1
|
Tian J, Liu J, Zhao H, Chen X, Geng X, Lu M, Li K. Molecular surveillance reveals a potential hotspot of tick-borne disease in Yakeshi City, Inner Mongolia. BMC Microbiol 2023; 23:359. [PMID: 37986042 PMCID: PMC10662550 DOI: 10.1186/s12866-023-03110-6] [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: 08/31/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
A molecular surveillance of tick-borne diseases was performed in Hulunbuir City, Inner Mongolia. A total of 149 ticks including three species (Ixodes persulcatus, Haemaphysalis concinna, and Dermacentor silvarum) were collected. As many as 11 tick-borne bacterial pathogens were identified in them. Some of them have high positive rates. For example, Candidatus Rickettsia tarasevichiae was detected with a high prevalence of 72.48%, while Candidatus Lariskella sp. was detected in 31.54% of ticks. For both Rickettsia raoultii and Anaplasma phagocytophilum, two distinct genotypes were identified based on their phylogenetic trees based on 16S rRNA, gltA, and groEL sequences. Remarkable genetic diversity was also observed for 16S and flaB genes of Borreliella garinii, an agent of Lyme disease. Rickettsia heilongjiangensis causing Far-Eastern spotted fever (2.68%, 4/149), Ehrlichia muris causing human ehrlichiosis (4.70%, 7/149), Borrelia miyamotoi causing relapsing fever (2.01%, 3/149), and Borreliella afzelii causing Lyme disease (2.01%, 3/149) were also detected. Additionally, a previously uncharacterized Anaplasma species closely related to Anaplasma ovis was identified. Herein we name it "Candidatus Anaplasma mongolica". Based on these results, we propose that Yakeshi City might be a potential hotspot of tick-borne diseases.
Collapse
Affiliation(s)
- Junhua Tian
- Wuhan Center for Disease Control and Prevention, Wuhan City, Hubei Province, 430024, China
| | - Jing Liu
- Wuhan Center for Disease Control and Prevention, Wuhan City, Hubei Province, 430024, China
| | - Hongqing Zhao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing City, 102206, China
| | - Xiaomin Chen
- Wuhan Center for Disease Control and Prevention, Wuhan City, Hubei Province, 430024, China
| | - Xueqin Geng
- Caidian Center for Disease Control and Prevention, Wuhan City, Hubei Province, 430100, China
| | - Miao Lu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing City, 102206, China.
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, Beijing, 102206, China.
| | - Kun Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing City, 102206, China.
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, Beijing, 102206, China.
| |
Collapse
|
2
|
Karshima SN, Ahmed MI, Mohammed KM, Pam VA. Global status of Anaplasma phagocytophilum infections in human population: A 50-year (1970-2020) meta-analysis. J Vector Borne Dis 2023; 60:265-278. [PMID: 37843237 DOI: 10.4103/0972-9062.364756] [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] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND & OBJECTIVES Anaplasma phagocytophilum causes human granulocytic anaplasmosis; a febrile tick-borne bacterial zoonosis of increasing public health importance in many parts of the world which is life threatening in undiagnosed, misdiagnosed and untreated cases. In this study we determined and reported the global status of the pathogen in man. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to perform a systematic review and meta-analysis of data published in six electronic databases between 1970 and 2020. We pooled data using the random-effects model, performed sensitivity analysis by the single study deletion method and assess across study bias by the funnel plot and its statistical significance by the Egger's regression test. RESULTS A total of 7018 cases of A. phagocytophilum were reported from 48,619 individuals examined across 22 countries in three continents. Overall pooled estimate was 8.13% (95% CI: 5.70 - 11.47) with a range of 4.64 (95% CI: 1.78 - 11.54) to 12.18% (95% CI: 7.66 - 18.83) across sub-groups. Regional prevalence was highest in North America 11.07% (95% CI: 3.13 - 32.38), while that in relation to study population was highest among occupationally exposed population 11.41% (95% CI: 5.69 - 21.56). INTERPRETATION & CONCLUSION The study revealed a significant variation in the prevalence of A. phagocytophilum across Asia, Europe and North America, with the highest prevalence in North America and among occupationally exposed population. To curtail the menace of this growing public health crisis, we recommend integrated control programmes involving tick control, the use of appropriate clothing by occupationally exposed population and health education.
