An Overview of One Health Concept Focusing on Toxoplasmosis

The "One Health" concept is a universal approach to sustainably balancing and optimizing the health of humans, animals, and ecosystems. This approach is based on the health of humans, domestic and wild animals, and plants in a wider environment in which self-renewable ecosystems exist, with essential characteristics of integration, unifying and holistic perspective. Toxoplasmosis, one of the most common zoonotic infections in both terrestrial and oceanic ecosystems in the world, is an ideal model disease for the "One Health" approach. Toxoplasmosis is a zoonotic disease caused by the obligate intracellular pathogen protozoan Toxoplasma gondii. In the life cycle of T. gondii, the definitive host is domestic cats and felines, and the intermediate hosts are all mammals (including humans), birds and reptiles. The infected cats have primary importance and play a crucial role in the contamination of habitats in the ecosystems with T. gondii oocysts. Thus, ecosystems with domestic cats and stray cats are contaminated with cat feces infected with T. gondii oocytes. T. gondii positivity has been scientifically demonstrated in all warm-blooded animals in terrestrial and aquatic habitats. The disease causes deaths and abortions in farm animals, resulting in great economic losses. However, the disease causes great problems in humans, especially pregnant women. During pregnancy, it may have effects such as congenital infections, lesions in the eye and brain of the fetus, premature birth, intrauterine growth retardation, fever, pneumonia, thrombocytopenia, ocular lesions, encephalitis, and abortion. The mechanism of death and abortion of the fetus in a pregnant woman infected with T. gondii occurs as a result of complete disruption of the maternal immune mechanism. The struggle against toxoplasmosis requires the universal collaboration and coordination of the World Organization for Animal Health, the World Health Organization and the World Food Organization in the "One Health" concept and integrative approaches of all responsible disciplines. Establishing universal environmental safety with the prevention and control of toxoplasmosis requires the annihilation of the feces of the infected cats using suitable techniques firstly. Then routinely, the monitoring and treatment of T. gondii positivity in cats, avoiding contact with contaminated foods and materials, and development of modern treatment and vaccine options. Particularly, mandatory monitoring or screening of T. gondii positivity during the pregnancy period in humans should be done. It would be beneficial to replace the French model, especially in the monitoring of disease in humans. In this article, the ecology of toxoplasmosis was reviewed at the base of the "One Health" concept.

Investigation of Zoonotic Cryptosporidium and Giardia intestinalis Species and Genotypes in Cats (Felis catus)

OBJECTIVE

Giardia intestinalis and Cryptosporidium spp. are important zoonotic protozoan parasites that infect humans and various animals. We investigated the occurrence of G. intestinalis and Cryptosporidium spp. infection in cats. To provide data on the zoonotic transmission dynamics of these parasites, genotypes of the detected isolates were investigated through DNA sequence characterization.

METHODS

A total of 100 fecal samples were collected from cats between June and October 2020 in Kayseri and Samsun provinces. Fecal samples were examined by nested polymerase chain reaction (PCR), targeting the β-giardin gene of G. intestinalis and small subunit (SSU) rRNA gene of Cryptosporidium spp. All PCR products were sequenced for genotyping.

RESULTS

Of the samples examined, Giardia intestinalis was determined in 8 samples (8.0%), whereas none of the samples were found positive for Cryptosporidium spp. Sequence analyses of the β-giardin PCR products indicated that all G. intestinalis isolates were classed into the zoonotic assemblage B.

CONCLUSION

This study adds to the current data on the molecular epidemiology of cryptosporidiosis and giardiasis in cats. The findings also highlight the potential risk of cats for public health concerning the zoonotic transmission dynamics of G. intestinalis.

Vector-borne Zoonotic Diseases in Turkey: Rising Threats on Public Health

Vector-borne zoonotic diseases (VBZDs) are a major problem for public health and animal welfare all over the world. In recent years, there has been an alarming increase in VBZDs, mainly caused by new or re-emerging arboviruses, bacteria and parasites. The World Health Organization enumerated 10 threats to global health for 2019, notably emphasizing climate change and emerging pathogens as growing priorities. It is important to review potential threats and develop new control programs for rising threats against human health and safety. Changes in host and vector population diversity and density may affect pathogen transmission patterns and influence VBZD emergence processes. In addition to environmental and climate-related changes, human and animal migratory patterns pose future threats. The geographic location and habitat features of Turkey support the establishment of many arthropod species as vectors of various diseases. To date, a total of 107 zoonotic infections have been reported originating from Turkey. Arthropods transmit 19 of 107 such infections, including 2 mosquito-borne, 9 tick-borne, 1 sandfly-borne, 3 flea-borne, 1 simuliid-borne, 1 mite-borne and 2 fly-borne diseases. In this review, we focus on the present status of knowledge on VBZDs as a rising threat to public health in Turkey to provide a foundation for future control efforts.

