Ehrlichial diseases

Common and atypical presentations of Anaplasma phagocytophilum infection in equids with emphasis on neurologic and muscle disease

BACKGROUND

Comprehensive descriptions of equids with granulocytic anaplasmosis (EGA) with neurologic or muscle disease and other atypical presentations are scarce in the literature.

OBJECTIVE

Describe the clinical signs, laboratory findings, treatment, and outcome of equids with EGA with emphasis on neurologic and muscle disease.

ANIMALS

Thirty-eight horses, 1 donkey.

METHODS

Retrospective study. Equids with EGA were included. The electronic data base was searched from January 2000 to December 2022 using the words anaplasmosis, ehrlichiosis, granulocytic, and rickettsia. Signalment and clinical data were reviewed. Data were evaluated for normality using Shapiro-Wilk test. Parametric and nonparametric statistics were used for normally and non-normally distributed data.

RESULTS

Common (41%) and other (59%) presentations were seen in horses ≥ 4 years of age (median, 14 years) with an overrepresentation of males (77%). Neurologic disease was common (41%), mainly presenting as diffuse symmetrical proprioceptive ataxia. Brain disease was less common manifesting as obtundation and cranial nerve deficits. Muscle disease was less common, with QH breeds with the variant causing myosin heavy chain myopathy (MYHM) having severe disease. Cavitary effusion, cardiomyopathy and disseminated intravascular coagulation (DIC) were uncommon. Clinical laboratory results varied depending on disease stage. Muscle enzyme activities were significantly higher in horses with muscle disease. Outcome was favorable with prompt tetracycline treatment. Death and long-term sequelae were not reported.

CONCLUSIONS AND CLINICAL IMPORTANCE

Common and atypical presentations of EGA have a favorable outcome with prompt tetracycline treatment. Quarter horse breeds with muscle disease should be genotyped for MYHM.

Detection and Genotypic Analysis of Anaplasma bovis and A. phagocytophilum in Horse Blood and Lung Tissue

A clinical case of Anaplasma bovis was reported for the first time in our previous study (2019) in a horse, a nondefinitive host. Although A. bovis is a ruminant and not a zoonotic pathogen, it is responsible for persistent infections in horses. In this follow-up study, the prevalence of Anaplasma spp., including A. bovis, was assessed in horse blood and lung tissue samples to fully understand Anaplasma spp. pathogen distribution and the potential risk factors of infection. Among 1696 samples, including 1433 blood samples from farms nationwide and 263 lung tissue samples from horse abattoirs on Jeju Island, a total of 29 samples (1.7%) tested positive for A. bovis and 31 (1.8%) samples tested positive for A. phagocytophilum, as determined by 16S rRNA nucleotide sequencing and restriction fragment length polymorphism. This study is the first to detect A. bovis infection in horse lung tissue samples. Further studies are needed to clarify the comparison of sample types within cohorts. Although the clinical significance of Anaplasma infection was not evaluated in this study, our results emphasize the need to clarify the host tropism and genetic divergence of Anaplasma to enable the development of effective prevention and control measures through broad epidemiological studies.

Improved molecular detection of Neorickettsia risticii with a duplex real-time PCR assay in the diagnosis of Potomac horse fever

Neorickettsia risticii, an obligate intracellular bacterium, is the causative agent of Potomac horse fever (PHF). Diagnosis of PHF is based on demonstration of serum antibodies, isolation of N. risticii, and/or detection of nucleic acid by a PCR assay. An existing real-time PCR assay targeting the N. risticii 16S rRNA has been validated using blood samples from horses with colitis, and snails; to our knowledge, the performance of the assay for other sample types has not been reported. We describe here a modification of the 16S rRNA gene assay by the addition of a set of primers and probe targeting the N. risticii p51 gene to form a duplex assay. We validated the new assay using diagnostic specimens from 56 horses with suspected PHF. The assay consistently detected down to 5 copies of synthetic targets, and did not show any cross-reaction with common equine enteric pathogens. Although we did not establish the diagnostic sensitivity and specificity of the duplex assay, results for both gene targets were in complete agreement, with the exception of 4 fecal samples that tested positive for the 16S rRNA gene only. Further analysis indicated that testing of fecal samples using our 16S rRNA gene assay alone can produce a false-positive result.

