Guidelines for the Detection of Rickettsia spp

Diversity and prevalence of spotted-fever group rickettsiae in ixodid ticks across Slovakia, Central Europe

Habitats with the sympatric occurrence of several ixodid tick species are significant from an epidemiological perspective. These habitats can influence the diversity and prevalence of tick-borne pathogens, and their monitoring can help estimate the risk of infection. A total of 1260 questing ticks from five species (Ixodes ricinus, Dermacentor marginatus, Dermacentor reticulatus, Haemaphysalis concinna, and Haemaphysalis inermis) were collected from vegetation using the flagging method in three different habitats in eastern Slovakia. Additionally, 900 rodent-attached ticks of six species (I. ricinus, Ixodes trianguliceps, D. marginatus, D. reticulatus, H. concinna, and H. inermis) collected from 149 small mammals belonging to seven species (Apodemus flavicollis, Apodemus agrarius, Microtus arvalis, Myodes glareolus, Micromys minutus, Crocidura leucodon, and Crocidura suaveolens) were selected for molecular analyses. DNA obtained from rodent-attached and questing ticks was tested by nested PCR targeting the gltA gene to determine the presence of Rickettsia spp. The ompA, ompB, and sca4 genes were amplified and sequenced to identify rickettsiae species. The overall prevalence of rickettsiae in questing and rodent-attached ticks was 12.5 % and 20.0 %, respectively. Overall studied localities, the most diverse spectrum of rickettsiae species, including R. helvetica, R. monacensis, R. raoultii, and R. slovaca, was recorded in questing and rodent-attached ticks in the natural habitat of the Slovak Karst. The dominant species, R. helvetica (62.9 %), was identified in two species of questing and rodent-attached ticks, specifically I. ricinus and H. concinna, and in rodent-attached D. reticulatus ticks. Rickettsia raoultii (20.4 %) was identified in questing and rodent-attached D. marginatus, D. reticulatus, and in questing H. concinna. Additionally, this study provides the first input of pathogenic R. raoultii in I. trianguliceps obtained from the striped field mouse (A. agrarius). Rickettsia monacensis (9.0 %) was detected in questing and rodent-attached I. ricinus, while Rickettsia slovaca (3.6 %) was found in questing and rodent-attached D. marginatus ticks. Natural biotopes with different tick species and hosts significantly affect the diversity and prevalence of rickettsiae.

Inter-species dynamics of non-coding RNAs: Impact on host immunomodulation and pathogen survival

Non-coding RNAs (ncRNAs) are composed of nucleotides that do not encode proteins but instead serve as guides. It interacts with amino acids at precise genomic sites, influencing chromatin structure and gene expression. These ncRNAs contribute to numerous inter-species dynamics, including those within the vector-host-pathogen triad. Vector-associated ncRNAs are released into hosts to combat the host immune system and sustain arthropod viability. Conversely, hosts may utilize specific ncRNAs as part of their defences to counteract pathogen-carrying vectors. Moreover, pathogens transmitted through vectors' saliva into hosts carry ncRNAs that enhances their virulence. While recent investigations have primarily focused on vector-associated ncRNAs in animal hosts, only a few have explored the functions of pathogen-associated ncRNAs and their role in initiating infections. Our review delves into the historical prospects of ncRNAs, mechanisms by which pathogen-derived ncRNAs influence host-pathogen interactions, regulate gene expression, and evade host defences. Ultimately, it underscores the importance ncRNAs mediated regulatory network in vector-host-pathogen dynamics, offering new strategies to combat vector-borne diseases and enhance public health outcomes.

Prevalence and diversity of spotted fever group Rickettsia species in ixodid ticks from domestic dogs in Chad, Africa

Tick-borne pathogens in the genus Rickettsia are the causative agents of severe and potentially fatal spotted fever group (SFG) and typhus group diseases in dogs and humans. Climate, habitat, and land-use changes are impacting vector ranges, with expansions potentially resulting in novel pathogens being introduced into naïve locations. Despite the public health importance of SFG Rickettsia, there are relatively few data on the prevalence and diversity of rickettsial pathogens in sub-Saharan Africa. The aim of this study was to characterize the SFG Rickettsia prevalence and diversity in ixodid ticks (104 Amblyomma spp., 160 Rhipicephalus spp., and one Hyalomma truncatum) collected from domestic dogs in Chad, Africa. Ticks were screened for Rickettsia spp. using a nested PCR targeting the 17-kDa gene. Species identification was through bidirectional Sanger sequencing of the 17-kDa, ompA, ompB, and/or gltA gene targets. A total of 43.3 % (115/265) ticks were positive for Rickettsia spp. and six Rickettsia species were identified: R. africae, R. massiliae, R. conorii, R. felis, R. monacensis and Candidatus Rickettsia muridii. Seven additional samples were positive for Rickettsia of undetermined species. Rickettsia africae, an important zoonotic pathogen, was found in 81 % (79/97) of A. variegatum and 29 % (2/7) of an A. marmoreum complex species, a group that infests a wide range of birds and mammals, including humans. Finally, we detected a high diversity of Rickettsia spp., most of which were zoonotic, in Rh. muhsamae. Collectively these data indicate there is a risk of rickettsiosis in Chad and further studies on ticks and rickettsial pathogens in this region are warranted.

Vector-Borne Zoonotic Lymphadenitis-The Causative Agents, Epidemiology, Diagnostic Approach, and Therapeutic Possibilities-An Overview

In addition to common skin pathogens, acute focal lymphadenitis in humans can, in rare cases, be caused by a zoonotic pathogen. Furthermore, it can develop in the absence of any direct or indirect contact with infected animals, in cases when the microorganism is transmitted by a vector. These clinical entities are rare, and therefore often not easily recognized, yet many zoonotic illnesses are currently considered emerging or re-emerging in many regions. Focal zoonotic vector-borne lymphadenitis and its numerous causative agents, with their variegated clinical manifestations, have been described in some case reports and small case series. Therefore, we summarized those data in this narrative overview, with the aim of raising clinical awareness, which could improve clinical outcomes. This overview briefly covers reported pathogens, their vectors and geographic distribution, and their main clinical manifestations, diagnostic possibilities, and recommended therapy. Vector-borne tularemia, plague, bartonellosis, rickettsioses, borreliosis, and Malayan filariasis are mentioned. According to the existing data, when acute focal bacterial vector-borne zoonotic lymphadenitis is suspected, in severe or complicated cases it seems prudent to apply combined aminoglycoside (or quinolone) plus doxycycline as an empirical therapy, pending definite diagnostic results. In this field, the "one health approach" and further epidemiological and clinical studies are needed.

Diversity of Rickettsia species in collected ticks from Southeast Iran

Rickettsia occurs worldwide and rickettsiosis is recognized as an emerging infection in several parts of the world. Ticks are reservoir hosts for pathogenic Rickettsia species in humans and domestic animals. Most pathogenic Rickettsia species belong to the spotted Fever Group (SFG). This study aimed to identify and diagnose tick fauna and investigate the prevalence of Rickettsia spp. in ticks collected from domestic animals and dogs in the rural regions of Kerman Province, Southeast Iran. In this study, tick species (fauna) were identified and 2100 ticks (350 pooled samples) from two genera and species including Rhipicephalus linnaei (1128) and Hyalomma deteritum (972) were tested to detect Rickettsia genus using Real-time PCR. The presence of the Rickettsia genus was observed in 24.9% (95%CI 20.28-29.52) of the pooled samples. Sequencing and phylogenetic analyses revealed the presence of Rickettsia aeschlimannii (48.98%), Rickettsia conorii israelensis (28.57%), Rickettsia sibirica (20.41%), and Rickettsia helvetica (2.04%) in the positive samples. The results showed a significant association between county variables and the following variables: tick spp. (p < 0.001), Rickettsia genus infection in ticks (p < 0.001) and Rickettsia spp. (p < 0.001). In addition, there was a significant association between tick species and host animals (dogs and domestic animals) (p < 0.001), Rickettsia spp infection in ticks (p < 0.001), and Rickettsia spp. (p < 0.001). This study indicates a high prevalence of Rickettsia spp. (SFG) in ticks of domestic animals and dogs in rural areas of Kerman Province. The health system should be informed of the possibility of rickettsiosis and the circulating species of Rickettsia in these areas.

