Tick-borne pathogens in ticks collected from birds in Taiwan

First report of Haemaphysalis bispinosa, molecular-geographic relationships of Ixodes granulatus and a new Dermacentor species from Vietnam

BACKGROUND

Vietnam and its region are regarded as an ixodid tick biodiversity hotspot for at least two genera: Haemaphysalis and Dermacentor. To contribute to our knowledge on the tick fauna of this country, ticks from these two genera as well as an Ixodes species were analyzed morphologically and their molecular-phylogenetic relationships were examined in taxonomic and geographical contexts.

METHODS

For this study, seven Haemaphysalis sp. ticks were removed from dogs and collected from the vegetation. These showed morphological differences from congeneric species known to occur in Vietnam. In addition, three Ixodes sp. ticks were collected from pygmy slow lorises (Xanthonycticebus pygmaeus), and a Dermacentor female had been previously collected from the vegetation. After DNA extraction, these were molecularly or phylogenetically analyzed based on the cytochrome c oxidase subunit I (cox1) and 16S rRNA genes.

RESULTS

The three species were morphologically identified as (i) Ixodes granulatus, which had nearly or exactly 100% sequence identities to conspecific ticks reported from large (approximately 2000 km) geographical distances but was more different (having lower, only 94.2% cox1 and 96.7% 16S rRNA sequence identity) from samples collected within 1000 km of Vietnam in Southern China and Malaysia, respectively; (ii) Haemaphysalis bispinosa, which showed 100% sequence identity to samples reported within both narrow and broad geographical ranges; and (iii) a new species, Dermacentor pseudotamokensis Hornok sp. nov., described here morphologically and shown to be phylogenetically a sister species to Dermacentor tamokensis.

CONCLUSIONS

Haemaphysalis bispinosa shows genetic homogeneity in the whole of South and Southeast Asia, probably owing to its frequent association with domestic ruminants and dogs (i.e. frequently transported hosts). However, I. granulatus, the Asian rodent tick, has a mixed geographical pattern of haplotypes, probably because it may associate with either synanthropic or wild-living rodents as primary hosts. This tick species is recorded here, for the first time to our knowledge, as parasitizing lorises in Vietnam and its region. Based on phylogenetic analyses, D. pseudotamokensis Hornok sp. nov., recognized and described here for the first time, was almost certainly misidentified previously as Dermacentor steini, drawing attention to the need to barcode all Dermacentor spp. in Southern Asia.

Detection of selected vector-borne pathogens in domestic animals, ectoparasites, and their owners in a rural community in Southwest Guatemala

Vector-borne pathogens, which are transmitted by blood-feeding arthropods to animals and people, are common in tropical regions where, combined with economic factors, can cause significant public health burden. A community-level study was undertaken in southwestern Guatemala to assess the presence of vector-borne pathogens in blood samples from humans (n = 98), their animals (n = 90), and ectoparasites (n = 83) over a period of 2 weeks. Human capillary blood was collected from participant's index finger, and animal venous blood (chickens, pigs, dogs, and cats) was collected from the jugular or cephalic veins at the enrollment period of a concurrent study. Ectoparasites (fleas, ticks, and lice) were collected from dogs at the time of the blood collection. Total DNA was extracted from the human blood, animal blood, and ectoparasites and assayed using published PCR assays for Anaplasma spp., Bartonella spp., and Ehrlichia spp. Ectoparasites were also tested for the presence of Rickettsia spp. DNA by PCR. Anaplasma spp. DNA was amplified from 1 of 39 (2.6 %) chickens and 1 of 6 (16.6 %) turkeys. All human and dog blood samples were negative for Bartonella spp. in the same community. Ehrlichia spp. DNA was amplified from 12 (60 %) of 20 dogs and sequencing documented Ehrlichia spp. in 2 dogs and the ticks and fleas collected from these dogs. All the Ehrlichia spp.-positive sequences showed 100 % homology to E. canis sequences and other uncultured Ehrlichia spp. strains isolated from animals. Rickettsia spp. DNA was not amplified from any of the ectoparasites assessed. Our findings suggest that Ehrlichia spp. are common in dogs and Anaplasma spp. are circulating in poultry in a rural community in southwest Guatemala. We expect these results to be used in awareness campaigns and public health interventions to reduce vector borne pathogens in the region.

Wide spectrum of tick-borne pathogens in juvenile Ixodes ricinus collected from autumn-migrating birds in the Vistula River Valley, Poland

BACKGROUND

Migratory birds serve as potential hosts for ticks and can be reservoirs of tick-borne pathogens (TBPs). The aim of our study was to investigate the prevalence of TBPs in juvenile Ixodes ricinus collected from Erithacus rubecula, Turdus merula, and Turdus philomelos passing through the Vistula River Valley, Poland - one of the most important European north-south routes for migratory birds.

METHODS

To detect TBPs in collected ticks we used a high-throughput microfluidic real-time PCR method. In addition, we performed a phylogenetic analysis of Borreliella garinii flaB and Rickettsia helvetica ompB sequences, considering haplotype diversity through a Median Joining Network.

