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Schudel S, Gygax L, Kositz C, Kuenzli E, Neumayr A. Human granulocytotropic anaplasmosis-A systematic review and analysis of the literature. PLoS Negl Trop Dis 2024; 18:e0012313. [PMID: 39102427 PMCID: PMC11326711 DOI: 10.1371/journal.pntd.0012313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 08/15/2024] [Accepted: 06/21/2024] [Indexed: 08/07/2024] Open
Abstract
Human granulocytotropic anaplasmosis (HGA) is a zoonotic tick-borne bacterial infection caused by Anaplasma phagocytophilum. While most cases are reported from North America, HGA has been recognized as an emerging disease in several regions of the world in recent decades. Most available data comes from case reports, case series and retrospective studies, while prospective studies and clinical trials are largely lacking. To obtain a clearer picture of the currently known epidemiologic distribution, clinical and paraclinical presentation, diagnostic aspects, complications, therapeutic aspects, and outcomes of HGA, we systematically reviewed the literature and analyzed and summarized the data. Cases of HGA are reported from all continents except from Antarctica. HGA primarily presents as an unspecific febrile illness (88.5% of the cases) often accompanied by thrombocytopenia (71.8% of the cases), abnormal liver injury tests (66.7% of the cases), and leukopenia (49.8% of the cases). Although we found complications reported in a total of 40.5% of the reviewed cases and severe and even life-threatening complications are not infrequent (e.g. acute renal failure 9.8%, multi organ failure 7.5%, ARDS 6.3%, a.o.), sequelae are rare (2.1% of the cases) and lethality is low (3.0% of the cases). Treatment with doxycycline shows a rapid response, with the fever subsiding in the majority of patients within one day of starting treatment. Unlike in human monocytotropic ehrlichiosis (HME), reports of opportunistic infections complicating HGA are rare. HGA during pregnancy does not appear to be associated with unfavorable outcomes. In addition, our analysis provides some evidence that HGA may differ in clinical aspects and laboratory characteristics in different regions of the world. Overall, the data analyzed indicates a non-negligible bias in reporting/publication, so a certain degree of caution is required when generalizing the data.
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Affiliation(s)
- Sophie Schudel
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Larissa Gygax
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christian Kositz
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Esther Kuenzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
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Tonnetti L, Marcos LA, Mamone L, Spitzer ED, Jacob M, Townsend RL, Stramer SL, West FB. A case of transfusion-transmission Anaplasma phagocytophilum from leukoreduced red blood cells. Transfusion 2024; 64:751-754. [PMID: 38491925 DOI: 10.1111/trf.17783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Anaplasma phagocytophilum is a tick-borne bacterium and the cause of human granulocytic anaplasmosis (HGA). Here, we report a case of transfusion-transmitted (TT)-HGA involving a leukoreduced (LR) red blood cell (RBC) unit. CASE REPORT A 64-year-old woman with gastric adenocarcinoma and multiple myeloma who received weekly blood transfusions developed persistent fevers, hypotension, and shortness of breath 1 week after receiving an RBC transfusion. Persistent fevers, new thrombocytopenia, and transaminitis suggested a tick-borne infection. RESULTS The absence of blood parasites on thick and thin blood smears suggested that malaria and Babesia infection were not present, and the recipient tested negative for antibodies to Borrelia burgdorferi. Blood testing by polymerase chain reaction (PCR) for Ehrlichia and Anaplasma species identified A. phagocytophilum. Treatment with doxycycline resolved the infection; however, the recipient expired due to complications of her known malignancies. The recipient lived in a nursing home and did not have pets or spend time outdoors. The donor was a female in her 70s from Maine who was diagnosed with HGA 3 weeks after donating blood and whose LR-RBCs from the donation were transfused to the recipient 9 days following collection. CONCLUSION This is a confirmed case of TT-HGA. Although rare, TT-HGA has been reported with LR-RBCs and platelets. In endemic areas, testing for tick-borne associated infections should be considered when investigating post-transfusion complications.
