1
|
Kubiak JM, Klevay M, Hilt EE, Ferrieri P. Acute Meningoencephalitis Associated with Borrelia miyamotoi, Minnesota, USA. Emerg Infect Dis 2024; 30:1472-1474. [PMID: 38916722 PMCID: PMC11210636 DOI: 10.3201/eid3007.231611] [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: 06/26/2024] Open
Abstract
Borrelia miyamotoi is an emerging tickborne pathogen that has been associated with central nervous system infections in immunocompromised patients, albeit infrequently. We describe a case-patient in Minnesota, USA, who had meningeal symptoms of 1 month duration. B. miyamotoi infection was diagnosed by Gram staining on cerebrospinal fluid and confirmed by sequencing.
Collapse
|
2
|
Janzén T, Choudhury F, Hammer M, Petersson M, Dinnétz P. Ticks - public health risks in urban green spaces. BMC Public Health 2024; 24:1031. [PMID: 38614967 PMCID: PMC11015579 DOI: 10.1186/s12889-024-18540-8] [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: 11/22/2023] [Accepted: 04/07/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Urban green spaces are important for human health, but they may expose visitors to tick-borne diseases. This not only presents a potential public health challenge but also undermines the expected public health gains from urban green spaces. The aim of this study is to assess the public health risk of tick-borne diseases in an urban green space used for recreation in Stockholm, Sweden. METHODS We used a mixed method approach identifying both the magnitude of the tick hazard and the extent of the human exposure to tick-borne diseases. At six entry points to an urban green space, we sampled ticks and documented microhabitat conditions from five randomly assigned 2 m × 2 m plots. Surrounding habitat data was analyzed using geographical information system (GIS). Nymphs and adult ticks were tested for Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum using TaqMan qPCR. Positive B. burgdorferi (s.l.) ticks were further analyzed by nested PCR amplification and sequence analysis. Population census data and visitor count data were used to estimate the degree of human exposure to tick-borne diseases. To further understand the degree to which visitors get in contact with infected ticks we also conducted interviews with visitors to green spaces. RESULTS High tick densities were commonly found in humid broadleaved forest with low field vegetation. High pathogen prevalence was significantly correlated with increasing proportions of artificial areas. Integrating the tick hazard with human exposure we found that the public health risk of tick-borne diseases was moderate to high at most of the studied entry points. Many of the visitors frequently used urban green spaces. Walking was the most common activity, but visitors also engaged in activities with higher risk for tick encounters. Individual protective measures were connected to specific recreational activities such as picking berries or mushrooms. CONCLUSIONS The number of visitors can be combined with tick inventory data and molecular analyses of pathogen prevalence to make crude estimations of the public health risk of tick-borne diseases in urban green spaces. The risk of encountering infected ticks is omnipresent during recreational activities in urban green spaces, highlighting the need for public health campaigns to reduce the risk of tick-borne diseases.
Collapse
Affiliation(s)
- Thérese Janzén
- Department of Natural Science, Environment and Technology, Södertörn University, Hudding, Sweden.
| | - Firoza Choudhury
- Department of Natural Science, Environment and Technology, Södertörn University, Hudding, Sweden
| | - Monica Hammer
- Department of Natural Science, Environment and Technology, Södertörn University, Hudding, Sweden
| | - Mona Petersson
- Department of Natural Science, Environment and Technology, Södertörn University, Hudding, Sweden
| | - Patrik Dinnétz
- Department of Natural Science, Environment and Technology, Södertörn University, Hudding, Sweden
| |
Collapse
|
3
|
Jaenson TGT, Gray JS, Lindgren PE, Wilhelmsson P. Coinfection of Babesia and Borrelia in the Tick Ixodes ricinus-A Neglected Public Health Issue in Europe? Pathogens 2024; 13:81. [PMID: 38251388 PMCID: PMC10818971 DOI: 10.3390/pathogens13010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
Ixodes ricinus nymphs and adults removed from humans, and larvae and nymphs from birds, have been analysed for infection with Babesia species and Borrelia species previously in separately published studies. Here, we use the same data set to explore the coinfection pattern of Babesia and Borrelia species in the ticks. We also provide an overview of the ecology and potential public health importance in Sweden of I. ricinus infected both with zoonotic Babesia and Borrelia species. Among 1952 nymphs and adult ticks removed from humans, 3.1% were PCR-positive for Babesia spp. Of these Babesia-positive ticks, 43% were simultaneously Borrelia-positive. Among 1046 immatures of I. ricinus removed from birds, 2.5% were Babesia-positive, of which 38% were coinfected with Borrelia species. This study shows that in I. ricinus infesting humans or birds in Sweden, potentially zoonotic Babesia protozoa sometimes co-occur with human-pathogenic Borrelia spp. Diagnostic tests for Babesia spp. infection are rarely performed in Europe, and the medical significance of this pathogen in Europe could be underestimated.