RESULTS

Our results showed a high prevalence and wide spectrum of TBPs in both larvae and nymphs of I. ricinus. Overall, including co-infections, 47.41% of the tested tick specimens were infected with at least one TBP. Borreliaceae spirochetes were detected in ticks collected from all examined bird species. Ticks (larvae and nymphs) collected from T. merula showed the highest prevalence of Bo. garinii (33.33%), Bo. burgdorferi s.s. (7.69%) and Borrelia miyamotoi (2.56%), while the highest number of ticks infected with Bo. valaisiana were collected from T. philomelos (8.11%). In turn, the highest prevalence of R. helvetica (20.00%) was observed in ticks collected from E. rubecula. Additionally, infections with A. phagocytophilum (5.00%), Ehrlichia spp. (2.50%), Ba. divergens (2.50%) and Ba. venatorum (2.50%) were only confirmed in ticks collected from this bird species. The phylogenetic analysis of Bo. garinii revealed that the detected haplotype circulates widely across various hosts and is geographically widespread, while the haplotype of R. helvetica is mainly detected in ticks in Central Europe.

CONCLUSIONS

Ticks carried by T. merula, T. philomelos, and E. rubecula migrating along the Vistula River Valley, Poland are characterized by a high prevalence and a wide spectrum of detected TBPs. Tested ticks carry widespread strains of Bo. garinii, in contrast to R. helvetica, which is mainly found in Central Europe. Therefore, further research on the possible role of birds as reservoirs of TBPs is needed.

Nation-wide surveillance of ticks (Acari: Ixodidae) on birds in Singapore

Surveillance programs focused on bird ticks are often challenging owing to the difficulty in capturing and screening birds as well as the fact that ticks on avian hosts frequently occur at a low prevalence. Nonetheless, elucidating the diversity and host preferences of avian ticks is critical for understanding public health risks posed by both migratory and resident birds. The first nation-wide surveillance program of avian ticks was initiated to examine bird-tick interactions in Singapore, a key juncture along the East Asian-Australasian flyway. Two tick species were detected, namely Haemaphysalis wellingtoni and Rhipicephalus linnaei, while five bird species were found to host ticks in Singapore, namely Columba livia, Gallus gallus, Ixobrychus flavicollis, Lanius cristatus, and Pitta moluccensis. The threats posed to public health by the human-biting tick H. wellingtoni are discussed along with the potential for migratory birds and ticks to transport tick-borne pathogens into, and through, Singapore.

Prevalence and diversity of spotted fever group Rickettsia species in ixodid ticks from domestic dogs in Chad, Africa

Tick-borne pathogens in the genus Rickettsia are the causative agents of severe and potentially fatal spotted fever group (SFG) and typhus group diseases in dogs and humans. Climate, habitat, and land-use changes are impacting vector ranges, with expansions potentially resulting in novel pathogens being introduced into naïve locations. Despite the public health importance of SFG Rickettsia, there are relatively few data on the prevalence and diversity of rickettsial pathogens in sub-Saharan Africa. The aim of this study was to characterize the SFG Rickettsia prevalence and diversity in ixodid ticks (104 Amblyomma spp., 160 Rhipicephalus spp., and one Hyalomma truncatum) collected from domestic dogs in Chad, Africa. Ticks were screened for Rickettsia spp. using a nested PCR targeting the 17-kDa gene. Species identification was through bidirectional Sanger sequencing of the 17-kDa, ompA, ompB, and/or gltA gene targets. A total of 43.3 % (115/265) ticks were positive for Rickettsia spp. and six Rickettsia species were identified: R. africae, R. massiliae, R. conorii, R. felis, R. monacensis and Candidatus Rickettsia muridii. Seven additional samples were positive for Rickettsia of undetermined species. Rickettsia africae, an important zoonotic pathogen, was found in 81 % (79/97) of A. variegatum and 29 % (2/7) of an A. marmoreum complex species, a group that infests a wide range of birds and mammals, including humans. Finally, we detected a high diversity of Rickettsia spp., most of which were zoonotic, in Rh. muhsamae. Collectively these data indicate there is a risk of rickettsiosis in Chad and further studies on ticks and rickettsial pathogens in this region are warranted.

Hematological and plasma profiles and ticks and tick-borne pathogens in wild Formosan black bears (Ursus thibetanus formosanus)

BACKGROUND

The endangered Formosan black bear (Ursus thibetanus formosanus) is the largest native carnivorous mammal in Taiwan. Diseases, poor management, illegal hunting, and habitat destruction are serious threats to the survival of bear populations. However, studies on the impact of diseases on bear populations are limited. Therefore, this study aimed to establish a database of the hematological and plasma profiles of free-ranging Formosan black bears and investigate the occurrence of ectoparasites, blood parasites, and vector-borne pathogens.

METHODS

Formosan black bears were captured in Yushan National Park (YNP) and Daxueshan Forest Recreation Area (DSY) in Taiwan. Blood samples were collected from each bear for hematological analysis and plasma biochemistry using a hematology analyzer. Parasites and pathogens were detected using a thin blood smear with Wright-Giemsa staining and polymerase chain reaction (PCR) assay. Additionally, macroscopic ectoparasites were collected from bears to detect blood parasites and other pathogens. Moreover, the relationships between the bear variables (sex, age, and occurrence of parasites or pathogens), ectoparasites, and infectious agents were also analyzed.

