Emerging tick-borne diseases and blood safety: summary of a public workshop

Guild Dynamics and Pathogen Interactions in Hyalomma Ticks From Algerian Cattle

Ticks are pivotal in transmitting a variety of pathogens that affect both humans and animals. These pathogens often occur in guilds, groups of species that exploit similar resources in similar ways. Although the composition of tick-borne pathogen (TBP) guilds is well-documented, the interactions among pathogens within these guilds remain poorly understood. We hypothesized that abiotic and biotic factors significantly influence the patterns of occurrence and interactions among pathogens within these guilds. To investigate this, we analyzed microfluidic-based high-throughput data on microorganisms from 166 Hyalomma excavatum ticks (94 male and 72 female) collected across different seasons from cattle in the central Algerian steppe using network analysis to uncover complex pathogen-pathogen interaction patterns. We found that female ticks had a higher infection rate (63.9%) with common pathogens such as Rickettsia slovaca (26.4%), unclassified Apicomplexa (22.2%), and Borrelia afzelii (19.4%). Male ticks showed a 56.4% infection rate, with Rickettsia (31.1%) and R. slovaca (16%) being the most prevalent. Notable pathogen-pathogen interactions within guilds were identified, with positive associations such as between R. slovaca and Rickettsia conorii in males, and B. afzelii and Borrelia spielmanii in females, indicating cooperative interactions. Conversely, negative associations, such as between Anaplasma phagocytophilum and Francisella tularensis, suggested competitive exclusion. The observed variation in interaction patterns under different conditions indicates that ecological determinants, both biotic and abiotic, influence pathogen association dynamics within guilds. These findings have significant implications for understanding disease transmission and developing control strategies.

Pilot Surveillance of Babesia, Borrelia burgdorferi, and Anaplasma phagocytophilum Among Chinese Blood Donors - Xinjiang, Inner Mongolia, and Heilongjiang PLADs, China, 2022-2023

What is already known about this topic?

Recently, tick-borne pathogens transmitted through blood transfusions have posed new risks to blood safety.

What is added by this report?

We developed a quality control system for nucleic acid testing (NAT) for Babesia, Borrelia burgdorferi, and Anaplasma phagocytophilum, evaluated five Triplex-NAT kits, and conducted external quality assessments of blood centers. This study screened 92,700 blood donors from Heilongjiang, Inner Mongolia, and Xinjiang provincial-level administrative divisions during 2022-2023. A donor in Hegang, Heilongjiang, tested positive for Borrelia burgdorferi, marking the first detection of this infection in Chinese blood donors.

What are the implications for public health practice?

Quality control of NAT is vital for managing tick-borne pathogen outbreaks. To ensure blood transfusion safety, screening should be strengthened in high-risk areas outside national borders.

Occult hepatitis B in Iranian blood donors, an overview of the challenges: A narrative review

Background

Occult hepatitis B infection (OBI) is a transfusion-transmitted infection. Although, screening the hepatitis B virus among blood donors can play an important role in increasing the health of blood products, OBI screening in blood transfusion centers is still a challenge. This review study aimed to appraise the challenges of OBI screening and its associated do's and don'ts in blood transfusion centers.

Methods

In this review study, a search was conducted on the electronic databases of PubMed, Web of Science, Scopus, Ovid, Irandoc, and Magiran from January 1996 to December 2020. Also, cross-sectional studies that determined the prevalence of OBI or anti-HBc were included in the study. In addition, studies with incomplete data on the prevalence of OBI were excluded.

Results

The prevalence of OBI varies among Iranian blood donors. The rates reported by blood transfusion centers of Mashhad, Ahvaz, and Tehran were 0%, and Isfahan, Shiraz, and Kerman were 0.9%, 0.08%, and 2.36%, respectively. In areas with high prevalence of hepatitis B virus, OBI screening only by anti-HBc test led to the exemption of blood donors from donating blood. Avoiding OBI screening also effected the risk of virus transmission to blood recipients. Plasma products had a higher risk (85%) of virus transmission.