Molecular surveillance of tick-borne diseases affecting horses in Poland-Own observations

The purpose of the study was to carry out the molecular surveillance of piroplasmosis, granulocytic anaplasmosis and lyme borreliosis in horses which originated from Poland and exhibited symptoms raising the suspicion of the aforementioned disease units. The presence of Theileria equi genetic material was detected in 37 out of 512 examined horses (7.2%), and Anaplasma phagocytophilum in 9 (1.8%). The DNA of Borrelia burgdorferi was found in 11 out of 204 examined horses (5.4%). The above-cited results indicate that the problem of tick-borne diseases affecting horses in Poland is not as significant as in other parts of Europe, however they have to be considered in differential diagnosis of the diseases with lethargy, fever, anaemia and thrombocytopenia.

Equine Granulocytic Anaplasmosis, A Neglected Disease: Risk Factors Associated with Prevalence of Antibodies in Equines

Background:

Anaplasma phagocytophilum, a tick-borne bacterium that causes granulocytic anaplasmosis, is a neglected pathogen in Brazil, and is diagnosed in several species of domestic and wild animals as well as in humans.

Objective:

This study aimed to investigate the prevalence of anti-A. phagocytophilum antibodies in Equidae from the state of Rio de Janeiro and to identify possible risk factors for infection.

Materials and Methods:

A total of 612 blood samples were collected from horses from 15 municipalities within the state. Moreover, an epidemiological questionnaire was administered to evaluate aspects related to seroreaction, taking into account the spatial distribution (properties, municipalities, and mesoregions), management practices, signs of disease, and the individual state of the animals. For the diagnosis, indirect immunofluorescence was performed.

Results:

In the present study, 124 (20.26%), out of a total of 612, animals with anti-A. phagocytophilum IgG antibodies at titers of 1:80 were detected. Multivariate logistic regression analysis showed that the presence of the infection at the property (P <0.0001) and the origin (P = 0.0095) of the horse were the true risk factors for infection in the state of Rio de Janeiro.

Conclusion:

This allows to infer that the bacterium is distributed in all mesoregions of the state of Rio de Janeiro and that animals from other states can introduce the infection and make a property a focus of disease; it can also be inferred that these properties are important in the maintenance of the disease and the permanence of bacteria circulating in horses. It is also noteworthy that this was the first identification of mules as hosts of A. phagocytophilum infection.

Anaplasma bovis infection in a horse: First clinical report and molecular analysis

A 23-year-old male Thoroughbred horse at the Korean Military Academy appeared thin with visible rib bones and presented clinical signs of fever, anorexia, lethargy, and severe dehydration. To determine the presence of various febrile disease-causing agents, the 23 cohabiting horses at the academy, including this horse, were subjected to hematology, blood chemistry, and molecular analysis using whole blood samples collected during regular medical check-ups. On the basis of clinical history, physical examination, hematology, blood chemistry, and fecal examination, differential diagnosis using molecular analyses was performed for various febrile disease-causing agents, including Lyme borreliae, Coxiella, piroplasms (Babesia and Theileria), Rickettsiales (Anaplasma, Ehrlichia, and Rickettsia), equine herpesvirus, equine infectious anemia virus, and equine arteritis virus. While other pathogens were not detected, PCR and phylogenetic analysis targeting the Anaplasma 16S rRNA gene revealed that the horse was infected with Anaplasma bovis. Although PCR targeting the groEL and gltA genes of A. bovis was not successful, the restriction enzyme fragment length polymorphism assay for differential diagnosis and determination of coinfectivity between Anaplasma phagocytophilum and A. bovis confirmed the pathogen as A. bovis. To the best of our knowledge, this is the first clinical report of A. bovis infection in a horse, suggesting a new reservoir host.

Immunogenicity of Potomac horse fever vaccine when simultaneously co-administered with rabies vaccine in a multivalent vaccine or as two monovalent vaccines at separate sites

Background

Potomac horse fever (PHF) is a potentially fatal enterocolitis of horses caused by Neorickettsia risticii. The disease was originally recognised almost 40 years ago in the state of Maryland in the US. It is now known to occur in many areas of North America, as well as having been described in South America and Europe. Monocomponent PHF vaccines are available, but clinical protection with vaccination has been reported to be inconsistent.

Objectives

This study was designed to assess the immunogenicity of a commercially available Potomac Horse Fever (PHF) vaccine when administered as either a monovalent PHF vaccine simultaneously co‐administered with a separate monovalent Rabies vaccine or as a multivalent PHF/Rabies vaccine in horses.