Collapse
Affiliation(s)
- Solomon Ngutor Karshima
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, Nigeria
| | - Musa Isiyaku Ahmed
- Department of Veterinary Parasitology and Entomology, Federal University of Agriculture Zuru, Nigeria
| | - Kaltume Mamman Mohammed
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, Nigeria
| | | |
Collapse
|
3
|
Chang FY, Wang RY, Yen TY, Shu PY, Yang SL. Human case of Anaplasma phagocytophilum infection in Eastern Taiwan. J Formos Med Assoc 2023; 122:286-289. [PMID: 36096862 DOI: 10.1016/j.jfma.2022.08.018] [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: 02/22/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Human granulocytic anaplasmosis (HGA) is a tick-borne infection caused by the bacterium Anaplasma phagocytophilum. In this study, we report an indigenous case of clinically diagnosed HGA. The patient was a 41-year-old man who experienced a tick bite and later developed fever, chills, myalgia, malaise, thrombocytopenia, leukocytosis with a left shift, elevated hepatic transaminase levels, and splenomegaly upon admission to the hospital. Immunofluorescence assays detected seroconversion against A. phagocytophilum, whereas tests for spotted fever group rickettsiae, murine typhus, scrub typhus, Q fever, and ehrlichiosis were negative. ELISA and Western blot analysis using recombinant MSP2 protein confirmed the exposure to A. phagocytophilum. Oral doxycycline and intravenous ceftriaxone were prescribed, and the patient made a full recovery. Our findings indicate the presence of HGA on the main island of Taiwan. Precautions against tick bites should be taken when engaging in outdoor activities, and HGA should be considered by physicians in the differential diagnosis.
Collapse
Affiliation(s)
- Feng-Yee Chang
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ruo-Yu Wang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Tsai-Ying Yen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Pei-Yun Shu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
| | - Su-Lin Yang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
| |
Collapse
|
4
|
Minahan NT, Wu WJ, Tsai KH. Rickettsia felis is an emerging human pathogen associated with cat fleas: A review of findings in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:10-19. [PMID: 36585292 DOI: 10.1016/j.jmii.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Rickettsia felis is an emerging rickettsial agent principally associated with cat fleas (Ctenocephalides felis), formerly discovered in 1990. Since then, clinical cases of R. felis infection have been identified globally by specific DNA sequences in patients with undifferentiated febrile illness, including in Taiwan, but such evidence is limited. R. felis rickettsiosis is self-limiting and easily treated with doxycycline, but its diagnosis remains a challenge. Environmental risk factors for R. felis rickettsiosis have yet to be clearly demonstrated, and its transmission biology is incompletely understood. Cat fleas are naturally infected with R. felis at varying rates, and vector competence in the transmission of R. felis has been demonstrated in animal models, including dogs, which may serve as reservoir hosts. In northern Taiwan, despite ∼20% of cat fleas infesting companion animals consistently found to be infected with R. felis, only a few cases of potential R. felis infection have been identified through a retrospective serological investigation, though without molecular confirmation. Ecological studies have identified divergent R. felis-like organisms in different arthropod hosts, but these strains appear to serve as nonpathogenic endosymbionts. Although its association with disease is limited, we believe cat flea-borne R. felis warrants increased recognition in an aging population due to immunosenescence and the proximity of companion animals to the elderly. Adopting a One Health approach involving collaboration and communication between clinicians, veterinarians, public health practitioners, and environmental scientists will improve our knowledge about this neglected pathogen and promote the prevention and control of vector-borne diseases.
