1
|
Apaa TT, McFadzean H, Gandy S, Hansford K, Medlock J, Johnson N. Anaplasma phagocytophilum Ecotype Analysis in Cattle from Great Britain. Pathogens 2023; 12:1029. [PMID: 37623989 PMCID: PMC10459425 DOI: 10.3390/pathogens12081029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/22/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Anaplasma phagocytophilum (A. phagocytophilum) is the aetiological agent of tick-borne fever in cattle and sheep, and granulocytic anaplasmosis in human and dogs. Livestock, companion animal and human infections with A. phagocytophilum have been reported globally. Across England and Wales, two isolates (called ecotypes) have been reported in ticks. This study examined A. phagocytophilum isolates present in livestock and wildlife in Great Britain (GB), with a particular focus on cattle. Clinical submissions (EDTA blood) from cattle (n = 21) and sheep (n = 3) were received by APHA for tick-borne disease testing and the animals were confirmed to be infected with A. phagocytophilum using a PCR targeting the Msp2 gene. Further submissions from roe deer (n = 2), red deer (n = 2) and Ixodes ricinus ticks (n = 22) were also shown to be infected with A. phagocytophilum. Subsequent analysis using a nested PCR targeting the groEL gene and sequencing confirmed the presence of ecotype I in cattle, sheep, red deer and Ixodes ricinus, and ecotype II in roe deer and I. ricinus removed from deer carcasses. Despite the presence of two ecotypes, widely distributed in ticks from England and Wales, only ecotype I was detected in cattle in this study.
Collapse
Affiliation(s)
- Ternenge Thaddaeus Apaa
- Vector Borne Diseases, Virology Department, Animal and Plant Health Agency, Woodham Lane, Addlestone KT15 3NB, UK
| | - Harriet McFadzean
- Animal and Plant Health Agency, Staplake Mount, Starcross, Exeter EX6 8PE, UK
| | - Sara Gandy
- Medical Entomology & Zoonoses, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Kayleigh Hansford
- Medical Entomology & Zoonoses, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Jolyon Medlock
- Medical Entomology & Zoonoses, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Nicholas Johnson
- Vector Borne Diseases, Virology Department, Animal and Plant Health Agency, Woodham Lane, Addlestone KT15 3NB, UK
| |
Collapse
|
2
|
Beltran A, Palomar AM, Ercibengoa M, Goñi P, Benito R, Lopez B, Oteo JA. MALDI-TOF MS as a tick identification tool in a tertiary hospital in Spain. Acta Trop 2023; 242:106868. [PMID: 36940856 DOI: 10.1016/j.actatropica.2023.106868] [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: 01/12/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 03/23/2023]
Abstract
In Spain, as in other countries, the spectrum of tick-borne diseases and their number have increased in recent years. The tick identification, at species level, can be a challenging outside research centers although this information is very usufull for decisions making. The performance of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) in tick identification of specimens collected from patients have been seldomly reported. The aim of the present study was to desing a protein-extraction protocol and build a tick-legs reference spectra. This protocol was then validated using specimens from both patients and non-patient sources. Nine species of ticks that usually bites humans in Spain were included: Dermacentor marginatus, Dermacentor reticulatus, Haemaphysalis punctata, Hyalomma usitanicum, Hyalomma marginatum, Ixodes ricinus, Rhipicephalus bursa, Rhipicephalus pusillus and Rhipicephalus sanguineus sensu lato. Other less-frequentbiting species were also included: Haemaphysalis inermis, Haemaphysalis concinna, Hyalomma scupense,Ixodes frontalis, Ixodes hexagonus, and Argas sp. Specimens were identified by PCR and sequencing of a fragment of the 16S rRNA gene of ticks. In the tests performed with non-patient collected specimens, a 100% correlation was observed between molecular methods and MS, while in the tests performed with ticks collected from patients a 92.59% correlation was observed. Misidentification was observed only in two of I. ricinus nymphs (identified as Ctenocephalides felis). Therefore, mass- spectrometry can be confidently used as a tick identification tool in a hospital setting for the rapid identification of tick vectors.