Study design

Randomised parallel group trial.

Methods

Ninety‐one client or University owned horses participated in this open‐label randomised study, with 45 horses receiving the monovalent vaccines at separate sites and 46 receiving the multivalent vaccine at a single site. Serum PHF IFA titres were determined twice prior to vaccination and at 1, 2 and 3 months after vaccination.

Results

Both vaccination protocols exhibited poor immunogenicity, with only one‐third of all the animals demonstrating seroconversion, defined as an increase in titre of greater than 400 over baseline, at any time point after vaccination. The monovalent PHF vaccine exhibited significantly greater immunogenicity in terms of the number of horses exhibiting seroconversion, as compared to the multivalent vaccine, at one (20 vs. 11, P = 0.03) and two (18 vs. 9, p = 0.02) months post vaccination. The monovalent PHF vaccine also exhibited significantly greater immunogenicity in terms of the median (interquartile range) IFA titres, as compared to the multivalent vaccine, at one (800 [200–1600] vs. 400 [200–800], P = 0.009) and 2 months (400 [200–1600] vs. 400 [100–800], P = 0.02) post vaccination. There was no significant difference between groups at 3 months in either seroconversion rate or median IFA titers.

Main limitations

This study did not assess the actual protective effects of PHF vaccination but rather used the serologic response to vaccination as a surrogate biomarker of immunity.

Conclusions

The multivalent PHF/Rabies vaccine exhibited lower immunogenicity as compared to the monovalent PHF vaccine co‐administered with a separate Rabies vaccine.

Equine Granulocytic Anaplasmosis 28 years later

Equine granulocytic anaplasmosis (EGA) is an important tick borne disease of equines that is caused by Anaplasma phagocytophilum (A. phagocytophilum). The etiological agent has veterinary as well as public health importance because of its zoonotic nature. A. phagocytophilum causes an acute illness in equines with loss of appetite, lethargy, hemorrhages and lameness. Clinically, EGA is diagnosed upon examination of morulae within neutrophils especially granulocytes in the blood. The best diagnostic tool for the detection of EGA is Polymerase chain reaction (PCR). Previous studies suggested that EGA is a self-limiting disease and tetracycline therapy is considered as a best treatment regimen. There is no comprehensive summary on the occurrence and distribution of the infection at global level. Therefore, we intended to provide a comprehensive summary on the prevalence and epidemiology of EGA in different areas of the world. It includes mapping the global distribution of EGA in different areas of the world to identify the endemic regions which may be a source of potential disease outbreak. For this purpose, the published data from 1990 to 2018 on EGA was reviewed and collected by electronic literature search of five databases including Google, Google Scholar, Science Direct, PubMed and Web of Science.

Ocular Manifestations of Systemic Disease in the Horse

Many systemic diseases have ocular manifestations. In some cases, ocular abnormalities are the most obvious or first recognized sign of disease that prompts veterinary evaluation. In other cases, the systemic disease leads to secondary ocular changes that might lead to loss of vision or globe if not addressed. Therefore, recognition of ocular abnormalities that might result from systemic diseases is an essential skill for the equine practitioner. This article provides practitioners with information regarding the most common systemic diseases of horses in North America that have ocular manifestations, organized by ocular signs.

Post-mortem hemoparasite detection in free-living Brazilian brown brocket deer (Mazama gouazoubira, Fischer 1814)

Tick-borne infections can result in serious health problems for wild ruminants, and some of these infectious agents can be considered zoonosis. The aim of the present study was the post-mortem detection of hemoparasites in free-living Mazama gouazoubira from Minas Gerais state, Brazil. The deer samples consisted of free-living M. gouazoubira (n = 9) individuals that died after capture. Necropsy examinations of the carcasses were performed to search for macroscopic alterations. Organ samples were collected for subsequent imprint slides, and nested PCR assays were performed to detect hemoparasite species. Imprint slide assays from four deer showed erythrocytes infected with Piroplasmida small trophozoites, and A. marginale corpuscles were observed in erythrocytes from two animals. A. marginale and trophozoite co-infections occurred in two deer. A nested PCR analysis of the organs showed that six of the nine samples were positive for Theileria sp., five were positive for A. phagocytophilum and three were positive for A. marginale, with co-infection occurring in four deer. The results of the present study demonstrate that post-mortem diagnostics using imprint slides and molecular assays are an effective method for detecting hemoparasites in organs.