RESULTS

In all, 21 wild bears (14 in YNP and 7 in DSY) were captured and released during the satellite tracking studies. Hematological analysis and plasma biochemistry indicated significant differences in white blood cells (WBC), segments, creatine kinase (CK), and lactate dehydrogenase (LDH) levels between foot snare and culvert-captured bears. Additionally, there were significant differences in total plasma protein (TPP), creatinine, Ca2+, Mg2+, and K+ levels between male and female bears. Moreover, pathogen-infected bears had significantly higher erythrocyte sedimentation rate (ESR; 30 min and 1 h) and globulin levels than uninfected bears. In total, 240 ticks were collected from 13 bears, among which eight adult tick species were identified, including Haemaphysalis flava, Haemaphysalis hystricis, Amblyomma testudinarium, Ixodes ovatus, Dermacentor taiwanensis, Haemaphysalis longicornis, Ixodes acutitarsus, Amblyomma javanense, and nymphs belonging to Haemaphysalis spp. PCR revealed that 13 (61.90%) and 8 (38.10%) bears harbored Hepatozoon ursi and Babesia DNA, respectively. Among the ticks examined, 157 (65.41%) and 128 (53.33%) samples were positive for H. ursi and Babesia, respectively.

CONCLUSIONS

To the best of our knowledge, this is the first study to establish a database of the hematological and plasma profiles of wild Formosan black bears and investigate ectoparasite infestation and Hepatozoon and Babesia spp.

INFECTION

In conclusion, these findings may serve as a reference for monitoring the health and population of locally endangered bears.

Concatenated ScaA and TSA56 Surface Antigen Sequences Reflect Genome-Scale Phylogeny of Orientia tsutsugamushi: An Analysis Including Two Genomes from Taiwan

Orientia tsutsugamushi is an obligate intracellular bacterium associated with trombiculid mites and is the causative agent of scrub typhus, a life-threatening febrile disease. Strain typing of O. tsutsugamushi is based on its immunodominant surface antigen, 56-kDa type-specific antigen (TSA56). However, TSA56 gene sequence-based phylogenetic analysis is only partially congruent with core genome-based phylogenetic analysis. Thus, this study investigated whether concatenated surface antigen sequences, including surface cell antigen (Sca) proteins, can reflect the genome-scale phylogeny of O. tsutsugamushi. Complete genomes were obtained for two common O. tsutsugamushi strains in Taiwan, TW-1 and TW-22, and the core genome/proteome was identified for 11 O. tsutsugamushi strains. Phylogenetic analysis was performed using maximum likelihood (ML) and neighbor-joining (NJ) methods, and the congruence between trees was assessed using a quartet similarity measure. Phylogenetic analysis based on 691 concatenated core protein sequences produced identical tree topologies with ML and NJ methods. Among TSA56 and core Sca proteins (ScaA, ScaC, ScaD, and ScaE), TSA56 trees were most similar to the core protein tree, and ScaA trees were the least similar. However, concatenated ScaA and TSA56 sequences produced trees that were highly similar to the core protein tree, the NJ tree being more similar. Strain-level characterization of O. tsutsugamushi may be improved by coanalyzing ScaA and TSA56 sequences, which are also important targets for their combined immunogenicity.

First molecular detection of a novel Babesia species from Haemaphysalis hystricis in Taiwan

Newly recorded ticks and emerging tick-borne pathogens have recently been reported in subtropical and tropical East Asia. In this study, a total of 1,615 ticks (259 Haemaphysalis hystricis, 1334 Rhipicephalus microplus, 19 H. flava, and 3 R. haemaphysaloides) were collected by flagging from vegetation in Taiwan during 2019-2021. All 1,615 captured tick samples tested negative for SFTSV and Borrelia, but 12 of 356 tick samples tested positive for PCR amplification of a fragment of the 18S rRNA gene of Babesia spp., with an infection rate of 3.37 % (12/356) and a minimum infection rate of 0.74 % (12/1,615). Among the 12 detected Babesia spp., 11 were identified as Babesia bigemina in R. microplus, and the other one, detected in H. hystricis, was classified as an unnamed novel Babesia sp. Interestingly, the 18S rRNA sequence from the isolate detected in H. hystricis shared 98.79 % to 99.50 % identity with those of recent isolates from Japan, China and Nigeria. The exact origin of the Babesia species is not known, but the findings highlight the importance of international cooperation and the exchange of information on ticks and tick-borne pathogens. This represents a rare report of a Babesia sp. identified in H. hystricis, a tick species that has been proposed as a novel vector for some Babesia spp. This study supports H. hystricis as a possible vector of Babesia spp.

Ixodid ticks from wild and domestic animals in East and Central Asian flyways

Tick-borne diseases have a significant impact on human and animal populations, posing an increasing threat to public health, particularly in the context of climate change. Along with the various natural hosts of ticks, birds play a notable role in transmitting ticks and tick-borne pathogens, indicating the importance of monitoring flyways and establishing a cooperative network for comprehensive surveillance and to collect diverse tick samples across various regions. This study aimed to develop an international network for surveillance of disease, collection of sufficient tick samples, and overall identification of the geographical distribution of host and ticks in Asian regions, especially in 11 countries on East Asian and Central Asian flyways. Ticks were collected from wild animals, domestic animals, and vegetation to identify the differences between Ixodid ticks and understand tick distribution. We collected a total 6,624 of ticks from 11 collaborating Asian countries, the Republic of Korea (ROK), Japan, Thailand, Philippines, Indonesia, Cambodia, Vietnam, Taiwan, Hong Kong, Mongolia and Pakistan. We identified 17 host animals and 47 species of both residential and migratory birds. Ticks from birds collected from four countries (ROK, Japan, Hong Kong and Mongolia) belonged to two genera, Haemaphysalis and Ixodes, including Haemaphysalis (H.) longicornis, H. flava, H. concinna, H. hystricis, H. formosensis, Ixodes (I.) nipponensis and I. persulcatus. The potential of migratory birds to cross ecological barriers with ticks and tick-borne diseases indicated the need for further investigations to understand the migration of birds as potential vectors and the new influx of zoonotic diseases along migratory bird flyways. This study suggests the potential risk of spreading tick-borne diseases through birds, thus highlighting the importance of international cooperative networking.