Collapse
Affiliation(s)
- Antonio Beltran
- Microbiology Department, Lozano Blesa University Hospital, 50009 Zaragoza, Spain; Group of Water and Environmental Health, Institute of Environmental Sciences (IUCA)..
| | - Ana M Palomar
- Center of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), Infectious Diseases Department, San Pedro University Hospital-Center for Biomedical Research from La Rioja (CIBIR), 26006 Logroño, Spain
| | - Maria Ercibengoa
- Biodonostia Health Research Institute, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group; Biodonostia Health Research Institute, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group; Osakidetza, Hospital Universitario Donostia, 20014 San Sebastián, Spain
| | - Pilar Goñi
- Department of Microbiology, Pediatrics, Radiology and Public Health, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain; Group of Water and Environmental Health, Institute of Environmental Sciences (IUCA)
| | - Rafael Benito
- Microbiology Department, Lozano Blesa University Hospital, 50009 Zaragoza, Spain; Department of Microbiology, Pediatrics, Radiology and Public Health, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain; Institute for Health Research Aragón, Zaragoza, Spain
| | - Beatriz Lopez
- Centro de Salud de Epila, 50290 Epila, Zaragoza, Spain
| | - Jose Antonio Oteo
- Center of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), Infectious Diseases Department, San Pedro University Hospital-Center for Biomedical Research from La Rioja (CIBIR), 26006 Logroño, Spain
| |
Collapse
|
3
|
Stanko M, Derdáková M, Špitalská E, Kazimírová M. Ticks and their epidemiological role in Slovakia: from the past till present. Biologia (Bratisl) 2021; 77:1575-1610. [PMID: 34548672 PMCID: PMC8446484 DOI: 10.1007/s11756-021-00845-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/06/2021] [Indexed: 01/26/2023]
Abstract
In Slovakia, 22 tick species have been found to occur to date. Among them, Ixodes ricinus, Dermacentor reticulatus, D. marginatus and marginally Haemaphysalis concinna, H. inermis and H. punctata have been identified as the species of public health relevance. Ticks in Slovakia were found to harbour and transmit zoonotic and/or potentially zoonotic agents such as tick-borne encephalitis virus (TBEV), spirochaetes of the Borrelia burgdorferi sensu lato (s.l.) complex, the relapsing fever sprirochaete Borrelia miyamotoi, bacteria belonging to the orders Rickettsiales (Rickettsia spp., Anaplasma phagocytophilum, Neoehrlichia mikurensis), Legionellales (Coxiella burnetii), and Thiotrichales (Francisella tularensis), and Babesia spp. parasites (order Piroplasmida). Ixodes ricinus is the principal vector of the largest variety of microorganisms including viruses, bacteria and piroplasms. TBEV, B. burgdorferi s.l., rickettsiae of the spotted fever group, C. burnetii and F. tularensis have been found to cause serious diseases in humans, whereas B. miyamotoi, A. phagocytophilum, N. mikurensis, Babesia microti, and B. venatorum pose lower or potential risk to humans. Distribution of TBEV has a focal character. During the last few decades, new tick-borne encephalitis (TBE) foci and their spread to new areas have been registered and TBE incidence rates have increased. Moreover, Slovakia reports the highest rates of alimentary TBE infections among the European countries. Lyme borreliosis (LB) spirochaetes are spread throughout the distribution range of I. ricinus. Incidence rates of LB have shown a slightly increasing trend since 2010. Only a few sporadic cases of human rickettsiosis, anaplasmosis and babesiosis have been confirmed thus far in Slovakia. The latest large outbreaks of Q fever and tularaemia were recorded in 1993 and 1967, respectively. Since then, a few human cases of Q fever have been reported almost each year. Changes in the epidemiological characteristics and clinical forms of tularaemia have been observed during the last few decades. Global changes and development of modern molecular tools led to the discovery and identification of emerging or new tick-borne microorganisms and symbionts with unknown zoonotic potential. In this review, we provide a historical overview of research on ticks and tick-borne pathogens in Slovakia with the most important milestones and recent findings, and outline future directions in the investigation of ticks as ectoparasites and vectors of zoonotic agents and in the study of tick-borne diseases.
