Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Audun Aase
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Herjan Bavelaar
- Division of Clinical Microbiology, Laboratory Medicine, Region Jönköping County, Jönköping, Sweden
| | - Signe Flottorp
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Pia Forsberg
- Division of Infectious Medicine, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | | | - Matilda Lövmar
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kenneth Nilsson
- Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, Uppsala, Sweden
| | - Dag Nyman
- The Åland Group for Borrelia Research, Mariehamn, Finland
| | | | - Johanna Sjöwall
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Infectious Diseases, Region Östergötland, Norrköping, Sweden
| | - Barbro H Skogman
- Department of Pediatrics and Center for Clinical Research, Dalarna-Uppsala University, Falun, Sweden.,Faculty of Medical and Health Sciences, Örebro University, Örebro, Sweden
| | - Ivar Tjernberg
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Chemistry and Transfusion Medicine, Region Kalmar County, Kalmar, Sweden
| | - Ingeborg Aaberge
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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3
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Matei IA, Estrada-Peña A, Cutler SJ, Vayssier-Taussat M, Varela-Castro L, Potkonjak A, Zeller H, Mihalca AD. A review on the eco-epidemiology and clinical management of human granulocytic anaplasmosis and its agent in Europe. Parasit Vectors 2019; 12:599. [PMID: 31864403 PMCID: PMC6925858 DOI: 10.1186/s13071-019-3852-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/13/2019] [Indexed: 11/11/2022] Open
Abstract
Anaplasma phagocytophilum is the agent of tick-borne fever, equine, canine and human granulocytic anaplasmosis. The common route of A. phagocytophilum transmission is through a tick bite, the main vector in Europe being Ixodes ricinus. Despite the apparently ubiquitous presence of the pathogen A. phagocytophilum in ticks and various wild and domestic animals from Europe, up to date published clinical cases of human granulocytic anaplasmosis (HGA) remain rare compared to the worldwide status. It is unclear if this reflects the epidemiological dynamics of the human infection in Europe or if the disease is underdiagnosed or underreported. Epidemiologic studies in Europe have suggested an increased occupational risk of infection for forestry workers, hunters, veterinarians, and farmers with a tick-bite history and living in endemic areas. Although the overall genetic diversity of A. phagocytophilum in Europe is higher than in the USA, the strains responsible for the human infections are related on both continents. However, the study of the genetic variability and assessment of the difference of pathogenicity and infectivity between strains to various hosts has been insufficiently explored to date. Most of the European HGA cases presented as a mild infection, common clinical signs being pyrexia, headache, myalgia and arthralgia. The diagnosis of HGA in the USA was recommended to be based on clinical signs and the patient’s history and later confirmed using specialized laboratory tests. However, in Europe since the majority of cases are presenting as mild infection, laboratory tests may be performed before the treatment in order to avoid antibiotic overuse. The drug of choice for HGA is doxycycline and because of potential for serious complication the treatment should be instituted on clinical suspicion alone.
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Affiliation(s)
- Ioana A Matei
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| | - Agustín Estrada-Peña
- Department of Animal Health, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Sally J Cutler
- School of Health, Sport & Bioscience, University of East London, London, UK.
| | - Muriel Vayssier-Taussat
- Department of Animal Health, French National Institute for Agricultural Research, Maisons-Alfort, France
| | - Lucía Varela-Castro
- Department of Animal Health, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain.,Animal Health Department, NEIKER-Instituto Vasco de Investigación y Desarrollo Agrario, Bizkaia Science and Technology Park, Derio, Bizkaia, Spain
| | - Aleksandar Potkonjak
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Herve Zeller
- Emerging and Vector-borne Diseases Programme, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrei D Mihalca
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
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Lotrič-Furlan S, Rojko T, Jelovšek M, Petrovec M, Avšič-Županc T, Lusa L, Strle F. Comparison of clinical and laboratory characteristics of patients fulfilling criteria for proven and probable human granulocytic anaplasmosis. Microbes Infect 2015; 17:829-33. [PMID: 26432519 DOI: 10.1016/j.micinf.2015.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 09/08/2015] [Accepted: 09/13/2015] [Indexed: 11/29/2022]
Abstract
To assess the value of clinical definitions for human granulocytic anaplasmosis (HGA) epidemiological, clinical and laboratory findings in 50 adult patients with proven HGA (Anaplasma phagocytophilum isolated from blood, and/or positive PCR result, and/or seroconversion or ≥4-fold change in serum IFA antibody titres to A. phagocytophilum) and 46 patients with probable HGA (demonstration of serum antibodies to A. phagocytophilum in titres ≥1:256) were compared. Patients with proven HGA were older (55 versus 43.5 years; p = 0.001), were more often treated with doxycycline (31/50, 62% versus 11/46, 23.9%; p < 0.001), more frequently reported chills (40/50, 80% versus 17/46, 36.9%; p < 0.001), myalgia (37/50, 74% versus 21/46, 45.7%; p = 0.005) and cough (10/50, 20% versus 2/46, 4.4%; p = 0.02), and had more often abnormal laboratory findings such as thrombocytopenia (45/50, 90% versus 22/46, 47.8%; p < 0.001), abnormal liver function test results (45/50, 87% versus 22/46, 47.8%; p < 0.001), leukopenia (38/50, 76% versus 21/46, 45.7%; p = 0.002) and elevated serum CRP concentration (48/50, 96% versus 31/46, 67.4%; p < 0.001). The dissimilarities imply that in some patients fulfilling criteria for probable HGA the signs and symptoms most likely are not the result of a recent infection with A. phagocytophilum and indicate that clinical definitions used in the present study have a distinctive value.
