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Pustijanac E, Buršić M, Millotti G, Paliaga P, Iveša N, Cvek M. Tick-Borne Bacterial Diseases in Europe: Threats to public health. Eur J Clin Microbiol Infect Dis 2024; 43:1261-1295. [PMID: 38676855 DOI: 10.1007/s10096-024-04836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Tick-borne diseases, caused by bacterial pathogens, pose a growing threat to public health in Europe. This paper provides an overview of the historical context of the discovery of the most impactful pathogens transmitted by ticks, including Borrelia burgdorferi sensu lato, Rickettsia spp., Anaplasma spp., Francisella spp., Ehrlichia spp., and Neoehrlichia mikurensis. Understanding the historical context of their discovery provides insight into the evolution of our understanding of these pathogens. METHODS AND RESULTS Systematic investigation of the prevalence and transmission dynamics of these bacterial pathogens is provided, highlighting the intricate relationships among ticks, host organisms, and the environment. Epidemiology is explored, providing an in-depth analysis of clinical features associated with infections. Diagnostic methodologies undergo critical examination, with a spotlight on technological advancements that enhance detection capabilities. Additionally, the paper discusses available treatment options, addressing existing therapeutic strategies and considering future aspects. CONCLUSIONS By integrating various pieces of information on these bacterial species, the paper aims to provide a comprehensive resource for researchers and healthcare professionals addressing the impact of bacterial tick-borne diseases in Europe. This review underscores the importance of understanding the complex details influencing bacterial prevalence and transmission dynamics to better combat these emerging public health threats.
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Affiliation(s)
- Emina Pustijanac
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia.
| | - Moira Buršić
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Gioconda Millotti
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Paolo Paliaga
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Neven Iveša
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Maja Cvek
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000, Rijeka, Croatia
- Teaching Institute of Public Health of the Region of Istria, Nazorova 23, 52100, Pula, Croatia
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2
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Taylor-Salmon E, Shapiro ED. Tick-borne infections in children in North America. Curr Opin Pediatr 2024; 36:156-163. [PMID: 38167816 PMCID: PMC10932821 DOI: 10.1097/mop.0000000000001326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Because both incidence and awareness of tick-borne infections is increasing, review of major infections and recent advances related to their diagnosis and management is important. RECENT FINDINGS A new algorithm, termed modified two-tier testing, for testing for antibodies to Borrelia burgdorferi , the cause of Lyme disease, has been approved and may replace traditional two-tier testing. In addition, doxycycline is now acceptable to use for treatment of and/or prophylaxis for Lyme disease for up to 21 days in children of any age. Borrelia miyamotoi , a bacterium in the relapsing fever type of Borrelia, is the first of this type of Borrelia that is transmitted by hard-bodied ticks such as Ixodes scapularis. SUMMARY Awareness of these infections and advances in their diagnosis and treatment is important to assure the best outcomes for affected patients. Table 1 contains a summary of infections discussed.
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Affiliation(s)
- Emma Taylor-Salmon
- Department of Pediatrics, Yale School of Medicine
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Eugene D Shapiro
- Department of Pediatrics, Yale School of Medicine
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
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Tian S, Jiang BG, Liu WS, Chen HR, Gao ZH, Pu EN, Li YQ, Chen JJ, Fang LQ, Wang GL, Du CH, Wei YH. Zoonotic pathogens identified in rodents and shrews from four provinces, China, 2015-2022. Epidemiol Infect 2023; 151:e174. [PMID: 37675640 PMCID: PMC10600915 DOI: 10.1017/s0950268823001450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/20/2023] [Accepted: 07/04/2023] [Indexed: 09/08/2023] Open
Abstract
Rodents and shrews are major reservoirs of various pathogens that are related to zoonotic infectious diseases. The purpose of this study was to investigate co-infections of zoonotic pathogens in rodents and shrews trapped in four provinces of China. We sampled different rodent and shrew communities within and around human settlements in four provinces of China and characterised several important zoonotic viral, bacterial, and parasitic pathogens by PCR methods and phylogenetic analysis. A total of 864 rodents and shrews belonging to 24 and 13 species from RODENTIA and EULIPOTYPHLA orders were captured, respectively. For viral pathogens, two species of hantavirus (Hantaan orthohantavirus and Caobang orthohantavirus) were identified in 3.47% of rodents and shrews. The overall prevalence of Bartonella spp., Anaplasmataceae, Babesia spp., Leptospira spp., Spotted fever group Rickettsiae, Borrelia spp., and Coxiella burnetii were 31.25%, 8.91%, 4.17%, 3.94%, 3.59%, 3.47%, and 0.58%, respectively. Furthermore, the highest co-infection status of three pathogens was observed among Bartonella spp., Leptospira spp., and Anaplasmataceae with a co-infection rate of 0.46%. Our results suggested that species distribution and co-infections of zoonotic pathogens were prevalent in rodents and shrews, highlighting the necessity of active surveillance for zoonotic pathogens in wild mammals in wider regions.
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Affiliation(s)
- Shen Tian
- Institute of Public Health, Guangzhou Medical University, Guangzhou, P.R. China
- Guangzhou Center for Disease Control and Prevention, Guangzhou, P.R. China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, P.R. China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Wan-Shuang Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Hao-Rong Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Zi-Hou Gao
- Yunnan Institute for Endemic Diseases Control and Prevention, Yunnan Provincial Key Laboratory of Natural Epidemic Disease Prevention and Control technology, Yunnan, P.R. China
| | - En-Nian Pu
- Yunnan Institute for Endemic Diseases Control and Prevention, Yunnan Provincial Key Laboratory of Natural Epidemic Disease Prevention and Control technology, Yunnan, P.R. China
| | - Yu-Qiong Li
- Yunnan Institute for Endemic Diseases Control and Prevention, Yunnan Provincial Key Laboratory of Natural Epidemic Disease Prevention and Control technology, Yunnan, P.R. China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Guo-Lin Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P.R. China
| | - Chun-Hong Du
- Yunnan Institute for Endemic Diseases Control and Prevention, Yunnan Provincial Key Laboratory of Natural Epidemic Disease Prevention and Control technology, Yunnan, P.R. China
| | - Yue-Hong Wei
- Institute of Public Health, Guangzhou Medical University, Guangzhou, P.R. China
- Guangzhou Center for Disease Control and Prevention, Guangzhou, P.R. China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, P.R. China
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4
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Deng YP, Fu YT, Yao C, Shao R, Zhang XL, Duan DY, Liu GH. Emerging bacterial infectious diseases/pathogens vectored by human lice. Travel Med Infect Dis 2023; 55:102630. [PMID: 37567429 DOI: 10.1016/j.tmaid.2023.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.
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Affiliation(s)
- Yuan-Ping Deng
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Yi-Tian Fu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China; Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Chaoqun Yao
- Department of Biomedical Sciences and One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
| | - Renfu Shao
- Centre for Bioinnovation, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Xue-Ling Zhang
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - De-Yong Duan
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Guo-Hua Liu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China.
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5
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Lionello FCP, Rotundo S, Bruno G, Marino G, Morrone HL, Fusco P, Costa C, Russo A, Trecarichi EM, Beltrame A, Torti C. Touching Base with Some Mediterranean Diseases of Interest from Paradigmatic Cases at the "Magna Graecia" University Unit of Infectious Diseases: A Didascalic Review. Diagnostics (Basel) 2023; 13:2832. [PMID: 37685370 PMCID: PMC10486464 DOI: 10.3390/diagnostics13172832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Among infectious diseases, zoonoses are increasing in importance worldwide, especially in the Mediterranean region. We report herein some clinical cases from a third-level hospital in Calabria region (Southern Italy) and provide a narrative review of the most relevant features of these diseases from epidemiological and clinical perspectives. Further, the pathogenic mechanisms involved in zoonotic diseases are reviewed, focusing on the mechanisms used by pathogens to elude the immune system of the host. These topics are of particular concern for individuals with primary or acquired immunodeficiency (e.g., people living with HIV, transplant recipients, patients taking immunosuppressive drugs). From the present review, it appears that diagnostic innovations and the availability of more accurate methods, together with better monitoring of the incidence and prevalence of these infections, are urgently needed to improve interventions for better preparedness and response.
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Affiliation(s)
- Ferdinando Carmelo Pio Lionello
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriele Bruno
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriella Marino
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Chiara Costa
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Anna Beltrame
- College of Public Health, University of South Florida, Gainesville, FL 33620, USA;
| | - Carlo Torti
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
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6
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Memon A, Abdelghany A, Abusuliman M, Eldesouki M, Fatima M, Abdelhalim O, Abosheaishaa H. Altered Mental Status on Top of Anaplasmosis-Induced Severe Rhabdomyolysis: A Rare Clinical Presentation. Cureus 2023; 15:e45020. [PMID: 37829994 PMCID: PMC10565524 DOI: 10.7759/cureus.45020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Human granulocytic anaplasmosis (HGA) is a disease caused by tick-borne infection of Anaplasma phagocytophilum. The typical symptoms are fever, malaise, and body aches accompanied by abnormal blood tests such as leukopenia, thrombocytopenia, and transaminitis. Some rare complications may occur, especially in patients living in heavily wooded areas, with a mean age of 70 years. We present a case of a 67-year-old male who was admitted for lower abdominal pain, fever, and diarrhea with derangement of his blood tests. Despite treatment, his condition deteriorated and complicated rhabdomyolysis and acute kidney dysfunction. Empiric treatment including doxycycline was initiated while waiting for the infection blood work results. PCR came back positive for HGA. Empiric therapy was narrowed down to doxycycline for 14 days, and the patient's condition began to improve gradually and steadily. Aggressive hydration markedly improved rhabdomyolysis and, in turn, kidney function. Our case underscores the importance of considering HGA in ambiguous clinical scenarios and highlights the value of early diagnosis, empiric treatment, and intravenous hydration, especially in the presence of rhabdomyolysis.