Prevalence of selected rickettsial infections in cats in Southern Germany

Prevalence of Anaplasma, Ehrlichia, Neorickettsia, and Wolbachia DNA in blood of 479 cats collected in different veterinary clinics in Southern Germany was determined using a previously published conventional PCR using 16S-23S intergenic spacer primers (5' CTG GGG ACT ACG GTC GCA AGA C 3' - forward; 5' CTC CAG TTT ATC ACT GGA AGT T 3' - reverse). Purified amplicons were sequenced to confirm genus and species. Associations between rickettsial infections, and feline immunodeficiency virus (FIV), as well as feline leukemia virus (FeLV) status were evaluated. Rickettsial prevalence was 0.4% (2/479; CI: 0.01-1.62%). In the two infected cats, Anaplasma phagocytophilum DNA was amplified. These cats came from different environment and had outdoor access. Both were ill with many of their problems likely related to other diseases. However, one cat had neutrophilia with left shift and the other thrombocytopenia potentially caused by their A. phagocytophilum infection. There was no significant difference in the FIV and FeLV status between A. phagocytophilum-negative and -positive cats. A. phagocytophilum can cause infection in cats in Southern Germany, and appropriate tick control is recommended.

Large scale screening of digeneans for Neorickettsia endosymbionts using real-time PCR reveals new Neorickettsia genotypes, host associations and geographic records

Digeneans are endoparasitic flatworms with complex life cycles including one or two intermediate hosts (first of which is always a mollusk) and a vertebrate definitive host. Digeneans may harbor intracellular endosymbiotic bacteria belonging to the genus Neorickettsia (order Rickettsiales, family Anaplasmataceae). Some Neorickettsia are able to invade cells of the digenean's vertebrate host and are known to cause diseases of wildlife and humans. In this study we report the results of screening 771 digenean samples for Neorickettsia collected from various vertebrates in terrestrial, freshwater, brackish, and marine habitats in the United States, China and Australia. Neorickettsia were detected using a newly designed real-time PCR protocol targeting a 152 bp fragment of the heat shock protein coding gene, GroEL, and verified with nested PCR and sequencing of a 1371 bp long region of 16S rRNA. Eight isolates of Neorickettsia have been obtained. Sequence comparison and phylogenetic analysis demonstrated that 7 of these isolates, provisionally named Neorickettsia sp. 1-7 (obtained from allocreadiid Crepidostomum affine, haploporids Saccocoelioides beauforti and Saccocoelioides lizae, faustulid Bacciger sprenti, deropegid Deropegus aspina, a lecithodendriid, and a pleurogenid) represent new genotypes and one (obtained from Metagonimoides oregonensis) was identical to a published sequence of Neorickettsia known as SF agent. All digenean species reported in this study represent new host records. Three of the 6 digenean families (Haploporidae, Pleurogenidae, and Faustulidae) are also reported for the first time as hosts of Neorickettsia. We have detected Neorickettsia in digeneans from China and Australia for the first time based on PCR and sequencing evidence. Our findings suggest that further surveys from broader geographic regions and wider selection of digenean taxa are likely to reveal new Neorickettsia lineages as well as new digenean host associations.

Anaplasma phagocytophilum strains from voles and shrews exhibit specific ankA gene sequences

Background

Anaplasma phagocytophilum is a Gram-negative bacterium that replicates obligate intracellularly in neutrophils. It is transmitted by Ixodes spp. ticks and causes acute febrile disease in humans, dogs, horses, cats, and livestock. Because A. phagocytophilum is not transmitted transovarially in Ixodes spp., it is thought to depend on reservoir hosts to complete its life cycle. In Europe, A. phagocytophilum was detected in roe deer, red deer, wild boars, and small mammals. In contrast to roe deer, red deer and wild boars have been considered as reservoir hosts for granulocytic anaplasmosis in humans, dogs, and horses according to groESL- and ankA-based genotyping. A. phagocytophilum variants infecting small mammals in Europe have not been characterized extensively to date.

Results

We amplified the total ankA open reading frames of 27 strains from voles and shrews. The analysis revealed that they harboured A. phagocytophilum strains that belonged to a distinct newly described ankA gene cluster. Further, we provide evidence that the heterogeneity of ankA gene sequences might have arisen via recombination.

Conclusions

Based on ankA-based genotyping voles and shrews are unlikely reservoir hosts for granulocytic anaplasmosis in humans, dogs, horses, and livestock in Europe.