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Affiliation(s)
- Stanka Lotrič-Furlan
- Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia.
| | - Tereza Rojko
- Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia
| | - Mateja Jelovšek
- Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia
| | - Lara Lusa
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Slovenia
| | - Franc Strle
- Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia
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5
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Henningsson AJ, Wilhelmsson P, Gyllemark P, Kozak M, Matussek A, Nyman D, Ekerfelt C, Lindgren PE, Forsberg P. Low risk of seroconversion or clinical disease in humans after a bite by an Anaplasma phagocytophilum-infected tick. Ticks Tick Borne Dis 2015; 6:787-92. [PMID: 26187418 DOI: 10.1016/j.ttbdis.2015.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 07/06/2015] [Accepted: 07/06/2015] [Indexed: 01/24/2023]
Abstract
The risk of contracting human granulocytic anaplasmosis (HGA) after a tick bite is mainly unknown. In this study we investigated the clinical and serological response in 30 humans bitten by ticks positive for Anaplasma phagocytophilum (Group A), 30 humans bitten by Borrelia burgdorferi sensu lato (s.l.)-positive ticks (Group B), and 30 humans bitten by ticks negative for both A. phagocytophilum and B. burgdorferi s.l. (Group C). Ticks, blood samples and questionnaires were collected from tick-bitten humans at 34 primary healthcare centres in Sweden and in the Åland Islands, Finland, at the time of the tick bite and after three months. A total of 2553 ticks detached from humans in 2007-2009 were analyzed by polymerase chain reaction, and 31 (1.2%) were positive for A. phagocytophilum, 556 (21.8%) were positive for B. burgdorferi s.l., and eight (0.3%) were co-infected by A. phagocytophilum and B. burgdorferi s.l. The overall prevalence of Anaplasma IgG antibodies in the included participants (n=90) was 17%, and there was no significant difference between the groups A-C. Only one of the participants (in Group C) showed a four-fold increase of IgG antibodies against A. phagocytophilum at the three-month follow-up, but reported no symptoms. The frequency of reported symptoms did not differ between groups A-C, and was unrelated to the findings of A. phagocytophilum and B. burgdorferi s.l. in the detached ticks. We conclude that the risk for HGA or asymptomatic seroconversion after a tick bite in Sweden or in the Åland Islands is low, even if the tick is infected by A. phagocytophilum.
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Affiliation(s)
- Anna J Henningsson
- Department of Clinical Microbiology, Ryhov County Hospital, S-551 85 Jönköping, Sweden.
| | - Peter Wilhelmsson
- Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, S-581 85 Linköping, Sweden
| | - Paula Gyllemark
- Department of Infectious Diseases, Ryhov County Hospital, S-551 85 Jönköping, Sweden
| | - Monika Kozak
- Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, S-581 85 Linköping, Sweden
| | - Andreas Matussek
- Department of Clinical Microbiology, Ryhov County Hospital, S-551 85 Jönköping, Sweden
| | - Dag Nyman
- The Åland Group for Borrelia Research, Bimelix Biomedical Laboratory, Torggatan 10, AX-22100 Mariehamn, Åland, Finland
| | - Christina Ekerfelt
- Division of Clinical Immunology, Department of Clinical and Experimental Medicine, Linköping University, S-551 85 Jönköping, Sweden
| | - Per-Eric Lindgren
- Department of Clinical Microbiology, Ryhov County Hospital, S-551 85 Jönköping, Sweden; Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, S-581 85 Linköping, Sweden
| | - Pia Forsberg
- Clinic of Infectious Diseases, Linköping University Hospital, and Department of Clinical and Experimental Medicine, Linköping University, S-551 85 Jönköping, Sweden
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Rizzoli A, Silaghi C, Obiegala A, Rudolf I, Hubálek Z, Földvári G, Plantard O, Vayssier-Taussat M, Bonnet S, Spitalská E, Kazimírová M. Ixodes ricinus and Its Transmitted Pathogens in Urban and Peri-Urban Areas in Europe: New Hazards and Relevance for Public Health. Front Public Health 2014; 2:251. [PMID: 25520947 PMCID: PMC4248671 DOI: 10.3389/fpubh.2014.00251] [Citation(s) in RCA: 285] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/09/2014] [Indexed: 12/30/2022] Open
Abstract
Tick-borne diseases represent major public and animal health issues worldwide. Ixodes ricinus, primarily associated with deciduous and mixed forests, is the principal vector of causative agents of viral, bacterial, and protozoan zoonotic diseases in Europe. Recently, abundant tick populations have been observed in European urban green areas, which are of public health relevance due to the exposure of humans and domesticated animals to potentially infected ticks. In urban habitats, small and medium-sized mammals, birds, companion animals (dogs and cats), and larger mammals (roe deer and wild boar) play a role in maintenance of tick populations and as reservoirs of tick-borne pathogens. Presence of ticks infected with tick-borne encephalitis virus and high prevalence of ticks infected with Borrelia burgdorferi s.l., causing Lyme borreliosis, have been reported from urbanized areas in Europe. Emerging pathogens, including bacteria of the order Rickettsiales (Anaplasma phagocytophilum, "Candidatus Neoehrlichia mikurensis," Rickettsia helvetica, and R. monacensis), Borrelia miyamotoi, and protozoans (Babesia divergens, B. venatorum, and B. microti) have also been detected in urban tick populations. Understanding the ecology of ticks and their associations with hosts in a European urbanized environment is crucial to quantify parameters necessary for risk pre-assessment and identification of public health strategies for control and prevention of tick-borne diseases.