Cervids as Sentinels for Rickettsia spp. in Portugal

Cervids are highly exposed to ticks, however, their role in the life cycle of these rickettsiae has not been fully elucidated. Given the expanding distribution and growing population of deer species in Portugal, coupled with their direct and indirect interactions with humans during hunting, it becomes crucial to explore their role as sentinels and potential reservoirs of Rickettsia. The present investigation aimed to detect and evaluate exposure to Rickettsia in free-living deer from Portugal. Blood samples (n = 77) were collected from hunted game animals (red deer and fallow deer) from different areas throughout Portugal (Idanha-a-Nova, Monte Fidalgo, Montalvão and Arraiolos) and sera were tested by immunofluorescence assay, to detect antibodies. Additionally, blood DNA samples were screened for SFGR by nested-polymerase chain reaction targeting a fragment of the outer membrane protein B (ompB) gene, as well as for Anaplasma and Ehrlichia spp. targeting the 16S rRNA gene. Thirty-five per cent (25 deer and two fallow deer) tested positive (sera with a titer ≥1:64) for IgG antibodies against Rickettsia conorii. No rickettsial DNA was detected by PCR for the ompB gene, and all DNA samples tested negative for Anaplasma and Ehrlichia. As far as we know, this study is the first screening of cervid species in Portugal for Rickettsia antibodies. The findings suggest that these animals serve as useful sentinel indicators for the circulation of rickettsiae, offering a complementary perspective to studies focused on ticks. The increasing numbers of hunted deer in Portugal and the potential zoonotic features of Rickettsia spp. highlight the importance of continued surveillance directed at tick-borne diseases, especially those involving wild animals.

Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia

Rickettsioses and leptospirosis are infectious diseases that are often underdiagnosed due to a lack of knowledge about their epidemiology, pathophysiology, diagnosis, management, among others.

Objetive

to characterize the seroprevalence and seroincidence of both Rickettsia and Leptospira agents and determine the risk factors for these outcomes in rural areas of Urabá, Antioquia.

Methods

a secondary data analysis using information on Rickettsia and Leptospira exposure from a prior prospective study that explored sociocultural and ecological aspects of Rickettsia infection in rural Urabá, Colombia. A multinomial mixed logistic regression model was employed to analyze factors linked to seroprevalent cases of Rickettsia, Leptospira and both, along with descriptive analyses of seroincident cases.

Results

the concomitant seroprevalence against Rickettsiaand Leptospira was 9.38% [95%CI 6.08%-13.37%] (56/597). The factors associated with this seroprevalence were age (ORa= 1.02 [95%CI 1.007-1.03]), male gender (ORa= 3.06 [95%CI 1.75-5.37]), fever history (ORa= 1.71 [95%CI 1.06-2.77]) the presence of breeding pigs (ORa= 2.29 [95%CI 1.36-3.88]), peridomicile yucca crops(ORa= 2.5 [95%CI 1.1-5.62]), and deforestation practices(ORa= 1.74 [95%CI 1.06-2.87]). The concomitant seroincidence against Rickettsia and Leptospira was 1.09% (3/274) [95%CI 0.29%-4.05%], three cases were female, with a median age of 31.83 years-old (IQR 8.69-56.99). At the household level, all the seroincident cases had households built partially or totally with soil floors, wooden walls, and zinc roofs. Two seroincident cases described the presence of equines, canines, and domestic chickens in intra or peri-domicile. Finally, two cases were exposed to synanthropic rodents, and one case to tick infestation.

Conclusion

there is evidence of seroprevalent and seroincident cases of seropositivity against both Rickettsia and Leptospira in rural areas of Urabá, Colombia. These findings can help improve public health surveillance systems in preventing, detecting, and attending to the different clinical cases caused by these pathogens.

Scalp eschar and neck lymph adenopathy after a tick bite (SENLAT) in Tuscany, Italy (2015-2022)

INTRODUCTION

The Scalp Eschar and Neck Lymph Adenopathy After a Tick Bite (SENLAT) syndrome is frequently caused by Rickettsia slovaca and Rickettsia raoultii. Only six microbiologically confirmed SENLAT cases have been reported in Italy between 1996 and 2021. We report ten cases of SENLAT seen between 2015 and 2022 in a tertiary care center in Tuscany, Italy.

CASES PRESENTATION

All patients were women; most common symptoms were scalp eschar on the site of tick bite (100%) and cervical lymphadenopathy (90%). No microbiological identification was obtained. Persistent alopecia, for several months to years, was observed in four patients. The known difficulty of microbiological diagnosis in SENLAT was worsened, in our cases, by factors as the absence of ticks available for identification and microbiological study, and antibiotic treatment administration previous to microbiological tests.

CONCLUSION

The report highlights the presence of SENLAT in Italy, aiming to raise the awareness toward the emergence of this clinical entity.

Dogs (Canis familiaris) as sentinels for determining the risk of occurrence of Rickettsia spp. and Anaplasma phagocytophilum in previously undiagnosed areas

Determining the occurrence of Rickettsia spp. and Anaplasma phagocytophilum in municipalities with no case records is important to define surveillance strategies and is essential to reduce lethality in different regions. Therefore, an approach aimed at enhancing surveillance in municipalities with an unknown epidemiological situation was tested, according to the classification suggested by Resolution SMA/SES 07/01/16. Canine sera collected in the annual anti-rabies campaign were submitted to the indirect fluorescent antibody test for Rickettsia amblyommatis, R. belli, R. parkeri, R. rickettsii and A. phagocytophilum. Titers ≥1:64 and ≥1:320 were considered positive for Rickettsia spp. and A. phagocytophilum, respectively. For Rickettsia spp., 61.8% of dogs were seropositive, with 26% positive for more than one species, and 42.3% were seropositive for R. rickettsii. Dogs from the urban area presented 5.16 (CI 1.18; 7.69) times greater odds of seropositivity for R. parkeri (p = 0.037) and 3.39 (CI 1.04; 3.70) times greater odds for R. belli (p = 0.017). Considering the 1:40 cutoff point, 19.1% of dogs were reactive for A. phagocytophilum. Two (1%) dogs in rural areas were positive (titer 1:640). The results indicate all species ever tested in Lavras/MG, since the present study is the city's first report on the subject. According to classifications of the aforementioned Resolution, the results determine that the municipality of Lavras should be considered a "risk area" for Brazilian spotted fever(BSF). The methodology presented is efficient, straight forward to perform and inexpensive for diagnosing a risk situation for BSF and human granulocytic anaplasmosis. Moreover, its use can be applied throughout Brazil and other countries as a public health alert guideline.

A story of a lone star tick: an imported case of Amblyomma americanum (Linnaeus, 1758) infected with Rickettsia amblyommatis that parasitized a US traveler returning to Mexico

In this study, we report the presence of a female Amblyomma americanum tick attached to a former resident of the East Coast of the United States who moved to Mexico city. The amplification and sequencing of gene fragments of the 16S-rDNA and cytochrome c oxidase subunit 1 corroborated the identification of the species of the tick. Additionally, the presence of DNA of Rickettsia amblyommatis was confirmed. This work is the first report of an exotic tick of the genus Amblyomma in a traveler from the US to Mexico and represents the second record of an imported tick attached to humans in Mexico.