Collapse
Affiliation(s)
- Thomas G. T. Jaenson
- Evolutionary Biology Centre, Department of Organismal Biology, Uppsala University, Norbyvägen 18d, SE-752 36 Uppsala, Sweden;
| | - Jeremy S. Gray
- UCD School of Biology and Environmental Science, University College Dublin, D04 N2E5 Dublin, Ireland;
| | - Per-Eric Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden;
- Department of Clinical Microbiology, Region Jönköping County, SE-551 11 Jönköping, Sweden
| | - Peter Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden;
- Department of Clinical Microbiology, Region Jönköping County, SE-551 11 Jönköping, Sweden
| |
Collapse
|
4
|
Carlströmer Berthén N, Tompa E, Olausson S, Nyberg C, Nyman D, Ringbom M, Perander L, Svärd J, Lindgren PE, Forsberg P, Wilhelmsson P, Sjöwall J, Nordberg M. The AxBioTick Study: Borrelia Species and Tick-Borne Encephalitis Virus in Ticks, and Clinical Responses in Tick-Bitten Individuals on the Aland Islands, Finland. Microorganisms 2023; 11:1100. [PMID: 37317075 DOI: 10.3390/microorganisms11051100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 06/16/2023] Open
Abstract
The AxBioTick study was initiated to investigate the prevalence of ticks and tick-borne pathogens and their impact on antibody and clinical responses in tick-bitten individuals on the Aland Islands. This geographical area is hyperendemic for both Lyme borreliosis (LB) and Tick-borne encephalitis (TBE). Blood samples and ticks were collected from 100 tick-bitten volunteers. A total of 425 ticks was collected, all determined to Ixodes ricinus using molecular tools. Of them 20% contained Borrelia species, of which B. garinii and B. afzelii were most common. None contained the TBE virus (TBEV). Blood samples were drawn in conjunction with the tick bite, and eight weeks later. Sera were analyzed for Borrelia- and TBEV-specific antibodies using an ELISA and a semiquantitative antibody assay. In total 14% seroconverted in Borrelia C6IgG1, 3% in TBEV IgG, and 2% in TBEV IgM. Five participants developed clinical manifestations of LB. The high seroprevalence of both Borrelia (57%) and TBEV (52%) antibodies are likely attributed to the endemic status of the corresponding infections as well as the TBE vaccination program. Despite the similar prevalence of Borrelia spp. detected in ticks in other parts of Europe, the infection rate in this population is high. The AxBioTick study is continuing to investigate more participants and ticks for co-infections, and to characterize the dermal immune response following a tick bite.