Collapse
Affiliation(s)
- Nicholas T Minahan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wen-Jer Wu
- Department of Entomology, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan
| | - Kun-Hsien Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Entomology, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
5
|
Karshima SN, Ahmed MI, Mohammed KM, Pam VA, Momoh-Abdullateef H, Gwimi BP. Worldwide meta-analysis on Anaplasma phagocytophilum infections in animal reservoirs: Prevalence, distribution and reservoir diversity. Vet Parasitol Reg Stud Reports 2023; 38:100830. [PMID: 36725159 DOI: 10.1016/j.vprsr.2022.100830] [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: 05/04/2022] [Revised: 12/06/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
A wide range of vertebrate species are competent reservoirs of Anaplasma phagocytophilum, where the pathogen is maintained in the enzootic cycle and transmitted to humans through activities of tick vectors. An insight into the role and diversity of these reservoirs is vital in understanding the epidemiology of this pathogen. Here, we determined the prevalence, distribution and reservoir diversity of A. phagocytophilum using a systematic review and meta-analysis. Data pooling was performed by the random-effects model, heterogeneity was assessed by the Cochran's Q-test and publication bias by Egger's regression test. Eighty-nine studies from 33 countries across 5 continents revealed A. phagocytophilum pooled prevalence of 15.18% (95% CI: 11.64, 19.57). Continental estimates varied significantly (p < 0.0001), with a range of 2.88% (95% CI: 0.25, 26.20) in South America to 19.91% (95% CI: 13.57, 28.24) in Europe. Country-based estimates ranged between 2.93% (95% CI: 1.17, 7.16) in Slovakia and 71.58% (95% CI: 25.91, 94.77) in Norway. Studies on A. phagocytophilum were concentrated in Europe (51.69%; 46/89) by continent and the USA (22.47%; 20/89) by country. Prevalence in wildlife (17.64%; 95% CI: 12.21-28.59) was significantly higher (p < 0.001) than that among domestic animals (10.68%; 95% CI: 6.61-16.83). Diverse species of wildlife, domestic animals and birds were infected by A. phagocytophilum. To curtail the public health, veterinary and economic consequences of A. phagocytophilum infections, we recommend an all-inclusive epidemiological approach that targets the human, animal and environmental components of the disease.
Collapse
Affiliation(s)
- Solomon Ngutor Karshima
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, PMB 28 Zuru, Kebbi State, Nigeria.
| | - Musa Isiyaku Ahmed
- Department of Veterinary Parasitology and Entomology, Federal University of Agriculture Zuru, PMB 28 Zuru, Kebbi State, Nigeria
| | - Kaltume Mamman Mohammed
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, PMB 28 Zuru, Kebbi State, Nigeria
| | - Victoria Adamu Pam
- Department of Zoology, Federal University Lafia, Lafia PMB 146, Nasarawa State, Nigeria
| | - Habiba Momoh-Abdullateef
- Department of Animal Health, Federal College of Animal Health and Production Technology, PMB 001, Vom, Plateau State, Nigeria
| | - Bulus Peter Gwimi
- Department of Veterinary Public Health and Preventive Medicine, Federal University of Agriculture Zuru, PMB 28 Zuru, Kebbi State, Nigeria
| |
Collapse
|
6
|
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.
Collapse
Affiliation(s)
- Douglas MacQueen
- Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850, USA; Weill Cornell Medicine.
| | | |
Collapse
|
7
|
Molecular Survey of Vector-Borne Pathogens in Ticks, Sheep Keds, and Domestic Animals from Ngawa, Southwest China. Pathogens 2022; 11:pathogens11050606. [PMID: 35631127 PMCID: PMC9143929 DOI: 10.3390/pathogens11050606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 01/27/2023] Open
Abstract
Vector-borne pathogens are mainly transmitted by blood-feeding arthropods such as ticks, mosquitoes, fleas, lice, mites, etc. They pose a significant threat to animal and human health due to their worldwide distribution. Although much work has been performed on these pathogens, some neglected areas and undiscovered pathogens are still to be further researched. In this study, ticks (Haemaphysalis qinghaiensis), sheep keds (Melophagus ovinus), and blood samples from yaks and goats were collected in Ngawa Tibetan and Qiang Autonomous Prefecture located on the eastern edge of the Qinghai–Tibet Plateau, Southwest China. Several vector-borne bacterial pathogens were screened and studied. Anaplasma bovis strains representing novel genotypes were detected in ticks (8.83%, 37/419), yak blood samples (45.71%, 64/140), and goat blood samples (58.93%, 33/56). Two spotted fever group (SFG) Rickettsiae, Candidatus Rickettsia jingxinensis, and a novel Rickettsia species named Candidatus Rickettsia hongyuanensis were identified in ticks. Another Rickettsia species closely related to the Rickettsia endosymbiont of Polydesmus complanatus was also detected in ticks. Furthermore, a Coxiella species was detected in ticks (3.34%, 14/419), keds (1.89%, 2/106), and yak blood (0.71%, 1/140). Interestingly, another Coxiella species and a Coxiella-like bacterium were detected in a tick and a goat blood sample, respectively. These results indicate the remarkable diversity of vector-borne pathogens circulating in this area. Further investigations on their pathogenicity to humans and domestic animals are still needed.