Toxoplasma gondii and Rickettsia spp. in ticks collected from migratory birds in the Republic of Korea

Migratory birds disperse ticks and associated tick-borne pathogens along their migratory routes. Four selected pathogens of medical importance (Coxiella burnetii, Rickettsia spp., Francisella tularensis, and Toxoplasma gondii) were targeted for detection in 804 ticks (365 pools) collected from migratory birds at Hong and Heuksan Islands in the Republic of Korea (ROK) from 2010 to 2011 and 2016. Toxoplasma gondii and Rickettsia spp., were detected in 1/365 (0.27%) and 34/365 (9.32%) pools of ticks, respectively. T. gondii and five rickettsial species were recorded in ticks collected from migratory birds for the first time in ROK. The five rickettsial species (R. monacensis, Candidatus Rickettsia longicornii, R. japonica, R. raoultii, and R. tamurae) were identified using sequence and phylogenetic analysis using ompA and gltA gene fragments. Rickettsia spp. are important pathogens that cause rickettsiosis in humans, with cases recorded in the ROK. These results provide important evidence for the potential role of migratory birds in the introduction and dispersal of T. gondii and Rickettsia spp. along their migratory routes and raise awareness of potential transmission of zoonotic tick-borne pathogens associated with migratory birds in the ROK.

Comparative mitogenomics elucidates the population genetic structure of Amblyomma testudinarium in Japan and a closely related Amblyomma species in Myanmar

Ticks are the second most important vector capable of transmitting diseases affecting the health of both humans and animals. Amblyomma testudinarium Koch 1844 (Acari: Ixodidae), is a hard tick species having a wide geographic distribution in Asia. In this study, we analyzed the composition of A. testudinarium whole mitogenomes from various geographical regions in Japan and investigated the population structure, demographic patterns, and phylogeographic relationship with other ixodid species. In addition, we characterized a potentially novel tick species closely related to A. testudinarium from Myanmar. Phylogeographic inference and evolutionary dynamics based on the 15 mitochondrial coding genes supported that A. testudinarium population in Japan is resolved into a star-like haplogroup and suggested a distinct population structure of A. testudinarium from Amami island in Kyushu region. Correlation analysis using Mantel test statistics showed that no significant correlation was observed between the genetic and geographic distances calculated between the A. testudinarium population from different localities in Japan. Finally, demographic analyses, including mismatch analysis and Tajima's D test, suggested a possibility of recent population expansion occurred within Japanese haplogroup after a bottleneck event. Although A. testudinarium has been considered widespread and common in East and Southeast Asia, the current study suggested that potentially several cryptic Amblyomma spp. closely related to A. testudinarium are present in Asia.

USING SURFACE WASHING TO REMOVE THE ENVIRONMENTAL COMPONENT FROM FLEA MICROBIOME ANALYSIS

Microbial metabarcoding is a common method to study the biology of blood-feeding arthropods and identify patterns of potential pathogen transmission. Before DNA extraction, specimens are often surface washed to remove environmental contaminants. While surface washing is common, its effects on microbial diversity remain unclear. We characterized the microbiome of the flea species Ceratophyllus idius, an avian ectoparasite, and a potential vector of pathogens, using high-throughput 16S rRNA sequencing. Half of the nests from which fleas were collected were subjected to an environmental manipulation in which nesting materials were periodically replaced. In a crossed study design we surface washed half of the flea samples from each environmental condition to produce 4 experimental conditions. Environmental manipulations resulted in significant differences in the diversity and structure of the flea microbiome, but these differences were unapparent when specimens were surface washed. Furthermore, differential abundance testing of the experimental groups revealed that surface washing predominantly affected the abundance of bacterial groups that are characterized as environmental contaminants. These findings suggest that environmental changes primarily affect the surface microbiome of arthropods and that surface washing is a useful tool to reduce the footprint of the external microbiome on analysis.

Risk factors analysis for neglected human rickettsioses in rural communities in Nan province, Thailand: A community-based observational study along a landscape gradient

In this study, we estimated exposure for Scrub typhus (STG), Typhus (TG) and Spotted fever groups (SFG) rickettsia using serology at a fine scale (a whole sub-district administration level) of local communities in Nan Province, Thailand. Geographical characteristics of the sub-district were divided into two landscape types: lowland agricultural area in an urbanized setting (lowland-urbanized area) and upland agricultural area located close to a protected area of National Park (upland-forested area). This provided an ideal contrast between the two landscapes with low and high levels of human-altered habitats to study in differences in disease ecology. In total, 824 serum samples of participants residing in the eight villages were tested by screening IgG ELISA, and subsequently confirmed by the gold standard IgG Immunofluorescent Assay (IFA). STG and TG IgG positivity were highest with seroprevalence of 9.8% and 9.0%, respectively; whereas SFG positivity was lower at 6.9%. Inhabitants from the villages located in upland-forested area demonstrated significantly higher STG exposure, compared to those villages in the lowland-urbanized area (chi-square = 51.97, p < 0.0001). In contrast, TG exposure was significantly higher in those villagers living in lowland-urbanized area (chi-square = 28.26, p < 0.0001). In addition to the effect of landscape types, generalized linear model (GLM) analysis identified socio-demographic parameters, i.e., gender, occupation, age, educational level, domestic animal ownership (dog, cattle and poultry) as influential factors to explain the level of rickettsial exposure (antibody titers) in the communities. Our findings raise the public health awareness of rickettsiosis as a cause of undiagnosed febrile illness in the communities.