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Affiliation(s)
- Aurangzeb Memon
- Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA
| | | | | | | | - Minahil Fatima
- Internal Medicine, Services Hospital Lahore, Lahore, PAK
| | - Omar Abdelhalim
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York City (NYC) Health and Hospitals, Queens Hospital Center, New York, USA
| | - Hazem Abosheaishaa
- Internal Medicine, Icahn School of Medicine at Mount Sinai, New York City (NYC) Health and Hospitals, Queens Hospital Center, New York, USA
- Internal Medicine/Gastroenterology, Cairo University, Cairo, EGY
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7
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Kolo A. Anaplasma Species in Africa-A Century of Discovery: A Review on Molecular Epidemiology, Genetic Diversity, and Control. Pathogens 2023; 12:pathogens12050702. [PMID: 37242372 DOI: 10.3390/pathogens12050702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Anaplasma species, belonging to the family Anaplasmataceae in the order Rickettsiales, are obligate intracellular bacteria responsible for various tick-borne diseases of veterinary and human significance worldwide. With advancements in molecular techniques, seven formal species of Anaplasma and numerous unclassified species have been described. In Africa, several Anaplasma species and strains have been identified in different animals and tick species. This review aims to provide an overview of the current understanding of the molecular epidemiology and genetic diversity of classified and unclassified Anaplasma species detected in animals and ticks across Africa. The review also covers control measures that have been taken to prevent anaplasmosis transmission on the continent. This information is critical when developing anaplasmosis management and control programs in Africa.
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Affiliation(s)
- Agatha Kolo
- Department of Molecular Microbiology and Immunology, The University of Texas at San Antonio, San Antonio, TX 78249, USA
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8
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Schäfer I, Kohn B, Silaghi C, Fischer S, Marsboom C, Hendrickx G, Müller E. Molecular and Serological Detection of Anaplasma phagocytophilum in Dogs from Germany (2008-2020). Animals (Basel) 2023; 13:ani13040720. [PMID: 36830507 PMCID: PMC9952382 DOI: 10.3390/ani13040720] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Anaplasma phagocytophilum is an obligate intracellular bacterium that causes granulocytic anaplasmosis in domestic animals, wildlife, and humans and is primarily transmitted by ticks of the Ixodes persulcatus complex. This retrospective study aims to determine the percentages of dogs that tested positive for A. phagocytophilum in Germany. It included the results of direct (polymerase chain reaction [PCR]) and indirect (immunofluorescence antibody test [IFAT], antibody-enzyme-linked immunosorbent assay [ELISA]) detection methods performed in the laboratory LABOKLIN on canine samples provided by German veterinarians from 2008 to 2020. Out of a total of 27,368 dogs tested by PCR, 1332 (4.9%) tested positive, while 24,720 (27.4%) of the 90,376 dogs tested by IFAT/ELISA had positive serology. High rates of positive PCR results were observed in months with known peaks in vector activity, showing that the dynamics of A. phagocytophilum infections in dogs in Germany are consistent with vector activity. In dogs with a positive PCR result, peaks in serology could be observed four weeks after initial testing. Male and senior dogs had higher rates of positive serology. A possible impact of environmental factors such as changes in climate should be investigated further. Overall, the upward trend in positive test results over the years indicates that canine granulocytic anaplasmosis will continue to become increasingly important for veterinary medicine.
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Affiliation(s)
- Ingo Schäfer
- LABOKLIN GmbH and Co. KG., 97688 Bad Kissingen, Germany
- Correspondence: ; Tel.: +49-971-72-0-20
| | - Barbara Kohn
- Small Animal Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany
| | - Cornelia Silaghi
- Institute of Infectology, Friedrich-Loeffler-Institute, 17493 Greifswald, Germany
| | - Susanne Fischer
- Institute of Infectology, Friedrich-Loeffler-Institute, 17493 Greifswald, Germany
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9
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Sampat HN, Sharma A, Nussbaum EZ. Case 5-2023: A 67-Year-Old Man with Interstitial Lung Disease, Fever, and Myalgias. N Engl J Med 2023; 388:642-650. [PMID: 36791165 DOI: 10.1056/nejmcpc2211364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- Hemal N Sampat
- From the Departments of Medicine (H.N.S., E.Z.N.), Pediatrics (H.N.S.), Radiology (A.S.), and Pathology (E.Z.N.), Massachusetts General Hospital, and the Departments of Medicine (H.N.S., E.Z.N.), Radiology (A.S.), and Pathology (E.Z.N.), Harvard Medical School - both in Boston
| | - Amita Sharma
- From the Departments of Medicine (H.N.S., E.Z.N.), Pediatrics (H.N.S.), Radiology (A.S.), and Pathology (E.Z.N.), Massachusetts General Hospital, and the Departments of Medicine (H.N.S., E.Z.N.), Radiology (A.S.), and Pathology (E.Z.N.), Harvard Medical School - both in Boston
| | - E Zachary Nussbaum
- From the Departments of Medicine (H.N.S., E.Z.N.), Pediatrics (H.N.S.), Radiology (A.S.), and Pathology (E.Z.N.), Massachusetts General Hospital, and the Departments of Medicine (H.N.S., E.Z.N.), Radiology (A.S.), and Pathology (E.Z.N.), Harvard Medical School - both in Boston
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10
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Athanasiou LV, Tsokana CN, Gougoulis DA, Tzivara AH, Dedousi A, Katsoulos PD. Natural Co-Exposure to Borrelia burgdorferi s.l. and Anaplasma phagocytophilum: Unraveling the Hematological Profile in Sheep. Life (Basel) 2023; 13:life13020469. [PMID: 36836826 PMCID: PMC9959091 DOI: 10.3390/life13020469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
The occurrence of co-infected hosts and questing ticks with more than one tick-borne pathogen-as in the case of Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato-is expected in endemic regions. Their synergy-in terms of pathogenesis and disease severity-has been suggested previously in humans. Limited data exist on the clinicopathological alterations in co-infected sheep. In this study, we investigated the impact of A. phagocytophilum and B. burgdorferi s.l. seropositivity, alone and in combination, on the hematological parameters of naturally infected sheep. A complete blood count was performed, and indirect immunofluorescence assays were used to detect IgG antibodies against A. phagocytophilum and IgG and IgM antibodies against B. burgdorferi s.l. Single natural exposure to B. burgdorferi s.l. was characterized by low Packed Cell Volume (PCV) values and platelet (PLT) counts, while single exposure to A. phagocytophilum was characterized by low PCV values, low white blood cell (WBC) counts, and an increased risk for leukopenia and neutropenia. Co-exposure resulted in the most severe blood abnormalities; all the blood parameters decreased, and the sheep presented an increased risk for anemia. Our study showed that natural co-exposure to A. phagocytophilum and B. burgdorferi s.l. in sheep leads to more severe blood abnormalities and enhances the pathogenic processes. More studies are needed to clarify the possible background mechanisms.
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Affiliation(s)
- Labrini V. Athanasiou
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, 43100 Karditsa, Greece
- Correspondence: ; Tel.: +30-24410-66-009; Fax: +30-24410-66-053
| | - Constantina N. Tsokana
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, 43100 Karditsa, Greece
| | - Dimitris A. Gougoulis
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, 43100 Karditsa, Greece
| | - Athanasia H. Tzivara
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, 43100 Karditsa, Greece
| | - Anna Dedousi
- Veterinary Research Institute, HAO-Demeter, 57001 Thessaloniki, Greece
| | - Panagiotis D. Katsoulos
- Clinic of Farm Animals, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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11
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Lu M, Meng C, Li Y, Zhou G, Wang L, Xu X, Li N, Ji Y, Tian J, Wang W, Li K. Rickettsia sp. and Anaplasma spp. in Haemaphysalis longicornis from Shandong province of China, with evidence of a novel species "Candidatus Anaplasma Shandongensis". Ticks Tick Borne Dis 2023; 14:102082. [PMID: 36403321 DOI: 10.1016/j.ttbdis.2022.102082] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022]
Abstract
Haemaphysalis longicornis is one of the most dominant and widespread tick species in China. This species mainly infests wild animals and occasionally attacks humans, and has been associated with the transmission of a variety of zoonotic pathogens including spotted fever group Rickettsia (SFGR), severe fever with thrombocytopenia syndrome virus (SFTSV), Anaplasma phagocytophilum, Babesia spp. and Theileria spp.. Although there are increasing reports of various pathogens associated with H. longicornis, some neglected pathogens in certain areas still need to be studied. In this study, a total of 171 H. longicornis ticks were collected from goats in three locations of Shandong Province, Eastern China (Zibo, Linyi, and Qingdao cities), and subsequently screened for the presence of Rickettsia, Anaplasma, and Ehrlichia bacteria. A total of four bacterial species were identified and characterized. "Candidatus Rickettsia jingxinensis" was detected in one tick specimen from Zibo city. Of 98 ticks from Linyi city, 63.27% (62/98) were tested positive for Anaplasma capra and 5.10% (5/98) were positive for Anaplasma bovis. Interestingly, a novel Anaplasma species was detected and characterized in one tick specimen from Zibo and one other from Linyi, respectively. Genetic and phylogenetic analysis based on the 16S, gltA, groEL, and msp4 genes indicated that it was divergent from all known Anaplasma species but mostly related to A. phagocytophilum and "Cadidatus Anaplasma boleense". Based on where it was first detected, we named it "Candidatus Anaplasma shandongensis".
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Affiliation(s)
- Miao Lu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Changping District, Beijing city, China
| | - Chao Meng
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Yilin Li
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Guangyi Zhou
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Lin Wang
- Laoshan No.3 middle school, 266061, Qingdao city, Shandong Province, China
| | - Xiaoyu Xu
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Na Li
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Yuqi Ji
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Junhua Tian
- Wuhan Center for Disease Control and Prevention, 430024, Wuhan city, Hubei Province, China
| | - Wen Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Changping District, Beijing city, China
| | - Kun Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Changping District, Beijing city, China; Tianjin Key Laboratory of Food and Biotechnology, Tianjin University of Commerce, 300134, Beichen District, Tianjin City, China.
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12
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A Quantum Vaccinomics Approach for the Design and Production of MSP4 Chimeric Antigen for the Control of Anaplasma phagocytophilum Infections. Vaccines (Basel) 2022; 10:vaccines10121995. [PMID: 36560405 PMCID: PMC9784196 DOI: 10.3390/vaccines10121995] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
Anaplasma phagocytophilum Major surface protein 4 (MSP4) plays a role during infection and multiplication in host neutrophils and tick vector cells. Recently, vaccination trials with the A. phagocytophilum antigen MSP4 in sheep showed only partial protection against pathogen infection. However, in rabbits immunized with MSP4, this recombinant antigen was protective. Differences between rabbit and sheep antibody responses are probably associated with the recognition of non-protective epitopes by IgG of immunized lambs. To address this question, we applied quantum vaccinomics to identify and characterize MSP4 protective epitopes by a microarray epitope mapping using sera from vaccinated rabbits and sheep. The identified candidate protective epitopes or immunological quantum were used for the design and production of a chimeric protective antigen. Inhibition assays of A. phagocytophilum infection in human HL60 and Ixodes scapularis tick ISE6 cells evidenced protection by IgG from sheep and rabbits immunized with the chimeric antigen. These results supported that the design of new chimeric candidate protective antigens using quantum vaccinomics to improve the protective capacity of antigens in multiple hosts.