Collapse
Affiliation(s)
- Michal Stanko
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
- Institute of Zoology, Slovak Academy of Sciences, Dúbravská cesta 9, 845 06 Bratislava, Slovakia
| | - Markéta Derdáková
- Institute of Zoology, Slovak Academy of Sciences, Dúbravská cesta 9, 845 06 Bratislava, Slovakia
| | - Eva Špitalská
- Institute of Virology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Mária Kazimírová
- Institute of Zoology, Slovak Academy of Sciences, Dúbravská cesta 9, 845 06 Bratislava, Slovakia
| |
Collapse
|
4
|
Montoya-Alonso JA, Morchón R, Costa-Rodríguez N, Matos JI, Falcón-Cordón Y, Carretón E. Current Distribution of Selected Vector-Borne Diseases in Dogs in Spain. Front Vet Sci 2020; 7:564429. [PMID: 33195540 PMCID: PMC7643126 DOI: 10.3389/fvets.2020.564429] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022] Open
Abstract
Currently, climate change, modifications of landscapes and habitats due to human activities, as well as an increase in the movement of reservoirs and new species of competent vectors, have contributed to the spread of canine vector-borne diseases. These are mostly emerging and neglected diseases, some of them with zoonotic potential. Therefore, the objective of this study was to assess the prevalence and distribution of four major canine vector-borne diseases (Dirofilaria immitis, Leishmania infantum, Anaplasma spp., and Ehrlichia canis) in Spain. Between September 2018 and February 2020, blood was sampled from 4643 client-owned dogs from 111 veterinary clinics from the 17 autonomous communities of Spain. All samples were tested for the detection of D. immitis antigens, and for antibodies against L. infantum, Anaplasma spp. and E. canis. Of the studied dogs, 22.14% were positive for one or several diseases while the prevalence was 6.25% (CI: 5.59–6.98) for D. immitis, and the seroprevalences were 10.36% (CI: 9.52–11.27) for L. infantum, 5.06% (CI: 4.47–5.73) for Anaplasma spp., and 4.26% (CI: 3.72–4.88) for E. canis. Co-infections by two and three vector-borne diseases were reported in 13% and 2% of the infected dogs, respectively. The studied vector-borne diseases are widely distributed throughout the Spanish geography, being observed and expanding northward in the case of D. immitis and L. infantum. The results point to an insufficiency of preventive measures to avoid the infection, and the need of the implementation of awareness campaigns among veterinarians and owners. Furthermore, a close collaboration between veterinarians, physicians and health authorities would be necessary for such zoonotic vector-borne diseases.
Collapse
Affiliation(s)
- José Alberto Montoya-Alonso
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Rodrigo Morchón
- Animal and Human Dirofilariosis Group, Laboratory of Parasitology, Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Noelia Costa-Rodríguez
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jorge Isidoro Matos
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Yaiza Falcón-Cordón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Elena Carretón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| |
Collapse
|
5
|
Matei IA, Estrada-Peña A, Cutler SJ, Vayssier-Taussat M, Varela-Castro L, Potkonjak A, Zeller H, Mihalca AD. A review on the eco-epidemiology and clinical management of human granulocytic anaplasmosis and its agent in Europe. Parasit Vectors 2019; 12:599. [PMID: 31864403 PMCID: PMC6925858 DOI: 10.1186/s13071-019-3852-6] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/13/2019] [Indexed: 11/11/2022] Open
Abstract
Anaplasma phagocytophilum is the agent of tick-borne fever, equine, canine and human granulocytic anaplasmosis. The common route of A. phagocytophilum transmission is through a tick bite, the main vector in Europe being Ixodes ricinus. Despite the apparently ubiquitous presence of the pathogen A. phagocytophilum in ticks and various wild and domestic animals from Europe, up to date published clinical cases of human granulocytic anaplasmosis (HGA) remain rare compared to the worldwide status. It is unclear if this reflects the epidemiological dynamics of the human infection in Europe or if the disease is underdiagnosed or underreported. Epidemiologic studies in Europe have suggested an increased occupational risk of infection for forestry workers, hunters, veterinarians, and farmers with a tick-bite history and living in endemic areas. Although the overall genetic diversity of A. phagocytophilum in Europe is higher than in the USA, the strains responsible for the human infections are related on both continents. However, the study of the genetic variability and assessment of the difference of pathogenicity and infectivity between strains to various hosts has been insufficiently explored to date. Most of the European HGA cases presented as a mild infection, common clinical signs being pyrexia, headache, myalgia and arthralgia. The diagnosis of HGA in the USA was recommended to be based on clinical signs and the patient’s history and later confirmed using specialized laboratory tests. However, in Europe since the majority of cases are presenting as mild infection, laboratory tests may be performed before the treatment in order to avoid antibiotic overuse. The drug of choice for HGA is doxycycline and because of potential for serious complication the treatment should be instituted on clinical suspicion alone.