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Affiliation(s)
- Laura Tonnetti
- Scientific Affairs, American Red Cross, Rockville, Maryland, USA
| | - Luis A Marcos
- Division of Infectious Diseases, Stony Brook University Hospital, Stony Brook, New York, USA
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, USA
| | - Linda Mamone
- Department of Pathology, Stony Brook University, Stony Brook, New York, USA
| | - Eric D Spitzer
- Department of Pathology, Stony Brook University, Stony Brook, New York, USA
| | - Matthew Jacob
- Division of Infectious Diseases, Stony Brook University Hospital, Stony Brook, New York, USA
| | | | | | - Fay B West
- American Red Cross, Biomedical Services, Farmington, Connecticut, USA
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Other bacterial agents (4th section). Transfusion 2024; 64 Suppl 1:S243-S270. [PMID: 38394037 DOI: 10.1111/trf.17695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/25/2024]
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Dumic I, Person E, Igandan O, Adetimehin O, Nordstrom CW, Williams C, Shweta F. Anaplasma phagocytophilum Community-Acquired Pneumonia: Case Report and Literature Review. Microorganisms 2023; 11:1483. [PMID: 37374985 DOI: 10.3390/microorganisms11061483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Anaplasma phagocytophilum is an emerging, Gram-negative, and obligate intracellular pathogen that is infrequently implicated as a causative agent of community-acquired pneumonia. In this paper, we report about an immunocompetent patient from the community who presented with fever, cough, and shortness of breath. Chest X-ray and CT showed bilateral lung infiltrates. Extensive workup for other common and uncommon causes of pneumonia was positive for anaplasmosis. The patient recovered completely with doxycycline therapy. In our literature review, we find that in 80% of reported cases of anaplasmosis pneumonia, empiric treatment did not contain doxycycline, which in some cases led to acute respiratory distress syndrome. Clinicians in tick-borne disease endemic regions should be aware of this unusual presentation of anaplasmosis in order to be able to select appropriate antimicrobial regimens and initiate timely management.
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Affiliation(s)
- Igor Dumic
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Emily Person
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Oladapo Igandan
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Omobolanle Adetimehin
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Charles W Nordstrom
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Christopher Williams
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Pulmonary Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Fnu Shweta
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Infectious Disease, Mayo Clinic Health System, Eau Claire, WI 54703, USA
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Ingram D, Joseph B, Hawkins S, Spain J. Anaplasmosis in Pennsylvania: Clinical Features, Diagnosis, and Outcomes of Patients Diagnosed With Anaplasma phagocytophilum Infection at Hershey Medical Center From 2008 to 2021. Open Forum Infect Dis 2023; 10:ofad193. [PMID: 37125231 PMCID: PMC10135425 DOI: 10.1093/ofid/ofad193] [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: 02/14/2023] [Accepted: 04/09/2023] [Indexed: 05/02/2023] Open
Abstract
Anaplasmosis is an emerging infection in the United States and in particular, Pennsylvania. We highlight the abrupt rise in cases of anaplasmosis in the past decade in the state of Pennsylvania with the hope of increasing clinician awareness. We identified a cohort of 61 patients diagnosed with anaplasmosis at our institution as well as cases reported to the Department of Health. From our review, we identified not only an increase in cases over time but what appears to be an expansion further into central and western Pennsylvania over time.
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Affiliation(s)
- David Ingram
- Correspondence: David Ingram, DO, Department of Medicine, Division of Infectious Diseases, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033 (); Betsy Joseph, MD, Department of Medicine, Division of Infectious Diseases, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033 ()
| | - Betsy Joseph
- Correspondence: David Ingram, DO, Department of Medicine, Division of Infectious Diseases, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033 (); Betsy Joseph, MD, Department of Medicine, Division of Infectious Diseases, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033 ()
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Dogra M, Thakur M, Kumar A, Thakur G. Tick-Borne Rhabdomyolysis: A Rare Case of Rhabdomyolysis and Acute Kidney Injury Due to Anaplasmosis. Cureus 2023; 15:e34835. [PMID: 36919073 PMCID: PMC10008484 DOI: 10.7759/cureus.34835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 02/12/2023] Open
Abstract
Anaplasmosis is a tick-borne illness commonly seen in the northeastern states of the United States. The most common presenting signs are fever, malaise, and body aches accompanied by leukopenia, thrombocytopenia, and transaminitis. Rhabdomyolysis and acute kidney injury are rare presentations that can lead to significant morbidity. We present the case of a patient who presented with non-specific symptoms of malaise, fatigue, and body aches and was found to have rhabdomyolysis and acute kidney injury on laboratory workup. A presumptive diagnosis of anaplasmosis was made, and the patient was started on treatment for the same. The patient recovered successfully. Our case highlights the rare presentation of anaplasmosis with rhabdomyolysis and acute kidney injury. Physician awareness is needed for early diagnosis and preventing morbidity.