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13
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Detection of Anaplasma phagocytophilum in horses from Germany by molecular and serological testing (2008-2021). Vet Parasitol 2022; 312:109840. [DOI: 10.1016/j.vetpar.2022.109840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/20/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022]
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Abstract
Human granulocytic anaplasmosis (HGA) is a bacterial infection caused by Anaplasma phagocytophilum and transmitted by the bite of the black-legged (deer tick) in North America. Its incidence is increasing. HGA can be transmitted after 24 to 48 hours of tick attachment. The incubation period is 5 to 14 days after a tick bite. Symptoms include fever, chills, headache, and myalgia. Complications include shock, organ dysfunction, and death. Mortality is less than 1% with appropriate treatment. Doxycycline is first line treatment for all ages. Start it empirically if symptoms and risk factors suggest HGA. PCR is the confirmatory test of choice.
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Affiliation(s)
- Douglas MacQueen
- Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850, USA; Weill Cornell Medicine.
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15
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Beck A, Bjork J, Biggerstaff BJ, Eisen L, Eisen R, Foster E, Signs K, Tsao JI, Kough E, Peterson M, Schiffman E, Muganda CP, Osborn R, Wozniak R, Bron GM, Phaneuf D, Smith D, Bartholomay L, Paskewitz S, Hinckley AF. Knowledge, attitudes, and behaviors regarding tick-borne disease prevention in Lyme disease-endemic areas of the Upper Midwest, United States. Ticks Tick Borne Dis 2022; 13:101925. [PMID: 35255349 PMCID: PMC10947721 DOI: 10.1016/j.ttbdis.2022.101925] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
Lyme disease and other tick-borne diseases are a major public health threat in the Upper Midwestern United States, including Michigan, Minnesota, and Wisconsin. To prevent tick bites and tick-borne diseases, public health officials commonly recommend personal protective measures and property management techniques. Adoption of tick-borne disease prevention behaviors and practices by individuals are, however, highly variable. We aimed to characterize current tick-borne disease knowledge, attitudes, and prevention behaviors (KAB) practiced by the public in these states, as well as their willingness to use specific tick control methods. We conducted a population-based survey in summer 2019 in 48 high-risk counties (those having a five-year average (2013-2017) Lyme disease incidence of ≥ 10 cases per 100,000 persons per year), in Michigan, Minnesota, and Wisconsin. A total of 2713 surveys were analyzed; survey weights were used to account for household selection probability and post-stratified to match county-level joint age and sex population distributions in population-level inference. An estimated 98% of the population had heard of Lyme disease, with most perceiving it as very or extremely serious (91%); however, only an estimated 25% perceived tick-borne diseases as very or extremely common in their community. Among those who spent time in places with ticks from April through October, an estimated 68% check themselves thoroughly for ticks most of the time or always and 43% use bug repellent on skin or clothing most of the time or always. An estimated 13% of the population had ever treated their property with a pesticide to kill ticks, and 3% had ever used devices that apply pesticide to rodents to kill ticks on their property. Willingness to practice tick bite prevention behaviors, however, was estimated to be much higher; with 82% being willing to perform tick checks at least once a day, and more than 60% willing to use bug repellent, tick control products on pets, or to bathe within two hours of being outdoors. We found that residents would likely be willing to support a county-wide tick control program to reduce the risk of tick-borne disease in their community (81%) or to apply tick control products to their property to reduce the risk of tick-borne disease in their household (79%). Tick checks were more likely to be practiced among participants who perceived tick-borne diseases to be highly prevalent in their community, if they or a household member had been previously diagnosed with a tick-borne disease?, or if they perceived tick exposure to be likely around their home, cabin, or vacation home. In addition, property-based tick control methods were associated with perceived risk of encountering ticks around the home, cabin, or vacation home. Participants who had seen information from state health departments were also more likely to practice preventive measures. The most common reported barriers to using any of these methods were forgetfulness, safety concerns, and lack of awareness. Our survey findings shed light on how residents from these Upper Midwest states may adopt tick control and tick bite prevention measures and how public health outreach may be most effective for this population.
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Affiliation(s)
- Alyssa Beck
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States
| | - Jenna Bjork
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Brad J Biggerstaff
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Lars Eisen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Rebecca Eisen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Erik Foster
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States
| | - Kimberly Signs
- Michigan Department of Health and Human Services, 333 South Grand Avenue, South Grand Building, Lansing, MI 48933, United States
| | - Jean I Tsao
- Michigan State University, Department of Fisheries and Wildlife and Department of Large Animal Clinical Sciences, 480 Wilson Road, Natural Resources Building, East Lansing, MI 48824, United States
| | - Erin Kough
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Molly Peterson
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Elizabeth Schiffman
- Minnesota Department of Health, 625 Robert Street North, Saint Paul, MN 55155, United States
| | - Christine P Muganda
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Rebecca Osborn
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Ryan Wozniak
- Wisconsin Department of Health Services, 1 West Wilson Street, Madison, WI 53703, United States
| | - Gebbiena M Bron
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Daniel Phaneuf
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Danielle Smith
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Lyric Bartholomay
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Susan Paskewitz
- University of Wisconsin-Madison, 1656 Linden Drive, Madison, WI 53706, United States
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, 3156 Rampart Road, Fort Collins, CO 80521, United States.
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16
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Test comparison for the detection of Anaplasma phagocytophilum antibodies in goats, and prevalence of granulocytic anaplasmosis in goats from Northern California and Southern Oregon. Small Rumin Res 2022. [DOI: 10.1016/j.smallrumres.2021.106608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Cho JM, Chang J, Kim DM, Kwak YG, Cho CR, Song JE. Human granulocytic anaplasmosis combined with rhabdomyolysis: a case report. BMC Infect Dis 2021; 21:1184. [PMID: 34823480 PMCID: PMC8613920 DOI: 10.1186/s12879-021-06869-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/13/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Human granulocytic anaplasmosis (HGA) is a systemic inflammatory response caused by the rickettsial bacterium Anaplasma phagocytophilum. Rhabdomyolysis and acute kidney injury (AKI) are rare complications of HGA. Here, we report a case of HGA concurrent with rhabdomyolysis and AKI in an elderly patient. CASE PRESENTATION An 84-year old woman with a medical history of hypertension was hospitalised after two days of fever, dizziness, whole body pain, and general weakness. Laboratory investigations showed severe thrombocytopenia, leukopenia, impaired renal function, and elevated cardiac enzyme and myoglobin levels. On the day after admission, peripheral blood smear revealed morula inclusions in neutrophils, a suggestive finding of HGA. Real-time polymerase chain reaction (PCR) results indicated the presence of A. phagocytophilum. Antibiotics were de-escalated to doxycycline monotherapy. After 10 days of antibiotic treatment, laboratory tests showed complete recovery from HGA complicated with rhabdomyolysis and AKI. CONCLUSIONS HGA can lead to serious complications in patients with associated risk factors. Therefore, in patients with HGA accompanied by rhabdomyolysis, management with antibiotics and hydration should be initiated immediately, and not delayed until diagnostic confirmation.
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Affiliation(s)
- Jeong Min Cho
- Division of Infectious Disease, Department of Internal Medicine, Inje University Ilsan Paik Hospital, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jeonghyun Chang
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Yee Gyung Kwak
- Division of Infectious Disease, Department of Internal Medicine, Inje University Ilsan Paik Hospital, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Chong Rae Cho
- Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Je Eun Song
- Division of Infectious Disease, Department of Internal Medicine, Inje University Ilsan Paik Hospital, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
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18
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Ladzinski AT, Baker M, Dunning K, Patel PP. Human Granulocytic Anaplasmosis presenting as Subacute Abdominal Pain and Hyponatremia. IDCases 2021; 25:e01183. [PMID: 34189035 PMCID: PMC8220232 DOI: 10.1016/j.idcr.2021.e01183] [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: 02/05/2021] [Revised: 05/18/2021] [Accepted: 06/09/2021] [Indexed: 12/03/2022] Open
Abstract
Human Granulocytic Anaplasmosis (HGA) is an acute febrile tick-borne illness caused by the organism Anaplasma phagocytophilum. Patients often present with fever and a flu-like symptoms following a tick bite. In this case, the patient presented with subacute abdominal pain and severe hyponatremia consistent with SIADH. The patient was started on appropriate empiric antibiotics given the patient’s tick exposure. Blood smear confirmed findings consistent with HGA and the patient continued antibiotic treatment with resolution of his symptoms. This case is unique in that the patient presented with severe hyponatremia that improved with treatment of the HGA. He also had subacute abdominal pain which is also a rare presentation of HGA. Our hope is that our case highlights the value of empiric treatment with appropriate monitoring to prevent downstream, severe sequelae from undiagnosed HGA. In the setting of climate change, increased duration of Ixodes spp. tick life cycles with emerging regional distribution of the ticks, coinfections with Borrelia burgdorferi and increased incidence of HGA in the last two decades, it is important to recognize this entity.
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Affiliation(s)
- Adam Timothy Ladzinski
- Department of Internal Medicine, Western Michigan University Homer Stryker M D School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, USA
| | - Melissa Baker
- Department of Internal Medicine, Western Michigan University Homer Stryker M D School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, USA
| | - Karla Dunning
- Pathology Services of Kalamazoo, 601 John St., Kalamazoo, MI, USA
| | - Prashant P Patel
- Department of Internal Medicine, Western Michigan University Homer Stryker M D School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, USA
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Moniuszko-Malinowska A, Dunaj J, Andersson MO, Chmielewski T, Czupryna P, Groth M, Grygorczuk S, Zajkowska J, Kondrusik M, Kruszewska E, Pancewicz S. Anaplasmosis in Poland - analysis of 120 patients. Ticks Tick Borne Dis 2021; 12:101763. [PMID: 34161867 DOI: 10.1016/j.ttbdis.2021.101763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 04/23/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
The aim of our study was to clarify the clinical picture of anaplasmosis through analysis of the symptoms and clinical signs presented by infected patients in a cohort of tick-bitten individuals. The study included 1375 patients with suspicion of tick-borne disease. Finally, 120 patients (8.7%) were diagnosed with anaplasmosis (HGA). Blood samples were examined by PCR for Anaplasma phagocytophilum, Candidatus Neoehrlichia mikurensis, Borrelia burgdorferi sensu lato, Babesia spp., and Bartonella spp.. Based on analysis of 120 patients with HGA we concluded that anaplasmosis is not as rare in Europe, as it is thought to be and often appears as a co-infection with other tick-borne pathogens. The co-infection rate of patients with A. phagocytophilum infection in tick endemic areas is high. Co-infection of A. phagocytophilum with B. burgdorferi s.l. or tick-borne encephalitis virus may influence symptom frequency. PCR together with medical history, clinical picture and basic laboratory tests is a sufficient method for the diagnosis of anaplasmosis. Doxycycline is an effective drug leading to complete recovery.