Evidence of human exposures to rickettsial pathogens were reported from a cross-sectional study at a whole sub-district scale of local communities in Nan Province, Thailand. Seroprevalence and level of rickettsial exposures demonstrated differences between the habitat types, ecological aspects and socio-demographic factors. In addition, abundance of domestic animals in the community appeared to be one of significant factors influencing levels of human exposure to rickettsial pathogens. Our findings will benefit the local public health by raising awareness of rickettsial infections as one of potential health concerns in the community. Inclusion of rickettsioses in routine laboratory diagnosis would help to differentiate unknown febrile illness and guide appropriate treatment. Further studies are required, particularly in the fields of disease ecology as well as medical and veterinary entomology, in order to better understand epidemiology and potential zoonotic transmission of these neglected rickettsioses in endemic areas.

Potential Role of Avian Populations in the Epidemiology of Rickettsia spp. and Babesia spp

Birds often are carriers of hard and/or soft ticks harboring pathogens of humans and veterinary concern. Migratory avian species, which cover long distance by their flight, may deeply influence the ticks’ distribution worldwide; in particular, they can introduce in a given geographic area new tick species and related tick-borne pathogens. Studies about the detection of tick-borne agents in birds are not numerous, whereas more attention has been turned to the presence of these microorganisms in ticks carried by birds. The present review focused on the role of avian populations in the epidemiology of rickettsioses and babesioses, which represent two severe problems for the health of humans and other mammals.

Detection of tick-borne pathogens in wild birds and their ticks in Western Siberia and high level of their mismatch

The Tomsk region located in the south of Western Siberia is one of the most high-risk areas for tick-borne diseases due to elevated incidence of tick-borne encephalitis and Lyme disease in humans. Wild birds may be considered as one of the reservoirs for tick-borne pathogens and hosts for infected ticks. A high mobility of wild birds leads to unpredictable possibilities for the dissemination of tick-borne pathogens into new geographical regions. The primary goal of this study was to evaluate the prevalence of tick-borne pathogens in wild birds and ticks that feed on them as well as to determine the role of different species of birds in maintaining the tick-borne infectious foci. We analysed the samples of 443 wild birds (60 species) and 378 ticks belonging to the genus Ixodes Latraille, 1795 collected from the wild birds, for detecting occurrence of eight tick-borne pathogens, the namely tick-borne encephalitis virus (TBEV), West Nile virus (WNV), and species of Borrelia, Rickettsia, Ehrlichia, Anaplasma, Bartonella and Babesia Starcovici, 1893, using RT-PCR/or PCR and enzyme immunoassay. One or more tick-borne infection markers were detected in 43 species of birds. All markers were detected in samples collected from fieldfare Turdus pilaris Linnaeus, Blyth's reed warbler Acrocephalus dumetorum Blyth, common redstart Phoenicurus phoenicurus (Linnaeus), and common chaffinch Fringilla coelebs Linnaeus. Although all pathogens have been identified in birds and ticks, we found that in the majority of cases (75.5 %), there were mismatches of pathogens in birds and ticks collected from them. Wild birds and their ticks may play an extremely important role in the dissemination of tick-borne pathogens into different geographical regions.

Seroepidemiological Study of Spotted Fever Group Rickettsiae and Identification of a Putative New Species, Rickesttsia sp. Da-1, in Gongliao, Northeast Taiwan

Tick-borne spotted fever group (SFG) rickettsioses were neglected in Taiwan. The study reported a seroepidemiological survey of SFG rickettsiae in residents in Gongliao District, Northeast Taiwan. Blood samples were examined for antibodies against SFG rickettsiae by enzyme-linked immunosorbent assay and immunofluorescence assay. Risk factors were assessed using logistic regression. Ticks parasitizing dogs were collected within a 2 km radius from the houses of seropositive participants, and PCR was performed to detect possible tick-borne pathogens. Of 1108 participants, 75 (6.8%) had antibodies against SFG rickettsiae. Residents were more likely to be seropositive if they were older than 65 years, recruited by Dr. Enjoy’s Clinic, or resided in Jilin village. A total of 184 ticks including 5 species (Rhipicephalus sanguineus, Rhipicephalus haemaphysaloides, Dermacentor auratus, Haemaphysalis hystricis, Haemaphysalis ornithophila) were collected. Rickettsia spp. were detected in 6.5% (12/184) of ticks. Rickettsia sp. TwKM01 was found in 6 R. sanguineus and 4 R. haemaphysaloides; while Rickettsia sp. TwKM03 was identified in 1 R. sanguineus. Moreover, gene-based pairwise analysis indicated identification of a putative new species, Rickettsia sp. Da-1, in D. auratus. These findings provided evidence of SFG rickettsiae infection in ticks and suggested SFG rickettsiae exposure in the residents.