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Affiliation(s)
- Megha Dogra
- Internal Medicine, Mary Imogene Bassett Hospital, Cooperstown, USA
| | - Manish Thakur
- Internal Medicine, Cayuga Medical Center, Ithaca, USA
| | - Amrat Kumar
- Internal Medicine, Mary Imogene Bassett Hospital, Cooperstown, USA
| | - Garima Thakur
- Internal Medicine, Indira Gandhi Medical College, Shimla, IND
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Abstract
Human granulocytic anaplasmosis (HGA) is a bacterial infection caused by Anaplasma phagocytophilum and transmitted by the bite of the black-legged (deer tick) in North America. Its incidence is increasing. HGA can be transmitted after 24 to 48 hours of tick attachment. The incubation period is 5 to 14 days after a tick bite. Symptoms include fever, chills, headache, and myalgia. Complications include shock, organ dysfunction, and death. Mortality is less than 1% with appropriate treatment. Doxycycline is first line treatment for all ages. Start it empirically if symptoms and risk factors suggest HGA. PCR is the confirmatory test of choice.
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Affiliation(s)
- Douglas MacQueen
- Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850, USA; Weill Cornell Medicine.
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Human Granulocytic Anaplasmosis-A Systematic Review of Published Cases. Microorganisms 2022; 10:microorganisms10071433. [PMID: 35889152 PMCID: PMC9318722 DOI: 10.3390/microorganisms10071433] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Anaplasma phagocytophilum is an emerging, Gram-negative, obligate intracellular pathogen that is transmitted by a tick vector. Human infection ranges from asymptomatic to severe disease that can present with pancytopenia, multiorgan failure, and death. The aim of this systematic review is to analyze case reports and case series reported over the last two decades in peer-reviewed journals indexed in the Medline/PubMed database according to the PRISMA guidelines. We found 110 unique patients from 88 case reports and series. The most common mode of transmission was tick bite (60.9%), followed by blood transfusion (8.2%). Infection was acquired by blood transfusion in nearly half (42%) of the immunocompromised patients. Most patients reported fever (90%), followed by constitutional (59%) and gastrointestinal symptoms (56%). Rash was present in 17% of patients, much higher than in previous studies. Thrombocytopenia was the most common laboratory abnormality (76%) followed by elevated aspartate aminotransferase (AST) (46%). The diagnosis was most commonly established using whole-blood polymerase chain reaction (PCR) in 76% of patients. Coinfection rate was 9.1% and Borrelia burgdorferi was most commonly isolated in seven patients (6.4%). Doxycycline was used to treat 70% of patients but was only used as an empiric treatment in one-third of patients (33.6%). The overall mortality rate was 5.7%, and one patient died from trauma unrelated to HGA. The mortality rates among immunocompetent and immunocompromised patients were 4.2% (n = 4/95) and 18.2% (n = 2/11), respectively. Four of the six patients who died (66.6%) received appropriate antibiotic therapy. Among these, doxycycline was delayed by more than 48 h in two patients.
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Atif FA, Mehnaz S, Qamar MF, Roheen T, Sajid MS, Ehtisham-ul-Haque S, Kashif M, Ben Said M. Epidemiology, Diagnosis, and Control of Canine Infectious Cyclic Thrombocytopenia and Granulocytic Anaplasmosis: Emerging Diseases of Veterinary and Public Health Significance. Vet Sci 2021; 8:vetsci8120312. [PMID: 34941839 PMCID: PMC8705095 DOI: 10.3390/vetsci8120312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 12/17/2022] Open
Abstract
This review highlights the diagnostic methods used, the control strategies adopted, and the global epidemiological status of canine cyclic thrombocytopenia and granulocytic anaplasmosis at the animal–human interface. Canine anaplasmosis is an important worldwide disease, mainly caused by Anaplasma platys and A. phagocytophilum with zoonotic implications. A. platys chiefly infects platelets in canids, while A. phagocytophilum is the most common zoonotic pathogen infecting neutrophils of various vertebrate hosts. Diagnosis is based on the identification of clinical signs, the recognition of intracellular inclusions observed by microscopic observation of stained blood smear, and/or methods detecting antibodies or nucleic acids, although DNA sequencing is usually required to confirm the pathogenic strain. Serological cross-reactivity is the main problem in serodiagnosis. Prevalence varies from area to area depending on tick exposure. Tetracyclines are significant drugs for human and animal anaplasmosis. No universal vaccine is yet available that protects against diverse geographic strains. The control of canine anaplasmosis therefore relies on the detection of vectors/reservoirs, control of tick vectors, and prevention of iatrogenic/mechanical transmission. The control strategies for human anaplasmosis include reducing high-risk tick contact activities (such as gardening and hiking), careful blood transfusion, by passing immunosuppression, recognizing, and control of reservoirs/vectors.