Transmission rates of the bacterial endosymbiont, Neorickettsia risticii, during the asexual reproduction phase of its digenean host, Plagiorchis elegans, within naturally infected lymnaeid snails

BACKGROUND

Neorickettsia are obligate intracellular bacterial endosymbionts of digenean parasites present in all lifestages of digeneans. Quantitative information on the transmission of neorickettsial endosymbionts throughout the complex life cycles of digeneans is lacking. This study quantified the transmission of Neorickettsia during the asexual reproductive phase of a digenean parasite, Plagiorchis elegans, developing within naturally parasitized lymnaeid pond snails.

METHODS

Lymnaea stagnalis snails were collected from 3 ponds in Nelson County, North Dakota and screened for the presence of digenean cercariae. Cercariae were identified to species by PCR and sequencing of the 28S rRNA gene. Neorickettsia infections were initially detected using nested PCR and sequencing of a partial 16S rRNA gene of pooled cercariae shed from each parasitized snail. Fifty to 100 single cercariae or sporocysts were isolated from each of six parasitized snails and tested for the presence of Neorickettsia using nested PCR to estimate the efficiency at which Neorickettsia were transmitted to cercariae during asexual development of the digenean.

RESULTS

A total of 616 L. stagnalis were collected and 240 (39%) shed digenean cercariae. Of these, 18 (8%) were Neorickettsia-positive. Six Neorickettsia infections were selected to determine the transmission efficiency of Neorickettsia from mother to daughter sporocyst and from daughter sporocyst to cercaria. The prevalence of neorickettsiae in cercariae varied from 11 to 91%. The prevalence of neorickettsiae in sporocysts from one snail was 100%.

CONCLUSION

Prevalence of Neorickettsia infection in cercariae of Plagiorchis elegans was variable and never reached 100%. Reasons for this are speculative, however, the low prevalence of Neorickettsia observed in some of our samples (11 to 52%) differs from the high prevalence of other, related bacterial endosymbionts, e.g. Wolbachia in Wolbachia-dependent filariid nematodes, where the prevalence among progeny is universally 100%. This suggests that, unlike the Wolbachia-filaria relationship, the Neorickettsia-digenean relationship is not obligatory mutualism. Our study represents the first quantitative estimate of the Neorickettsia transmission through the asexual phase of the digenean life cycle.

Congenital infection with Anaplasma phagocytophilum in a calf in northern Germany

Anaplasma phagocytophilum is a Gram-negative, obligate intracellular tick-transmitted bacterium that replicates in neutrophils. It causes tick-borne fever (TBF) in sheep and cattle, but also elicits febrile disease in humans as well as in other domestic animals such as dogs, horses, and cats. Although increasingly recognized in Europe, the first laboratory-confirmed case of TBF in cattle from Germany has been published only recently. We here present the unusual case of an intrauterine transmission of A. phagocytophilum in a calf from northern Germany. To our knowledge, this is the first report of such an event occurring under field conditions in cattle.

New genetic lineages, host associations and circulation pathways of Neorickettsia endosymbionts of digeneans

Neorickettsia is a genus of intracellular bacteria endosymbiotic in digeneans that may also invade cells of vertebrates and are known to cause diseases of wildlife and humans. Herein, we report results of screening for Neorickettsia of an extensive collection of DNA extracts from adult and larval digeneans obtained from various vertebrates and mollusks in the United States. Seven isolates of Neorickettsia were detected by PCR and sequenced targeting a 527 bp long region of 16S rRNA. Sequence comparison and phylogenetic analysis demonstrated that four isolates matched published sequences of Neorickettsia risticii. Three other isolates, provisionally named "catfish agents 1 and 2" (obtained from Megalogonia ictaluri and Phyllodistomum lacustri, both parasitic in catfishes) and Neorickettsia sp. (obtained from cercariae of Diplostomum sp.), differed from previously known genotypes of Neorickettsia and are likely candidates for new species. All 7 isolates of Neorickettsia were obtained from digenean species and genera that were not previously reported as hosts of these bacteria. Members of four digenean families (Dicrocoeliidae, Heronimidae, Macroderoididae and Gorgoderidae) are reported as hosts of Neorickettsia for the first time. Our study reveals several new pathways of Neorickettsia circulation in nature. We have found for the first time a Neorickettsia from a digenean (dicrocoeliid Conspicuum icteridorum) with an entirely terrestrial life cycle. We found N. risticii in digeneans (Alloglossidium corti and Heronimus mollis) with entirely aquatic life cycles. Previously, this Neorickettsia species was known only from digeneans with aquatic/terrestrial life cycles. Our results suggest that our current knowledge of the diversity, host associations and circulation of neorickettsiae is far from satisfactory.