Neglected human Rickettsia felis infection in Taiwan: A retrospective seroepidemiological survey of patients with suspected rickettsioses

BACKGROUND

Current knowledge on Rickettsia felis infection in humans is based on sporadic case reports. Here we conducted a retrospective seroepidemiological survey of R. felis infection among febrile patients visiting a medical center in Taipei.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 122 patients with suspected rickettsioses presenting with fever of unknown origin (FUO) but tested negative for scrub typhus, murine typhus, or Q fever were retrospectively identified during 2009 to 2010. The archived serum samples were examined for the presence of antibodies against R. felis, Rickettsia japonica, and Rickettsia typhi using microimmunofluorescence (MIF) assay. Serological evidence of Rickettsia exposure was found in 23 (19%, 23/122) patients. Eight patients had antibodies reactive to R. felis, including four with current infection (a ≥4-fold increase in IgG titer between acute and convalescent sera). The clinical presentations of these four patients included fever, skin rash, lymphadenopathy, as well as more severe conditions such as pancytopenia, hepatomegaly, elevated liver enzymes/bilirubin, and life-threatening acute respiratory distress syndrome. One of the patients died after doxycycline was stopped after being tested negative for scrub typhus, Q fever, and murine typhus.

CONCLUSIONS

Rickettsia felis is a neglected flea-borne pathogen in Taiwan, and its infection can be life-threatening. Further prospective studies of the prevalence of R. felis among patients with FUO and compatible clinical manifestations are warranted.

Multi-Locus Sequence Typing of Ehrlichia chaffeensis Reveals Extensive Genotypic Variation across the United States

Ehrlichia chaffeensis causes human monocytic ehrlichiosis, and its principal vector is the Amblyomma americanum tick. The most frequently identified cases of ehrlichiosis come from the southeastern and south central states of the United States. In this study, a molecular typing system was developed that allows for the genetic differentiation of E. chaffeensis isolates. This multi-locus typing system included sequencing and analyzing intergenic regions ECH0033-ECH0035 and ECH0217-ECH0218, plus, variable genes variable length PCR target, 28-kDa, 120-kDa, and hemE. We examined a total of 31 unique isolates from humans and white-tailed deer, and eight DNA samples extracted from infected A. americanum collected from multiple states. This is the largest evaluation of E. chaffeensis isolates and their genotypes. Our findings show that when sequences of all six loci were concatenated and compared, the 39 samples could be separated into 23 genotypes and further grouped into six phylogenetic clades. The data in this study show no clear pattern between the geographic alignment with the genetic differentiation between the strains. As a result, this poses a challenge to understanding the spread of E. chaffeensis in the United States. Interestingly, our findings indicate that multiple strains from distant geographic origins share the same mutations, which suggests that the strains are being moved from one site to another by their hosts or vectors. In addition, we are seeing a northward shift in the lone star tick distribution in the United States. Last, some data also suggest minimal genetic mutations have occurred over time among strains that are within geographical proximity.

Geographic distribution and modeling of ticks in the Republic of Korea and the application of tick models towards understanding the distribution of associated pathogenic agents

Encounters with ticks harboring pathogenic agents have demonstrated increasing public health implications. Tick surveillance in the Republic of Korea (ROK) is essential for determining tick distributions and the potential regions where tick-borne pathogens may be found. Extensive tick collections (tick drags and tick flagging) were previously performed by Force Health Protection & Preventive Medicine (FHP&PM), Medical Activity-Korea (MEDDAC-K)/65^th Medical Brigade (MED BDE) personnel, in collaboration with the Public Health Activity-Korea in the ROK. A total of 144,131 ticks were collected from 2,019 locations during 2004 to 2016. The associated location data (GPS coordinates) for each of the collection sites were incorporated into distribution maps using ArcGIS and combined with environmental data in the Maxent ecological niche modeling program (n = 733 geographical unique locations from 1,429 presence records/collection locations) to produce estimates of tick distributions for each species. The predominant tick species found and modeled were, in order of prevalence: Haemaphysalis longicornis, H. flava, Ixodes nipponensis, H. phasiana, I. turdus, Amblyomma testudinarium, H. japonica, and I. persulcatus. Haemaphysalis longicornis, H. flava, and I. nipponensis were the most widely distributed and most commonly collected species of ticks. The maps and models of suitable habitat regions produced in this study provide a better understanding of where there are potential risks of encountering a particular tick species, and which, as demonstrated herein with rickettsiae, can be used to study tick-pathogen dynamics of diseases. Knowledge of the distribution of ticks is important in the ROK because of the presence of tick-borne diseases, such as severe fever with thrombocytopenia syndrome, tick-borne encephalitis, rickettsioses, and borrelioses.

Detection of Borrelia burgdorferi Sensu Lato and Relapsing Fever Borrelia in Feeding Ixodes Ticks and Rodents in Sarawak, Malaysia: New Geographical Records of Borrelia yangtzensis and Borrelia miyamotoi

Members of the Borrelia burgdorferi sensu lato (Bbsl) complex are etiological agents of Lyme disease (LD), and Borrelia miyamotoi is one of the relapsing fever Borrelia (RFB). Despite the serological evidence of LD in Malaysia, there has been no report from Sarawak, Malaysian Borneo. Thus, this study aimed to detect and characterize Borrelia in rodents and Ixodes ticks from primary forests and an oil palm (OP) plantation in Sarawak. Borrelia yangtzensis (a member of the Bbsl complex) was detected in 43.8% (14/32) of Ixodes granulatus; most of the positive ticks were from the OP plantation (13/14). Out of 56 rodents, B. yangtzensis was detected in four Rattus spp. from the OP plantation and B. miyamotoi was detected in one rodent, Sundamys muelleri, from the primary forest. Further, the positive samples of B. yangtzensis were randomly selected for multilocus sequence analysis (MLSA). The MLSA results of successfully amplified tick samples revealed a clustering with the sequences isolated from Japan and China. This study is the first evidence of B. miyamotoi, a known human pathogen in Malaysia, and B. yangtzensis, which is circulating in ticks and rodents in Sarawak, Malaysian Borneo, and presenting a new geographical record of the Borrelia spp.