Collapse
Affiliation(s)
- Nellie Carlströmer Berthén
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
- Bimelix AB, 22100 Mariehamn, The Aland Islands, Finland
| | - Eszter Tompa
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden
| | - Susanne Olausson
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
- Bimelix AB, 22100 Mariehamn, The Aland Islands, Finland
| | - Clara Nyberg
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
| | - Dag Nyman
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
- Bimelix AB, 22100 Mariehamn, The Aland Islands, Finland
| | - Malin Ringbom
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
- The Aland Islands Healthcare Services, 22100 Mariehamn, The Aland Islands, Finland
| | - Linda Perander
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
- The Aland Islands Healthcare Services, 22100 Mariehamn, The Aland Islands, Finland
| | - Joel Svärd
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden
| | - Per-Eric Lindgren
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden
- Clinical Microbiology, Laboratory Medicine, County Hospital Ryhov, 551 85 Jonkoping, Sweden
| | - Pia Forsberg
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden
| | - Peter Wilhelmsson
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden
- Clinical Microbiology, Laboratory Medicine, County Hospital Ryhov, 551 85 Jonkoping, Sweden
| | - Johanna Sjöwall
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linkoping University, 581 83 Linkoping, Sweden
- Department of Infectious Diseases, Vrinnevi Hospital, 603 79 Norrkoping, Sweden
| | - Marika Nordberg
- Borrelia Research Group of the Aland Islands, 22100 Mariehamn, The Aland Islands, Finland
- The Aland Islands Healthcare Services, 22100 Mariehamn, The Aland Islands, Finland
| |
Collapse
|
5
|
Guccione C, Colomba C, Iaria C, Cascio A. Rickettsiales in the WHO European Region: an update from a One Health perspective. Parasit Vectors 2023; 16:41. [PMID: 36717936 PMCID: PMC9885594 DOI: 10.1186/s13071-022-05646-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/29/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The availability of molecular techniques has significantly increased our understanding of bacteria of the order Rickettsiales, allowing the identification of distinct species in both vector and host arthropods. However, the literature lacks studies that comprehensively summarize the vast amount of knowledge generated on this topic in recent years. The purpose of this study was to conduct a comprehensive analysis of the distribution of Rickettsiales in arthropod vectors, animals and humans in the WHO European Region in order to provide useful information to predict the emergence of certain diseases in specific geographical areas and to formulate hypotheses regarding the possible pathogenetic role of some rickettsial species in the etiology of human pathological conditions. METHODS A systematic review of the literature in the PubMed and EMBASE databases was conducted following the PRISMA methodology using the search terms "Spotted fever" OR "rickettsiosis" OR "ricketts*" AND all the countries of the WHO European Region, from 1 January 2013 to 12 February 2022. Only studies that identified rickettsiae in human, animal or arthropod samples using molecular techniques were included in the review. RESULTS A total of 467 articles considering 61 different species of Rickettsiales with confirmed or suspected human pathogenicity were analyzed in the review. More than 566 identifications of Rickettsiales DNA in human samples were described, of which 89 cases were assessed as importation cases. A total of 55 species of ticks, 17 species of fleas, 10 species of mite and four species of lice were found infected. Twenty-three species of Rickettsiales were detected in wild and domestic animal samples. CONCLUSION The routine use of molecular methods to search for Rickettsiales DNA in questing ticks and other blood-sucking arthropods that commonly bite humans should be encouraged. Molecular methods specific for Rickettsiales should be used routinely in the diagnostics of fever of unknown origin and in all cases of human diseases secondary to an arthropod bite or animal contact.
Collapse
Affiliation(s)
- Cristoforo Guccione
- grid.10776.370000 0004 1762 5517Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Claudia Colomba
- grid.10776.370000 0004 1762 5517Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy ,grid.419995.9Pediatric Infectious Disease Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Chiara Iaria
- grid.419995.9Infectious Disease Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Antonio Cascio
- grid.10776.370000 0004 1762 5517Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy ,Infectious and Tropical Disease Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
| |
Collapse
|
6
|
Boyer PH, Lenormand C, Jaulhac B, Talagrand-Reboul E. Human Co-Infections between Borrelia burgdorferi s.l. and Other Ixodes-Borne Microorganisms: A Systematic Review. Pathogens 2022; 11:pathogens11030282. [PMID: 35335606 PMCID: PMC8948674 DOI: 10.3390/pathogens11030282] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/14/2022] [Accepted: 02/19/2022] [Indexed: 01/03/2023] Open
Abstract
When it comes to tick-borne diseases, co-infections are often mentioned. This concept includes several entities. On the one hand, tick vectors or vertebrate reservoir host can harbor several microorganisms that can be pathogenic for humans. On the other hand, human co-infections can also be understood in different ways, ranging from seropositivity without clinical symptoms to co-disease, i.e., the simultaneous clinical expression of infections by two tick-borne microorganisms. The latter, although regularly speculated, is not often reported. Hence, we conducted a systematic review on co-infections between B. burgdorferi s.l., the etiological agent of Lyme borreliosis, and other microorganisms potentially transmitted to humans by Ixodes spp. ticks. A total of 68 relevant articles were included, presenting 655 cases of possible co-infections. Most cases of co-infections corresponded to patients with one tick-borne disease and presenting antibody against another tick-borne microorganism. Co-disease was particularly frequent in two situations: patients with clinical symptoms of high fever and erythema migrans (EM), and patients with neurological symptoms linked to the TBEv or a neuroborreliosis. No impact on severity was evidenced. Further studies are needed to better appreciate the frequency and the impact of co-infections between several tick-borne microorganisms.