Collapse
Affiliation(s)
- Ioana A Matei
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| | - Agustín Estrada-Peña
- Department of Animal Health, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Sally J Cutler
- School of Health, Sport & Bioscience, University of East London, London, UK.
| | - Muriel Vayssier-Taussat
- Department of Animal Health, French National Institute for Agricultural Research, Maisons-Alfort, France
| | - Lucía Varela-Castro
- Department of Animal Health, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain.,Animal Health Department, NEIKER-Instituto Vasco de Investigación y Desarrollo Agrario, Bizkaia Science and Technology Park, Derio, Bizkaia, Spain
| | - Aleksandar Potkonjak
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Herve Zeller
- Emerging and Vector-borne Diseases Programme, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrei D Mihalca
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| |
Collapse
|
6
|
Han F, Lu X, Xiao C, Chang M, Huang K. Estimation of Health Effects and Economic Losses from Ambient Air Pollution in Undeveloped Areas: Evidence from Guangxi, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152707. [PMID: 31362448 PMCID: PMC6695923 DOI: 10.3390/ijerph16152707] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 11/19/2022]
Abstract
Guangxi Zhuang Autonomous Region, located in the southwest of China, has rapidly developed since the late 2000s. Similar to other regions, economic development has been accompanied by environmental problems, especially air pollution, which can adversely affect the health of residents in the area. In this study, we estimated the negative health effects of three major ambient pollutants, Particulate Matter with a diameter of 10 μm or less (PM10), Sulfur Dioxide (SO2) and Nitrogen Dioxide (NO2) in Guangxi from 2011 to 2016 using a log-linear exposure–response function. We monetarized the economic loss using the value of statistical life (VSL) and the cost of illness (COI) methods. The results show that the total possible short-term all-cause mortality values due to PM10, SO2, and NO2 were 28,396, with the confidence intervals from 14,664 to 42,014 (14,664–42,014), 24,618 (15,480–33,371), and 46,365 (31,158–61,423), respectively. The mortality from the three pollutants was 48,098 (19,972–75,973). The economic loss of the health burden from the three pollutants was 40,555 (24,172–57,585), which was 2.86% (1.70–4.06%) of the regional gross domestic product. The result of the comparative analysis among different cities showed that urbanization, industrialization, and residents’ income are important factors in air-pollution-caused health damage and subsequent economic loss. We conclude that the health burden caused by ambient pollutants in developing regions, accompanied by its rapid socio-economic growth, is significant and tighter regulation is needed in the future to alleviate air pollution and mitigate the related health damage.
Collapse
Affiliation(s)
- Feng Han
- Key Laboratory of Beibu Gulf Environment Change and Resources Utilization of Ministry of Education, Nanning Normal University, Nanning 530001, China
| | - Xingcheng Lu
- Division of Environment, Hong Kong University of Science & Technology, Clear Water Bay, Hong Kong, China
| | - Cuicui Xiao
- School of Environmental, Tsinghua University, Beijing 100084, China
| | - Miao Chang
- School of Environmental, Tsinghua University, Beijing 100084, China.