Neorickettsial endosymbionts of the digenea: diversity, transmission and distribution

Digeneans are endoparasitic flatworms with complex life cycles and distinct life stages that parasitize different host species. Some digenean species harbour bacterial endosymbionts known as Neorickettsia (Order Rickettsiales, Family Anaplasmataceae). Neorickettsia occur in all life stages and are maintained by vertical transmission. Far from benign however, Neorickettsia may also be transmitted horizontally by digenean parasites to their vertebrate definitive hosts. Once inside, Neorickettsia can infect macrophages and other cell types. In some vertebrate species (e.g. dogs, horses and humans), neorickettsial infections cause severe disease. Taken from a mostly parasitological perspective, this article summarizes our current knowledge on the transmission ecology of neorickettsiae, both for pathogenic species and for neorickettsiae of unknown pathogenicity. In addition, we discuss the diversity, phylogeny and geographical distribution of neorickettsiae, as well as their possible evolutionary associations with various groups of digeneans. Our understanding of neorickettsiae is at an early stage and there are undoubtedly many more neorickettsial endosymbioses with digeneans waiting to be discovered. Because neorickettsiae can infect vertebrates, it is particularly important to examine digenean species that regularly infect humans. Rapid advances in molecular tools and their application towards bacterial identification bode well for our future progress in understanding the biology of Neorickettsia.

Molecular detection of tick-borne pathogens of the family Anaplasmataceae in Brazilian brown brocket deer (Mazama gouazoubira, Fischer, 1814) and marsh deer (Blastocerus dichotomus, Illiger, 1815)

Deer are important natural reservoir hosts of Anaplasmataceae. The present study used nested PCR and nucleotide sequencing to evaluate the occurrence of Anaplasmataceae species in 23 free-living and six captive specimens of the cervids Mazama gouazoubira and Blastocerus dichotomus in Minas Gerais State, Brazil. Blood samples were tested for the presence of Ehrlichia and Anaplasma spp. using nPCR assays and sequencing of the msp4, msp1 and 16S rRNA genes. The identity of each sequence was confirmed by comparison with sequences available from GenBank using BLAST software. Of the animals investigated, 93.1% (27/29) were infected with haemoparasites including Anaplasma marginale (79.3%), Ehrlichia chaffeensis (3.4%), Anaplasma bovis (3.4%) and Anaplasma spp. (assigned to A. platys and A. phagocytophilum) (17.2%). Co-infection occurred in 20% (6/29) of the deer examined. Four (13.8%) were infected with A. marginale and Anaplasma sp., one (3.4%) was infected with A. marginale and E. chaffeensis, and one (3.4%) was infected with A. marginale and A. bovis. The results of the present study suggest that cross-protection does not occur in these deer. Immunological cross-reaction occurs when sera are tested diagnostically because these bacteria are closely related taxonomically, reinforcing the importance of molecular diagnosis followed by nucleotide sequencing.

Distinct host species correlate with Anaplasma phagocytophilum ankA gene clusters

Anaplasma phagocytophilum is a gram-negative, tick-transmitted, obligate intracellular bacterium that elicits acute febrile diseases in humans and domestic animals. In contrast to the United States, human granulocytic anaplasmosis seems to be a rare disease in Europe despite the initial recognition of A. phagocytophilum as the causative agent of tick-borne fever in European sheep and cattle. Considerable strain variation has been suggested to occur within this species, because isolates from humans and animals differed in their pathogenicity for heterologous hosts. In order to explain host preference and epidemiological diversity, molecular characterization of A. phagocytophilum strains has been undertaken. Most often the 16S rRNA gene was used, but it might be not informative enough to delineate distinct genotypes of A. phagocytophilum. Previously, we have shown that A. phagocytophilum strains infecting Ixodes ricinus ticks are highly diverse in their ankA genes. Therefore, we sequenced the 16S rRNA and ankA genes of 194 A. phagocytophilum strains from humans and several animal species. Whereas the phylogenetic analysis using 16S rRNA gene sequences was not meaningful, we showed that distinct host species correlate with A. phagocytophilum ankA gene clusters.