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Affiliation(s)
- Annapaola Rizzoli
- Fondazione Edmund Mach, Research and Innovation Centre, San Michele all'Adige , Trento , Italy
| | - Cornelia Silaghi
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Vetsuisse-Faculty, Swiss National Centre for Vector Entomology, Institute for Parasitology, University of Zurich , Zürich , Switzerland
| | - Anna Obiegala
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig , Germany
| | - Ivo Rudolf
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Zdeněk Hubálek
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Gábor Földvári
- Department of Parasitology and Zoology, Faculty of Veterinary Science, Szent István University , Budapest , Hungary
| | - Olivier Plantard
- INRA, UMR1300 BioEpAR , Nantes , France ; LUNAM Université, Oniris, Ecole nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique, UMR BioEpAR , Nantes , France
| | - Muriel Vayssier-Taussat
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Sarah Bonnet
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Eva Spitalská
- Institute of Virology, Slovak Academy of Sciences , Bratislava , Slovakia
| | - Mária Kazimírová
- Institute of Zoology, Slovak Academy of Sciences , Bratislava , Slovakia
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7
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Farkas R, Gyurkovszky M, Lukács Z, Aladics B, Solymosi N. Seroprevalence of some vector-borne infections of dogs in Hungary. Vector Borne Zoonotic Dis 2014; 14:256-60. [PMID: 24689833 DOI: 10.1089/vbz.2013.1469] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The first comprehensive study on the prevalence of canine vector-borne pathogens (Anaplasma phagocytophilum, Borrelia burgdorferi, Ehrlichia canis, and Dirofilaria immitis) was carried in Hungary because, except for babesiosis and dirofilariosis caused by Dirofilaria repens, there were no data on their regional distribution and prevalence. In 2011 and 2012, 1305 blood samples were collected from randomly selected, apparently healthy pet dogs in 167 localities of 19 counties of Hungary. All sera samples from dogs were screened for simultaneous qualitative detection of circulating antibodies to E. canis and B. burgdorferi sensu lato and A. phagocytophilum and D. immitis antigen using SNAP(®) 4Dx (IDEXX Laboratories). Overall, 170 dogs (13.0%; 95% confidence interval [CI] 11-15) were serologically positive to one or more of the tested pathogens. A. phagocytophilum was the most prevalent pathogen detected in 102 dogs by antibody titers (7.9%, 95% CI 6.5-9.5), followed by D. immitis (2.4%, 95% CI 1.0-4.0, n=64) and B. burgdorferi (0.4%, 95% CI 0.0-1.1, n=11) out of 1305 tested dogs. The least prevalent infection was with E. canis, with only two positive dogs (0.16%, 95% CI 0.03-0.6). Co-infection was found in eight dogs (0.61%, 95% CI 0.29-1.21), of which seven were seropositive to two pathogens (five with A. phagocytophilum and D. immitis, two with A. phagocytophilum and B. burgdorferi). One dog was serologically positive to three pathogens (A. phagocytophilum, B. burgdorferi, and D. immitis). Purebred and crossbred animals did not show significantly different levels of seropositivity. There was no significant association between the gender and the results of diagnostic testing. Logistic regression analysis showed a higher chance of seropositivity in the older dogs.
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Affiliation(s)
- Robert Farkas
- 1 Faculty of Veterinary Science, Szent István University , Budapest, Hungary
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8
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Nordberg M, Forsberg P, Berglund J, Bjöersdorff A, Ernerudh J, Garpmo U, Haglund M, Nilsson K, Eliasson I. Aetiology of Tick-Borne Infections in an Adult Swedish Population—Are Co-Infections with Multiple Agents Common? ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojcd.2014.41007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Rizzoli A, Silaghi C, Obiegala A, Rudolf I, Hubálek Z, Földvári G, Plantard O, Vayssier-Taussat M, Bonnet S, Spitalská E, Kazimírová M. Ixodes ricinus and Its Transmitted Pathogens in Urban and Peri-Urban Areas in Europe: New Hazards and Relevance for Public Health. Front Public Health 2014. [PMID: 25520947 DOI: 10.3389/fpubh.2014.00251.pmid:25520947;pmcid:pmc4248671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Tick-borne diseases represent major public and animal health issues worldwide. Ixodes ricinus, primarily associated with deciduous and mixed forests, is the principal vector of causative agents of viral, bacterial, and protozoan zoonotic diseases in Europe. Recently, abundant tick populations have been observed in European urban green areas, which are of public health relevance due to the exposure of humans and domesticated animals to potentially infected ticks. In urban habitats, small and medium-sized mammals, birds, companion animals (dogs and cats), and larger mammals (roe deer and wild boar) play a role in maintenance of tick populations and as reservoirs of tick-borne pathogens. Presence of ticks infected with tick-borne encephalitis virus and high prevalence of ticks infected with Borrelia burgdorferi s.l., causing Lyme borreliosis, have been reported from urbanized areas in Europe. Emerging pathogens, including bacteria of the order Rickettsiales (Anaplasma phagocytophilum, "Candidatus Neoehrlichia mikurensis," Rickettsia helvetica, and R. monacensis), Borrelia miyamotoi, and protozoans (Babesia divergens, B. venatorum, and B. microti) have also been detected in urban tick populations. Understanding the ecology of ticks and their associations with hosts in a European urbanized environment is crucial to quantify parameters necessary for risk pre-assessment and identification of public health strategies for control and prevention of tick-borne diseases.