| | - Ke Huang
- Guangxi Environmental Protection Bureau, No.16 of Foziling Road, Nanning 530001, China
| |
Collapse
|
7
|
Palomar AM, Portillo A, Santibáñez P, Mazuelas D, Roncero L, García-Álvarez L, Santibáñez S, Gutiérrez Ó, Oteo JA. Detection of tick-borne Anaplasma bovis, Anaplasma phagocytophilum and Anaplasma centrale in Spain. MEDICAL AND VETERINARY ENTOMOLOGY 2015; 29:349-53. [PMID: 26111122 DOI: 10.1111/mve.12124] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 02/13/2015] [Accepted: 02/21/2015] [Indexed: 05/10/2023]
Abstract
The genus Anaplasma (Rickettsiales: Anaplasmataceae) includes species of medical and veterinary importance. The presence of Anaplasma spp. in ticks from birds, as well as in Haemaphysalis punctata (Ixodida: Ixodidae) specimens collected from cattle and vegetation in northern Spain was investigated. A total of 336 ticks from birds [174 Ixodes frontalis (Ixodida: Ixodidae), 108 H. punctata, 34 Hyalomma marginatum (Ixodida: Ixodidae), 17 Ixodes ricinus (Ixodida: Ixodidae) and three Ixodes spp.], and 181 H. punctata specimens collected from cattle (n = 71) and vegetation (n = 110) were analysed. Anaplasma bovis was detected in five H. punctata, including two from birds (1.9%) and three from vegetation (2.7%). Four I. frontalis (2.3%) (one co-infected with 'Candidatus Midichloria mitochondrii') and one I. ricinus (5.9%) removed from birds, as well as four H. punctata (5.6%) collected from cattle showed Anaplasma phagocytophilum infection. In addition, Anaplasma centrale was found in two H. punctata, one from a cow (1.4%) and the other from vegetation (0.9%). This study represents the first evidence of the presence of A. bovis in European ticks, and reports the first detection of A. bovis and A. centrale in H. punctata, and the first finding of A. phagocytophilum and 'Ca. Midichloria mitochondrii' in I. frontalis.
Collapse
Affiliation(s)
- A M Palomar
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
| | - A Portillo
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
| | - P Santibáñez
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
| | - D Mazuelas
- Abies, Environment Resources, Inc., Logroño, La Rioja, Spain
| | - L Roncero
- Abies, Environment Resources, Inc., Logroño, La Rioja, Spain
| | - L García-Álvarez
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
| | - S Santibáñez
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
| | - Ó Gutiérrez
- Aranzadi Society of Sciences, San Sebastián, Guipúzcoa, Spain
| | - J A Oteo
- Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital San Pedro-CIBIR, Logroño, La Rioja, Spain
| |
Collapse
|
8
|
Rizzoli A, Silaghi C, Obiegala A, Rudolf I, Hubálek Z, Földvári G, Plantard O, Vayssier-Taussat M, Bonnet S, Spitalská E, Kazimírová M. Ixodes ricinus and Its Transmitted Pathogens in Urban and Peri-Urban Areas in Europe: New Hazards and Relevance for Public Health. Front Public Health 2014; 2:251. [PMID: 25520947 PMCID: PMC4248671 DOI: 10.3389/fpubh.2014.00251] [Citation(s) in RCA: 285] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/09/2014] [Indexed: 12/30/2022] Open
Abstract
Tick-borne diseases represent major public and animal health issues worldwide. Ixodes ricinus, primarily associated with deciduous and mixed forests, is the principal vector of causative agents of viral, bacterial, and protozoan zoonotic diseases in Europe. Recently, abundant tick populations have been observed in European urban green areas, which are of public health relevance due to the exposure of humans and domesticated animals to potentially infected ticks. In urban habitats, small and medium-sized mammals, birds, companion animals (dogs and cats), and larger mammals (roe deer and wild boar) play a role in maintenance of tick populations and as reservoirs of tick-borne pathogens. Presence of ticks infected with tick-borne encephalitis virus and high prevalence of ticks infected with Borrelia burgdorferi s.l., causing Lyme borreliosis, have been reported from urbanized areas in Europe. Emerging pathogens, including bacteria of the order Rickettsiales (Anaplasma phagocytophilum, "Candidatus Neoehrlichia mikurensis," Rickettsia helvetica, and R. monacensis), Borrelia miyamotoi, and protozoans (Babesia divergens, B. venatorum, and B. microti) have also been detected in urban tick populations. Understanding the ecology of ticks and their associations with hosts in a European urbanized environment is crucial to quantify parameters necessary for risk pre-assessment and identification of public health strategies for control and prevention of tick-borne diseases.
