Preferences of different tick species for human hosts in Turkey

Perception of Ticks and Tick-Borne Diseases Worldwide

In this comprehensive review study, we addressed the challenge posed by ticks and tick-borne diseases (TBDs) with growing incidence affecting human and animal health worldwide. Data and perspectives were collected from different countries and regions worldwide, including America, Europe, Africa, Asia, and Oceania. The results updated the current situation with ticks and TBD and how it is perceived by society with information bias and gaps. The study reinforces the importance of multidisciplinary and international collaborations to advance in the surveillance, communication and proposed future directions to address these challenges.

Arthropod vectors of disease agents: their role in public and veterinary health in Turkiye and their control measures

Mosquitoes, sandflies, and ticks are hematophagous arthropods that pose a huge threat to public and veterinary health. They are capable of serving as vectors of disease agents that can and have caused explosive epidemics affecting millions of people and animals. Several factors like climate change, urbanization, and international travel contribute substantially to the persistence and dispersal of these vectors from their established areas to newly invaded areas. Once established in their new home, they can serve as vectors for disease transmission or increase the risk of disease emergence. Turkiye is vulnerable to climate change and has experienced upward trends in annual temperatures and rising sea levels, and greater fluctuations in precipitation rates. It is a potential hotspot for important vector species because the climate in various regions is conducive for several insect and acari species and serves as a conduit for refugees and immigrants fleeing areas troubled with armed conflicts and natural disasters, which have increased substantially in recent years. These people may serve as carriers of the vectors or be infected by disease agents that require arthropod vectors for transmission. Although it cannot be supposed that every arthropod species is a competent vector, this review aims to (1)illustrate the factors that contribute to the persistence and dispersal of arthropod vectors, (2)determine the status of the established arthropod vector species in Turkiye and their capability of serving as vectors of disease agents, and (3)assess the role of newly-introduced arthropod vectors into Turkiye and how they were introduced into the country. We also provide information on important disease incidence (if there's any) and control measures applied by public health officials from different provinces.

Molecular detection of zoonotic blood pathogens in ticks from illegally imported turtles in Italy

International trade of animals may represent a gateway for the spreading of zoonotic pathogens and their vectors. Amongst animals, reptiles are commonly illegally imported worldwide, being Italy in the fifth position of importation of these animals. Thus, the current study analysed the pathogens associated with Hyalomma aegyptium ticks, which were collected from illegally imported tortoises from North Africa to Italy. All tick DNA samples were tested by conventional PCR for the presence of Anaplasma spp., Babesia spp., Borrelia spp., Coxiella burnetti, Ehrlichia spp., Hepatozoon spp., Rickettsia spp. and microfilariae of filarioids. Out of 22% (n=161) of ticks screened, 78.9% (n=127) were males and 21.1% (n=34) females. Among them, three male specimens collected from two different turtles (1.9%; 95% CI; 0.5-5.5) scored positive for Anaplasma spp./Ehrlichia spp., whereas all females were negative. BLAST analysis of the sequences obtained from positive samples revealed 99-99.3% nucleotide identity with the sequence of Ehrlichia ewingii available in GenBank. The finding of E. ewingii in ticks from imported reptiles warrants the need for imposing strict rules in the international trade of reptiles to effectively reduce the introduction of exotic pathogens and their vectors in new geographic areas.

Detailed Infestation Spectrums About Biological Stages of Hard Ticks (Acari: Ixodida: Ixodidae) in Humans: A Systematic Review and Meta-Analysis

PURPOSE

A comprehensive systematic meta-analysis review which deals with the degrees and trends of human infestation by biological stages of ticks, the degrees and trends of human infestation by biological stages of ticks in rural and urban areas, the infestation scale of tick attachment sites in body parts of humans, and the degrees of tick infestation in human age groups is critical. Therefore, this systematic meta-analysis review summarizes the above-detailed human infestation spectrums about biological stages of hard ticks.

METHODS

After a preliminary review from 605 papers representing areas of the study objectives, 96 were selected for detailed human infestation spectrums of biological stages of hard ticks.

RESULTS

In general, the results suggest that the adult ticks, and mostly females attack humans more than larval and nymphalid ones, and adult males, respectively. Unlike the trends of human infestation by larval and nymphalid stages of ticks, and the adult, male and female ticks which exhibited approximately a sharply decreasing trend, the global trend of human infestation by hard ticks exhibited approximately a sharply increasing trend over time. Ticks attack humans more in rural area than urban area. Also, the trends of human tick infestation in rural and urban areas exhibit, respectively, a sharp increase and decrease trends over time.