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Affiliation(s)
- Annapaola Rizzoli
- Fondazione Edmund Mach, Research and Innovation Centre, San Michele all'Adige , Trento , Italy
| | - Cornelia Silaghi
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Vetsuisse-Faculty, Swiss National Centre for Vector Entomology, Institute for Parasitology, University of Zurich , Zürich , Switzerland
| | - Anna Obiegala
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig , Germany
| | - Ivo Rudolf
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Zdeněk Hubálek
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Gábor Földvári
- Department of Parasitology and Zoology, Faculty of Veterinary Science, Szent István University , Budapest , Hungary
| | - Olivier Plantard
- INRA, UMR1300 BioEpAR , Nantes , France ; LUNAM Université, Oniris, Ecole nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique, UMR BioEpAR , Nantes , France
| | - Muriel Vayssier-Taussat
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Sarah Bonnet
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Eva Spitalská
- Institute of Virology, Slovak Academy of Sciences , Bratislava , Slovakia
| | - Mária Kazimírová
- Institute of Zoology, Slovak Academy of Sciences , Bratislava , Slovakia
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10
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Severinsson K, Jaenson TG, Pettersson J, Falk K, Nilsson K. Detection and prevalence of Anaplasma phagocytophilum and Rickettsia helvetica in Ixodes ricinus ticks in seven study areas in Sweden. Parasit Vectors 2010; 3:66. [PMID: 20684755 PMCID: PMC2923137 DOI: 10.1186/1756-3305-3-66] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 08/04/2010] [Indexed: 11/10/2022] Open
Abstract
Background Tick-borne Anaplasma phagocytophilum and Rickettsia spp. are considered to be emerging human pathogens, but only limited data are available on their occurrence in Sweden. Two real-time PCR assays followed by nested PCR and sequence analysis were carried out to investigate the prevalence of A. phagocytophilum and spotted fever rickettsiae in ticks from seven areas in Sweden. Results In 139 pooled samples, representing a total of 1245 Ixodes ricinus ticks (204 larvae, 963 nymphs, 38 males, 40 females), the overall positive mean infection prevalence was 1.3-15.0% for A. phagocytophilum and 1.5-17.3% for R. helvetica. A. phagocytophilum was only detected in nymphs (1.7-19.4%), whereas R. helvetica was detected in all three tick stages. Support for vertical and transstadial transmission was only obtained for R. helvetica. Both agents showed similar infection rates across study areas, although infection rates were greater in coastal areas. Conclusions The results show that both pathogens occurred in all seven locations, indicating that they are prevalent in Sweden and should be considered etiological agents in patients recently bitten by ticks.
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Affiliation(s)
- Kristofer Severinsson
- Department of Medical Sciences, Clinical Bacteriology, Uppsala University, Uppsala, Sweden.
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11
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First described case of human granulocytic anaplasmosis in a patient in Eastern Austria. Wien Med Wochenschr 2010; 160:91-93. [PMID: 20300926 DOI: 10.1007/s10354-009-0733-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 11/18/2009] [Indexed: 10/19/2022]
Abstract
A 64-year-old otherwise healthy patient presented with high fever, thrombocytopenia, elevated liver enzymes and an erythema on the belly. The patient remembered a tick bite four weeks ago when walking with his dog before the specific symptoms started. A meningococcal disease or hematological illness was excluded. The serological results for tick-borne diseases showed a high IgG antibody titer for Anaplasma phagocytophila. All symptoms and laboratory parameters normalized after one week of hospitalization. The patient received no treatment and recovered completely. This is the first confirmed case of human granulocytic anaplasmosis (HGA) in Eastern Austria.
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Heyman P, Cochez C, Hofhuis A, van der Giessen J, Sprong H, Porter SR, Losson B, Saegerman C, Donoso-Mantke O, Niedrig M, Papa A. A clear and present danger: tick-borne diseases in Europe. Expert Rev Anti Infect Ther 2010; 8:33-50. [PMID: 20014900 DOI: 10.1586/eri.09.118] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ticks can transmit a variety of viruses, bacteria or parasites that can cause serious infections or conditions in humans and animals. While tick-borne diseases are becoming an increasing and serious problem in Europe, tick-borne diseases are also responsible for major depressions in livestock production and mortality in sub-Saharan Africa, Latin America and Asia. This review will focus on the most important circulating tick-transmitted pathogens in Europe (Borrelia spp., Anaplasma phagocytophilum, Babesia spp., tick-borne encephalitis virus, Rickettsia spp. and Crimean-Congo hemorrhagic fever virus).
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Affiliation(s)
- Paul Heyman
- Research Laboratory for Vector Borne Diseases, Queen Astrid Military Hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
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13
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Hulínská D, Votýpka J, Vanousová D, Hercogová J, Hulínský V, Drevová H, Kurzová Z, Uherková L. Identification of Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato in patients with erythema migrans. Folia Microbiol (Praha) 2009; 54:246-56. [PMID: 19649743 DOI: 10.1007/s12223-009-0039-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 01/26/2009] [Indexed: 11/24/2022]
Abstract
Anaplasma phagocytophilum has been first isolated from the blood of two Czech patients simultaneously with a cultivation of Borrelia burgdorferi sensu lato from their erythema migrans lesions. Cultivation of different Borrelia spp. from 12 erythema migrans biopsies, from 2 blood, one liquor and one placenta sample in BSK-H medium was successful. Adapted conventional methods targeting 16S rRNA and OspA genes for real-time polymerase chain reaction (PCR) and partial sequencing of these genes together with microscopical examinations of the blood smears provided a direct detection of the B. afzelii, B. burgdorferi, B. garinii, B. valaisiana and B. bissettii in the skin, B. garinii in the blood, placenta and liquor in 24 (36.3 %) patients, and A. phagocytophilum in 10 (15 %) patients with erythema migrans. Positive indirect IgM immunofluorescence against Anaplasma sp. was obtained in 7 cases, specific IgG antibodies were detected in 12 patients. Three women suffering from erythema migrans in the first trimester had positive PCR for Anaplasma and/or for Borrelia in the blood and two of them, later, in the placenta. Interpretation of laboratory data can bring important contribution to establishing the role of Anaplasma sp. in erythema migrans and forming the principle of precaution with laboratory diagnosis during pregnancy which always should be reflected in the resistance of Anaplasma sp. toward penicillins.
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Affiliation(s)
- D Hulínská
- National Reference Laboratory, WHO Centre for Reference and Research on Borreliosis, National Institute of Public Health, Prague, Czech Republic.