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Affiliation(s)
- Farhan Ahmad Atif
- Medicine Section, Department of Clinical Sciences, College of Veterinary and Animal Sciences, Jhang, Sub-Campus University of Veterinary and Animal Sciences, Lahore 54600, Pakistan; (S.M.); (M.K.)
- Correspondence: or (F.A.A.); or (M.B.S.); Tel.: +92-47-7671270 (F.A.A.); +216-58-964147 (M.B.S.)
| | - Saba Mehnaz
- Medicine Section, Department of Clinical Sciences, College of Veterinary and Animal Sciences, Jhang, Sub-Campus University of Veterinary and Animal Sciences, Lahore 54600, Pakistan; (S.M.); (M.K.)
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad 38000, Pakistan;
| | - Muhammad Fiaz Qamar
- Department of Pathobiology, College of Veterinary and Animal Sciences, Jhang, Sub-Campus University of Veterinary and Animal Sciences, Lahore 54600, Pakistan; (M.F.Q.); (S.E.-u.-H.)
| | - Taleeha Roheen
- Department of Chemistry (Biochemistry), University of Sargodha, Sargodha 40100, Pakistan;
| | - Muhammad Sohail Sajid
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad 38000, Pakistan;
| | - Syed Ehtisham-ul-Haque
- Department of Pathobiology, College of Veterinary and Animal Sciences, Jhang, Sub-Campus University of Veterinary and Animal Sciences, Lahore 54600, Pakistan; (M.F.Q.); (S.E.-u.-H.)
| | - Muhammad Kashif
- Medicine Section, Department of Clinical Sciences, College of Veterinary and Animal Sciences, Jhang, Sub-Campus University of Veterinary and Animal Sciences, Lahore 54600, Pakistan; (S.M.); (M.K.)
| | - Mourad Ben Said
- Higher Institute of Biotechnology of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
- Laboratory of Microbiology at the National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
- Correspondence: or (F.A.A.); or (M.B.S.); Tel.: +92-47-7671270 (F.A.A.); +216-58-964147 (M.B.S.)
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Mowla SJ, Drexler NA, Cherry CC, Annambholta PD, Kracalik IT, Basavaraju SV. Ehrlichiosis and Anaplasmosis among Transfusion and Transplant Recipients in the United States. Emerg Infect Dis 2021; 27:2768-2775. [PMID: 34670661 PMCID: PMC8544963 DOI: 10.3201/eid2711.211127] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Physicians should be aware that these infections are rare but can have severe outcomes. Ehrlichiosis and anaplasmosis are emerging tickborne diseases that can also be transmitted through blood transfusions or organ transplants. Since 2000, ehrlichiosis and anaplasmosis cases in the United States have increased substantially, resulting in potential risk to transplant and transfusion recipients. We reviewed ehrlichiosis and anaplasmosis cases among blood transfusion and solid organ transplant recipients in the United States from peer-reviewed literature and Centers for Disease Control and Prevention investigations. We identified 132 cases during 1997–2020, 12 transfusion-associated cases and 120 cases in transplant recipients; 8 cases were donor-derived, and in 13 cases illness occurred <1 year after transplant. Disease in the remaining 99 cases occurred ≥1 year after transplant, suggesting donor-derived disease was unlikely. Severe illness or death were reported among 15 transfusion and transplant recipients. Clinicians should be alert for these possible infections among transfusion and transplant recipients to prevent severe complications or death by quickly treating them.