Prevalence of Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Rickettsia spp. and Babesia spp. in cattle serum and questing ticks from Belgium

BACKGROUND

Anaplasmosis, borreliosis, rickettsiosis and babesiosis are tick-borne diseases of medical, veterinary and economic importance. In Belgium, little is known on the prevalence of these diseases in animals and previous screenings relate only to targeted geographic regions, clinical cases or a limited number of tested samples. We therefore performed the first nationwide seroprevalence study of Anaplasma spp., A. phagocytophilum, Borrelia spp., Rickettsia spp. and Babesia spp. in Belgian cattle. We also screened questing ticks for the aforementioned pathogens.

METHODS

ELISAs and IFATs were performed on a representative sample set of cattle sera stratified proportionally to the number of cattle herds per province. Questing ticks were collected in areas where the highest prevalence for the forenamed pathogens in cattle serum were observed. Ticks were analyzed by quantitative PCR for A. phagocytophilum (n = 783), B. burgdorferi sensu lato (n = 783) and Rickettsia spp. (n = 715) and by PCR for Babesia spp. (n = 358).

RESULTS

The ELISA screening for antibodies to Anaplasma spp. and Borrelia spp. in cattle sera showed an overall seroprevalence of 15.6% (53/339) and 12.9% (52/402), respectively. The IFAT screening for antibodies against A. phagocytophilum, Rickettsia spp. and Babesia spp. resulted in an overall seroprevalence of 34.2% (116/339), 31.2% (99/317) and 3.4% (14/412), respectively. At the provincial level, the provinces of Liege and Walloon Brabant harboured the highest seroprevalence of Anaplasma spp. (44.4% and 42.7% respectively) and A. phagocytophilum (55.6% and 71.4%). East Flanders and Luxembourg exhibited the highest seroprevalence of Borrelia spp. (32.4%) and Rickettsia spp. (54.8%) respectively. The province of Antwerp showed the highest seroprevalence of Babesia spp. (11%). The screening of field-collected ticks resulted in a prevalence of 13.8% for B. burgdorferi s.l., with B. afzelii and B. garinii being the most common genospecies (65.7% and 17.1%, respectively). Rickettsia spp. was detected in 7.1% of the tested ticks and the only identified species was R. helvetica. A low prevalence was found for A. phagocytophilum (0.5%) and no Babesia positive tick was detected.

CONCLUSIONS

The seroprevalence data in cattle indicate hot spots for tick-borne pathogens in specific provinces and highlights the importance of veterinary surveillance in anticipating the emergence of diseases among humans. The detection of all pathogens, with the exception of Babesia spp. in questing ticks, underlines the need of raising awareness among public and professionals on other tick-borne diseases along with lyme borreliosis.

Transovarial transmission of pathogenic protozoa and rickettsial organisms in ticks

Transovarial transmission (TOT) is an efficient vertical transmission of pathogens that is observed in many arthropod vectors. This method seems to be an evolutionarily unique development observed only in Babesia sensu stricto (clade VI) and Rickettsia spp., whereas transstadial transmission is the common/default way of transmission. Transovarial transmission does not necessarily contribute to the amplification of tick-borne pathogens but does contribute to the maintenance of disease in the environment. This review aims to provide an updated summary of previous reports on TOT of tick-borne pathogens.

Bartonella spp. and Typhus Group Rickettsiae among Persons Experiencing Homelessness, São Paulo, Brazil

Persons experiencing homelessness in São Paulo, Brazil, were seropositive for Bartonella spp. (79/109, 72.5%) and typhus group rickettsiae (40/109, 36.7%). Bartonella quintana DNA was detected in 17.1% (14/82) body louse pools and 0.9% (1/114) blood samples. Clinicians should consider vectorborne agents as potential causes of febrile syndromes in this population.

Advanced approaches for the diagnosis and chemoprevention of canine vector-borne pathogens and parasites-Implications for the Asia-Pacific region and beyond

Vector-borne pathogens (VBPs) of canines are a diverse range of infectious agents, including viruses, bacteria, protozoa and multicellular parasites, that are pernicious and potentially lethal to their hosts. Dogs across the globe are afflicted by canine VBPs, but the range of different ectoparasites and the VBPs that they transmit predominate in tropical regions. Countries within the Asia-Pacific have had limited prior research dedicated to exploring the epidemiology of canine VBPs, whilst the few studies that have been conducted show VBP prevalence to be high, with significant impacts on dog health. Moreover, such impacts are not restricted to dogs, as some canine VBPs are zoonotic. We reviewed the status of canine VBPs in the Asia-Pacific, with particular focus on nations in the tropics, whilst also investigating the history of VBP diagnosis and examining recent progress in the field, including advanced molecular methods, such as next-generation sequencing (NGS). These tools are rapidly changing the way parasites are detected and discovered, demonstrating a sensitivity equal to, or exceeding that of, conventional molecular diagnostics. We also provide a background to the armoury of chemopreventive products available for protecting dogs from VBP. Here, field-based research within high VBP pressure environments has underscored the importance of ectoparasiticide mode of action on their overall efficacy. The future of canine VBP diagnosis and prevention at a global level is also explored, highlighting how evolving portable sequencing technologies may permit diagnosis at point-of-care, whilst further research into chemopreventives will be essential if VBP transmission is to be effectively controlled.

Tick-Borne Rickettsioses in the Iberian Peninsula

Tick-borne rickettsioses (TBR) are caused by obligate, intracellular bacteria of the spotted-fever group (SFG) of the genus Rickettsia (Order Rickettsiales), transmitted by hard ticks. TBR are one of the oldest known vector-borne zoonoses and pose a threat to both human and animal health, as over the years, new SFG Rickettsia spp. have been reported worldwide with the potential to be human pathogens. In Portugal and Spain, the countries that constitute the Iberian Peninsula, reported TB rickettsiae causing human disease include Rickettsia conorii conorii, Rickettsia conorii israelensis, Rickettsia slovaca, Rickettsia raoultii, Candidatus Rickettsia rioja, Rickettsia sibirica mongolitimonae, and Rickettsia monacensis. An allochthonous case of TBR caused by Rickettsia massiliae, described in Spain, points to the need to monitor disease epidemiology, to predict risks of exposure and spread of disease, and taking into account globalization and climate changes. This review aims to provide up-to-date information on the status of TBR in the Iberian Peninsula, as well as to show the importance of a national and international collaborative epidemiology surveillance network, towards monitoring Rickettsia spp. circulation in both Portugal and Spain.

Epidemiological Study of the Occurrence of Typhus Group Rickettsia Natural Infection in Domiciliated Dogs from a Rural Community in South-Eastern Mexico

Simple Summary

Rickettsioses are relevant emergent and reemergent zoonoses in the Americas, including Mexico. Murine typhus caused by typhus group (TG) Rickettsia is prevalent in humans and their companion animals, such as dogs. This study found that 23.9% of the dogs (34/142) were infected by TG Rickettsia in Maxcanú, Yucatan (southeastern Mexico). Statistical analyses showed that reduced outdoor activities, age, sex and previous antiparasitic treatment are associated factors with less risk of TG Rickettsia infection in the sampled dogs. Monitoring and controlling these factors could help to restrict the enzootic transmission risk and prevent the potential zoonotic transmission.