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14
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Thomas RJ, Stephen Dumler J, Carlyon JA. Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and Ehrlichia ewingii ehrlichiosis. Expert Rev Anti Infect Ther 2009; 7:709-22. [PMID: 19681699 PMCID: PMC2739015 DOI: 10.1586/eri.09.44] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anaplasma phagocytophilum, Ehrlichia chaffeensis and Ehrlichia ewingii are emerging tick-borne pathogens and are the causative agents of human granulocytic anaplasmosis, human monocytic ehrlichiosis and E. ewingii ehrlichiosis, respectively. Collectively, these are referred to as human ehrlichioses. These obligate intracellular bacterial pathogens of the family Anaplasmataceae are transmitted by Ixodes spp. or Amblyomma americanum ticks and infect peripherally circulating leukocytes to cause infections that range in clinical spectra from asymptomatic seroconversion to mild, severe or, in rare instances, fatal disease. This review describes: the ecology of each pathogen; the epidemiology, clinical signs and symptoms of the human diseases that each causes; the choice methods for diagnosing and treating human ehrlichioses; recommendations for patient management; and is concluded with suggestions for potential future research.
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Affiliation(s)
- Rachael J Thomas
- Department of Microbiology and Immunology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - J Stephen Dumler
- Division of Medical Microbiology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MA, USA
| | - Jason A Carlyon
- Department of Microbiology and Immunology, Virginia Commonwealth University School of Medicine, Molecular Medicine Research Building, 1220 East Broad Street, Room 4052, PO Box 980678, Richmond, VA 23298-0678, USA Tel.: +1 804 628 3382 Fax: +1 804 828 9946
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15
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Lotric-Furlan S, Rojko T, Petrovec M, Avsic-Zupanc T, Strle F. Epidemiological, clinical and laboratory characteristics of patients with human granulocytic anaplasmosis in Slovenia. Wien Klin Wochenschr 2006; 118:708-13. [PMID: 17160612 DOI: 10.1007/s00508-006-0700-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Human granulocytic anaplasmosis (HGA) has been recently recognized as an emerging tick-borne disease. Several reports indicate the presence of infection with Anaplasma phagocytophilum in Europe. Between January 1996 and December 2004, 24 adult patients with proven HGA were identified in a prospective study conducted at the Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia, on the etiology of febrile illnesses occurring within 30 days after a tick bite. The diagnosis of acute HGA was established from seroconversion in 18 (75%) patients or at least a four-fold increase in antibody titers to A. phagocytophilum antigens in six (25%) patients and molecular identification of ehrlichial organisms in 15 (62.5%) patients. Clinical characteristics and laboratory findings were similar to those reported from the other European countries. All the patients had an acute febrile illness with headache, malaise, myalgia and/or arthralgia. Leukopenia was found in 16 (66.7%) patients, thrombocytopenia in 20 (83.3%), abnormal liver function test results in 23 (95.8%), elevated erythrocyte sedimentation rates in 18 (75%), and elevated concentration of C-reactive protein in 23 (95.8%). The disease course was relatively mild; none of the patients died and no long-term sequelae were found during a follow-up of one year even though only 15 (62.5%) were treated with doxycycline. At the examination one year after the first visit, 16/24 (66.7%) patients tested seropositive (> or =1 : 256) for A. phagocytophilum antibody, and two years after the first visit positive titers were still present in 10/18 (55.6%) patients.
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Affiliation(s)
- Stanka Lotric-Furlan
- Department of Infectious Diseases, University Medical Center Ljubljana, University of Ljubljana, Slovenia.
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16
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Katsarolis I, Tsiodras S, Panagopoulos P, Giannitsioti E, Skarantavos G, Ioannidis T, Giamarellou H. Septic arthritis due to Salmonella enteritidis associated with infliximab use. ACTA ACUST UNITED AC 2005; 37:304-5. [PMID: 15804667 DOI: 10.1080/00365540410021171] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A unique case of septic arthritis caused by Salmonella enteritidis in a patient receiving infliximab for rheumatoid arthritis is presented. Antimicrobial chemotherapy with surgical intervention was necessary for eradication of the infection. Physicians should be aware of rare manifestations of Salmonella infections associated with infliximab use, especially in endemic areas.
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Affiliation(s)
- Ioannis Katsarolis
- Fourth Department of Internal Medicine, Attikon University General Hospital, Athens University Medical School, Athens, Greece.
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17
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Branger S, Rolain JM, Raoult D. Evaluation of antibiotic susceptibilities of Ehrlichia canis, Ehrlichia chaffeensis, and Anaplasma phagocytophilum by real-time PCR. Antimicrob Agents Chemother 2005; 48:4822-8. [PMID: 15561862 PMCID: PMC529244 DOI: 10.1128/aac.48.12.4822-4828.2004] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We determined MICs of antibiotics against Anaplasma phagocytophilum, Ehrlichia chaffeensis, and Ehrlichia canis by real-time quantitative PCR. The doubling times of the organisms were established: 19 h for E. chaffeensis, 26 h for A. phagocytophilum, and 28 h for E. canis. In comparison to the reference method for determining sensitivities, which uses Diff-Quick staining, our PCR assay was very sensitive and specific. We confirmed that doxycycline and rifampin are highly active against these bacteria and found variable susceptibilities to fluoroquinolones; A. phagocytophilum was susceptible, but E. canis and E. chaffeensis were only partly susceptible. Beta-lactam compounds, cotrimoxazole, macrolide compounds, and telithromycin showed no activity against any of the three organisms. Thiamphenicol was found to be more active than chloramphenicol. For the first time, we showed that these three species have numerous point mutations in their 23S RNA genes, with those at positions 754, 2057, 2058, 2059, and 2611 (Escherichia coli numbering) known to confer resistance to macrolide compounds in other bacteria. The role of each of these mutations in resistance to these drugs should be investigated in the future. Our study confirms previous reports that quantitative PCR is a reliable method for determining antibiotic susceptibility; therefore, it might be useful for screening new drugs.