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El Hamiani Khatat S, Daminet S, Duchateau L, Elhachimi L, Kachani M, Sahibi H. Epidemiological and Clinicopathological Features of Anaplasma phagocytophilum Infection in Dogs: A Systematic Review. Front Vet Sci 2021; 8:686644. [PMID: 34250067 PMCID: PMC8260688 DOI: 10.3389/fvets.2021.686644] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Anaplasma phagocytophilum is a worldwide emerging zoonotic tick-borne pathogen transmitted by Ixodid ticks and naturally maintained in complex and incompletely assessed enzootic cycles. Several studies have demonstrated an extensive genetic variability with variable host tropisms and pathogenicity. However, the relationship between genetic diversity and modified pathogenicity is not yet understood. Because of their proximity to humans, dogs are potential sentinels for the transmission of vector-borne pathogens. Furthermore, the strong molecular similarity between human and canine isolates of A. phagocytophilum in Europe and the USA and the positive association in the distribution of human and canine cases in the USA emphasizes the epidemiological role of dogs. Anaplasma phagocytophilum infects and survives within neutrophils by disregulating neutrophil functions and evading specific immune responses. Moreover, the complex interaction between the bacterium and the infected host immune system contribute to induce inflammatory injuries. Canine granulocytic anaplasmosis is an acute febrile illness characterized by lethargy, inappetence, weight loss and musculoskeletal pain. Hematological and biochemistry profile modifications associated with this disease are unspecific and include thrombocytopenia, anemia, morulae within neutrophils and increased liver enzymes activity. Coinfections with other tick-borne pathogens (TBPs) may occur, especially with Borrelia burgdorferi, complicating the clinical presentation, diagnosis and response to treatment. Although clinical studies have been published in dogs, it remains unclear if several clinical signs and clinicopathological abnormalities can be related to this infection.
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Affiliation(s)
- Sarah El Hamiani Khatat
- Department of Medicine, Surgery and Reproduction, Hassan II Institute of Agronomy and Veterinary Medicine, Rabat, Morocco
| | - Sylvie Daminet
- Department of Companion Animals, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Luc Duchateau
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Latifa Elhachimi
- Department of Pathology and Veterinary Public Health, Unit of Parasitology, Hassan II Institute of Agronomy and Veterinary Medicine, Rabat, Morocco
| | - Malika Kachani
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Hamid Sahibi
- Department of Pathology and Veterinary Public Health, Unit of Parasitology, Hassan II Institute of Agronomy and Veterinary Medicine, Rabat, Morocco
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Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Nash KJ, Odunayo A, Sharp CR, Spada E, Thomason J, Walton J, Wardrop KJ. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring. J Vet Emerg Crit Care (San Antonio) 2021; 31:167-188. [PMID: 33751789 DOI: 10.1111/vec.13045] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/06/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats. DESIGN Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi-style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated. RESULTS Twenty-nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus CONCLUSIONS: This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
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Affiliation(s)
- Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
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Abstract
Increases in tick-borne disease prevalence and transmission are important public health issues. Efforts to control these emerging diseases are frustrated by the struggle to control tick populations and to detect and treat infections caused by the pathogens that they transmit. This review covers tick-borne infectious diseases of nonrickettsial bacterial, parasitic, and viral origins. While tick surveillance and tracking inform our understanding of the importance of the spread and ecology of ticks and help identify areas of risk for disease transmission, the vectors are not the focus of this document. Here, we emphasize the most significant pathogens that infect humans as well as the epidemiology, clinical features, diagnosis, and treatment of diseases that they cause. Although detection via molecular or immunological methods has improved, tick-borne diseases continue to remain underdiagnosed, making the scope of the problem difficult to assess. Our current understanding of the incidence of tick-borne diseases is discussed in this review. An awareness of the diseases that can be transmitted by ticks in specific locations is key to detection and selection of appropriate treatment. As tick-transmitted pathogens are discovered and emerge in new geographic regions, our ability to detect, describe, and understand the growing public health threat must also grow to meet the challenge.