Collapse
|
8
|
Parasitic and Vector-Borne Infections in HIV-Positive Patients in Slovakia-Evidence of an Unexpectedly High Occurrence of Anaplasma phagocytophilum. Pathogens 2021; 10:pathogens10121557. [PMID: 34959511 PMCID: PMC8704717 DOI: 10.3390/pathogens10121557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022] Open
Abstract
In HIV (human immunodeficiency virus) infected people, the immunodeficiency caused by a reduced level of CD4 (cluster of differentiation 4) T-lymphocytes increases the risk of infectious diseases. Additionally, in individuals with immunologically compromising conditions, tick-borne or some parasitic pathogens may cause chronic, debilitating opportunistic infections and even death. The study aimed at determining the IgG seropositivity of HIV-infected patients to Toxoplasma gondii, Toxocara spp., Echinococcus multilocularis, and E. granulosus s.l. and performing the molecular identification of T. gondii and some tick-borne pathogens, namely, Borrelia spp., Babesia spp., Anaplasma phagocytophilum, Rickettsia spp., and Bartonella spp. Out of 89 HIV-positive patients, specific IgG antibodies to T. gondii were detected in 17 (19.1%) and to Borrelia spp. in 12 (13.5%) individuals. Seropositivity to Toxocara spp., E. multilocularis, and E. granulosus s.l. was not recorded. Molecular approaches showed positivity to T. gondii in two (2.2%) patients, and 11 (12.4%) individuals had positive PCR signal for the msp2 gene of A. phagocytophilum. Relatively high prevalence of A. phagocytophilum in HIV-positive patients suggests that these people are more susceptible to some vector-borne pathogens. The presence of opportunistic infections may pose a health risk for patients with weakened immune systems, and should not be neglected during the regular monitoring of the patient’s health status.
Collapse
|
9
|
Yen TY, Wang HC, Chang YC, Su CL, Chang SF, Shu PY, Tsai KH. Seroepidemiological Study of Spotted Fever Group Rickettsiae and Identification of a Putative New Species, Rickesttsia sp. Da-1, in Gongliao, Northeast Taiwan. Pathogens 2021; 10:pathogens10111434. [PMID: 34832589 PMCID: PMC8617620 DOI: 10.3390/pathogens10111434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Tick-borne spotted fever group (SFG) rickettsioses were neglected in Taiwan. The study reported a seroepidemiological survey of SFG rickettsiae in residents in Gongliao District, Northeast Taiwan. Blood samples were examined for antibodies against SFG rickettsiae by enzyme-linked immunosorbent assay and immunofluorescence assay. Risk factors were assessed using logistic regression. Ticks parasitizing dogs were collected within a 2 km radius from the houses of seropositive participants, and PCR was performed to detect possible tick-borne pathogens. Of 1108 participants, 75 (6.8%) had antibodies against SFG rickettsiae. Residents were more likely to be seropositive if they were older than 65 years, recruited by Dr. Enjoy’s Clinic, or resided in Jilin village. A total of 184 ticks including 5 species (Rhipicephalus sanguineus, Rhipicephalus haemaphysaloides, Dermacentor auratus, Haemaphysalis hystricis, Haemaphysalis ornithophila) were collected. Rickettsia spp. were detected in 6.5% (12/184) of ticks. Rickettsia sp. TwKM01 was found in 6 R. sanguineus and 4 R. haemaphysaloides; while Rickettsia sp. TwKM03 was identified in 1 R. sanguineus. Moreover, gene-based pairwise analysis indicated identification of a putative new species, Rickettsia sp. Da-1, in D. auratus. These findings provided evidence of SFG rickettsiae infection in ticks and suggested SFG rickettsiae exposure in the residents.
Collapse
Affiliation(s)
- Tsai-Ying Yen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan; (T.-Y.Y.); (H.-C.W.)
| | - Hsi-Chieh Wang
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan; (T.-Y.Y.); (H.-C.W.)
| | - Yin-Chao Chang
- Dr. Enjoy’s Clinic, Gong-Liao District, New Taipei City 228003, Taiwan;
| | - Chien-Ling Su
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei 115210, Taiwan; (C.-L.S.); (S.-F.C.)
| | - Shu-Fen Chang
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei 115210, Taiwan; (C.-L.S.); (S.-F.C.)
| | - Pei-Yun Shu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei 115210, Taiwan; (C.-L.S.); (S.-F.C.)
- Correspondence: (P.-Y.S.); (K.-H.T.); Tel.: +886-2-26531372 (P.-Y.S.); +886-2-33668103 (K.-H.T.)
| | - Kun-Hsien Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan; (T.-Y.Y.); (H.-C.W.)