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Affiliation(s)
- S Branger
- Unité des Rickettsies, CNRS UMR 6020A, Faculté de Médecine, Marseille, France
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18
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Brouqui P, Bacellar F, Baranton G, Birtles RJ, Bjoërsdorff A, Blanco JR, Caruso G, Cinco M, Fournier PE, Francavilla E, Jensenius M, Kazar J, Laferl H, Lakos A, Lotric Furlan S, Maurin M, Oteo JA, Parola P, Perez-Eid C, Peter O, Postic D, Raoult D, Tellez A, Tselentis Y, Wilske B. Guidelines for the diagnosis of tick-borne bacterial diseases in Europe. Clin Microbiol Infect 2004; 10:1108-32. [PMID: 15606643 DOI: 10.1111/j.1469-0691.2004.01019.x] [Citation(s) in RCA: 250] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ticks are obligate haematophagous acarines that parasitise every class of vertebrate (including man) and have a worldwide distribution. An increasing awareness of tick-borne diseases among clinicians and scientific researchers has led to the recent description of a number of emerging tick-borne bacterial diseases. Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 11 tick-borne human bacterial pathogens have been described in Europe. Aetiological diagnosis of tick-transmitted diseases is often difficult and relies on specialised laboratories using very specific tools. Interpretation of laboratory data is very important in order to establish the diagnosis. These guidelines aim to help clinicians and microbiologists in diagnosing infection transmitted by tick bites and to provide the scientific and medical community with a better understanding of these infectious diseases.
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Affiliation(s)
- P Brouqui
- Unité des Rickettsies, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
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19
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Parola P. Tick-borne rickettsial diseases: emerging risks in Europe. Comp Immunol Microbiol Infect Dis 2004; 27:297-304. [PMID: 15225980 DOI: 10.1016/j.cimid.2004.03.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2004] [Indexed: 11/28/2022]
Abstract
Ticks are currently considered the main vectors of human infectious diseases in Europe, particularly since their role in the transmission of the agent of Lyme borreliosis was demonstrated in the 1980s. In the recent years, ticks have also been shown to be the vectors of numerous emerging rickettsial diseases. Although Mediterranean spotted fever (MSF) due to Rickettsia conorii was thought for a long time to be the only tick-borne rickettsial disease prevalent in Europe, five more spotted fever rickettsiae have been described as emerging pathogens in the last decade. Further, cases of infection due to Anaplasma phagocytophilum, the agent of human anaplasmosis (previously known as human granulocytic ehrlichiosis), have been reported throughout Europe. We present here these emerging diseases and discuss other potential threat for the future.
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Affiliation(s)
- Philippe Parola
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Université de la Méditerranée, Faculté de Médecine, 27 Bd. Jean Moulin, 13385 Marseille Cedex 5, France.
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20
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Abstract
Human granulocytic ehrlichiosis (HGE) is a tick-borne zoonosis caused by Anaplasma phagocytophilum. A MEDLINE literature search revealed that the European story of HGE began in 1995 with an article on the presence of serum antibodies to A. phagocytophilum. At present, there is seroepidemiological information indicating the presence of infection with HGE agent(s) for several European countries; seroprevalence rates range from zero or very low to up to 28%. The proportion of seropositive persons increases with age and is higher in persons exposed to ticks. Knowledge of the causative agent of HGE and of animal reservoirs in Europe is limited. Ixodes ricinus is a recognized vector of A. phagocytophilum in Europe. Prevalence of the agent in questing I. ricinus is usually higher in adult ticks than in nymphs and ranges from zero or very low to > 30%. Pronounced differences between countries and marked variability by localities were established. Up to March 2003 about 65 human patients (all but one were adults) with confirmed HGE and several patients fulfilling criteria for probable HGE had been reported. The majority of them came from Central Europe (Slovenia) and Scandinavia (Sweden) but there are individual reports from several other European countries. The patients presented with an acute febrile illness that as a rule occurred after a tick bite; the majority had leukopenia and/or thrombocytopenia, elevated concentration of C-reactive protein and mild abnormalities of liver function test results. A small number of patients does not permit reliable conclusions on the clinical features of European HGE; however, there is an impression that at least in central Europe (but maybe not in Scandinavia) the disease is, from the clinical angle, only mild to moderately severe and (most likely) self-limited. The relatively high proportion of the population with HGE serum antibodies and the presence of A. phagocytophilum (like) agent(s) in ticks, small mammals and deer as found in several European countries are discordant with the rather low number of patients with proven HGE. The discordance may indicate inadequate awareness among European physicians, limited recording and reporting of the disease, and/or the presence of and the infection of humans with nonpathogenic A. phagocytophilum (like) strains present in ticks. Additional studies are needed to better define the biological and public health significance of HGE in Europe.
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Affiliation(s)
- Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia.
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21
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von Loewenich FD, Baumgarten BU, Schröppel K, Geissdörfer W, Röllinghoff M, Bogdan C. High diversity of ankA sequences of Anaplasma phagocytophilum among Ixodes ricinus ticks in Germany. J Clin Microbiol 2004; 41:5033-40. [PMID: 14605135 PMCID: PMC262509 DOI: 10.1128/jcm.41.11.5033-5040.2003] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In Germany humans with acute granulocytic ehrlichiosis have not yet been described. Here, we characterized three different genes of Anaplasma phagocytophilum strains infecting German Ixodes ricinus ticks in order to test whether they differ from strains in other European countries and the United States. A total of 1,022 I. ricinus ticks were investigated for infection with A. phagocytophilum by nested PCR and sequence analysis. Forty-two (4.1%) ticks were infected. For all positive ticks, parts of the 16S rRNA and groESL genes were sequenced. The complete coding sequence of the ankA gene could be determined in 24 samples. The 16S rRNA and groESL gene sequences were as much as 100% identical to known sequences. Fifteen ankA sequences were >/=99.37% identical to sequences derived from humans with granulocytic ehrlichiosis in Europe and from a horse with granulocytic ehrlichiosis in Germany. Thus, German I. ricinus ticks most likely harbor A. phagocytophilum strains that can cause disease in humans. Nine additional sequences were clearly different from known ankA sequences. Because these newly described sequences have never been obtained from diseased humans or animals, their biological significance is currently unknown. Based on this unexpected sequence heterogeneity, we propose to use the ankA gene for further phylogenetic analyses of A. phagocytophilum and to investigate the biology and pathogenicity of strains that differ in the ankA gene.