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Zaid T, Ereqat S, Nasereddin A, Al‐Jawabreh A, Abdelkader A, Abdeen Z. Molecular characterization of Anaplasma and Ehrlichia in ixodid ticks and reservoir hosts from Palestine: a pilot survey. Vet Med Sci 2019; 5:230-242. [PMID: 30762295 PMCID: PMC6498520 DOI: 10.1002/vms3.150] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Tick-borne anaplasmosis and ehrlichiosis are clinically important emerging zoonoses usually overlooked by veterinarians and physicians alike. This study aimed at detecting and genetically characterizing Ehrlichia and Anaplasma species in ixodid ticks and their animal hosts from the West Bank, Palestine. A total of 723 ixodid ticks belonging to three genera (Rhipicephalus, Hyalomma, Haemaphysalis) were collected from dogs, sheep, goats and camels. In addition, 189 blood samples were collected from dogs, sheep, camels, horses and a goat from the West Bank, Palestine. All tick and blood samples were investigated for the presence of Anaplasma and Ehrlichia targeting a 345 bp fragment of the 16S rRNA gene followed by sequence analysis. The infection rate of Anaplasma spp. in ticks was 6.5% (47/723). Anaplasma platys was identified in 28% (13/47) of them. Whereas, based on a partial sequence (851 bp) of msp4 gene, 38% (18/47) were identified as A. ovis. The species of the remaining 16 positive samples (16/47, 34%) could not be identified. Simultaneously, the infection rate of Ehrlichia spp. in the ticks was 0.6% (4/723). Three of which were E. canis and one was Ehrlichia spp. The infection rate of A. platys in dogs' blood samples was 10% (13/135), while it was 1.5% (2/135) for E. canis. The infection rate of Anaplasma in sheep blood samples was 40% (19/47), out of which 26% (5/19) were caused by A. ovis as revealed by msp4-PCR. Implementation of purely-spatial analysis by saTScan for all cases of Anaplasma revealed two statistically significant clusters in two districts; Tubas town and Majdal-Bani-Fadil village on the western hills of the Jordan Valley. Most cases of Anaplasma (83%) were from rural areas where life cycle components (vector, host and reservoir) abundantly interact. This study is the first in Palestine to reveal the presence of Anaplasma and Ehrlichia in ticks, dogs and sheep providing crucial platform for future epidemiological surveys and control strategies in the country and region.
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Affiliation(s)
- Taher Zaid
- Biochemistry and Molecular Biology DepartmentFaculty of MedicineAl‐Quds UniversityAbu DisPalestine
- UCD School of Veterinary MedicineUniversity College DublinBelfieldIreland
| | - Suheir Ereqat
- Biochemistry and Molecular Biology DepartmentFaculty of MedicineAl‐Quds UniversityAbu DisPalestine
| | | | - Amer Al‐Jawabreh
- Al‐Quds Public Health SocietyEast JerusalemPalestine
- Arab American UniversityJeninPalestine
| | | | - Ziad Abdeen
- Al‐Quds Public Health SocietyEast JerusalemPalestine
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15
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Goel R, Westblade LF, Kessler DA, Sfeir M, Slavinski S, Backenson B, Gebhardt L, Kane K, Laurence J, Scherr D, Bussel J, Dumler JS, Cushing MM. Death from Transfusion-Transmitted Anaplasmosis, New York, USA, 2017. Emerg Infect Dis 2019; 24:1548-1550. [PMID: 30016241 PMCID: PMC6056119 DOI: 10.3201/eid2408.172048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
We report a death from transfusion-transmitted anaplasmosis in a 78-year-old man. The patient died of septic shock 2 weeks after a perioperative transfusion with erythrocytes harboring Anaplasma phagocytophilum. The patient's blood specimens were positive for A. phagocytophilum DNA beginning 7 days after transfusion; serologic testing remained negative until death.
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16
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Eraso-Cadena MP, Molina-Guzmán LP, Cardona X, Cardona-Arias JA, Ríos-Osorio LA, Gutierrez-Builes LA. Serological evidence of exposure to some zoonotic microorganisms in cattle and humans with occupational exposure to livestock in Antioquia, Colombia. CAD SAUDE PUBLICA 2018; 34:e00193617. [PMID: 30329003 DOI: 10.1590/0102-311x00193617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 06/08/2018] [Indexed: 11/21/2022] Open
Abstract
Bacteria belonging to Anaplasma, Ehrlichia, Rickettsia and Coxiella genera are considered emerging pathogens and livestock is one of the contexts where the transmission of these microorganisms can occur. The goal of this study was to determine serological evidence for the exposure to these bacteria in cattle and humans with occupational exposure to livestock in the subregions North and Magdalena Medio, Antioquia, Colombia, and to explore related factors. A cross-sectional study was conducted in 48 livestock farms distributed in six municipalities from both subregions: Belmira, Entrerríos and San Pedro de los Milagros (North), and Puerto Berrío, Puerto Nare and Puerto Triunfo (Magdalena Medio). Blood samples from 332 people and 384 bovines were evaluated by serology (IgM and IgG) screening for bacteria from the Anaplasma, Ehrlichia, Rickettsia, and Coxiella genera. Seropositivity in humans from both regions was 42.4% (95%CI: 31.2-55.1) for Anaplasma, 74.2% (95%CI: 66.0-84.4) for Ehrlichia, 72.5% (95%CI: 62.1-82.0) for Rickettsia, and 60.7% (95%CI: 59.7-69.1) for Coxiella burnetii. In cattle, seropositivity was 31.6% (95%CI: 19.9-44.2), 66.8% (95%CI: 55.2-78.1), 64.6% (95%CI: 53.8-74.5), and 61.6% (95%CI: 51.9-69.2), respectively. History of biting by ticks, milking, vaccination, having dogs and hens in the residence, as well as the consumption of raw milk derivatives were some factors associated with the infection by the bacteria studied. The results suggest a previous and recent exposure to these zoonotic bacteria genera in people with occupational exposure to livestock, as well as in cattle in the two studied subregions.