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Affiliation(s)
- Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland.
| | - Justyna Dunaj
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Martin O Andersson
- Center for Ecology and Evolution in Microbial Model Systems (EEMiS), Linnaeus University, SE-391 82 Kalmar, Sweden
| | - Tomasz Chmielewski
- National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Monika Groth
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Sambor Grygorczuk
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Maciej Kondrusik
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Ewelina Kruszewska
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
| | - Sławomir Pancewicz
- Department of Infectious Diseases and Neuroinfections Medical University of Bialystok, Zurawia, 14 15-540 Bialystok, Poland
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20
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Madigan J. Anaplasma phagocytophilum
(
Ehrlichia equi
) 50 years later. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. Madigan
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California Davis Davis California USA
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21
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Turbett SE, Anahtar MN, Pattanayak V, Azar MM, Coffey KC, Eng G, Rudolf JW, Lewandrowski KB, Baron J, Rosenberg ES, Branda JA. Use of Routine Complete Blood Count Results to Rule Out Anaplasmosis Without the Need for Specific Diagnostic Testing. Clin Infect Dis 2021; 70:1215-1221. [PMID: 31044232 DOI: 10.1093/cid/ciz346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/25/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Anaplasmosis presents with fever, headache, and laboratory abnormalities including leukopenia and thrombocytopenia. Polymerase chain reaction (PCR) is the preferred diagnostic but is overutilized. We determined if routine laboratory tests could exclude anaplasmosis, improving PCR utilization. METHODS Anaplasma PCR results from a 3-year period, with associated complete blood count (CBC) and liver function test results, were retrospectively reviewed. PCR rejection criteria, based on white blood cell (WBC) and platelet (PLT) counts, were developed and prospectively applied in a mock stewardship program. If rejection criteria were met, a committee mock-refused PCR unless the patient was clinically unstable or immunocompromised. RESULTS WBC and PLT counts were the most actionable routine tests for excluding anaplasmosis. Retrospective review demonstrated that rejection criteria of WBC ≥11 000 cells/µL or PLT ≥300 000 cells/µL would have led to PCR refusal in 428 of 1685 true-negative cases (25%) and 3 of 66 true-positive cases (5%) involving clinically unstable or immunocompromised patients. In the prospective phase, 155 of 663 PCR requests (23%) met rejection criteria and were reviewed by committee, which endorsed refusal in 110 of 155 cases (71%) and approval in 45 (29%), based on clinical criteria. PCR was negative in all 45 committee-approved cases. Only 1 of 110 mock-refused requests yielded a positive PCR result; this patient was already receiving doxycycline at the time of testing. CONCLUSIONS A CBC-based stewardship algorithm would reduce unnecessary Anaplasma PCR testing, without missing active cases. Although the prospectively evaluated screening approach involved medical record review, this was unnecessary to prevent errors and could be replaced by a rejection comment specifying clinical situations that might warrant overriding the algorithm.
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Affiliation(s)
- Sarah E Turbett
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Melis N Anahtar
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Vikram Pattanayak
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Marwan M Azar
- Department of Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - K C Coffey
- Department of Section of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - George Eng
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Joseph W Rudolf
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis
| | - Kent B Lewandrowski
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Jason Baron
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Eric S Rosenberg
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
| | - John A Branda
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston
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22
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Naimi WA, Gumpf JJ, Cockburn CL, Camus S, Chalfant CE, Li PL, Carlyon JA. Functional inhibition or genetic deletion of acid sphingomyelinase bacteriostatically inhibits Anaplasma phagocytophilum infection in vivo. Pathog Dis 2021; 79:ftaa072. [PMID: 33220685 PMCID: PMC7787905 DOI: 10.1093/femspd/ftaa072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
Anaplasma phagocytophilum infects neutrophils to cause granulocytic anaplasmosis. It poorly infects mice deficient in acid sphingomyelinase (ASM), a lysosomal enzyme critical for cholesterol efflux, and wild-type mice treated with desipramine that functionally inhibits ASM. Whether inhibition or genetic deletion of ASM is bacteriostatic or bactericidal for A. phagocytophilum and desipramine's ability to lower pathogen burden requires a competent immune system were unknown. Anaplasma phagocytophilum-infected severe combined immunodeficiency disorder (SCID) mice were administered desipramine or PBS, followed by the transfer of blood to naïve wild-type mice. Next, infected wild-type mice were given desipramine or PBS followed by transfer of blood to naïve SCID mice. Finally, wild-type or ASM-deficient mice were infected and blood transferred to naïve SCID mice. The percentage of infected neutrophils was significantly reduced in all desipramine-treated or ASM-deficient mice and in all recipients of blood from these mice. Infection was markedly lower in ASM-deficient and desipramine-treated wild-type mice versus desipramine-treated SCID mice. Yet, infection was never ablated. Thus, ASM activity contributes to optimal A. phagocytophilum infection in vivo, pharmacologic inhibition or genetic deletion of ASM impairs infection in a bacteriostatic and reversible manner and A. phagocytophilum is capable of co-opting ASM-independent lipid sources.
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Affiliation(s)
- Waheeda A Naimi
- Department of Microbiology and Immunology, Virginia Commonwealth University (VCU) Medical Center, VCU School of Medicine, Richmond, VA, 23398 USA
| | - Jacob J Gumpf
- Department of Microbiology and Immunology, Virginia Commonwealth University (VCU) Medical Center, VCU School of Medicine, Richmond, VA, 23398 USA
| | - Chelsea L Cockburn
- Department of Microbiology and Immunology, Virginia Commonwealth University (VCU) Medical Center, VCU School of Medicine, Richmond, VA, 23398 USA
| | - Sarah Camus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University (VCU) Medical Center, VCU School of Medicine, Richmond, VA, 23298 USA
| | - Charles E Chalfant
- Department of Cell Biology, Microbiology, and Molecular Biology, University of South Florida, Tampa, FL,33620 USA
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University (VCU), Richmond, VA 23298, USA
- The Moffitt Cancer Center, Tampa, FL 33620, USA
- Research Service, James A. Haley Veterans' Hospital, Tampa, FL 33612, USA
| | - Pin-Lan Li
- Department of Pharmacology and Toxicology, Virginia Commonwealth University (VCU) Medical Center, VCU School of Medicine, Richmond, VA, 23298 USA
| | - Jason A Carlyon
- Department of Microbiology and Immunology, Virginia Commonwealth University (VCU) Medical Center, VCU School of Medicine, Richmond, VA, 23398 USA
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23
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Immunization against Anaplasma phagocytophilum Adhesin Binding Domains Confers Protection against Infection in the Mouse Model. Infect Immun 2020; 88:IAI.00106-20. [PMID: 32661123 DOI: 10.1128/iai.00106-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/02/2020] [Indexed: 11/20/2022] Open
Abstract
Anaplasma phagocytophilum causes granulocytic anaplasmosis, a debilitating infection that can be fatal in the immunocompromised. It also afflicts animals, including dogs, horses, and sheep. No granulocytic anaplasmosis vaccine exists. Because A. phagocytophilum is an obligate intracellular bacterium, inhibiting microbe-host cell interactions that facilitate invasion can disrupt infection. The binding domains of A. phagocytophilum adhesins A. phagocytophilum invasion protein A (AipA), A. phagocytophilum surface protein (Asp14), and outer membrane protein A (OmpA) are essential for optimal bacterial entry into host cells, but their relevance to infection in vivo is undefined. In this study, C57BL/6 mice were immunized with a cocktail of keyhole limpet hemocyanin-conjugated peptides corresponding to the AipA, Asp14, and OmpA binding domains in alum followed by challenge with A. phagocytophilum The bacterial peripheral blood burden was pronouncedly reduced in immunized mice compared to controls. Examination of pre- and postchallenge sera from these mice revealed that immunization elicited antibodies against AipA and Asp14 peptides but not OmpA peptide. Nonetheless, pooled sera from pre- and postchallenge groups, but not from control groups, inhibited A. phagocytophilum infection of HL-60 cells. Adhesin domain immunization also elicited interferon gamma (IFN-γ)-producing CD8-positive (CD8+) T cells. A follow-up study confirmed that immunization against only the AipA or Asp14 binding domain was sufficient to reduce the bacterial peripheral blood load in mice following challenge and elicit antibodies that inhibit A. phagocytophilum cellular infection in vitro These data demonstrate that AipA and Asp14 are critical for A. phagocytophilum to productively infect mice, and immunization against their binding domains elicits a protective immune response.
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Rau A, Munoz-Zanzi C, Schotthoefer AM, Oliver JD, Berman JD. Spatio-Temporal Dynamics of Tick-Borne Diseases in North-Central Wisconsin from 2000-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145105. [PMID: 32679849 PMCID: PMC7400118 DOI: 10.3390/ijerph17145105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
Lyme disease is a well-recognized public health problem in the USA, however, other tick-borne diseases also have major public health impacts. Yet, limited research has evaluated changes in the spatial and temporal patterns of non-Lyme tick-borne diseases within endemic regions. Using laboratory data from a large healthcare system in north-central Wisconsin from 2000-2016, we applied a Kulldorf's scan statistic to analyze spatial, temporal and seasonal clusters of laboratory-positive cases of human granulocytic anaplasmosis (HGA), babesiosis, and ehrlichiosis at the county level. Older males were identified as the subpopulation at greatest risk for non-Lyme tick-borne diseases and we observed a statistically significant spatial and temporal clustering of cases (p < 0.05). HGA risk shifted from west to east over time (2000-2016) with a relative risk (RR) ranging from 3.30 to 11.85, whereas babesiosis risk shifted from south to north and west over time (2004-2016) with an RR ranging from 4.33 to 4.81. Our study highlights the occurrence of non-Lyme tick-borne diseases, and identifies at-risk subpopulations and shifting spatial and temporal heterogeneities in disease risk. Our findings can be used by healthcare providers and public health practitioners to increase public awareness and improve case detection.