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22
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Remy V, Hansmann Y, De Martino S, Christmann D, Brouqui P. Human anaplasmosis presenting as atypical pneumonitis in France. Clin Infect Dis 2003; 37:846-8. [PMID: 12955649 DOI: 10.1086/377502] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2003] [Accepted: 05/06/2003] [Indexed: 11/03/2022] Open
Abstract
Human anaplasmosis is a febrile illness caused by Anaplasma phagocytophilum, an intracellular bacterium transmitted by Ixodes ticks in the United States and Europe. Although cough is reported in 30% of the American cases, interstitial pneumonitis has been noted only once. Of the 9 confirmed cases reported in Europe, 3 presented with atypical pneumonitis. A. phagocytophilum should be added to the list of agents responsible for interstitial pneumonitis, especially in areas where human anaplasmosis is endemic.
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Affiliation(s)
- V Remy
- Service de Maladies Infectieuses et Pathologies Tropicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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23
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Christova I, Van De Pol J, Yazar S, Velo E, Schouls L. Identification of Borrelia burgdorferi sensu lato, Anaplasma and Ehrlichia species, and spotted fever group Rickettsiae in ticks from Southeastern Europe. Eur J Clin Microbiol Infect Dis 2003; 22:535-42. [PMID: 12938010 DOI: 10.1007/s10096-003-0988-1] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Prevalence data for tick-borne pathogens are used to assess the risk for human health. In this study the presence and identity of Borrelia burgdorferi sensu lato, Ehrlichia, Anaplasma, and Rickettsia species in Bulgarian Ixodes ricinus ticks and in non- Ixodes ticks from Turkey and Albania was determined by polymerase chain reaction (PCR) and reverse line blot hybridization. In the adult Bulgarian ticks, the prevalence of Borrelia burgdorferi sensu lato infection was approximately 40%, while Borrelia afzelii was the predominant species, representing more than half of all Borrelia-positive ticks. Ehrlichia and Anaplasma species were detected in 35% of the adult Ixodes ricinus ticks and in 10% of the nymphs. Sequence analysis of PCR products reacting with the Anaplasma phagocytophila probe revealed a 16S rRNA gene identical to that of the Anaplasma phagocytophila prototype strain. Ehrlichia and Anaplasma species were found in approximately 7% of the non- Ixodes ticks. Sequence analysis of some of these samples revealed the presence of Anaplasma ovis, Ehrlichia canis, and a species closely resembling Ehrlichia chaffeensis. About half of all adult ticks examined and approximately 20% of all nymphs were infected with Rickettsia species. In Ixodes ricinus ticks, Rickettsia helvetica and a Rickettsia species designated as IRS3 were found in high prevalence. Rickettsia conorii was found in virtually all non- Ixodes tick species from Albania and Turkey. The results of this study show that many tick-borne diseases are most probably endemic in the Balkan area. Furthermore, the results suggest that there is a considerable chance for simultaneous transmission of tick-borne pathogens to human beings.
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Affiliation(s)
- I Christova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Boulevard Yanko Sakazov 26, 1504 Sofia, Bulgaria
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Walder G, Falkensammer B, Aigner J, Tiwald G, Dierich MP, Würzner R, Lechleitner P. First documented case of human granulocytic ehrlichiosis in Austria. Wien Klin Wochenschr 2003; 115:263-6. [PMID: 12778780 DOI: 10.1007/bf03040326] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report the first documented case of human granulocytic ehrlichiosis (HGE) in Austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findings observed in other European adults with high fever, transient thrombocytopenia, elevated levels of CRP and LDH, arthralgias, myalgias, fatigue and subfebrile temperature. Flu-like symptoms started about seven days after a tick bite and lasted for ten days, followed by an asymptomatic interval of three days and an acute onset of fever up to 39.5 degrees C on day 20. On admission, the patient showed high antibody titres against Anaplasma phagocytophilum (IgG 1:1024, IgM 1:640); six weeks later the IgG-titre had risen to 1:2048, and IgM-levels had fallen below 1:40. The demonstration of anti-platelet antibodies in acute-phase serum was noteworthy. We conclude that also in Austria HGE should be considered in patients with febrile thrombocytopenia, especially when the medical history reveals recent tick exposure.
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Affiliation(s)
- Gernot Walder
- Institut für Hygiene und Sozialmedizin, Universität Innsbruck, Innsbruck, Austria.
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25
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Mäkinen J, Vuorinen I, Oksi J, Peltomaa M, He Q, Marjamäki M, Viljanen MK. Prevalence of granulocytic Ehrlichia and Borrelia burgdorferi sensu lato in Ixodes ricinus ticks collected from Southwestern Finland and from Vormsi Island in Estonia. APMIS 2003; 111:355-62. [PMID: 12716393 DOI: 10.1034/j.1600-0463.2003.1110209.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Altogether, 343 adult and 111 nymphal Ixodes ricinus ticks collected from parks in Turku and suburban and rural islands of the Turku archipelago, Finland, and 100 adult I. ricinus ticks collected from Vormsi Island, Estonia, were included in this study. Using the polymerase chain reaction the ticks were examined for 16S rDNA of the Ehrlichia phagocytophila genogroup and for Borrelia burgdorferi sensu lato recA and flagellin genes. None of the Finnish ticks was found to be infected with E. phagocytophila, whereas 3% of the Estonian ticks were positive for this organism. The rate of Finnish ticks infected with B. burgdorferi sensu lato varied from 0% to 11.6% (mean 5%; 9% for adult and 4% for nymphal ticks). The corresponding rate for Estonian ticks was 15%. Borrelia afzelii was the most common genospecies in both Finnish (2.6%) and Estonian (12%) ticks. B. burgdorferi sensu stricto was detected in 2.0% of the Finnish ticks, but in none of the Estonian ticks. These results suggest that the E. phagocytophila genogroup is very rare in Finnish ticks, although the ticks were collected from an area endemic for Lyme borreliosis. In Estonia, E. phagocytophila is found in ticks and may cause disease.