Abstract

The aim is to describe the Typhus group (TG) Rickettsia infection in dogs and to identify factors associated with this infection. We collected blood samples and gathered exposure and clinical data of 142 dogs from a rural community of Yucatan. The Rickettsia group was determined by semi-nested PCR. Generalized linear models with binomial error distribution were used to model the associated factors from the dog sample for risk ratio (RR) estimation. Thirty-four dogs (23.9%) showed molecular evidence of TG Rickettsia DNA. The multivariate model showed that mixed-breed dogs (RR = 0.06) and dogs that had received antiparasitic treatment (RR = 0.049) had a lower risk of getting infected, taking as reference the purebred group and the non-treated dogs, respectively. Looking at variable interactions, adult dogs without outdoor activities had a lower infection risk than puppies (RR = 0.26). Among dogs with antiparasitic treatment, females had a higher infection risk than male dogs (RR = 26.2). The results showed enzootic TG Rickettsia circulation in dogs of a rural community. The factors outdoor activities, age and previous antiparasitic treatment, as well as the clinical variables signs of hemorrhages and epistaxis, were associated with a less chance of natural infection in the studied dogs. Prevention and control of the enzootic transmission risk of TG Rickettsia should help to reduce the potential zoonotic transmission of this pathogen.

Unraveling the epidemiological relationship between ticks and rickettsial infection in Africa

Tick-borne rickettsioses are emerging and re-emerging diseases of public health concern caused by over 30 species of Rickettsia. Ticks are obligate hematophagous arthropods with over 700 species of Ixodid ticks known worldwide. The escalating geographical dispersal of tick vectors and concomitant increase in the incidences of tick-borne diseases have fueled interest in the ecology of tick-borne pathogens. This review focuses on aspects of the Rickettsia pathogen, including biology, taxonomy, phylogeny, genetic diversity, epidemiology of the disease, and the role of vertebrate host in the perpetuation of rickettsioses in Africa. Our review also highlights some of the species of Rickettsia that are responsible for disease, the role of tick vectors (both hard and soft ticks) and the species of Rickettsia associated with diverse tick species across the continent. Additionally, this article emphasizes the evolutionary perspective of rickettsiae perpetuation and the possible role of amplifying vertebrate host and other small mammals, domestic animals and wildlife in the epidemiology of Rickettsia species. We also specifically, discussed the role of avian population in the epidemiology of SFG rickettsiae. Furthermore, we highlighted tick-borne rickettsioses among travelers due to African tick-bite fever (ATBF) and the challenges to surveillance of rickettsial infection, and research on rickettsiology in Africa. Our review canvasses the need for more rickettsiologists of African origin based within the continent to further research towards understanding the biology, characterization, and species distribution, including the competent tick vectors involved in their transmission of rickettsiae across the continent in collaboration with established researchers in western countries. We further highlighted the need for proper funding to encourage research despite competing demands for resources across the various sectors. We finalize by discussing the similarities between rickettsial diseases around the world and which steps need to be taken to help foster our understanding on the eco-epidemiology of rickettsioses by bridging the gap between the growing epidemiological data and the molecular characterization of Rickettsia species.

An update on spotted fever group serology in Kerman Province, Iran

Rickettsia conorii is the causative agent of Mediterranean spotted fever (MSF) and reports of its geographical distribution are spreading every day. Recently, some cases of the MSF have been reported from Iran. However, little information is available about the MSF epidemiology in Iran. The aim of the current study was to investigate anti-R. conorii IgG seroprevalence among farmers living in the rural regions of Kerman province (in southeastern Iran). In this study, 281 blood samples were collected from farmers in Zarand and Jiroft counties and tested for detection of anti-R. conorii IgG antibodies using the ELISA method. Among the 281 samples, 14 farmers (4.98%, CI 95%; 2.45-7.55%) had anti-R. conorii IgG antibodies. Seroprevalence of MSF in Zarand and Jiroft counties were 4.58% and 5.33%, respectively. The serological evidence of this study indicates the seroprevalence of R. conorii in rural areas of the Kerman province of Iran. So, it is recommended that the Iranian health care system pay attention to the MSF.

Rare Case of Rickettsiosis Caused by Rickettsia monacensis, Portugal, 2021

We report a case of rickettsiosis caused by Rickettsia monacensis in an immunocompetent 67-year-old man in Portugal who had eschar, erythematous rash, and an attached Ixodes ricinus tick. Seroconversion and eschar biopsy led to confirmed diagnosis by PCR. Physicians should be aware of this rare rickettsiosis, especially in geographic regions with the vector.

High Prevalence of Tick-Borne Zoonotic Rickettsia slovaca in Ticks from Wild Boars, Northeastern Italy

Simple Summary

Tick-borne rickettsioses are emerging diseases that have become widespread in many European countries, particularly in those facing the Mediterranean basin. Although Rickettsia conorii was traditionally thought to be the most threatening species, in recent decades, thanks to the improvements in biomolecular tools, other zoonotic species have been identified, such as Rickettsia slovaca, the etiological agent of scalp eschar and neck lymphadenopathy after tick bite (SENLAT), as well as other neglected species. These pathogens are present in Italy, but few data are available. This research aimed to improve the epidemiological knowledge of rickettsial infections in tick and wild boar populations in the Euganean Hills Regional Park, an enclosed area in northeastern Italy. Both tick and wild boar blood samples were tested using biomolecular methods to detect and identify Rickettsia species. Only ticks tested positive, and Rickettsia slovaca was the most frequently detected species, showing a high prevalence, followed by Rickettsia monacensis and Rickettsia helvetica. These data highlight a non-negligible presence of these pathogens in northern Italy and outline that rickettsial infections deserve further investigation.

Abstract

Tick-borne rickettsiae are emerging pathogens that are becoming widespread in Europe. Rickettsiae are endemic in Italy, but epidemiological data are currently scarce. This study aimed to improve our knowledge about rickettsial infections in tick and wild boar populations. Blood and ticks were collected from 102 wild boars in 2010 and 2018. Ticks were also collected from the vegetation in the area. All of the samples were examined using real-time PCR targeting the gltA gene to detect Rickettsia DNA. Positivity was confirmed by PCR amplifying the gltA and/or ompB genes. A total of 254 ticks and 89 blood samples were analyzed. Zoonotic rickettsiae were detected in the ticks but not in the blood samples. Rickettsia slovaca (R. slovaca) was the most prevalent in ticks and was found in 23.7% of Dermacentor marginatus (D. marginatus) and in 3.4% of Ixodes ricinus (I. ricinus). Other zoonotic species were identified, such as Rickettsia monacensis, which was detected in 12% of I. ricinus ticks, and Rickettsia helvetica which was found in 3.4% of questing I. ricinus ticks and in 1.1% of D. marginatus collected from wild boars. This study highlights a high prevalence of zoonotic rickettsiae, particularly that of R. slovaca, in northeastern Italy. As rickettsioses are underreported and underdiagnosed in human medicine, both clinicians and researchers should pay more attention to this topic.

Molecular confirmation of Rickettsia parkeri in humans from Southern Mexico

Human tick-borne rickettsioses are caused by Rickettsia africae, Rickettsia massiliae, Rickettsia parkeri, Rickettsia philipi and Rickettsia rickettsii in the American continent. Rickettsia parkeri represents the second most important agent of eschar-associated spotted fever throughout the American continent. In Mexico, the presence of three strains of this bacterium (Black Gap, Maculatum and Atlantic Rainforest) has recently been reported in four species of ticks from five states (Baja California, Campeche, Sonora, Tabasco and Veracruz) and rickettsaemia was demonstrated in a dog from the state of Yucatán. We report two human cases of R. parkeri-rickettsiosis from Yucatan, Mexico. These findings have increased the interest in R. parkeri surveillance in the human population, due to the fluctuating regional Spotted Fever morbidity and mortality in the country.