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Affiliation(s)
- Austin Rau
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (A.R.); (C.M.-Z.); (J.D.O.)
| | - Claudia Munoz-Zanzi
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (A.R.); (C.M.-Z.); (J.D.O.)
| | | | - Jonathan D. Oliver
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (A.R.); (C.M.-Z.); (J.D.O.)
| | - Jesse D. Berman
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (A.R.); (C.M.-Z.); (J.D.O.)
- Correspondence: ; Tel.: +1-612-626-0923
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Rivera JE, Young K, Kwon TS, McKenzie PA, Grant MA, McBride DA. Anaplasmosis Presenting With Respiratory Symptoms and Pneumonitis. Open Forum Infect Dis 2020; 7:ofaa265. [PMID: 32793764 PMCID: PMC7415301 DOI: 10.1093/ofid/ofaa265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022] Open
Abstract
Anaplasmosis is a now common tick-borne illness that is characterized by the presence of fever, myalgias, thrombocytopenia, and elevated liver function tests. We report 4 cases with an atypical presentation with pulmonary symptoms and imaging findings, along with the characteristics of each patient, clinical course, and response to therapy.
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Affiliation(s)
- Jose E Rivera
- Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Katelyn Young
- Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Tae Sung Kwon
- Infectious Diseases, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Paula A McKenzie
- Infectious Diseases, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Michelle A Grant
- Pathology, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Darrell A McBride
- Infectious Diseases, Geisinger Medical Center, Danville, Pennsylvania, USA
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Sykes DB, Zhang EW, Karp Leaf RS, Nardi V, Turbett SE. Case 10-2020: An 83-Year-Old Man with Pancytopenia and Acute Renal Failure. N Engl J Med 2020; 382:1258-1266. [PMID: 32212524 DOI: 10.1056/nejmcpc1916250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- David B Sykes
- From the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Massachusetts General Hospital, and the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Harvard Medical School - both in Boston
| | - Eric W Zhang
- From the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Massachusetts General Hospital, and the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Harvard Medical School - both in Boston
| | - Rebecca S Karp Leaf
- From the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Massachusetts General Hospital, and the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Harvard Medical School - both in Boston
| | - Valentina Nardi
- From the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Massachusetts General Hospital, and the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Harvard Medical School - both in Boston
| | - Sarah E Turbett
- From the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Massachusetts General Hospital, and the Departments of Medicine (D.B.S., R.S.K.L., S.E.T.), Radiology (E.W.Z.), and Pathology (V.N., S.E.T.), Harvard Medical School - both in Boston
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Azagi T, Hoornstra D, Kremer K, Hovius JWR, Sprong H. Evaluation of Disease Causality of Rare Ixodes ricinus-Borne Infections in Europe. Pathogens 2020; 9:pathogens9020150. [PMID: 32102367 PMCID: PMC7168666 DOI: 10.3390/pathogens9020150] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Tal Azagi
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
- Correspondence:
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location Academic Medical Center, Amsterdam 1105 AZ, The Netherlands; (D.H.); (J.W.R.H.)
| | - Kristin Kremer
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
| | - Joppe W. R. Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location Academic Medical Center, Amsterdam 1105 AZ, The Netherlands; (D.H.); (J.W.R.H.)
| | - Hein Sprong
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
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Green RS, Naimi WA, Oliver LD, O'Bier N, Cho J, Conrad DH, Martin RK, Marconi RT, Carlyon JA. Binding of Host Cell Surface Protein Disulfide Isomerase by Anaplasma phagocytophilum Asp14 Enables Pathogen Infection. mBio 2020; 11:e03141-19. [PMID: 31992623 PMCID: PMC6989111 DOI: 10.1128/mbio.03141-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/09/2019] [Indexed: 11/20/2022] Open
Abstract
Diverse intracellular pathogens rely on eukaryotic cell surface disulfide reductases to invade host cells. Pharmacologic inhibition of these enzymes is cytotoxic, making it impractical for treatment. Identifying and mechanistically dissecting microbial proteins that co-opt surface reductases could reveal novel targets for disrupting this common infection strategy. Anaplasma phagocytophilum invades neutrophils by an incompletely defined mechanism to cause the potentially fatal disease granulocytic anaplasmosis. The bacterium's adhesin, Asp14, contributes to invasion by virtue of its C terminus engaging an unknown receptor. Yeast-two hybrid analysis identified protein disulfide isomerase (PDI) as an Asp14 binding partner. Coimmunoprecipitation confirmed the interaction and validated it to be Asp14 C terminus dependent. PDI knockdown and antibody-mediated inhibition of PDI reductase activity impaired A. phagocytophilum infection of but not binding to host cells. Infection during PDI inhibition was rescued when the bacterial but not host cell surface disulfide bonds were chemically reduced with tris(2-carboxyethyl)phosphine-HCl (TCEP). TCEP also restored bacterial infectivity in the presence of an Asp14 C terminus blocking antibody that otherwise inhibits infection. A. phagocytophilum failed to productively infect myeloid-specific-PDI conditional-knockout mice, marking the first demonstration of in vivo microbial dependency on PDI for infection. Mutational analyses identified the Asp14 C-terminal residues that are critical for binding PDI. Thus, Asp14 binds and brings PDI proximal to A. phagocytophilum surface disulfide bonds that it reduces, which enables cellular and in vivo infection.IMPORTANCEAnaplasma phagocytophilum infects neutrophils to cause granulocytic anaplasmosis, an emerging potentially fatal disease and the second-most common tick-borne illness in the United States. Treatment options are limited, and no vaccine exists. Due to the bacterium's obligatory intracellular lifestyle, A. phagocytophilum survival and pathogenesis are predicated on its ability to enter host cells. Understanding its invasion mechanism will yield new targets for preventing bacterial entry and, hence, disease. We report a novel entry pathway in which the A. phagocytophilum outer membrane protein Asp14 binds host cell surface protein disulfide isomerase via specific C-terminal residues to promote reduction of bacterial surface disulfide bonds, which is critical for cellular invasion and productive infection in vivo Targeting the Asp14 C terminus could be used to prevent/treat granulocytic anaplasmosis. Our findings have broad implications, as a thematically similar approach could be applied to block infection by other intracellular microbes that exploit cell surface reductases.
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Affiliation(s)
- Ryan S Green
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Waheeda A Naimi
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Lee D Oliver
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Nathaniel O'Bier
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Jaehyung Cho
- Department of Pharmacology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Daniel H Conrad
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Rebecca K Martin
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Richard T Marconi
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Jason A Carlyon
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
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Abstract
Increases in tick-borne disease prevalence and transmission are important public health issues. Efforts to control these emerging diseases are frustrated by the struggle to control tick populations and to detect and treat infections caused by the pathogens that they transmit. This review covers tick-borne infectious diseases of nonrickettsial bacterial, parasitic, and viral origins. While tick surveillance and tracking inform our understanding of the importance of the spread and ecology of ticks and help identify areas of risk for disease transmission, the vectors are not the focus of this document. Here, we emphasize the most significant pathogens that infect humans as well as the epidemiology, clinical features, diagnosis, and treatment of diseases that they cause. Although detection via molecular or immunological methods has improved, tick-borne diseases continue to remain underdiagnosed, making the scope of the problem difficult to assess. Our current understanding of the incidence of tick-borne diseases is discussed in this review. An awareness of the diseases that can be transmitted by ticks in specific locations is key to detection and selection of appropriate treatment. As tick-transmitted pathogens are discovered and emerge in new geographic regions, our ability to detect, describe, and understand the growing public health threat must also grow to meet the challenge.
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Lee-Lewandrowski E, Chen Z, Branda J, Baron J, Kaufman HW. Laboratory Blood-Based Testing for Non-Lyme Disease Tick-Borne Infections at a National Reference Laboratory. Am J Clin Pathol 2020; 153:139-145. [PMID: 31584611 DOI: 10.1093/ajcp/aqz139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We evaluated trends in non-Lyme disease tick-borne disease (NLTBI) testing at a national reference laboratory. METHODS Testing data performed at Quest Diagnostics during 2010 to 2016 were analyzed nationally and at the state level. RESULTS Testing and positivity for most NLTBIs increased dramatically from 2010 through 2016 based on testing from a large reference laboratory. The number of positive cases, though not as stringent as criteria for public health reporting, generally exceeds that reported by the Centers for Disease Control and Prevention. The frequency of NLTBI in the US is seasonal but testing activity and positive test results are observed throughout all months of the year. Positive results for NLTBI testing mostly originated from a limited number of states, indicating the geographic concentration and distribution of NLTBIs reported in this study. CONCLUSIONS This report provides an important complementary source of data to best understand trends in and spread of NLTBI.