Representative Genotyping, Recombination and Evolutionary Dynamics Analysis of TSA56 Gene Segment of Orientia tsutsugamushi

Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi (O. tsutsugamushi). Orientia tsutsugamushi has various genotypes and more new strains with difference in sequences increasingly appeared. Whether the accurateness of one special nested PCR method which amplifies segment instead of entire open reading frame (ORF) sequence meets the current work of identifying new strains and classifying genotypes remains to be confirmed. And the origins and evolution of this organism have not been thoroughly elucidated. Accordingly, in this study, segments and the entire ORF of the 56-kDa type-specific antigen (TSA56) gene of O. tsutsugamushi were collected, including 209 clinically isolated strains in Guangzhou, China from 2012 to 2016 and 139 reference strains worldwide. By performing phylogenetic analysis, we proved that the accurateness of the particular PCR method which almost met detection need. This re-grouping result showed that segments perfectly represented and identified strains of Karp, Boryong, Gilliam, TA763, Kawasaki and part of Kato genotype, and this accuracy is not restricted by region and time. Sequence diversification of Shimokoshi and some Kato strains made their genotyping need to consider entire ORF sequences, but their weak recognition might not be due to recombination. The frequent genetic recombination and high point mutations contributed to genetic diversification of the TSA56 gene. Major overlapping regions of most recombination events occurred between strains of the same genotype, especially Karp and Kato genotype. And cross-genotype overlapping events occurred between Karp and Boryong/Gilliam/TA763/Kato, Kato and Kawasaki/Gilliam/TA686, Boryong and TA686, and Gilliam and Kawasaki. But Segment has quite low recombination frequency and stable mutation trend from 1943 to 2016. So segment is a relatively conserved part of the TSA56 ORF as for its stable trend of genetic diversity, and it may anchor and represent the entire TSA56 ORF gene. And genetic diversity is rejected as one potential reason for the increased incidence of scrub typhus. But an occasional recombination event created an unrecognized genotype which might be due to the breakage of VD II and AD II. Additionally, strains in Guangzhou were homologous and Karp genotype was detected as a dominant.

Human Case of Ehrlichia chaffeensis Infection, Taiwan

In 2018, an immunosuppressed woman in southern Taiwan had onset of fever, chills, myalgia, malaise, thrombocytopenia, lymphocytopenia, and elevated hepatic transaminases. Investigation revealed infection with Ehrlichia chaffeensis. This autochthonous case of human monocytotropic ehrlichiosis was confirmed by PCR, DNA sequencing, and seroconversion.

Distribution and Ecological Drivers of Spotted Fever Group Rickettsia in Asia

Spotted fever group and related rickettsia (SFGR) are a neglected group of pathogens that belong to the genus Rickettsia. SFGR are zoonotic and are transmitted by arthropod vectors, primarily ticks, fleas and mites to accidental hosts. These emerging and re-emerging infections are widely distributed throughout the world. Land-use change and increasing human-wildlife conflict compound the risk of SFGR infection to local people in endemic areas and travelers to these regions. In this article, we discuss the rickettsial organisms causing spotted fever and related diseases, their arthropod vectors in Asia and the impact of land-use change on their spread.

Detection of Borrelia DNA in Tick Species Collected from Vegetation and Wild Animals in Fukuoka, Japan

We screened for the presence of Borrelia spp. in ticks collected from vegetation by flagging and from wild animals between May 2017 and November 2018 in Fukuoka, located in the northern Kyushu region of Japan. A total of 1,601 ticks were collected and separated based on morphology into nine species, namely Ixodes turdus, I. ovatus, Amblyomma testudinarium, Haemaphysalis flava, H. formosensis, H. kitaokai, H. longicornis, H. hystricis, and H. megaspinosa. The ticks were segregated into 561 pools and nested PCR was used to detect borrelial DNA. Borrelia turdi and Borrelia sp. HM were identified in two of the 561 pools. This is the first report of the presence of the Lyme disease group of Borrelia and of the relapsing fever group of Borrelia in Fukuoka, Japan.

Human granulocytic anaplasmosis in Kinmen, an offshore island of Taiwan

Background

Human granulocytic anaplasmosis, a tick-borne infection caused by Anaplasma phagocytophilum, has received scant attention, while scrub typhus, a mite-transmitted disease caused by Orientia tsutsugamushi, is the most common rickettsiosis in Taiwan. The clinical presentations of both diseases are characterized by undifferentiated fever, headache and malaise. Moreover, both pathogens have been detected in small mammals that serve as hosts for chiggers and ticks in the wild. The objective of the present study was to investigate whether human granulocytic anaplasmosis occurs in Taiwan.

Methodology/Principal findings

Blood samples from 274 patients suspected of having scrub typhus in Kinmen, an offshore island of Taiwan, in 2011 and 2012 were retrospectively examined by immunofluorescence assays. IgG antibodies reactive with Anaplasma phagocytophilum was found in 31.8% (87/274) of the patients. Paired serology identified 3 patients with human granulocytic anaplasmosis and 8 patients with coinfection with O. tsutsugamushi and A. phagocytophilum. Laboratory tests showed that elevated serum ALT/AST, creatinine, and BUN levels were observed in patients with anaplasmosis and coinfection, but elevated serum CRP levels, thrombocytopenia, and anemia were only observed in coinfected patients. PCR detected A. phagocytophilum 16S rDNA and p44/msp2 in 2 patients. The phylogenetic analysis suggested that the replicons of the 16S rDNA shared high sequence similarity with the reference sequences in the Korea, USA, Japan, and China. The amplicons of p44/msp2 were close to those of the human variants identified in the USA and Japan.