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Affiliation(s)
- Johanna Mäkinen
- National Public Health Institute of Finland, Department in Turku, Turku, Finland.
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Bjöersdorff A, Wittesjö B, Berglun J, Massung RF, Eliasson I. Human granulocytic ehrlichiosis as a common cause of tick-associated fever in Southeast Sweden: report from a prospective clinical study. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 2002; 34:187-91. [PMID: 12030391 DOI: 10.1080/00365540110080061] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Between May and December 1998, tick-associated febrile illness was prospectively studied in Southeast Sweden in order to assess the occurrence of human granulocytic ehrlichiosis (HGE). Inclusion criteria were fever (> or = 38.0 degrees C), with or without headache, myalgia or arthralgia in patients with an observed tick bite or tick exposure within 1 month prior to onset of symptoms. Patients with clinical signs of Lyme borreliosis were included. Of the 27 patients included, we identified 4 cases of HGE. Three of the patients had coinfection with Lyme borreliosis, which presented as erythema migrans. All 27 patients presented with a 2-5 d history of fever. None of the clinical signs or laboratory parameters monitored was helpful in predicting ehrlichiosis in this group with tick-associated fever conditions. Within the HGE-negative group (n = 23), 12 patients had clinical or laboratory signs of Lyme borreliosis. For 11 patients, the aetiology of the fever remained unclear. Our results suggest that HGE is common in tick-infested areas of Southeast Sweden, and may occur as a coinfection of Lyme borreliosis. Granulocytic ehrlichiosis should be suspected in patients who present with tick-associated fever, with or without erythema migrans. Ehrlichia serology and PCR should be employed to confirm the diagnosis.
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Abstract
Ehrlichiosis comprises a group of emerging tick-borne infectious diseases caused by obligate intracellular Gram-negative bacteria that infect leukocytes. Infections caused by members of the genus Ehrlichia have been described in animals and humans, but to date there are no convincing reports of the presence of other types of human ehrlichiosis different from human granulocytic ehrlichiosis (HGE) in Europe. The European vector is the same as that of Lyme borreliosis, the hard tick Ixodes ricinus, and HGE has a similar epidemiology to that of Borrelia burgdorferi infection. Across Europe, I. ricinus is infected to a variable extent (0.4-66.7%) with the causative agent Ehrlichia (Anaplasma) phagocytophila genogroup, and since its first description in Slovenia in 1997, details of 15 patients have been published. Diagnosis requires careful consideration of all circumstances and symptoms (history of tick bite and the presence of a flu-like syndrome with variable degrees of anemia, thrombocytopenia, and leukopenia, and elevated liver enzymes). Some differences can be seen between US and European HGE patients. European HGE cases have a less severe course, and the presence of morulae is uncommon. In Europe, verification of HGE has been based on PCR and immunofluorescence antibody tests, because no isolation from humans has been reported.
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Affiliation(s)
- J R Blanco
- Internal Medicine and Infectious Diseases Service, Hospital de La Rioja, Logroño, Spain
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Bjöersdorff A, Bagert B, Massung RF, Gusa A, Eliasson I. Isolation and characterization of two European strains of Ehrlichia phagocytophila of equine origin. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:341-3. [PMID: 11874874 PMCID: PMC119922 DOI: 10.1128/cdli.9.2.341-343.2002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2001] [Revised: 06/07/2001] [Accepted: 10/24/2001] [Indexed: 11/20/2022]
Abstract
We report the isolation and partial genetic characterization of two equine strains of granulocytic Ehrlichia of the genogroup Ehrlichia phagocytophila. Frozen whole-blood samples from two Swedish horses with laboratory-verified granulocytic ehrlichiosis were inoculated into HL-60 cell cultures. Granulocytic Ehrlichia was isolated and propagated from both horses. DNA extracts from the respective strains were amplified by PCR using primers directed towards the 16S rRNA gene, the groESL heat shock operon gene, and the ank gene. The amplified gene fragments were sequenced and compared to known sequences in the GenBank database. With respect to the 16S rRNA gene, the groESL gene, and the ank gene, the DNA sequences of the two equine Ehrlichia isolates were identical to sequences found in isolates from clinical cases of granulocytic ehrlichiosis in humans and domestic animals in Sweden. However, compared to amplified DNA from an American Ehrlichia strain of the E. phagocytophila genogroup, differences were found in the groESL gene and ank gene sequences.
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Affiliation(s)
- Anneli Bjöersdorff
- Department of Clinical Microbiology, Kalmar County Hospital, SE-391 85 Kalmar, Sweden.
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Bjöersdorff A, Bergström S, Massung RF, Haemig PD, Olsen B. Ehrlichia-infected ticks on migrating birds. Emerg Infect Dis 2001; 7:877-9. [PMID: 11747702 PMCID: PMC2631880 DOI: 10.3201/eid0705.017517] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During the spring of 1996, an estimated 581,395 Ehrlichia-infected ticks were imported into Sweden by migrating birds. Ehrlichia gene sequences found in ticks collected from these migrating birds were identical to those of granulocytic ehrlichiosis found in domestic animals and humans in Sweden. These findings support the idea that birds may play a role in dispersing Ehrlichia.
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