Mediterranean Spotted Fever: Current Knowledge and Recent Advances

Mediterranean spotted fever (MSF) is an emerging tick-borne rickettsiosis of the spotted fever group (SFG), endemic in the Mediterranean basin. By virtue of technological innovations in molecular genetics, it has been determined that the causative agent of MSF is Rickettsia conorii subspecies conorii. The arthropod vector of this bacterium is the brown dog tick Rhipicephalus sanguineus. The true nature of the reservoir of R. conorii conorii has not been completely deciphered yet, although many authors theorize that the canine population, other mammals, and the ticks themselves could potentially contribute as reservoirs. Typical symptoms of MSF include fever, maculopapular rash, and a characteristic eschar ("tache noire"). Atypical clinical features and severe multi-organ complications may also be present. All of these manifestations arise from the disseminated infection of the endothelium by R. conorii conorii. Several methods exist for the diagnosis of MSF. Serological tests are widely used and molecular techniques have become increasingly available. Doxycycline remains the treatment of choice, while preventive measures are focused on modification of human behavior and vector control strategies. The purpose of this review is to summarize the current knowledge on the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of MSF.

Autochthonous Case of Rickettsia slovaca Infection in Russia

We describe an autochthonous case of Rickettsia slovaca infection in a man 35 years of age from Russia who had tickborne lymphadenopathy. We used ELISA and quantitative PCR testing to further identify DNA and confirm diagnosis. Physicians in Russia should consider similar diseases in differential diagnoses after tick bites.

Epidemiology of Rickettsial Infection in the Municipality of Uramita, Colombia

This study aimed to analyze epidemiological indicators related to seroprevalent and seroincident cases of spotted fever group rickettsiae (SFGR) and to identify housing conditions related to tick infestation. A prospective study (2016-2018) was conducted to examine rickettsial seropositivity in humans, domestic animals, and wild mammals in the municipality of Uramita, Antioquia, Colombia, where a previous Rickettsia rickettsii outbreak was reported from 2014 to 2015. The seroprevalence and its associated factors were estimated at baseline, and the seroincidence and its risk factors for humans were estimated 20 months later. A cross-sectional analysis was performed to evaluate the housing conditions linked to tick infestation. The SFGR seroprevalence was 26.70% (95% confidence interval [CI], 20.79-31.37), and the factors associated with SFGR seropositivity were male sex (adjusted prevalence ratio [PRa], 1.67; 95% CI, 1.19-2.32), age (evaluated in 5-year increments) (PRa, 1.05; 95% CI, 1.01-1.09), and household proximity (PRascattered vs. very near=3.87; 95% CI, 1.12-8.66). The overall seroincidence was 7.40% (95% CI, 4.71-11.06), and the factors associated with SFGR seroincident cases were the presence of wild animals (adjusted relative risk [RRa], 2.46; 95% CI, 1.06-4.72) and the presence of trees in the peri-domiciliary area (RRa, 0.47; 95% CI, 0.23-0.94). The prevalence of house tick infestation was 27.81% (95% CI, 21.93-34.80), and the factors associated with infestation were dirt floors (PRa, 5.88; 95% CI, 2.28-10.31), fiber cement roofs (PRa, 1.76; 95% CI, 1.07-2.83), and the presence of canines in peri-domiciliary or intra-domiciliary areas (PRa, 5.05; 95% CI, 3.31-7.19). Seropositivity rates for canines and opossums were 35.62% (26/73) and 100% (6/6), respectively. Identification of these factors will help to implement efficient surveillance programs in Colombia.

A multipronged next-generation sequencing metabarcoding approach unearths hyperdiverse and abundant dog pathogen communities in Cambodia

Recent surveys in Southeast Asia, including Cambodia, have identified canine vector-borne pathogens (VBPs), including those with zoonotic potential, as highly prevalent. The lack of veterinary care alongside the close association semidomesticated dogs have with humans in the region exacerbates these zoonotic risks. Nonetheless, the number of studies investigating such pathogens and the threats they pose to dog and human health is limited. Here, we utilize a next-generation sequencing (NGS)-based metabarcoding protocol to conduct an assumption-free characterization of the bacterial, apicomplexan, and kinetoplastid blood-borne pathogens of free-roaming dogs from across Cambodia. From 467 dogs at five field sites, 62% were infected with one of eight confirmed pathogens, comprising Anaplasma platys (32%), Ehrlichia canis (20%), Hepatozoon canis (18%), Babesia vogeli (14%), Mycoplasma haemocanis (13%), the zoonotic pathogen Bartonella clarridgeiae (3%), Candidatus Mycoplasma haematoparvum (0.2%), and Trypanosoma evansi (0.2%). Coinfections of between two and four VBPs were common with 28% of dogs found to have a mixed infection. Moreover, DNA from putatively infectious agents belonging to the bacterial family and genera Coxiella, Mycobacterium, Neisseria, Rickettsiaceae, Treponema, and two uncharacterized Mycoplasma species were identified, in addition to protozoan genera Colpodella, Parabodo, and Bodo. Using a multiple logistic regression model, the presence of ectoparasites, abnormal mucous membranes, anemia, and total protein were found as predictors of canine VBP exposure. This study represents the first time an NGS metabarcoding technique has been used to holistically detect the bacterial and protozoan hemoparasites communities of dogs through an in-depth survey, highlighting the power of such methods to unearth a wide spectrum of pathogenic organisms in an unbiased manner.

Novel High-Throughput Multiplex qPCRs for the Detection of Canine Vector-Borne Pathogens in the Asia-Pacific

The Asia-Pacific hosts a large diversity of canine vector-borne pathogens (VBPs) with some of the most common and most pathogenic, generating significant mortality as well as a spectrum of health impacts on local dog populations. The VBPs Anaplasma platys, Babesia gibsoni, Babesia vogeli, Ehrlichia canis, Hepatozoon canis and haemotropic Mycoplasma spp. are all endemic throughout the region, with many exhibiting shifting geographical distributions that warrant urgent attention. Moreover, many of these species cause similar clinical signs when parasitising canine hosts, whilst knowledge of the exact pathogen is critical to ensure treatment is effective. This is complicated by frequent coinfection that can exacerbate pathology. Here, we describe the development, optimisation and validation of two novel quadruplex Taq-Man based real-time PCRs (qPCRs) for the specific and sensitive detection of the aforementioned VBPs. To ensure accurate evaluation of diagnostic performance, results of our qPCRs were evaluated on field samples from Thai dogs and compared with both conventional PCR (cPCR) results and next-generation sequencing (NGS) metabarcoding. Our qPCRs were found to be more sensitive at detecting canine VBP than cPCR and generated results similar to those achieved by NGS. These qPCRs will provide a valuable high-throughput diagnostic tool available to epidemiologists, researchers and clinicians for the diagnosis of key canine VBPs in the Asia-Pacific and further afield.

Diversity of Rickettsia in ticks collected from wild animals in Panama

This paper presents new data about Rickettsia species detected in ticks collected from wild animals, using 16S rRNA, gltA and ompA. Rickettsia DNA was found in 66 of 101 ticks. Using EZ BioCloud libraries were produced reads that identified Rickettsia aeschlimannii, and Illumina BaseSpace produced reads of Rickettsia rickettsii group, Rickettsia bellii group, and unclassified Rickettsia. Using gltA and ompA gene-specific primers, R. aeschlimannii could not be confirmed, but detection of Rickettsia amblyommatis was achieved in Amblyomma auricularium, Amblyomma geayi, Amblyomma mixtum, and Amblyomma pacae; R. bellii from Amblyomma dissimile, "Candidatus Rickettsia colombianensi" from A. dissimile, Rickettsia spp. closely related to R. raoultii from A. geayi, Rickettsia tamurae from A. dissimile, and Rickettsia endosymbionts of Ixodes from Ixodes affinis. There were no databases available specifically for 16S rRNA of Neotropical Rickettsia, highlighting the need to use species primers over only 16S rRNA primers to achieve more accurate interpretations and identifications. These findings increase the number of Rickettsia species detected in Panama and highlight the need to establish isolates to further characterize the nature of Rickettsia in the area.