Abortion in a Horse Following Neorickettsia Risticii Infection

A pregnant 18-year-old Quarterhorse mare presented with fever, anorexia, tachycardia, tachypnea, and gastrointestinal hypermotility at day 68 of gestation. Potomac horse fever was diagnosed based on polymerase chain reaction (PCR) analysis of whole blood and a high antibody titer to Neorickettsia risticii. The mare made a rapid clinical recovery following antibiotic therapy, but aborted 98 days later. Necropsy on the aborted fetus revealed lymphohistiocytic colitis, lymphadenitis, myocarditis, and hepatitis. The placenta was grossly and histologically normal. Formalin-fixed lymph node, thymus, liver, and colon taken from the aborted fetus were positive by PCR for N. risticii DNA. Potomac horse fever is a common disease in horses that may result in delayed abortion. The microscopic lesions in the fetus are characteristic, and the diagnosis can be confirmed by PCR on formalin-fixed tissues.

Diagnostic equine serology

This article is presented with two main goals: (1) to provide equine clinicians with a resource for identifying types of serum tests available and (2) to outline briefly the necessary sample type, assay principle, and relative strengths and weakness of the various methods. Specific etiologies are presented and grouped by clinical diagnosis categories, along with brief comments concerning each disorder and its relevant diagnostic assays. This organization provides an abstracted list of infectious disorders commonly considered for the various clinical presentations and a summary of available serologic tests for narrowing the differential diagnosis list. The reader is also provided with a list of specific laboratories that perform the diagnostic assay for the mentioned disorders.

Enteritis and colitis in horses

Enteritis and colitis remain challenging and life-threatening diseases despite many recent advances. Successful treatment is largely dependent on early recognition and directed therapy, which is facilitated by obtaining a complete history and physical examination. A number of new therapies and methods of monitoring critically ill patients have become integral components of treatment success. The critical monitoring of equine foals and adults continues to be an exciting and emerging field.

Digenetic trematodes,Acanthatriumsp. andLecithodendriumsp., as vectors ofNeorickettsia risticii, the agent of Potomac horse fever

Neorickettsia(formerlyEhrlichia)risticii, the agent of Potomac horse fever (PHF), has been recently detected in trematode stages found in the secretions of freshwater snails and in aquatic insects. Insectivores, such as bats and birds, may serve as the definitive host of the trematode vector. To determine the definitive helminth vector, five bats (Myotis yumanensis) and three swallows (Hirundo rustica,Tachycineta bicolor) were collected from a PHF endemic location in northern California. Bats and swallows were dissected and their major organs examined for trematodes and forN. risticiiDNA using a nested polymerase chain reaction (PCR) assay. Adult digenetic trematodes,Acanthatriumsp. and/orLecithodendriumsp., were recovered from the gastrointestinal tract of all bats and from one swallow. The intestine of three bats, the spleen of two bats and one swallow as well as the liver of one swallow tested PCR positive forN. risticii. From a total of seven pools of identical digenetic trematodes collected from single hosts, two pools ofAcanthatriumsp. and one pool ofLecithodendriumsp. tested PCR positive. The results of this investigation provide preliminary evidence that at least two trematodes in the family Lecithodendriidae are vectors ofN. risticii. The data also suggest that bats and swallows not only act as a host for trematodes but also as a possible natural reservoir forN. risticii.

New Findings on Anaplasmosis Caused by Infection withAnaplasma phagocytophilum

Ixodes ricinus (I. ricinus) is one of the vectors of Anaplasma phagocytophilum (A. phagocytophilum) in Europe, in which rates of infection range from 1.9% to 34%. In 1998, human granulocytic ehrlichiosis-like (HGE-like) Ehrlichia DNA was detected in Italy, by PCR technique in one I. ricinus nymph out of 55 ticks that were examined. In 1996, 6.3% of 310 human sera in high-risk subjects from Italy were found positive for antibodies to Ehrlichia phagocytophila (E. phagocytophila). In the same year, the authors reported the first case of equine granulocytic ehrlichiosis. In 1997, only 2 out of 563 equine blood samples examined were found positive for antibodies to E. phagocytophila in the Latium region. In 1998, serological positivity was not observed in 14 symptomatic race horses. In 2002, a symptomatic horse living in Rome was found positive for Ehrlichia equi (E. equi) antibodies, as confirmed by PCR. E. equi was also demonstrated in horses by detection of specific antibodies from two asymptomatic ponies. We tested 128 sera from sheep in different flocks, and antibodies to E. phagocytophila were detected in 17 sera (13.3%) of these sheep. From 2000 to 2004, 147 dog sera were tested for antibodies against A. phagocytophilum, and 7 of these sera were positive (4.8%). These data confirm the presence of the infection in human, domestic animals, and pets in Italy. Studies are under way to correlate the distributions of the disease and tick vector, I. ricinus.