Conclusions

Determining an appropriate screening strategy based on prevalence status, the cost-effectiveness of screening tests, and the policies of each blood transfusion center is essential.

Rickettsia species in Dermacentor reticulatus ticks feeding on human skin and clinical manifestations of tick-borne infections after tick bite

Dermacentor reticulatus ticks are sporadically removed from human skin and therefore the medical consequences of their feeding are neglected compared to Ixodes ricinus. We investigated the prevalence of pathogens in D. reticulatus removed from human skin and possible clinical manifestations suggestive of tick-borne diseases after a tick bite. A total of 2153 ticks were studied and of these only 34 were D. reticulatus. The mean prevalence of Rickettsia in D. reticulatus was 50.0% and R. raoultii was identified in 82.4% of infected D. reticulatus ticks. We confirmed the first case of R. aeschlimannii infection in D. reticulatus ticks. Among participants bitten by D. reticulatus, 13.3% reported reddening around the tick bite site and flu-like symptoms, including lymphadenopathy and 3.3% reported eschar on the tick site bite. All of the participants with flu-like symptoms after tick removal were bitten by ticks infected with R. raoultii. The results of this study indicate that even though D. reticulatus ticks bite humans sporadically, pathogenic Rickettsia have a remarkably high prevalence in this tick species. We can expect that the incidence of tick-borne lymphadenopathy might increase with the reported expansion of the D. reticulatus into new areas and its growing abundance in Central Europe.

Investigation of Tick-Borne Pathogens in Ixodes ricinus in a Peri-Urban Park in Lombardy (Italy) Reveals the Presence of Emerging Pathogens

Ticks are important vectors of a great range of pathogens of medical and veterinary importance. Lately, the spread of known tick-borne pathogens has been expanding, and novel ones have been identified as (re)emerging health threats. Updating the current knowledge on tick-borne pathogens in areas where humans and animals can be easily exposed to ticks represents a starting point for epidemiological studies and public awareness. A PCR screening for tick-borne pathogens was carried out in Ixodes ricinus ticks collected in a peri-urban recreational park in Ticino Valley, Italy. The presence of Rickettsia spp., Borrelia burgdorferi senso latu complex, Anaplasma spp. and Babesia spp. was evaluated in a total of 415 I. ricinus specimens. Rickettsia spp. (R monacensis and R. helvetica) were detected in 22.96% of the samples, while B. burgdorferi s.l. complex (B. afzelii and B. lusitaniae) were present in 10.94%. Neoehrlichia mikurensis (1.99%) and Babesia venatorum (0.73%) were reported in the area of study for the first time. This study confirmed the presence of endemic tick-borne pathogens and highlighted the presence of emerging pathogens that should be monitored especially in relation to fragile patients, the difficult diagnosis of tick-borne associated diseases and possible interactions with other tick-borne pathogens.

Identification of a new orthonairovirus associated with human febrile illness in China

The genus Orthonairovirus, which is part of the family Nairoviridae, includes the important tick-transmitted pathogens Crimean-Congo hemorrhagic fever virus and Nairobi sheep disease virus, as well as many other poorly characterized viruses found in ticks, birds and mammals^1,2. In this study, we identified a new orthonairovirus, Songling virus (SGLV), from patients who reported being bitten by ticks in Heilongjiang Province in northeastern China. SGLV shared similar genomic and morphological features with orthonairoviruses and phylogenetically formed a unique clade in Tamdy orthonairovirus of the Nairoviridae family. The isolated SGLV induced cytopathic effects in human hepatoma cells in vitro. SGLV infection was confirmed in 42 hospitalized patients analyzed between 2017 and 2018, with the main clinical manifestations being headache, fever, depression, fatigue and dizziness. More than two-thirds (69%) of patients generated virus-specific antibody responses in the acute phase. Taken together, these results suggest that this newly discovered orthonairovirus is associated with human febrile illness in China.