Collapse
Affiliation(s)
- Pierre H. Boyer
- Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, UR7290, ITI InnoVec, 3 Rue Koeberlé, F-67000 Strasbourg, France; (C.L.); (B.J.); (E.T.-R.)
- Correspondence:
| | - Cédric Lenormand
- Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, UR7290, ITI InnoVec, 3 Rue Koeberlé, F-67000 Strasbourg, France; (C.L.); (B.J.); (E.T.-R.)
- Service de Dermatologie, Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, F-67000 Strasbourg, France
| | - Benoît Jaulhac
- Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, UR7290, ITI InnoVec, 3 Rue Koeberlé, F-67000 Strasbourg, France; (C.L.); (B.J.); (E.T.-R.)
- French National Reference Center for Borrelia, Hôpitaux Universitaires de Strasbourg, F-67000 Strasbourg, France
| | - Emilie Talagrand-Reboul
- Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, UR7290, ITI InnoVec, 3 Rue Koeberlé, F-67000 Strasbourg, France; (C.L.); (B.J.); (E.T.-R.)
| |
Collapse
|
7
|
Lager M, Wilhelmsson P, Matussek A, Lindgren PE, Henningsson AJ. Molecular Detection of Borrelia Bacteria in Cerebrospinal Fluid-Optimisation of Pre-Analytical Sample Handling for Increased Analytical Sensitivity. Diagnostics (Basel) 2021; 11:diagnostics11112088. [PMID: 34829435 PMCID: PMC8623531 DOI: 10.3390/diagnostics11112088] [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: 10/08/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
The main tools for clinical diagnostics of Lyme neuroborreliosis (LNB) are based on serology, i.e., detection of antibodies in cerebrospinal fluid (CSF). In some cases, PCR may be used as a supplement, e.g., on CSF from patients with early LNB. Standardisation of the molecular methods and systematic evaluation of the pre-analytical handling is lacking. To increase the analytical sensitivity for detection of Borrelia bacteria in CSF by PCR targeting the 16S rRNA gene, parameters were systematically evaluated on CSF samples spiked with a known amount of cultured Borrelia bacteria. The results showed that the parameters such as centrifugation time and speed, the use of complementary DNA as a template (in combination with primers and a probe aiming at target gene 16S rRNA), and the absence of inhibitors (e.g., erythrocytes) had the highest impact on the analytical sensitivity. Based on these results, a protocol for optimised handling of CSF samples before molecular analysis was proposed. However, no clinical evaluation of the proposed protocol has been done so far, and further investigations of the diagnostic sensitivity need to be performed on well-characterised clinical samples from patients with LNB.
Collapse
Affiliation(s)
- Malin Lager
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
- Correspondence: ; Tel.: +46-(0)10-2425238
| | - Peter Wilhelmsson
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Andreas Matussek
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Laboratory Medicine, Oslo University Hospital, 0450 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
| | - Per-Eric Lindgren
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Anna J. Henningsson
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
- Division of Clinical Microbiology, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| |
Collapse
|