CONCLUSIONS

The majority of ticks mostly attach to human body trunk and extremity than head and neck, and genital area. Ticks attack human age groups of 0-9, 20-39, and 40-59 years more than those aged between 10 and 19 or older than 60 years.

TICKS PARASITIZING THE SPUR-THIGHED TORTOISE (TESTUDO GRAECA) POPULATION OF TUNISIA

From March to April 2017, a total of 147 free-ranging spur-thighed tortoises (Testudo graeca) was captured in different habitat types of northern Tunisia and examined for tick infestation. A total of 134 was infested, yielding an infestation prevalence of 91.2%. From these tortoises, 1,174 ticks were collected, a subsample (10%, n=120) of which was randomly selected and identified; the remaining ticks were stored at -80 C and examined for zoonotic pathogens. Only adult Hyalomma aegyptium were found among the subsample of ticks collected for spur-thighed tortoise. The prevalence of tick infestation did not vary significantly within the study area but differences in intensity were observed in relation to the size of tortoises and the vegetation coverage. Our results provide strong evidence that adult H. aegyptium is the predominant tick species found on wild spur-thighed tortoises in northern Tunisia, where the species is commonly traded illegally across the Mediterranean Basin. Considering the potential transmission of several zoonotic pathogens by H. aegyptium to humans, we highlight the need to develop a surveillance system to prevent the introduction and the spread of tick-borne pathogens in the Mediterranean Basin.

New insights about human tick infestation features: a systematic review and meta-analysis

There are many studies that provide information regarding ticks infesting humans. However, there is no a meta-analysis about the global ranks of tick infestation rates and records, global monthly tick bites and annually and periodically trends of tick infestation rates, and the global tick infestation rates among years, mounts, regions, and countries. The study provides new insights about the above objectives in a global context and therefore performed. After a preliminary review of the 610 papers representing objective areas, 241 were selected for detailed meta-analysis. In general, the global ranks of tick species were, respectively, between 0.01-85.4% and 1-53 for human infestation rates and records. Twenty-six and sixteen tick species have more than 10% and 10 records of human tick infestation rates and records, respectively. It seems these tick species tend to be more blood-feeding on humans and as a result can be more dangerous to humans. The outcome of study demonstrated that there is no difference between seasonal human tick infestation patterns in the northern and southern hemispheres. The most global monthly mean tick bites in humans were observed in June then followed in July, August, May, and September. The global annually and periodically trends of tick infestation rates in humans exhibited decreasing trends over the past decades suggesting the preventive measure to prohibit human tick infestation have been successful. It seems that the ranks of tick infestation rates and records in humans may be as two indexes to illustrate the degree of importance of tick infesting humans.

Comparison of Preferred Bite Sites Between Mites and Ticks on Humans in Korea

Identification of mite and tick bite sites provides important clinical information. The predominant mite species in Korea associated with scrub typhus are Leptotrombidium pallidum and Leptotrombidium scutellare The most abundant tick species is Haemaphysalis longicornis To date, there has been no comparative study on preferred bite sites between mites and ticks in humans. This study included a review of medical records and a field study. For mite bite sites, eschars were checked on 506 patients with scrub typhus, confirmed by indirect immunofluorescence assay or nested polymerase chain reaction on the 56-kDa type-specific antigen gene of Orientia tsutsugamushi Tick bite sites were identified and marked on a diagram for 91 patients who experienced tick bites within the previous year through a field epidemiological investigation. The mite and tick bite sites in Koreans were compared. The most frequently observed mite bite sites were the anterior chest, including the axillae (29.1%) and the abdominal region, including the inguinal area (26.1%). Tick bite sites were most frequent on the lower extremities (33.0%), followed by the abdominal region, including the inguinal area (26.4%), and upper extremities (26.4%). The distribution was significantly different between mite and tick bite sites (P < 0.001). There was a statistically significant difference in the mite bite (P = 0.001), but not tick bite sites (P = 0.985), between men and women. This is the first report on the differences between tick and mite bite sites, and may help clinicians reach a rapid diagnosis of mite- or tick-borne infection.