Pharmacokinetics and tissue distribution of doxycycline after oral administration of single and multiple doses in horses

OBJECTIVE

To determine pharmacokinetics, safety, and penetration into interstitial fluid (ISF), polymorphonuclear leukocytes (PMNLs), and aqueous humor of doxycycline after oral administration of single and multiple doses in horses.

ANIMALS

6 adult horses.

PROCEDURE

The effect of feeding on drug absorption was determined. Plasma samples were obtained after administration of single or multiple doses of doxycycline (20 mg/kg) via nasogastric tube. Additionally, ISF, PMNLs, and aqueous humor samples were obtained after the final administration. Horses were monitored for adverse reactions.

RESULTS

Feeding decreased drug absorption. After multiple doses, mean +/- SD time to maximum concentration was 1.63 +/- 1.36 hours, maximum concentration was 1.74 +/- 0.3 microg/mL, and elimination half-life was 12.07 +/- 3.17 hours. Plasma protein binding was 81.76 +/- 2.43%. The ISF concentrations correlated with the calculated percentage of non-protein-bound drug. Maximum concentration was 17.27 +/- 8.98 times as great in PMNLs, compared with plasma. Drug was detected in aqueous humor at 7.5% to 10% of plasma concentrations. One horse developed signs of acute colitis and required euthanasia.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that doxycycline administered at a dosage of 20 mg/kg, PO, every 24 hours will result in drug concentrations adequate for killing intracellular bacteria and bacteria with minimum inhibitory concentration < or = 0.25 microg/mL. For bacteria with minimum inhibitory concentration of 0.5 to 1.0 microg/mL, a dosage of 20 mg/kg, PO, every 12 hours may be required; extreme caution should be exercised with the higher dosage until more safety data are available.

Antimicrobial therapy for gastrointestinal diseases

Antibiotics will always be needed in horses for many types of infections, but the adverse consequences also must be considered. For the conditions described in this article, there is justification for antibiotic therapy. The intestinal problems that antibiotics can induce are among the risks from their administration to horses. Disruption of the endogenous bacterial population, colitis, and diarrhea are the most common complications from antibiotic therapy.

Ehrlichiosis and related infections

Ehrlichiosis is a term that has been used to describe infection with any of a number of related intracellular, vector-borne pathogens. A recent reclassification has resulted in the transfer of several species previously known as Ehrlichia to the genus Anaplasma or Neorickettsia. Ehrlichia and Anaplasma are transmitted largely through the bite of infected ticks, while vectors for Neorickettsia include trematodes and the intermediate hosts (i.e., fish, snails, and insects) involved in the trematode life cycle. Dogs (and cats) are susceptible to infection with several of these pathogens, and veterinarians should be aware of the similarities and differences between E canis and related infections. Pets with suggestive clinical signs and laboratory abnormalities may be started on doxycycline pending specific diagnostic testing. The veterinarian practicing in endemic areas must understand the implications and limitations of serologic and molecular testing to confirm a diagnosis. For animals in endemic areas, prevention of exposure to vectors can lessen the risk of disease for pets and might lessen the potential for animals to become carriers of disease for their human companions.

Equine ehrlichiosis in Italy

The authors review equine granulocytic ehrlichiosis (EGE) in Italy from 1996 to 2002. In 1996, the first case of EGE has been observed in a horse affected with specific symptomatology (fever, lethargy, anorexia, limb edema, thrombocytopenia, and petechiae). In 1997, a seroepidemiological survey was performed in the province of Rome on 563 animals using IFAT. The authors describe the last case, which occurred on 2002 in a 15-year-old male, bay, half-breed, tick-infested horse. Clinical features included fever, lethargy, limb edema, icterus, leukocytopenia, and thrombocytopenia. Laboratory tests were positive for ELISA and IFAT and several morulae were seen in the cytoplasm of neutrophils in buffy coat smears. The authors think that in Italy the prevalence of EGE is underestimated because of the nonpathognomonic clinical symptoms, the diffusion of specific infected vector, and the nonroutine nature of specific laboratory tests.