Tick-borne zoonoses and commonly used diagnostic methods in human and veterinary medicine

Around the world, human health and animal health are closely linked in terms of the One Health concept by ticks acting as vectors for zoonotic pathogens. Animals do not only maintain tick cycles but can either be clinically affected by the same tick-borne pathogens as humans and/or play a role as reservoirs or sentinel pathogen hosts. However, the relevance of different tick-borne diseases (TBDs) may vary in human vs. veterinary medicine, which is consequently reflected by the availability of human vs. veterinary diagnostic tests. Yet, as TBDs gain importance in both fields and rare zoonotic pathogens, such as Babesia spp., are increasingly identified as causes of human disease, a One Health approach regarding development of new diagnostic tools may lead to synergistic benefits. This review gives an overview on zoonotic protozoan, bacterial and viral tick-borne pathogens worldwide, discusses commonly used diagnostic techniques for TBDs, and compares commercial availability of diagnostic tests for humans vs. domestic animals, using Germany as an example, with the aim of highlighting existing gaps and opportunities for collaboration in a One Health framework.

Detection of tick-borne pathogens in Rhipicephalus sanguineus sensu lato and dogs from different districts of Portugal

Dogs are highly exposed to pathogens transmitted by ectoparasites. The Mediterranean climate of Southern Europe, together with the presence of stray and/or neglected pets in close proximity with humans, contribute for tick expansion and stand for increased risk to infections in humans due to the zoonotic potential of many of these agents. The aim of this study was to perform a molecular survey in dogs (suspected of tick-borne disease and/or infested with ticks), as well as in ticks collected from those animals, from 12 districts of Portugal to investigate the occurrence of Rickettsia spp. and other tick-borne pathogens (Babesia, Ehrlichia, Anaplasma and Hepatozoon). Additionally, a serological survey of spotted fever group Rickettsia in Portuguese dogs was performed using an in-house immunofluorescence assay (IFA). A total of 200 whole-blood samples and 221 Rhipicephalus sanguineus s. l. ticks were collected from dogs. A total of 14 (7 %) blood samples and 10 (4.5 %) ticks yielded presumptively positive 420-bp amplicons using the Rickettsia spp. partial ompB nested PCR. Screening of the ompB-positive samples using the gltA gene showed 8 positive ticks. All Rickettsia ompB and gltA sequences had the highest identity with R. massiliae. The Rickettsia-positive dogs were further tested for other tick-borne pathogens and were found to be infected with Babesia spp. (n = 5), but not with Ehrlichia, Anaplasma or Hepatozoon. Of the 149 dog serum specimens tested in the serological assay, 103 (69 %) were positive for IgG antibodies against spotted fever group Rickettsia. Antibodies were found in dogs from all the studied districts, in 55 (53 %) of the stray and in 48 (47 %) of the owned dogs. Our study detected and characterized for the first time R. massiliae in dogs from Portugal, broadening the geographical range of this canine pathogen and adding knowledge to the impact of this disease in dogs.

Rickettsia parkeri (Rickettsiales: Rickettsiaceae) detected in Amblyomma maculatum ticks collected on dogs in Tabasco, Mexico

The present study was carried out to identify Rickettsia species with zoonotic potential in ticks collected from dogs in a rural area in Tabasco, Mexico. In total 197 Amblyomma maculatum ticks were collected from 40 domestic dogs. The collected specimens were pooled and subjected to DNA extraction. A fragment (380 bp) of citrate synthase gene (gltA) was amplified by polymerase chain reaction (PCR) using universal primers for Rickettsia. A second PCR was later performed to amplify a fragment (420 bp) of the outer membrane protein B gene (ompB). The PCR products were purified, sequenced and compared using the basic local alignment search tool (BLAST). Twenty out of 40 (50%) tick pools assayed were positive for rickettsial DNA using both primer pairs. The consensus sequence obtained from the ompB gene fragments showed 99.5-100% of identity with strains of Rickettsia parkeri. This study provides the first molecular evidence of the presence of R. parkeri in A. maculatum ticks infesting domestic dogs from southeastern Mexico. Close contact between dogs and humans should lead to consider the infection caused by this species of Rickettsia among the differential diagnoses for people of Tabasco, Mexico, who show acute febrile syndrome associated to inoculation eschar and have a clinical history of tick exposure.

New Real-Time PCRs to Differentiate Rickettsia spp. and Rickettsia conorii

Rickettsia species are an important cause of emerging infectious diseases in people and animals, and rickettsiosis is one of the oldest known vector-borne diseases. Laboratory diagnosis of Rickettsia is complex and time-consuming. This study was aimed at developing two quantitative real-time PCRs targeting ompB and ompA genes for the detection, respectively, of Rickettsia spp. and R. conorii DNA. Primers were designed following an analysis of Rickettsia gene sequences. The assays were optimized using SYBR Green and TaqMan methods and tested for sensitivity and specificity. This study allowed the development of powerful diagnostic methods, able to detect and quantify Rickettsia spp. DNA and differentiate R. conorii species.

Tickbite-associated chronic pruritic lesions in an Afro-descendant population in the Cauca Department, Colombia. I. Clinical features and impact on health

BACKGROUND

During a health survey in a remote area in southwest Colombia, it became apparent that a high percentage of the population suffered from chronic pruritus in association with high numbers of ticks and tickbites.

OBJECTIVE

To determine the clinical features and severity of tickbite-associated pruritus.

METHOD

At twotime points - 8 weeks apart to account for seasonal effects - a cross-sectional study was conducted encompassing physical examination of the population, histological analysis of skin biopsies, and determining serum for antibodies against spotted fever (SFG) rickettsiae and typhus group (TG) rickettsiae. Ticks were identified using morphological criteria, and infection by rickettsiae was determined by PCR.

RESULTS

About 94.5% of the population (95% CI 92-97%) showed clinical signs of a pruritic arthropod reaction and of chronic pruritus with lichenoid papules and hyper- and hypopigmented nodules on otherwise noninflamed skin. Pruritus markedly impaired the quality of life in terms of sleeping disturbances. No signs for other diseases were observed. Chronic pruritus appeared to be because of repeated tickbites and scratching, but not because of other dermatological or medical conditions. Antibodies against SFG and TG-rickettsiae were detected at 79.0% (95% CI 73-86) and 3.6% (95% CI 0.7-6), respectively. Ticks were identified as Amblyomma cajennense.

CONCLUSION

Remarkably high exposure to tick bites caused an unusually high rate of acute and chronic pruritus and markedly impaired quality of life of the investigated rural community. This underlines the necessity of public health measures and surveillance of rickettsial disease.

Serological Evidence of Rickettsia Exposure among Patients with Unknown Fever Origin in Angola, 2016-2017

Spotted fever group Rickettsia (SFGR) is one among the aetiologies that cause fever of unknown origin in Angola. Despite their occurrence, there is little information about its magnitude in this country either because it is misdiagnosed or due to the lack of diagnostic resources. For this purpose, eighty-seven selected malaria- and yellow fever-negative serum specimens collected between February 2016 and March 2017 as part of the National Laboratory of Febrile Syndromes, from patients with fever (≥37.5°C) for at least 4 days and of unknown origin, were screened for Rickettsia antibodies through an immunofluorescence assay (IFA). Serological results were interpreted according to the 2017 guidelines for the detection of Rickettsia spp. Three seroreactive patients had detectable IgM antibodies to Rickettsia with an endpoint titre of 32 and IgG antibodies with endpoint titres of 128 and 256. These findings supported a diagnosis of Rickettsia exposure amongst these patients and highlight that rickettsioses may be among the cause of unknown febrile syndromes in Angola. Therefore, physicians must be aware of this reality and must include this vector-borne disease as part of aetiologies that should be considered and systematically tested in order to delineate appropriate strategies of diagnostic and control of Rickettsia in Angola.