Molecular Characterization and Phylogenetic Analyses of Oestrus ovis Larvae Causing Human Naso-pharyngeal Myiasis Based on CO1 Barcode Sequences

Objective

The identification and molecular characterization of the bot fly larvae from an infected human with naso-pharyngeal myiasis in Turkey were aimed in this study.

Methods

A total of 8 bot fly larvae from a 49-year-old woman with naso-pharyngeal infection in Adana province constituted the materials of this study. Morphological identification was performed on the larvae according to described keys. The barcode region of the CO1 gene from the genomic DNA extracts of the larvae was amplified and sequence analyses were utilized. Haplotype and genetic distance analyses were performed in CO1 sequences and a phylogenetic tree was built revealing phylogenetic relationships.

Results

All bot fly larvae were identified as second stage larvae of Oestrus ovis in terms of morphologic characteristics. There was no polymorphism among the CO1 sequences of all isolates leading to detection of a single novel haplotype. The newly characterized haplotype in this study clustered with the O. ovis haplotypes from Bosnia and Herzegovina, Croatia, Brazil, and Iran in a monophyletic clade with an overall identity of 99.5%. Interspecific genetic differences among the subfamilies of Oestridae were in the range of 19.8% to 30.8%.

Conclusion

This study has provided the first molecular characterization data on O. ovis larvae from an accidental human host in Turkey based on CO1 barcode sequences.

Overview of Zoonotic Diseases in Turkey: The One Health Concept and Future Threats

Zoonotic infections are globally important diseases and lead to huge economic losses in both low- and middle-income and high-income countries. Global warming, environmental and ecological changes, illegal movement of animals and humans, regional civil wars, and poverty are predisposing factors for the emergence of zoonotic infections and their distribution worldwide; they are also a big threat for the future. In addition, environmental pollution and antimicrobial resistance are immense serious threats and dangers to prevent and control zoonotic infections. The natural location of Turkey allows many emerged or re-emerged infections with zoonotic characteristics by animal movements, such as bird immigrations, and by human movements due to civil wars as seen with regional refugees. Numerous zoonotic diseases, including 37 bacterial, 13 fungal, 29 viral, 28 parasitic (3 trematodes, 7 cestodes, 10 nematodes, and 8 protozoan), and totally 107 infections, have been reported from Turkey to date. Additionally, many ectoparasitic zoonoses within 15 different arthropod groups and one leech infestation have been reported from Turkey to date. The "One Health" initiative is particularly relevant for developing strategies to combat zoonotic diseases. In this article, we review the occurrence of zoonotic diseases in man and animals in Turkey in the light of the "One Health" perspective.

Experimental Toxoplasmosis in Japanese Quails (Coturnix coturnix japonica)

OBJECTIVE

In this study, forming of experimental toxoplasmosis in quails; clinical, pathological, and serological determination of tissue lesions and bioassay techniques, which were aimed to compare them and determine pathogenesis.

METHODS

A total of 120 one-year-old female quails (Coturnix coturnix japonica) were divided into oral infection, parenteral infection, and control groups. The oral group was infected with 0.5 ml inoculum suspension containing 106 tachyzoites of Toxoplasma gondii, whereas the control group was administered 0.5 ml of saline. The parenteral group was further divided into the following four subgroups: intraperitoneal, intramuscular, intravenous, and cloacal. The quails of the parenteral group were also divided into two groups and one by control group within itself for the 105 and 104 doses of the tachyzoite inoculums.

RESULTS

Because of acute toxoplasmosis, death occurred in a quail that as intramuscularly infected with 105 tachyzoites; the quail exhibited neurological clinical symptoms such as torticollis, ataxia, and tremor. In histopathologic examination, T. gondii tissue cysts were detected in infected quails that were intramuscularly infected with 105 tachyzoites. Mouse trials were conducted using tissues of seropositive quails and isolated from peritoneal fluids infected mice. By Sabin-Feldman dye test and indirect hemagglutination test, seropositivity was observed in quails infected with 105 and 104 tachyzoites.

CONCLUSION

Similar studies and subclinical cases, which may overlooked was concluded for diagnosis of toxoplasmosis with useful bioassay applications and serological tests.