Natural Anaplasmataceae infection in Rhipicephalus bursa ticks collected from sheep in the French Basque Country

Rhipicephalus bursa is one of 79 species of the genus Rhipicephalus in the family of Ixodidae. In this study, we investigated Anaplasmataceae bacteria associated with R. bursa collected after an epizootic outbreak of ovine anaplasmosis. 76 adult ticks, (60 male and 16 female ticks), were removed from sheep in two farms and all identified as R. bursa, all females were partially engorged. We found that 50% of the ticks were positive in the initial Anaplasmataceae qPCR screening. Bacterial species was identified by analyzing the sequences of amplicons of 23S rRNA, groEL and rpoB genes. 22.4% of ticks contained DNA of Anaplasma phagocytophilum and 7.9% the DNA of Anaplasma ovis. Based on 23S rRNA and groEL genes analysis, we found that 19.7% of ticks contained a potentially new species of Ehrlichia. We propose the status of Candidatus for this uncultured species and we provisionally name it Candidatus Ehrlichia urmitei. No Wolbachia were identified. These results show that R. bursa can be a carrier of Anaplasmataceae bacteria.

The dependence of Hyalomma aegyptium on its tortoise host Testudo graeca in Algeria

Hyalomma aegyptium (Linnaeus, 1758) (Ixodida: Ixodidae) has recently been confirmed as a carrier of numerous pathogenic, including zoonotic, agents. Four environmentally distinct regions of Algeria, located between the humid coastal zone and the arid Saharan Atlas range, were selected in order to compare differences in tick abundance among localities, and the correlations between tick abundance and host population characteristics and other environmental conditions. Sampling was carried out during May and early June in 2010-2012. A total of 1832 H. aegyptium were removed from 201 tortoises. Adult ticks accounted for 52% of the collection. In the pre-adult stages, larvae were dominant. Data on prevalence, intensity (mean ± standard deviation, range) and abundance of tick infestation were calculated for each locality. Locally, prevalences reached 100%. The sex ratio was biased in favour of males (4.2). Intensities of infestation differed significantly among the localities studied for all developmental stages of the tick. The intensity of infestation by adult ticks was positively correlated to the size of the tortoise and with tortoise population density in the habitat. However, findings for immature tick stages were independent of both variables. No significant correlations between infestation intensities and the climatic parameters tested were found. Immature ticks were observed to prefer the front parts of their tortoise hosts, whereas the majority of adults were attached to the rear parts.

Detection of Rickettsia and Ehrlichia spp. in Ticks Associated with Exotic Reptiles and Amphibians Imported into Japan

One of the major routes of transmission of rickettsial and ehrlichial diseases is via ticks that infest numerous host species, including humans. Besides mammals, reptiles and amphibians also carry ticks that may harbor Rickettsia and Ehrlichia strains that are pathogenic to humans. Furthermore, reptiles and amphibians are exempt from quarantine in Japan, thus facilitating the entry of parasites and pathogens to the country through import. Accordingly, in the current study, we examined the presence of Rickettsia and Ehrlichia spp. genes in ticks associated with reptiles and amphibians originating from outside Japan. Ninety-three ticks representing nine tick species (genera Amblyomma and Hyalomma) were isolated from at least 28 animals spanning 10 species and originating from 12 countries (Ghana, Jordan, Madagascar, Panama, Russia, Sri Lanka, Sudan, Suriname, Tanzania, Togo, Uzbekistan, and Zambia). None of the nine tick species are indigenous in Japan. The genes encoding the common rickettsial 17-kDa antigen, citrate synthase (gltA), and outer membrane protein A (ompA) were positively detected in 45.2% (42/93), 40.9% (38/93), and 23.7% (22/93) of the ticks, respectively, by polymerase chain reaction (PCR). The genes encoding ehrlichial heat shock protein (groEL) and major outer membrane protein (omp-1) were PCR-positive in 7.5% (7/93) and 2.2% (2/93) of the ticks, respectively. The p44 gene, which encodes the Anaplasma outer membrane protein, was not detected. Phylogenetic analysis showed that several of the rickettsial and ehrlichial sequences isolated in this study were highly similar to human pathogen genes, including agents not previously detected in Japan. These data demonstrate the global transportation of pathogenic Rickettsia and Ehrlichia through reptile- and amphibian-associated ticks. These imported animals have potential to transfer pathogens into human life. These results highlight the need to control the international transportation of known and potential pathogens carried by ticks in reptiles, amphibians, and other animals, in order to improve national and international public health.