Rickettsia africae an Agent of African Tick Bite Fever in Ticks Collected from Domestic Animals in Eastern Cape, South Africa

Background: Ticks transmit a plethora of pathogens of zoonotic implications. Their distribution, diversity and the pathogens they transmit differ from one ecological location to another. Rickettsia africae is the agent of African tick bite fever found in South Africa, a zoonotic infection that is frequently reported among travelers who have visited many sub-Saharan African countries where the pathogen is prevalent. Methods: Ticks were collected from domestic animals in Raymond Nkandla Municipality, Eastern Cape, South Africa. The ticks were identified morphologically prior to DNA extraction followed by molecular identification of randomly selected ticks from the morphologically delineated groups. To assess for the presence of tick-borne pathogens belonging to Rickettsia spp. by PCR (polymerase chain reaction), we used specific primer pairs targeting the gltA, ompA and ompB genes. The selected amplified ticks, all positive ompB and forty three ompA amplicons were sequenced in a commercial sequencing facility. The obtained nucleotide sequences were edited and subjected to BLASTn for homology search and phylogenetic analyses were performed with MEGA 7 Version for genetic relationships with curated reference sequences in GenBank. Results: A total of 953 ticks collected in the study were delineated into three genera consisting of Amblyomma, Rhipicephalus and Hyalomma in decreasing order of abundance. The presence of rickettsial DNA was detected in 60/953 (6.3%) from the three genera of ticks screened. Genetic analyses of the DNA sequences obtained showed that they have phylogenetic relationship to members of the spotted fever group rickettsiae with R. africae, being the predominant SFGR (spotted fever group rickettsiae) detected in the screened ticks. Conclusion: This report shows that R. africae is the predominant spotted fever group rickettsiae in ticks collected from domestic animals in the study area and the human health impacts are not known.

Duplex qPCR assay for detection and quantification of Anaplasma phagocytophilum and Rickettsia spp

Anaplasma phagocytophilum and Rickettsia spp. are vector-borne zoonotic bacteria, which are clinically important especially in immunocompromised patients. There are large gaps in the current knowledge of their geographic distribution and prevalence in both their vectors and hosts. Our aim was to develop reliable and easy detection method for both these pathogens. We made a new hydrolysis probe based duplex Real-Time PCR assay based on previous studies. We optimized the assays and tested them to provide reliable recommended procedures with a sensitivity to a minimum of 10 target DNA copies per sample. The assays were designed to be specific for A. phagocytophilum and in the same reaction detect multiple species of rickettsiae. We designed gBlock quantification standards that provide the option to identify differences in pathogen load among different samples in subsequent studies.

Detection of Rickettsia spp. in Fleas Collected from Small Mammals in Slovakia, Central Europe

This survey is aimed at investigation of species composition of fleas removed from small terrestrial mammals captured in rural, suburban, and urban types of habitat and molecular screening of the presence and diversity of Rickettsia species in collected ectoparasites. In total, 279 fleas (Siphonaptera) belonging to 9 species of 2 families, Ceratophyllidae and Hystrichopsyllidae, were collected from 115 (46%) out of 250 trapped small mammals of eight species (Apodemus agrarius, Apodemus flavicollis, Apodemus uralensis, Myodes glareolus, Microtus arvalis, Microtus subterraneus, Crocidura leucodon, and Sorex minutus). Rickettsia spp. were found in 2.5% (7/279) of tested fleas, namely in Ctenophthalmus agyrtes, Ctenophthalmus solutus, Ctenophthalmus uncinatus, Megabothris turbidus, and Amalareus penicilliger. Rickettsia felis, Rickettsia helvetica, and unidentified Rickettsia species were detected in fleas infesting small mammals in Eastern Slovakia. The results of the study suggest that some species of rickettsiae have a different range of arthropod vectors.

Coculture at the crossroads of the new microbiology techniques for the isolation of strict intracellular bacteria

Coculture played a major role in clinical microbiology by elucidating strict intracellular bacteria era. Since some of these bacteria are human pathogens, in-depth studies at the strain level are necessary to better understand their pathologies and treatment. Over the last decades, culture-independent tools have taken over the diagnostic procedure at the expense of coculture. These tools, although proven to be rapid and efficient, cannot overcome the need to culture the bacteria, as strain isolation remains a key factor to understanding its epidemiology, virulence and antibiotic susceptibility testing. Moreover, strain availability allows the development of molecular and serological tools, and remains crucial for taxonomy. This review revisits the current status of culture, its advantages, drawbacks and future needs.

Evaluation of Disease Causality of Rare Ixodes ricinus-Borne Infections in Europe

In Europe, Ixodes ricinus ticks transmit pathogens such as Borrelia burgdorferi sensu lato and tick-borne encephalitis virus (TBEV). In addition, there is evidence for transmission to humans from I. ricinus of Anaplasma phagocytophilum, Babesia divergens, Babesia microti, Babesia venatorum, Borrelia miyamotoi, Neoehrlichia mikurensis, Rickettsia helvetica and Rickettsia monacensis. However, whether infection with these potential tick-borne pathogens results in human disease has not been fully demonstrated for all of these tick-borne microorganisms. To evaluate the available evidence for a causative relation between infection and disease, the current study analyses European case reports published from 2008 to 2018, supplemented with information derived from epidemiological and experimental studies. The evidence for human disease causality in Europe found in this review appeared to be strongest for A. phagocytophilum and B. divergens. Nonetheless, some knowledge gaps still exist. Importantly, comprehensive evidence for pathogenicity is lacking for the remaining tick-borne microorganisms. Such evidence could be gathered best through prospective studies, for example, studies enrolling patients with a fever after a tick bite, the development of specific new serological tools, isolation of these microorganisms from ticks and patients and propagation in vitro, and through experimental studies.

The Rickettsioses: A Practical Update

Rickettsia are small, obligately intracellular, gram-negative bacilli. They are distributed among a variety of hematophagous arthropod vectors and cause illness throughout the world. Rickettsioses present as an acute undifferentiated febrile illness and are often accompanied by headache, myalgias, and malaise. Cutaneous manifestations include rash and eschar, which both occur at varying incidence depending on the infecting species. Serology is the mainstay of diagnosis, and the indirect immunofluorescence assay is the test of choice. Reactive antibodies are seldom present during early illness, so testing should be performed on both acute-phase and convalescent-phase sera. Doxycycline is the treatment of choice.

Assessment of a metabarcoding approach for the characterisation of vector-borne bacteria in canines from Bangkok, Thailand

BACKGROUND

Globally, bacterial vector-borne disease (VBD) exerts a large toll on dogs in terms of morbidity and mortality but nowhere is this more pronounced than in the tropics. Tropical environments permit a burgeoning diversity and abundance of ectoparasites some of which can transmit an extensive range of infectious agents, including bacteria, amongst others. Although some of these vector-borne bacteria are responsible for both animal and human diseases in the tropics, there is a scarcity of epidemiological investigation into these pathogens' prevalence. The situation is further exacerbated by frequent canine co-infection, complicating symptomatology that regular diagnostic techniques may miss or be unable to fully characterise. Such limitations draw attention to the need to develop screening tools capable of detecting a wide range of pathogens from a host simultaneously.