- Department of Public Health, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
- Correspondence: (P.-Y.S.); (K.-H.T.); Tel.: +886-2-26531372 (P.-Y.S.); +886-2-33668103 (K.-H.T.)
| |
Collapse
|
10
|
Yang WH, Hsu MS, Shu PY, Tsai KH, Fang CT. Neglected human Rickettsia felis infection in Taiwan: A retrospective seroepidemiological survey of patients with suspected rickettsioses. PLoS Negl Trop Dis 2021; 15:e0009355. [PMID: 33872325 PMCID: PMC8084327 DOI: 10.1371/journal.pntd.0009355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/29/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Current knowledge on Rickettsia felis infection in humans is based on sporadic case reports. Here we conducted a retrospective seroepidemiological survey of R. felis infection among febrile patients visiting a medical center in Taipei. METHODOLOGY/PRINCIPAL FINDINGS A total of 122 patients with suspected rickettsioses presenting with fever of unknown origin (FUO) but tested negative for scrub typhus, murine typhus, or Q fever were retrospectively identified during 2009 to 2010. The archived serum samples were examined for the presence of antibodies against R. felis, Rickettsia japonica, and Rickettsia typhi using microimmunofluorescence (MIF) assay. Serological evidence of Rickettsia exposure was found in 23 (19%, 23/122) patients. Eight patients had antibodies reactive to R. felis, including four with current infection (a ≥4-fold increase in IgG titer between acute and convalescent sera). The clinical presentations of these four patients included fever, skin rash, lymphadenopathy, as well as more severe conditions such as pancytopenia, hepatomegaly, elevated liver enzymes/bilirubin, and life-threatening acute respiratory distress syndrome. One of the patients died after doxycycline was stopped after being tested negative for scrub typhus, Q fever, and murine typhus. CONCLUSIONS Rickettsia felis is a neglected flea-borne pathogen in Taiwan, and its infection can be life-threatening. Further prospective studies of the prevalence of R. felis among patients with FUO and compatible clinical manifestations are warranted.
Collapse
Affiliation(s)
- Wan-Hsiu Yang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Meng-Shiuan Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Internal Medicine, Section of Infectious Disease, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Healthcare Administration, Oriental Institute of Technology, Taipei, Taiwan
| | - Pei-Yun Shu
- Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Kun-Hsien Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chi-Tai Fang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
11
|
Rar V, Tkachev S, Tikunova N. Genetic diversity of Anaplasma bacteria: Twenty years later. INFECTION GENETICS AND EVOLUTION 2021; 91:104833. [PMID: 33794351 DOI: 10.1016/j.meegid.2021.104833] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 01/04/2023]
Abstract
The genus Anaplasma (family Anaplasmataceae, order Rickettsiales) includes obligate intracellular alphaproteobacteria that multiply within membrane-bound vacuoles and are transmitted by Ixodidae ticks to vertebrate hosts. Since the last reclassification of Anaplasmataceae twenty years ago, two new Anaplasma species have been identified. To date, the genus includes eight Anaplasma species (A. phagocytophilum, A. marginale, A. centrale, A. ovis, A. bovis, A. platys, A. odocoilei, and A. capra) and a large number of unclassified genovariants that cannot be assigned to known species. Members of the genus can cause infection in humans and a wide range of domestic animals with different degrees of severity. Long-term persistence which, in some cases, is manifested as cyclic bacteremia has been demonstrated for several Anaplasma species. Zoonotic potential has been shown for A. phagocytophilum, the agent of human granulocytic anaplasmosis, and for some other Anaplasma spp. that suggests a broader medical relevance of this genus. Genetic diversity of Anaplasma spp. has been intensively studied in recent years, and it has been shown that some Anaplasma spp. can be considered as a complex of genetically distinct lineages differing by geography, vectors, and host tropism. The aim of this review was to summarize the current knowledge concerning the natural history, pathogenic properties, and genetic diversity of Anaplasma spp. and some unclassified genovariants with particular attention to their genetic characteristics. The high genetic variability of Anaplasma spp. prompted us to conduct a detailed phylogenetic analysis for different Anaplasma species and unclassified genovariants, which were included in this review. The genotyping of unclassified genovariants has led to the identification of at least four distinct clades that might be considered in future as new candidate species.