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Affiliation(s)
| | - Licet Paola Molina-Guzmán
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - Ximena Cardona
- Departamento de Asistencia Técnica, COLANTA, Medellín, Colombia
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17
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Battilani M, De Arcangeli S, Balboni A, Dondi F. Genetic diversity and molecular epidemiology of Anaplasma. INFECTION GENETICS AND EVOLUTION 2017; 49:195-211. [PMID: 28122249 DOI: 10.1016/j.meegid.2017.01.021] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 11/25/2022]
Abstract
Anaplasma are obligate intracellular bacteria of cells of haematopoietic origin and are aetiological agents of tick-borne diseases of both veterinary and medical interest common in both tropical and temperate regions. The recent disclosure of their zoonotic potential has greatly increased interest in the study of these bacteria, leading to the recent reorganisation of Rickettsia taxonomy and to the possible discovery of new species belonging to the genus Anaplasma. This review is particularly focused on the common and unique characteristics of Anaplasma marginale and Anaplasma phagocytophilum, with an emphasis on genetic diversity and evolution, and the main distinguishing features of the diseases caused by the different Anaplasma spp. are described as well.
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Affiliation(s)
- Mara Battilani
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra, 50, 40064 Ozzano Emilia, Bo, Italy.
| | - Stefano De Arcangeli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra, 50, 40064 Ozzano Emilia, Bo, Italy
| | - Andrea Balboni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra, 50, 40064 Ozzano Emilia, Bo, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra, 50, 40064 Ozzano Emilia, Bo, Italy
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18
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Biggs HM, Behravesh CB, Bradley KK, Dahlgren FS, Drexler NA, Dumler JS, Folk SM, Kato CY, Lash RR, Levin ML, Massung RF, Nadelman RB, Nicholson WL, Paddock CD, Pritt BS, Traeger MS. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States. MMWR Recomm Rep 2016; 65:1-44. [PMID: 27172113 DOI: 10.15585/mmwr.rr6502a1] [Citation(s) in RCA: 311] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Tickborne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low-cost, effective antibacterial therapy. Recognition early in the clinical course is critical because this is the period when antibacterial therapy is most effective. Early signs and symptoms of these illnesses are nonspecific or mimic other illnesses, which can make diagnosis challenging. Previously undescribed tickborne rickettsial diseases continue to be recognized, and since 2004, three additional agents have been described as causes of human disease in the United States: Rickettsia parkeri, Ehrlichia muris-like agent, and Rickettsia species 364D. This report updates the 2006 CDC recommendations on the diagnosis and management of tickborne rickettsial diseases in the United States and includes information on the practical aspects of epidemiology, clinical assessment, treatment, laboratory diagnosis, and prevention of tickborne rickettsial diseases. The CDC Rickettsial Zoonoses Branch, in consultation with external clinical and academic specialists and public health professionals, developed this report to assist health care providers and public health professionals to 1) recognize key epidemiologic features and clinical manifestations of tickborne rickettsial diseases, 2) recognize that doxycycline is the treatment of choice for suspected tickborne rickettsial diseases in adults and children, 3) understand that early empiric antibacterial therapy can prevent severe disease and death, 4) request the appropriate confirmatory diagnostic tests and understand their usefulness and limitations, and 5) report probable and confirmed cases of tickborne rickettsial diseases to public health authorities.
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Affiliation(s)
- Holly M Biggs
- National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia
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