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Affiliation(s)
- Elizabeth Lee-Lewandrowski
- Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
| | | | - John Branda
- Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
| | - Jason Baron
- Department of Pathology, Division of Clinical Laboratories and Molecular Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
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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: 75] [Impact Index Per Article: 15.0] [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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Kim JH, Lee CS, Moon C, Kwak YG, Kim BN, Kim ES, Kang JM, Park WB, Oh MD, Park SW. Co-Infection of Scrub Typhus and Human Granulocytic Anaplasmosis in Korea, 2006. J Korean Med Sci 2019; 34:e257. [PMID: 31602827 PMCID: PMC6786965 DOI: 10.3346/jkms.2019.34.e257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/22/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections. METHODS The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described. RESULTS One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV. CONCLUSION We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
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Affiliation(s)
- Jeong Han Kim
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Seop Lee
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Chisook Moon
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
| | - Yee Gyung Kwak
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
| | - Baek Nam Kim
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae Myung Kang
- Department of Internal Medicine, Pohang St. Mary's Hospital, Pohang, Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Myoung Don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Won Park
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Kim B, Idahosa O, Jahre JA. Fulminant Human Granulocytic Anaplasmosis after CABG: An Unusual Occurrence. Am J Med 2019; 132:e744-e745. [PMID: 31132329 DOI: 10.1016/j.amjmed.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Brian Kim
- St. Luke's Internal Medicine Residency - Bethlehem St. Luke's University Health Network, Bethlehem, Pa.
| | - Osamudiamen Idahosa
- Department of Critical Care Medicine, St. Luke's University Health Network, Bethlehem, Pa
| | - Jeffrey A Jahre
- Department of Infectious Disease, St. Luke's University Health Network, Bethlehem, Pa
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Analysis of CCL-4, CCL-17, CCL-20 and IL-8 concentrations in the serum of patients with tick-borne encephalitis and anaplasmosis. Cytokine 2019; 125:154852. [PMID: 31561102 DOI: 10.1016/j.cyto.2019.154852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/16/2019] [Accepted: 09/08/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Tick-borne co-infections are a serious epidemiological and clinical problem. Only a few studies aimed to investigate the effect of tick-borne encephalitis (TBE) and human granulocytic anaplasmosis (HGA) co-infection in the course of the inflammatory process and the participation of chemokines in the pathomechanism of these diseases. The aim of the study was to evaluate CCL-4, CCL-17, CCL-20, and IL-8 serum concentrations in patients with HGA, TBE and HGA + TBE co-infection. METHODS Eighty-seven patients with HGA (n = 20), TBE (n = 49) and HGA + TBE (n = 18) were included to the study. The control group (CG) consisted of 20 healthy people. Concentrations of cytokines were measured in serum using commercial ELISA assays. In patients with TBE and HGA + TBE inflammatory markers were assessed during the acute and convalescent period. The results were analyzed using non-parametric tests with p < 0.05 considered as significant. RESULTS Before treatment, significantly higher concentrations of IL-8, CCL-4 and CCL-20 were observed in HGA patients. CCL-4 and CCL-20 concentrations were significantly higher in TBE patients compared to CG. Concentrations of IL-8, CCL-4, and CCL-20 were significantly higher in HGA + TBE than in CG. After treatment, a significant reduction of IL-8, CCL-4, and CCL-20 concentrations in TBE patients and IL-8 in HGA + TBE co-infection was observed. CCL-4 concentration was higher in HGA + TBE co-infection in comparison to patients with TBE after treatment. CONCLUSIONS Our study confirms that concentrations of IL-8, CCL-4, and CCL-20 are increased in the course of HGA and TBE. Their concentrations in serum may be used to monitor the course of TBE and HGA, as well as possibly detect co-infections with the diseases.
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Chen R, Kou Z, Xu L, Cao J, Liu Z, Wen X, Wang Z, Wen H. Analysis of epidemiological characteristics of four natural-focal diseases in Shandong Province, China in 2009-2017: A descriptive analysis. PLoS One 2019; 14:e0221677. [PMID: 31454372 PMCID: PMC6711524 DOI: 10.1371/journal.pone.0221677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 08/13/2019] [Indexed: 01/09/2023] Open
Abstract
Background Natural-focal diseases are serious diseases that endanger human health. They threaten about 100 million people in Shandong Province, and cause illness in thousands of people each year. However, information on the epidemiological characteristics of natural-focal diseases in Shandong Province has been limited. The purpose of the study was to describe and analyze the epidemiological characteristics of natural-focal diseases in Shandong Province, 2009–2017. Methods We describe the incidence and distribution of four natural-focal diseases in Shandong Province using surveillance data from 2009–2017. Results From 2009–2017, 11123 cases of four natural-focal diseases including 257 deaths were reported in Shandong Province, China. The four natural-focal diseases were severe fever with thrombocytopenia syndrome (SFTS), human granulocytic anaplasmosis (HGA), typhus, and scrub typhus. The high-risk groups of the four diseases were farmers and the elderly. The incidence rate of scrub typhus was significantly higher in females. However, this difference was not seen in the other three diseases. The four diseases were mainly clustered in the middle-southern part of Shandong Province and the Shandong Peninsula. The annual incidence of SFTS and scrub typhus increased, typhus was relatively stable, and HGA declined. However, the range of SFTS expanded, while HGA shrunk, and typhus and scrub typhus were unchanged. The epidemic period of SFTS and HGA was from May to October, typhus was from October to November, and scrub typhus was from September to November. The fatality rates of SFTS, typhus, scrub typhus, and HGA were 9.19%, 0%, 0.01%, and 2.24%, respectively. Conclusions Our study described and analyzed the prevalence of natural-focal diseases in Shandong Province, and confirmed that age was closely related to the SFTS fatality rate. This study may help to improve the understanding of the prevalence of natural-focal diseases in Shandong Province in recent years and to better develop accurate prevention and control strategies for natural-focal diseases.
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Affiliation(s)
- Rui Chen
- Department of Microbiological Laboratory Technology, School of Public Health, Shandong University, Key laboratory for the prevention and control of infectious diseases (key laboratory of China’s “13th Five-Year”, Shandong University), Jinan, Shandong Province, China
| | - Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Liuchen Xu
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Jie Cao
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Ziwei Liu
- Department of Microbiological Laboratory Technology, School of Public Health, Shandong University, Key laboratory for the prevention and control of infectious diseases (key laboratory of China’s “13th Five-Year”, Shandong University), Jinan, Shandong Province, China
| | - Xiaojing Wen
- Department of Microbiological Laboratory Technology, School of Public Health, Shandong University, Key laboratory for the prevention and control of infectious diseases (key laboratory of China’s “13th Five-Year”, Shandong University), Jinan, Shandong Province, China
| | - Zhiyu Wang
- Department of Microbiological Laboratory Technology, School of Public Health, Shandong University, Key laboratory for the prevention and control of infectious diseases (key laboratory of China’s “13th Five-Year”, Shandong University), Jinan, Shandong Province, China
| | - Hongling Wen
- Department of Microbiological Laboratory Technology, School of Public Health, Shandong University, Key laboratory for the prevention and control of infectious diseases (key laboratory of China’s “13th Five-Year”, Shandong University), Jinan, Shandong Province, China
- * E-mail:
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Khatri A, Lloji A, Doobay R, Wang G, Knoll B, Dhand A, Nog R. Anaplasma phagocytophilum presenting with orchitis in a renal transplant recipient. Transpl Infect Dis 2019; 21:e13129. [PMID: 31215144 DOI: 10.1111/tid.13129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/21/2019] [Accepted: 06/04/2019] [Indexed: 02/01/2023]
Abstract
Human granulocytic anaplasmosis (HGA), caused by Anaplasma phagocytophilum, is an emerging tick-borne disease. It is spread by the black-legged deer tick Ixodes scapularis that serves as the vector for six human pathogens. HGA is still rarely reported in solid organ transplant recipients. In solid organ transplant recipients, orchitis has been reported secondary to chickenpox, tuberculosis and infections due to Listeria monocytogenes and Nocardia asteroides. Orchitis as a presenting feature of HGA infection has only been reported in animals. We present a unique case of a renal transplant recipient with HGA that presented as orchitis. We also compare the clinical presentation and laboratory findings of our patient with other cases of HGA in transplant recipients. To the best of our knowledge, our patient is one of the first cases of A phagocytophilum mono-infection causing a classical presentation of orchitis in a transplant patient.
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Affiliation(s)
- Akshay Khatri
- Department of Internal Medicine, New York Medical College at Westchester Medical Center, Valhalla, New York
| | - Amanda Lloji
- Department of Internal Medicine, New York Medical College at Westchester Medical Center, Valhalla, New York
| | - Richard Doobay
- Department of Internal Medicine, New York Medical College at Westchester Medical Center, Valhalla, New York
| | - Guiqing Wang
- Department of Microbiology, Virology & Molecular Diagnostics, New York Medical College at Westchester Medical Center, Valhalla, New York
| | - Bettina Knoll
- Department of Transplant Infectious Diseases, New York Medical College at Westchester Medical Center, Valhalla, New York
| | - Abhay Dhand
- Department of Transplant Infectious Diseases, New York Medical College at Westchester Medical Center, Valhalla, New York
| | - Rajat Nog
- Department of Transplant Infectious Diseases, New York Medical College at Westchester Medical Center, Valhalla, New York
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El Khoury L, Furie R. Inflammatory arthritis: a unique presentation of human anaplasmosis. Clin Rheumatol 2018; 38:257-259. [DOI: 10.1007/s10067-018-4395-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 01/19/2023]
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Uminski K, Kadkhoda K, Houston BL, Lopez A, MacKenzie LJ, Lindsay R, Walkty A, Embil J, Zarychanski R. Anaplasmosis: An emerging tick-borne disease of importance in Canada. IDCases 2018; 14:e00472. [PMID: 30524954 PMCID: PMC6278667 DOI: 10.1016/j.idcr.2018.e00472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 12/04/2022] Open
Abstract
Human Granulocytic Anaplasmosis (HGA) is an infection caused by the intracellular bacterium Anaplasma phagocytophilum. As a tick-borne disease, the public health impact of HGA continues to increase with range expansion of the disease vector. The clinical presentation of HGA is often a non-specific febrile illness. The presence of leukopenia, thrombocytopenia, and mild hepatic injury are frequently noted on laboratory investigations, which can be important diagnostic clues in attaining an appropriate diagnosis. Herein we present three cases of HGA, highlighting the spectrum of disease by which HGA can manifest. Although each case has their unique features, we outline important shared clinical elements to facilitate an empiric diagnosis while definitive laboratory investigations are pending. Our case series further serves to highlight the critical importance of prompt antimicrobial treatment to reduce morbidity and potential mortality.