Collapse
Affiliation(s)
- Vera Rar
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russian Federation.
| | - Sergey Tkachev
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russian Federation
| | - Nina Tikunova
- Institute of Chemical Biology and Fundamental Medicine, SB RAS, Novosibirsk, Russian Federation
| |
Collapse
|
12
|
Langenwalder DB, Schmidt S, Silaghi C, Skuballa J, Pantchev N, Matei IA, Mihalca AD, Gilli U, Zajkowska J, Ganter M, Hoffman T, Salaneck E, Petrovec M, von Loewenich FD. The absence of the drhm gene is not a marker for human-pathogenicity in European Anaplasma phagocytophilum strains. Parasit Vectors 2020; 13:238. [PMID: 32381072 PMCID: PMC7206706 DOI: 10.1186/s13071-020-04116-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/29/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Anaplasma phagocytophilum is a Gram-negative obligate intracellular bacterium that replicates in neutrophil granulocytes. It is transmitted by ticks of the Ixodes ricinus complex and causes febrile illness in humans and animals. The geographical distribution of A. phagocytophilum spans the Americas, Europe, Africa and Asia. However, human disease predominantly occurs in North America but is infrequently reported from Europe and Asia. In North American strains, the absence of the drhm gene has been proposed as marker for pathogenicity in humans whereas no information on the presence or absence of the drhm gene was available for A. phagocytophilum strains circulating in Europe. Therefore, we tested 511 European and 21 North American strains for the presence of drhm and compared the results to two other typing methods: multilocus sequence typing (MLST) and ankA-based typing. RESULTS Altogether, 99% (478/484) of the analyzable European and 19% (4/21) of the North American samples from different hosts were drhm-positive. Regarding the strains from human granulocytic anaplasmosis cases, 100% (35/35) of European origin were drhm-positive and 100% (14/14) of North American origin were drhm-negative. Human strains from North America and Europe were both part of MLST cluster 1. North American strains from humans belonged to ankA gene clusters 11 and 12 whereas European strains from humans were found in ankA gene cluster 1. However, the North American ankA gene clusters 11 and 12 were highly identical at the nucleotide level to the European cluster 1 with 97.4% and 95.2% of identity, respectively. CONCLUSIONS The absence of the drhm gene in A. phagocytophilum does not seem to be associated with pathogenicity for humans per se, because all 35 European strains of human origin were drhm-positive. The epidemiological differences between North America and Europe concerning the incidence of human A. phagocytophilum infection are not explained by strain divergence based on MLST and ankA gene-based typing.
Collapse
Affiliation(s)
- Denis B Langenwalder
- Department of Medical Microbiology and Hygiene, Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacherstrasse 67, 55131, Mainz, Germany
| | - Sabine Schmidt
- Department of Medical Microbiology and Hygiene, Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacherstrasse 67, 55131, Mainz, Germany
| | - Cornelia Silaghi
- Institute of Infectology, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Jasmin Skuballa
- Chemical and Veterinary Investigations Office Karlsruhe (CVUA Karlsruhe), Weissenburgerstrasse 3, 76187, Karlsruhe, Germany
| | - Nikola Pantchev
- IDEXX Laboratories, Mörikestrasse 28/3, 71636, Ludwigsburg, Germany
| | - Ioana A Matei
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Andrei D Mihalca
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Manastur 3-5, 400372, Cluj-Napoca, Romania
| | - Urs Gilli
- IDEXX Diavet AG, Schlyffistrasse 10, 8806, Bäch, Switzerland
| | - Joanna Zajkowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, ul.Żurawia 14, 15-345, Białystok, Poland
| | - Martin Ganter
- Clinic for Swine and Small Ruminants, University of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173, Hannover, Germany
| | - Tove Hoffman
- Department of Medical Biochemistry and Microbiology (IMBIM), Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Erik Salaneck
- Department of Medical Sciences, Zoonosis Science Center, Uppsala University, Uppsala, Sweden
| | - Miroslav Petrovec
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia
| | - Friederike D von Loewenich
- Department of Medical Microbiology and Hygiene, Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacherstrasse 67, 55131, Mainz, Germany.
| |
Collapse
|
13
|
Yen TY, Tung YJ, Wang HC, Tsai KH. Detection of Ehrlichia chaffeensis in a febrile patient in Kinmen, an offshore island of Taiwan. J Formos Med Assoc 2019; 119:1329-1330. [PMID: 31831322 DOI: 10.1016/j.jfma.2019.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Tsai-Ying Yen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Jung Tung
- Kinmen Hospital, Ministry of Health and Welfare, Kinmen, Taiwan
| | - Hsi-Chieh Wang
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
| | - Kun-Hsien Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Infectious Diseases Research and Education Center, Ministry of Health and Welfare and National Taiwan University, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan.
| |
Collapse
|