RESULTS

Here, we detail the employment of a next-generation sequencing (NGS) metabarcoding methodology to screen for the spectrum of bacterial VBD that are infecting semi-domesticated dogs across temple communities in Bangkok, Thailand. Our NGS detection protocol was able to find high levels of Ehrlichia canis, Mycoplasma haemocanis and Anaplasma platys infection rates as well as less common pathogens, such as "Candidatus Mycoplasma haematoparvum", Mycoplasma turicensis and Bartonella spp. We also compared our high-throughput approach to conventional endpoint PCR methods, demonstrating an improved detection ability for some bacterial infections, such as A. platys but a reduced ability to detect Rickettsia.

CONCLUSIONS

Our methodology demonstrated great strength at detecting coinfections of vector-borne bacteria and rare pathogens that are seldom screened for in canines in the tropics, highlighting its advantages over traditional diagnostics to better characterise bacterial pathogens in environments where there is a dearth of research.

Infección y enfermedad por Rickettsia spp. del grupo de las fiebres manchadas en pacientes febriles del Urabá antioqueño, Colombia

Objetivo: determinar la frecuencia de la infección y enfermedad por Rickettsia spp. del grupo de las fiebres manchadas en pacientes febriles del Urabá antioqueño, que asistieron a centros hospitalarios de la región.Métodos: se incluyeron en el estudio pacientes febriles provenientes de 9 instituciones de salud de la región del Urabá, los cuales fueron encuestados para determinar sus variables clínicas y demográficas. De estos pacientes se obtuvieron muestras de suero durante las fases aguda y convaleciente de la enfermedad. Para cada muestra se determinó la seropositividad (título ≥ 64) y su título de anticuerpos seriados dobles mediante inmunofluorescencia indirecta para IgG contra el antígeno de Rickettsia rickettsii.Resultados: se analizaron 89 pacientes febriles con 89 muestras de fase aguda y 60 en fase convaleciente. Los síntomas más comunes de los pacientes fueron cefalea, ictericia, mialgias, náuseas, dolor abdominal, trombocitopenia y vómito. El 55,1 % de los pacientes provenía de áreas rurales. Se obtuvo seropositividad del 40,4 % con títulos entre 64-512, infección previa en un 33,7 % y rickettsiosis en 6 pacientes (6,7 %). Los pacientes con seroconversión o serorefuerzo provenían de los municipios de Apartadó (n = 2), Chigorodó (n = 1), Necoclí (n = 2) y Turbo (n = 1); el hallazgo clínico más destacado fue la trombocitopenia.Conclusiones: se demostró que la infección y la enfermedad rickettsial continúan siendo activas en la zona del Urabá. Este hallazgo permite alertar a las autoridades de salud de la región para que se brinde tratamiento con antibióticos a los casos sospechosos de manera temprana y de esta forma evitar las muertes o secuelas derivadas de este tipo de infecciones.

Serological and molecular evidence of Bartonella henselae in cats from Luanda city, Angola

A total of 100 domestic cats from Luanda (Angola) were tested for the presence of antibodies against Bartonella henselae and spotted fever group of Rickettsia (SFGR) using indirect immunofluorescence assay (IFA). Molecular screening targeting the riboflavin synthase (ribC) gene for Bartonella and outer membrane protein B (ompB) gene for Rickettsia, using conventional PCR and sequencing was also performed in cat´s blood samples. Sixty-six percent of the cats from Luanda had IgG antibodies against Bartonella species but none of them had antibodies against SFGR. Of the total seroreactive cats for Bartonella henselae, 4.5% had an IgG titre of 64 (cut-off), 60.6% a titre of 128, 28.8% a titre of 256 and 6.1% a titre of 512. A statistically significant association was observed between seropositivity for Bartonella henselae and the lack of access to prophylaxis against ectoparasites (p = 0.018). Molecular detection and further sequence analysis of the positive amplicons allowed identification of Bartonella henselae in a 2-year old male cat. To the best of our knowledge this study confirms for the first time, the presence of Bartonela henselae circulating in domestic cats from Luanda. This fact call the attention for the possible cases of cat-scratch disease in humans.

Detection of Rickettsia conorii israelensis DNA in the Blood of a Cat and a Dog From Southern Portugal

Vector-borne rickettsioses represent emerging threats to public health worldwide. The aim of this work was the screening for the presence of Rickettsia spp. in the blood of dogs and cats from southern Portugal. A PCR product of the expected size was amplified from DNA extracts obtained from blood samples of 29 out of 225 (12.9%) cats and in 2 out of 375 (.5%) dogs using genus-specific primers targeting Rickettsia gltA. Rickettsia conorii israelensis was identified by phylogenetical analysis of partial ompB sequences, amplified from blood samples taken from both a cat and a dog. The obtained results reinforce the idea that domestic animals may act as sentinels for the presence of vector-borne Rickettsia spp. in a given geographical area. In addition, rickettsioses should be included in the differential diagnosis of canine and feline vector-borne diseases.

Genome Sequence of "Candidatus Rickettsia colombianensi," a Novel Tick-Associated Bacterium Distributed in Colombia

This is the first report of the genome sequence of “Candidatus Rickettsia colombianensi” strain Adcor 2, deposited in DDBJ/ENA/GenBank under the accession number RAQN00000000. The draft genome showed 36.01% similarity with that of Rickettsia monacensis strain IrR/Munich (NCBI accession number LN794217), 37.81% similarity with that of Rickettsia heilongjiangensis 054 (NCBI accession number CP002912), and 43.88% similarity with that of Rickettsia tamurae AT-1 (NCBI accession number CCMG01000001).

This is the first report of the genome sequence of “Candidatus Rickettsia colombianensi” strain Adcor 2, deposited in DDBJ/ENA/GenBank under the accession number RAQN00000000. The draft genome showed 36.01% similarity with that of Rickettsia monacensis strain IrR/Munich (NCBI accession number LN794217), 37.81% similarity with that of Rickettsia heilongjiangensis 054 (NCBI accession number CP002912), and 43.88% similarity with that of Rickettsia tamurae AT-1 (NCBI accession number CCMG01000001).

Exploring the bacteriome in anthropophilic ticks: To investigate the vectors for diagnosis

OBJECTIVE

The aim of this study was to characterize the bacterial microbiome of hard ticks with affinity to bite humans in La Rioja (North of Spain).

METHODS

A total of 88 adult ticks (22 Rhipicephalus sanguineus sensu lato, 27 Haemaphysalis punctata, 30 Dermacentor marginatus and 9 Ixodes ricinus) and 120 I. ricinus nymphs (CRETAV collection, La Rioja, Spain), representing the main anthropophilic species in our environment, were subjected to a metagenomic analysis of the V3-V4 region of the 16S rRNA gene using an Illumina MiSeq platform. Data obtained with Greengenes database were refined with BLAST. Four groups of samples were defined, according to the four tick species.

RESULTS

Proteobacteria was the predominant phylum observed in all groups. Gammaproteobacteria was the most abundant class, followed by Alphaproteobacteria for R. sanguineus, H. punctata and D. marginatus but the relative abundance of reads for these classes was reversed for I. ricinus. This tick species showed more than 46% reads corresponding to 'not assigned' OTUs (Greengenes), and >97% of them corresponded to 'Candidatus Midichloriaceae' using BLAST. Within Rickettsiales, 'Candidatus Midichloria', Rickettsia, Ehrlichia, 'Candidatus Neoehrlichia' and Wolbachia were detected. I. ricinus was the most alpha-diverse species. Regarding beta-diversity, I. ricinus and H. punctata samples grouped according to their tick species but microbial communities of some R. sanguineus and D. marginatus specimens clustered together.

CONCLUSIONS

The metagenomics approach seems useful to discover the spectrum of tick-related bacteria. More studies are needed to identify and differentiate bacterial species, and to improve the knowledge of tick-borne diseases in Spain.