The Current Status of Ticks in Turkey: A 100-Year Period Review from 1916 to 2016

Environmental and bio-ecological changes, some administrative and political mistakes, and global warming seriously affect the behaviors of ticks in Turkey and globally. The global public sensitivity toward tick infestations has increased along with increases in tick-borne diseases (TBDs). Recently, the World Health Organization (WHO) developed a new political concept, "One Health," for specific struggle strategies against tick infestations and TBDs. To highlight the importance of the issue, the WHO had declared the year 2015 for vector-borne diseases and adopted the slogan "small bites big threat". In global struggle strategies, the epidemiological aspects and dynamics of increasing tick populations and their effects on the incidence of the TBDs mainly with zoonotic characteristics have been specifically targeted. In Turkey, during the last century, approximately 47 tick species, including eight soft and 39 hard tick species in three and six genera belonging to Argasidae and Ixodidae, respectively, had already been reported. In this article, the recorded tick species, regional infestations, and medical and veterinary importance in Turkey were chronologically reviewed based on a 100-year period between 1916 and 2016.

Blood Meal Identification of the Mosquito (Diptera: Culicidae) Specimens Belong to Culex pipiens Complex that were Collected from Kayseri Province

OBJECTIVE

This study aimed to determine the host preferences in blood meal of specimens belonging to Culex pipiens complex.

METHODS

A total of 1284 female mosquitos were morphologically examined, and genomic DNA isolations were individually performed on 376 (28.4%) specimens that were determined to be Cx. pipiens complex. PCR was performed with primers to specifically amplify the avian and mammalian mitochondrial cytochrome b (mt-cytb) gene region. Amplicons were cloned, and the obtained plasmids were sequenced to determine host species.

RESULTS

Of 376 specimens, 148 (39.4%) were positive for the avian and/or mammalian blood meal. Among the positive specimens, 43, 98, and seven were determined to be positive for only mammalian, avian, and both avian and mammalian blood, respectively. Avian host preference in blood meal of the specimens belonging to Cx. pipiens was found to be significant. Of 15 avian blood positive isolates, nine, three, two, and one were designated as blood meal from avian species in Passeriformes, Accipitriformes, Columbiformes, and Strigiformes orders, respectively. While six, four, three, and two out of 15 mammalian blood-positive specimens were found to be positive for human, cattle, sheep, and dog blood, respectively.

CONCLUSION

Molecular data regarding the host preferences of the Cx. pipiens species complex in blood meal were revealed for the first time in Turkey with this study.

Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients

OBJECTIVES

Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients.

METHODS

This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4(+) T-cell: 236 and 216 cells/mm(3), median HIV-1 RNA: 4.95+E5 and 1.08E+6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations.

RESULT

INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated:F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%).

CONCLUSIONS

The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.

A fatal case caused by massive honey bee stings

Bee venom is a complex substance which acts in different ways; local or systemic anaphylaxis associated with IgE and direct toxic effects of the large volume of injected venom. We report a 10- year-old boy who was the vulnerable of 5989 honey bee attacks. To the best of our knowledge, this case had the ultimate number of honey bee stings in the literature, until now. He was admitted to pediatric intensive care unit after 3 hours of incident. Plasmapheresis was started to remove circulating venom that can cause many systemic side effects. Unfortunately, multiorgan failure developed on the 2nd day of admission due to severe hemolysis and rabdomyolysis. Additional therapies modalities, mechanical ventilation, hemodialysis, and antihypertensive drugs were added to the treatment during the disease process. Despite all of the treatments, the patient was failed on 12th day of hospitalization.

[Molecular characterization of Babesia bovis msa-2c gene]

OBJECTIVE

This study was carried out to determine the molecular characterization of msa-2c gene of one Babesia bovis isolate from cattle in the Aegean Region and to compare identities with similar isolates from the World and Turkey.

METHODS

Between 2008-2010 blood samples were collected from a total of 235 cattle localized in 9 provinces of the Marmara and Aegean Regions. Smears were prepared, genomic DNA's were extracted from the blood samples and investigated for Babesia species by RLB. PCR was performed on one sample determined as B. bovis, the obtained amplicon was purified, sequenced and deposited to GenBank. Identities with similar isolates from Turkey and the World were investigated.

RESULTS

Bovine babesiosis was not determined in the microscopic examination. According to the RLB results there was no B. bovis positivity in cattle from the Marmara Region, while only one B. bovis positivity was detected in cattle from the Aegean Region. The molecular prevalence of B. bovis was determined as 0.42% in the total of the examined 235 cattle. The sequenced B. bovis isolate shared 91-92% and 89-96% identities with the isolates from Turkey and the World, respectively.

CONCLUSION

Molecular characterization of msa-2c gene region of B. bovis detected from cattle in the Aegean Region was carried out in this study.