Conclusions

Our findings indicated that A. phagocytophilum infection was prevalent but unrecognized in Taiwan.

Human granulocytic anaplasmosis is a tick-borne rickettsial infection caused by Anaplasma phagocytophilum. Although most cases resolve readily, life-threatening complications can occur without prompt antibiotic treatment. The major difficulty in diagnosing human granulocytic anaplasmosis is due to the nonspecific nature of the symptoms. Given that scrub typhus is the most frequently reported rickettsial disease in Taiwan and shares similar early clinical signs with anaplasmosis, we retrospectively examined blood samples from patients with suspected diagnoses of scrub typhus in 2011 and 2012. While serological evidence of potential past exposure was found in as many as 31.8% (87/274) of the patients, current or recent anaplasmosis was supported by seroconversion in 11 patients, including 8 patients coinfected with scrub typhus. Anaplasma phagocytophilum DNA was detected in acute phase samples, and the amplified fragments were phylogenetically close to those of variants in the Korea, the USA, Japan, and China. Herein, for the first time, we confirmed the presence of human granulocytic anaplasmosis in Taiwan. By reporting coinfections with anaplasmosis and scrub typhus, the study further highlighted the health risk of increasing contact with wild rodents.

Detection and isolation of tick-borne bacteria (Anaplasma spp., Rickettsia spp., and Borrelia spp.) in Amblyomma varanense ticks on lizard (Varanus salvator)

Ticks are one of the arthropods that play an important role in the transmission of numerous pathogens to livestock and humans. We investigated the presence of tick-borne bacteria in 23 Amblyomma varanense that fed on a water monitor (Varanus salvator) in Indonesia. Anaplasmataceae and borreliae were detected by PCR in 17.4% and 95.7% of ticks, respectively. "Candidatus Rickettsia sepangensis", spotted fever group of Rickettsia, was detected in 21.7% of ticks. The water monitor is a common reptile that is widely encountered in city areas in Asian countries. Our results suggested that Am. varanense on water monitor in Indonesia harbored several kinds of bacteria.

Molecular characterization of Anaplasma and Ehrlichia in ixodid ticks and reservoir hosts from Palestine: a pilot survey

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.

Natural infection of questing ixodid ticks with protozoa and bacteria in Chonburi Province, Thailand

Ixodid ticks are important vectors of tick-borne disease agents affecting humans and animals, with wildlife often serving as important reservoirs. This study examined protozoal and bacterial infection in questing ticks in forest habitats in Chonburi Province, Thailand in 2015, using PCR and DNA sequencing techniques. A total of 12,184 ticks were morphologically identified to species and a subset of ticks were confirmed by PCR, targeting the tick mitochondrial 16S rRNA gene. Tick species collected included Haemaphysalis lagrangei (92.8%), H. wellingtoni (0.1%), and Rhipicephalus microplus (7.0%). In total, 419 tick pools [ELM(1] [ST2] were examined by PCR amplification of a fragment of the 18S rRNA gene of Babesia and Theileria species, and the 16S rRNA gene of bacteria in the family Anaplasmataceae. Results revealed a tick infection rate for the tick pools of 57.0% (239/419) including four pathogens and one bacterial symbiont. The highest infection rate in H. lagrangei, H. wellingtoni, and R. microplus pools was recorded for Anaplasma spp. at 55.6% (233/419) including three Anaplasma species genotype groups Anaplasma spp. closely related to A. bovis, A. platys, and unidentified Anaplasma spp. Theileria spp. showed a lower infection rate in H. lagrangei at 4.3% (18/419) with three Theileria species genotypes closely related to T. cervi, T. capreoli, and unidentified Theileria spp. Only 0.2% (1/419) of H. lagrangei pools contained Babesia spp., Ehrlichia spp., or Wolbachia spp. [ELM(3] [ST4] These findings provided information on tick species in wildlife habitats and detected protozoa and bacteria in the ticks. The results suggest that these tick species are possible vectors for transmitting tick-borne disease agents in Thailand wildlife habitats.

The Re-Emergence and Emergence of Vector-Borne Rickettsioses in Taiwan

Rickettsial diseases, particularly vector-borne rickettsioses (VBR), have a long history in Taiwan, with studies on scrub typhus and murine typhus dating back over a century. The climatic and geographic diversity of Taiwan's main island and its offshore islands provide many ecological niches for the diversification and maintenance of rickettsiae alike. In recent decades, scrub typhus has re-emerged as the most prevalent type of rickettsiosis in Taiwan, particularly in eastern Taiwan and its offshore islands. While murine typhus has also re-emerged on Taiwan's western coast, it remains neglected. Perhaps more alarming than the re-emergence of these rickettsioses is the emergence of newly described VBR. The first case of human infection with Rickettsia felis was confirmed in 2005, and undetermined spotted fever group rickettsioses have recently been detected. Taiwan is at a unique advantage in terms of detecting and characterizing VBR, as it has universal health coverage and a national communicable disease surveillance system; however, these systems have not been fully utilized for this purpose. Here, we review the existing knowledge on the eco-epidemiology of VBR in Taiwan and recommend future courses of action.