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Affiliation(s)
- Kelsey Uminski
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Kamran Kadkhoda
- Cadham Provincial Laboratory, Government of Manitoba, Winnipeg, MB, Canada
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Brett L. Houston
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, Section of Medical Oncology and Hematology, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Department of Medical Oncology and Hematology, Winnipeg, MB, Canada
| | - Alison Lopez
- CancerCare Manitoba, Department of Medical Oncology and Hematology, Winnipeg, MB, Canada
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Pediatrics and Child Health, Section of Infectious Diseases, Winnipeg, MB, Canada
| | - Lauren J. MacKenzie
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Robbin Lindsay
- Public Health Agency of Canada, National Microbiology Laboratory, Zoonotic Diseases and Special Pathogens, Winnipeg, MB, Canada
| | - Andrew Walkty
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - John Embil
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Ryan Zarychanski
- Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Internal Medicine, Section of Medical Oncology and Hematology, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Department of Medical Oncology and Hematology, Winnipeg, MB, Canada
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Torii S, Matsuno K, Qiu Y, Mori-Kajihara A, Kajihara M, Nakao R, Nao N, Okazaki K, Sashika M, Hiono T, Okamatsu M, Sakoda Y, Ebihara H, Takada A, Sawa H. Infection of newly identified phleboviruses in ticks and wild animals in Hokkaido, Japan indicating tick-borne life cycles. Ticks Tick Borne Dis 2018; 10:328-335. [PMID: 30478009 DOI: 10.1016/j.ttbdis.2018.11.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/31/2018] [Accepted: 11/12/2018] [Indexed: 11/25/2022]
Abstract
Recent discoveries of tick-borne pathogens have raised public health concerns on tick-borne infectious diseases and emphasize the need to assess potential risks of unrecognized tick-borne pathogens. First, to determine the existence of tick-borne phleboviruses (TBPVs), genetic surveillance of phleboviruses in ticks was conducted mainly in Hokkaido, the northernmost island in Japan from 2013 to 2015. Genes of two TBPVs, previously reported as Mukawa virus (MKWV) and a newly identified relative of MKWV, Kuriyama virus (KURV), were detected and the viruses were isolated from Ixodes persulcatus collected in Hokkaido, but not in I. persulcatus collected from other areas of Japan. These viruses were phylogenetically and antigenically similar to each other. Next, to investigate the infection of MKWV in mammals, serum samples from wildlife captured in Hokkaido from 2007 to 2011 were used for serological screening. Neutralizing antibodies against MKWV were detected in both Yezo-deer (Cervus nippon yesoensis) (2/50) and raccoons (Procyon lotor) (16/64). However, no infectious MKWV was recovered from laboratory mice in experimental infections, though viral RNAs were detected in their tissues. Thus, MKWV and KURV may maintain tick-mammalian life cycles in Hokkaido, suggesting their potential as causative agents of tick-borne diseases in mammals.
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Affiliation(s)
- Shiho Torii
- Division of Molecular Pathobiology, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan; Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Keita Matsuno
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan; Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan.
| | - Yongjin Qiu
- Division of Collaboration and Education, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Akina Mori-Kajihara
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Masahiro Kajihara
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Ryo Nakao
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Naganori Nao
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Katsunori Okazaki
- Laboratory of Microbiology and Immunology, Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Tobetsu, Japan
| | - Mariko Sashika
- Laboratory of Wildlife Biology and Medicine, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Takahiro Hiono
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Masatoshi Okamatsu
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshihiro Sakoda
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan; Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Hideki Ebihara
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ayato Takada
- Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan; Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Hirofumi Sawa
- Division of Molecular Pathobiology, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan; Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; Global Virus Network, Baltimore, USA
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Nguyen Trong TP, Wang J, Majzoub-Altweck M, Fell S, Straubinger RK. Recovering host cell-free Anaplasma phagocytophilum from HL-60 cells by using rock tumbler grit in comparison to the syringe lysis method. Ticks Tick Borne Dis 2018; 10:280-285. [PMID: 30455057 DOI: 10.1016/j.ttbdis.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/26/2018] [Accepted: 11/08/2018] [Indexed: 12/25/2022]
Abstract
Anaplasma phagocytophilum (Ap) is a tick-transmitted obligate intracellular bacterium and the causative agent of the granulocytic anaplasmosis in various species of domestic animals and in humans. During intracellular development Ap transforms from a dense-cored cell form into a reticulate cell form and vice versa. For isolation of intracellular bacteria, a range of different purification methods is used. However, unlike other Gram-negative bacteria Ap is considered to be sensitive to mechanical stress and osmolarity changes. An updated semi-purification method using rock tumbler grit is introduced here to increase the outcome of bacteria and to facilitate the procedure of host cell lysis. The objective of this study was to evaluate the structural integrity and infectivity of Ap after lysis of the host cells using rock tumbler grit and to compare the outcome to that of the frequently used method, syringe lysis. Human promyelocytic leukemia cell lines (HL-60) were infected with Ap and following host cell-free bacteria were assessed by transmission electron microscopy. The outcome of the different purification methods was compared using live/dead-staining based on immunofluorescence to count the number of viable bacteria and real-time PCR to compare the amount of DNA. Subsequently the isolated bacteria were tested to infect naive cell cultures. We observed that both Ap dense-cored cells and reticulate cells are preserved intact after the application of rock tumbler grit. The number of viable, host cell-free bacteria was higher by factor 1.7-2.4 compared to the syringe lysis protocol. Quantitative analysis based on real-time PCR showed an increase of bacterial DNA up to 1.6-2.9 times higher using the rock tumbler grit protocol. Bacteria released from the same number of infected host cells were used for new infections. Flow cytometric analysis of the cell cultures confirmed that the number of Ap organisms recovered by using the rock tumbler grit protocol resulted in higher infection rates than the number of Ap organisms recovered by using syringe lysis protocol. Our observations indicate that the rock tumbler grit protocol can be applied as a safe, robust and convenient method to recover Ap compared to syringe lysis.
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Affiliation(s)
- Thu Phong Nguyen Trong
- Institute for Infectious Diseases and Zoonoses, Department of Veterinary Sciences, Faculty of Veterinary Medicine, LMU Munich, Veterinaerstr. 13, 80539, Munich, Germany.
| | - Jinyong Wang
- Department of Microbiology & Immunology Chicago Medical School Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road 2-407, North Chicago, IL, 60064, USA.
| | - Monir Majzoub-Altweck
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine Faculty of Veterinary Medicine, LMU Munich, Veterinaerstr. 13, 80539, Munich, Germany.
| | - Shari Fell
- Institute for Infectious Diseases and Zoonoses, Department of Veterinary Sciences, Faculty of Veterinary Medicine, LMU Munich, Veterinaerstr. 13, 80539, Munich, Germany.
| | - Reinhard K Straubinger
- Institute for Infectious Diseases and Zoonoses, Department of Veterinary Sciences, Faculty of Veterinary Medicine, LMU Munich, Veterinaerstr. 13, 80539, Munich, Germany.
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Samson M, Wilcox SR, Liu SW. Rash and Thrombocytopenia. J Emerg Med 2018; 55:710-713. [PMID: 30262250 DOI: 10.1016/j.jemermed.2018.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/20/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Margot Samson
- University of Central Florida College of Medicine, Orlando, Florida
| | - Susan R Wilcox
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Shan W Liu
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
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Identification of novel immunoreactive proteins and delineation of a specific epitope of Anaplasma phagocytophilum. Microb Pathog 2018; 125:183-188. [PMID: 30217516 DOI: 10.1016/j.micpath.2018.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/27/2018] [Accepted: 09/11/2018] [Indexed: 01/09/2023]
Abstract
Human granulocytic anaplasmosis (HGA), an increasingly recognized febrile tick-borne illness, is caused by a gram-negative obligate intracellular bacterium Anaplasma phagocytophilum. Because of nonspecific clinical manifestations, diagnosis of HGA highly depends on laboratory tests. Identification of immunoreactive proteins is prerequisite for development of specific and sensitive immunoassays for HGA. In this study, we identified novel immunoreactive proteins of A. phagocytophilum. Previous studies indicated that secreted proteins of A. phagocytophilum and other bacteria can be immunoreactive antigens. Here we in silico screened A. phagocytophilum genome for encoding proteins which bear features of type IV secretion system substrates. Among seventy seven predicted proteins, fourteen proteins were determined for antigenicity and nine proteins were showed to be immunoreactive antigens. In addition, an APH1384 peptide harboring a B cell epitope predicted by bioinformatics was found specifically reacting with anti-A. phagocytophilum sera. Hereby, we identified novel immunoreactive proteins and delineated a specific epitope of A. phagocytophilum, which might be employed for HGA diagnosis.
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Trost CN, Lindsay LR, Dibernardo A, Chilton NB. Three genetically distinct clades of Anaplasma phagocytophilum in Ixodes scapularis. Ticks Tick Borne Dis 2018; 9:1518-1527. [DOI: 10.1016/j.ttbdis.2018.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/02/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
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Differential Susceptibility of Male Versus Female Laboratory Mice to Anaplasma phagocytophilum Infection. Trop Med Infect Dis 2018; 3:tropicalmed3030078. [PMID: 30274474 PMCID: PMC6161277 DOI: 10.3390/tropicalmed3030078] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/07/2018] [Accepted: 07/18/2018] [Indexed: 12/20/2022] Open
Abstract
Human granulocytic anaplasmosis (HGA) is a debilitating, non-specific febrile illness caused by the granulocytotropic obligate intracellular bacterium called Anaplasma phagocytophilum. Surveillance studies indicate a higher prevalence of HGA in male versus female patients. Whether this discrepancy correlates with differential susceptibility of males and females to A. phagocytophilum infection is unknown. Laboratory mice have long been used to study granulocytic anaplasmosis. Yet, sex as a biological variable (SABV) in this model has not been evaluated. In this paper, groups of male and female C57Bl/6 mice that had been infected with A. phagocytophilum were assessed for the bacterial DNA load in the peripheral blood, the percentage of neutrophils harboring bacterial inclusions called morulae, and splenomegaly. Infected male mice exhibited as much as a 1.85-fold increase in the number of infected neutrophils, which is up to a 1.88-fold increase in the A. phagocytophilum DNA load, and a significant increase in spleen size when compared to infected female mice. The propensity of male mice to develop a higher level of A. phagocytophilum infection is relevant for studies utilizing the mouse model. This stresses the importance of including SABV and aligns with the observed higher incidence of infection in male versus female patients.
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Duygu F, Sari T, Gunal O, Barut S, Atay A, Aytekin F. Cutaneous Findings of Crimean-Congo Hemorrhagic Fever: a Study of 269 Cases. Jpn J Infect Dis 2018; 71:408-412. [PMID: 29962486 DOI: 10.7883/yoken.jjid.2018.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease. We aimed to investigate the cutaneous manifestations of CCHF and reveal their associations with fatality. Two hundred and sixty-nine patients diagnosed with CCHF were assessed. Skin findings were observed in 170 (63.2%) patients. A facial rash was the most common cutaneous finding (n = 82, 30.5%). In severe cases, hemorrhagic cutaneous manifestations (petechiae and ecchymoses) were recognized. A statistically significant correlation was obtained between cutaneous manifestations and fatality, and it was determined that there was a strong positive correlation between fatality and ecchymosis (r = 567, p < 0.001). In addition, a logistic regression analysis was performed, and death occurred 4.69 times more in those with skin signs than in those without. We hypothesize that CCHF patients with ecchymosis are at the highest risk and that cutaneous findings can contribute to the prognosis of CCHF.