Transstadial transmission of Borrelia turcica in Hyalomma aegyptium ticks

Borrelia turcica comprises the third major group of arthropod-transmitted borreliae and is phylogenetically divergent from other Borrelia groups. The novel group of Borrelia was initially isolated from Hyalomma aegyptium ticks in Turkey and it was recently found in blood and multiple organs of tortoises exported from Jordan to Japan. However, the ecology of these spirochetes and their development in ticks or the vertebrate hosts were not investigated in detail; our aims were to isolate the pathogen and to evaluate the possibility of transstadial transmission of Borrelia turcica by H. aegyptium ticks. Ticks were collected from Testudo graeca tortoises during the summer of 2013 from southeastern Romania. Engorged nymphs were successfully molted to the adult stage. Alive B. turcica was isolated from molted ticks by using Barbour-Stoenner-Kelly (BSK) II medium. Four pure cultures of spirochetes were obtained and analyzed by PCR and sequencing. Sequence analysis of glpQ, gyrB and flaB revealed 98%–100% similarities with B. turcica. H. aegyptium ticks collected from T. graeca tortoises were able to pass the infection with B. turcica via transstadial route, suggesting its vectorial capacity.

Identification of tick-borne pathogens in ticks feeding on humans in Turkey

Background

The importance of tick-borne diseases is increasing all over the world, including Turkey. The tick-borne disease outbreaks reported in recent years and the abundance of tick species and the existence of suitable habitats increase the importance of studies related to the epidemiology of ticks and tick-borne pathogens in Turkey. The aim of this study was to investigate the presence of and to determine the infection rates of some tick-borne pathogens, including Babesia spp., Borrelia burgdorferi sensu lato and spotted fever group rickettsiae in the ticks removed from humans in different parts of Ankara.

Methodology/Principal Findings

A total of 169 ticks belonging to the genus Haemaphysalis, Hyalomma, Ixodes and Rhipicephalus were collected by removing from humans in different parts of Ankara. Ticks were molecularly screened for Babesia spp., Borrelia burgdorferi sensu lato and spotted fever group rickettsiae by PCR and sequencing analysis. We detected 4 Babesia spp.; B. crassa, B. major, B. occultans and B. rossi, one Borrelia spp.; B. burgdorferi sensu stricto and 3 spotted fever group rickettsiae; R. aeschlimannii, R. slovaca and R. hoogstraalii in the tick specimens analyzed. This is the report showing the presence of B. rossi in a region that is out of Africa and in the host species Ha. parva. In addition, B. crassa, for which limited information is available on its distribution and vector species, and B. occultans, for which no conclusive information is available on its presence in Turkey, were identified in Ha. parva and H. marginatum, respectively. Two human pathogenic rickettsia species (R. aeschlimannii and R. slovaca) were detected with a high prevalence in ticks. Additionally, B. burgdorferi sensu stricto was detected in unusual tick species (H. marginatum, H. excavatum, Hyalomma spp. (nymph) and Ha. parva).

Conclusions/Significance

This study investigates both the distribution of several tick-borne pathogens affecting humans and animals, and the presence of new tick-borne pathogens in Turkey. More epidemiological studies are warranted for B. rossi, which is very pathogenic for dogs, because the presented results suggest that B. rossi might have a wide distribution in Turkey. Furthermore, we recommend that tick-borne pathogens, especially R. aeschlimannii, R. slovaca, and B. burgdorferi sensu stricto, should be taken into consideration in patients who had a tick bite in Turkey.

Ticks are widespread in over all Turkey. Primary tick-borne diseases (TBDs), such as theileriosis, babesiosis, and anaplasmosis, affecting animals have been known for a long time in Turkey. However, TBDs have become a major concern in humans in recent years due to the recent Crimean-Congo hemorrhagic fever outbreak in Turkey. We know that some TBDs like CCHF, Lyme borreliosis, spotted fever group rickettsiosis, babesiosis and anaplasmosis exist in this geography. However, the other diseases except for CCHF are neglected in patients. In this study, we aimed to investigate Babesia spp., Borrelia burgdorferi sensu lato and spotted fever group rickettsiae in ticks removed from humans in different parts of Ankara by using PCR and sequencing. The result of this study showed that 4 Babesia species, one B. burgdorferi sensu lato, and 3 spotted fever group rickettsia are detected in ticks. The most striking result of this study is that B. rossi, which is very pathogenic for dogs, was reported for the first time from a region that is out of Africa and in Ha. parva. Therefore, B. rossi should be considered in dogs in Turkey. Furthermore, we propose that R. aeschlimannii, R. slovaca, and B. burgdorferi sensu stricto should be taken into consideration in patients who had a tick bite in Ankara.