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Affiliation(s)
- Fazilet Duygu
- Department of Infectious Diseases and Clinical Microbiology, Ankara Oncology Training and Research Hospital
| | - Tugba Sari
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Pamukkale University
| | - Ozgur Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital
| | - Sener Barut
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University
| | - Ayfer Atay
- Department of Infectious Diseases and Clinical Microbiology, Bakirköy Dr. Sadi Konuk Training and Research Hospital
| | - Feyza Aytekin
- Department of Infectious Diseases and Clinical Microbiology, Ministry of Health-Giresun University Dr. A. Ilhan Ozdemir Training and Research Hospital
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Kobayashi KJ, Weil AA, Branda JA. Case 16-2018: A 45-Year-Old Man with Fever, Thrombocytopenia, and Elevated Aminotransferase Levels. N Engl J Med 2018; 378:2023-2029. [PMID: 29791814 DOI: 10.1056/nejmcpc1712227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Kimiyoshi J Kobayashi
- From the Departments of Medicine (K.J.K., A.A.W.) and Pathology (J.A.B.), Massachusetts General Hospital, and the Departments of Medicine (K.J.K., A.A.W.) and Pathology (J.A.B.), Harvard Medical School - both in Boston
| | - Ana A Weil
- From the Departments of Medicine (K.J.K., A.A.W.) and Pathology (J.A.B.), Massachusetts General Hospital, and the Departments of Medicine (K.J.K., A.A.W.) and Pathology (J.A.B.), Harvard Medical School - both in Boston
| | - John A Branda
- From the Departments of Medicine (K.J.K., A.A.W.) and Pathology (J.A.B.), Massachusetts General Hospital, and the Departments of Medicine (K.J.K., A.A.W.) and Pathology (J.A.B.), Harvard Medical School - both in Boston
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47
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Shabana II, Alhadlag NM, Zaraket H. Diagnostic tools of caprine and ovine anaplasmosis: a direct comparative study. BMC Vet Res 2018; 14:165. [PMID: 29788965 PMCID: PMC5964659 DOI: 10.1186/s12917-018-1489-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/07/2018] [Indexed: 12/01/2022] Open
Abstract
Background The diagnosis of anaplasmosis is rather conflicting with other haemoprotozoans. Hence, the study aimed to compare and evaluate the efficiency of competitive ELISA (cELISA), indirect fluorescence antibody (IFA), and Polymerase chain reaction (PCR) for precise diagnosis of Anaplasma spp. and to assess their concordance with microscopic examination (ME). Results A total of 312 blood samples (189 sheep and 123 goats) were examined for Anaplasma infection during a 1 year period. Giemsa-stained blood smears were examined under the microscope. IFA and cELISA were used for the detection of Anaplasma spp. antibodies. PCR was used as a standard of truth and for the identification of Anaplasma species. Using cELISA assay, 47.4% (148) were positive (93 sheep and 55 goats) with a sensitivity and specificity of 91.9, and 86.9%, respectively. Using IFA, it was found that 57.4% (179)were positive (113 sheep and 66 goats) with a sensitivity and specificity of 100, and 93.3%, respectively. PCR assay identified A. ovis in 49 (25.3%) sheep and 30 (15.5%) goats, and A. phagocytophilumin 74 (38.1%) sheep and 41 (20.8%) goats. Conclusions High sensitivity and specificity values of IFA and ELISA tests compared to microscopic examination strongly support their utility in the diagnosis of Anaplasma infection. PCR was a more specific diagnostic tool that allows to discriminate between Anaplasma subspecies, which makes it the method of choice for anaplasmosis diagnosis.
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Affiliation(s)
- I I Shabana
- Biology Department, Faculty of Science, Taibah University, Al- madinah Al-munawarah, Saudi Arabia. .,Faculty of Veterinary Medicine, Department of Bacteriology, Immunology and Mycology, Suez Canal University, Ismailia, Egypt.
| | - N M Alhadlag
- Biology Department, Faculty of Science, Taibah University, Al- madinah Al-munawarah, Saudi Arabia
| | - H Zaraket
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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48
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Kříž B, Malý M, Balátová P, Kodym P, Kurzová Z, Daniel M, Kybicová K. A serological study of antibodies to Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato in the sera of healthy individuals collected two decades apart. Acta Parasitol 2018; 63:33-39. [PMID: 29351070 DOI: 10.1515/ap-2018-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/21/2017] [Indexed: 11/15/2022]
Abstract
Sera collected from healthy individuals from the general population in the Czech Republic during repeated cross-sectional surveys were analyzed. Samples collected in the same six districts in two time periods, 1978-1989 and 2001, were compared. The study subjects were divided into six age categories between 10 and 59 years. Overall, 434 samples from 1978-1989 and 270 samples from 2001 were screened for Anaplasma phagocytophilum (AP) and Borrelia burgdorferi sensu lato (BB). The anti-AP positivity rates were 13.1% and 11.5% in the first and second period, respectively, and did not differ significantly between the periods (P = 0.559). The anti-BB antibodies were detected in 33.9% and 14.8% of study subjects, respectively. The positivity rates were significantly lower in the second period (P<0.001). No considerable changes were observed in the sex distribution of positive findings between the two periods. The highest positivity rates of anti-AP antibodies were found in the 10-14 year age group: 16.0% in 1978-1989 and 16.7% in 2001. The age distribution of the anti-AP antibody positivity rates did not change substantially (P = 0.872). In 1978-1989, the lowest anti-BB antibody positivity rate (26.7%) was found in the 10-14 year age group, with a gradual increase with age to 41.1% in 50-59 year-olds. In 2001, the positivity rate in the 10-14 year age group was 26.2% and was not significantly different from that in the first period (P = 0.955). However, the positivity rates in the older age groups 15-59 years decreased significantly (P<0.001) and varied between 8.3% and 15.1%.
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Affiliation(s)
- Bohumír Kříž
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
| | - Marek Malý
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
| | - Pavla Balátová
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
| | - Petr Kodym
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
| | - Zuzana Kurzová
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
| | - Milan Daniel
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
| | - Kateřina Kybicová
- National Institute of Public Health, Šrobárova 48, 100 42 Praha 10, Czech Republic
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Reller ME, Dumler JS. Development and Clinical Validation of a Multiplex Real-Time Quantitative PCR Assay for Human Infection by Anaplasma phagocytophilum and Ehrlichia chaffeensis. Trop Med Infect Dis 2018; 3:tropicalmed3010014. [PMID: 30274412 PMCID: PMC6136628 DOI: 10.3390/tropicalmed3010014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/19/2018] [Accepted: 01/21/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Human granulocytic anaplasmosis (HGA), caused by Anaplasma phagocytophilum, and human monocytic ehrlichiosis (HME), caused by Ehrlichia chaffeensis, often present as undifferentiated fever but are not treated by typical empiric regimens for acute febrile illness. Their role as agents of vector-borne febrile disease in tropical regions is more poorly studied than for other rickettsial infections. Limitations in diagnosis have impaired epidemiologic and clinical research and needless morbidity and mortality occur due to untreated illness. Methods: We designed and clinically validated a multiplex real-time quantitative PCR assay for Anaplasma phagocytophilum and Ehrlichia chaffeensis using samples confirmed by multiple gold-standard methods. Results: Clinical sensitivity and specificity for A. phagocytophilum were 100% (39/39) and 100% (143/143), respectively, and for E. chaffeensis 95% (20/21) and 99% (159/161), respectively. Conclusions: These assays could support early diagnosis and treatment as well as the high-throughput testing required for large epidemiologic studies.
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Affiliation(s)
- Megan E Reller
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
- Duke Hubert-Yeargan Center for Global Health, Durham, NC 27708, USA.
- Duke Global Health Institute, Durham, NC 27710, USA.
| | - J Stephen Dumler
- Joint Departments of Pathology, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Joint Pathology Center, Bethesda, MD 20814, USA.
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Chirek A, Silaghi C, Pfister K, Kohn B. Granulocytic anaplasmosis in 63 dogs: clinical signs, laboratory results, therapy and course of disease. J Small Anim Pract 2017; 59:112-120. [PMID: 29171663 DOI: 10.1111/jsap.12787] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 09/24/2017] [Accepted: 09/28/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe the clinical signs, laboratory results, therapy and course of disease in dogs with canine granulocytic anaplasmosis in which co-infections had been excluded. METHODS Medical records of dogs naturally infected with Anaplasma phagocytophilum were retrospectively evaluated with regard to clinical signs and laboratory abnormalities at the time of presentation, therapy and course of disease. RESULTS Nine hundred and seventy-four dogs with clinical signs suspicious for canine granulocytic anaplasmosis were tested for A. phagocytophilum DNA by modified real-time PCR; 72 dogs had a positive result. Nine of the positive dogs were excluded from further evaluation due to other diseases or lack of data. The most common clinical signs in the 63 A. phagocytophilum-positive dogs included in the study were lethargy and reduced activity (83%), fever (67%) and inappetence (63%). Thrombocytopenia was the most common laboratory abnormality (86%), followed by increased liver enzyme activities and hyperbilirubinaemia (77%), anaemia (70%), hypoalbuminaemia (62%) and leucocytosis (27%). Of 36 thrombocytopenic dogs tested for platelet-bound antibodies, 44% were positive. Of the 63 infected dogs, 59 (97%) recovered, two dogs died (epileptic seizures and immune-mediated haemolytic anaemia) and two were lost to follow-up. CLINICAL SIGNIFICANCE In areas where it is endemic, canine granulocytic anaplasmosis should be considered as a potential cause of acute nonspecific clinical signs or immune-mediated disease if tick exposure cannot be excluded.
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Affiliation(s)
- A Chirek
- Clinic for Small Animals, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - C Silaghi
- Comparative Tropical Medicine and Parasitoloy, Ludwig-Maximilians-Universität München, 80802, Munich, Germany.,National Center of Vector Entomology, Institute of Parasitology, University of Zurich, 8057, Zurich, Switzerland
| | - K Pfister
- Comparative Tropical Medicine and Parasitoloy, Ludwig-Maximilians-Universität München, 80802, Munich, Germany.,Parasite Consulting GmbH, CH-3006, Bern, Switzerland
| | - B Kohn
- Clinic for Small Animals, Faculty of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
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