Collapse
Affiliation(s)
- Annapaola Rizzoli
- Fondazione Edmund Mach, Research and Innovation Centre, San Michele all'Adige , Trento , Italy
| | - Cornelia Silaghi
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Vetsuisse-Faculty, Swiss National Centre for Vector Entomology, Institute for Parasitology, University of Zurich , Zürich , Switzerland
| | - Anna Obiegala
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig , Germany
| | - Ivo Rudolf
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Zdeněk Hubálek
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Gábor Földvári
- Department of Parasitology and Zoology, Faculty of Veterinary Science, Szent István University , Budapest , Hungary
| | - Olivier Plantard
- INRA, UMR1300 BioEpAR , Nantes , France ; LUNAM Université, Oniris, Ecole nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique, UMR BioEpAR , Nantes , France
| | - Muriel Vayssier-Taussat
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Sarah Bonnet
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Eva Spitalská
- Institute of Virology, Slovak Academy of Sciences , Bratislava , Slovakia
| | - Mária Kazimírová
- Institute of Zoology, Slovak Academy of Sciences , Bratislava , Slovakia
| |
Collapse
|
9
|
García JC, Núñez MJ, Portillo A, Oteo JA. [Human anaplasmosis: two case-reports]. Enferm Infecc Microbiol Clin 2014; 33:68-9. [PMID: 25073813 DOI: 10.1016/j.eimc.2014.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 04/27/2014] [Accepted: 05/02/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Juan C García
- Servicio de Medicina Interna, Complejo Hospitalario Universitario de Pontevedra, Servicio Gallego de Salud, Pontevedra, España.
| | - Manuel J Núñez
- Servicio de Medicina Interna, Complejo Hospitalario Universitario de Pontevedra, Servicio Gallego de Salud, Pontevedra, España
| | - Aránzazu Portillo
- Departamento de Enfermedades Infecciosas, Hospital de San Pedro-Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, La Rioja, España
| | - José A Oteo
- Departamento de Enfermedades Infecciosas, Hospital de San Pedro-Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, La Rioja, España
| |
Collapse
|
10
|
Rizzoli A, Silaghi C, Obiegala A, Rudolf I, Hubálek Z, Földvári G, Plantard O, Vayssier-Taussat M, Bonnet S, Spitalská E, Kazimírová M. Ixodes ricinus and Its Transmitted Pathogens in Urban and Peri-Urban Areas in Europe: New Hazards and Relevance for Public Health. Front Public Health 2014. [PMID: 25520947 DOI: 10.3389/fpubh.2014.00251.pmid:25520947;pmcid:pmc4248671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Tick-borne diseases represent major public and animal health issues worldwide. Ixodes ricinus, primarily associated with deciduous and mixed forests, is the principal vector of causative agents of viral, bacterial, and protozoan zoonotic diseases in Europe. Recently, abundant tick populations have been observed in European urban green areas, which are of public health relevance due to the exposure of humans and domesticated animals to potentially infected ticks. In urban habitats, small and medium-sized mammals, birds, companion animals (dogs and cats), and larger mammals (roe deer and wild boar) play a role in maintenance of tick populations and as reservoirs of tick-borne pathogens. Presence of ticks infected with tick-borne encephalitis virus and high prevalence of ticks infected with Borrelia burgdorferi s.l., causing Lyme borreliosis, have been reported from urbanized areas in Europe. Emerging pathogens, including bacteria of the order Rickettsiales (Anaplasma phagocytophilum, "Candidatus Neoehrlichia mikurensis," Rickettsia helvetica, and R. monacensis), Borrelia miyamotoi, and protozoans (Babesia divergens, B. venatorum, and B. microti) have also been detected in urban tick populations. Understanding the ecology of ticks and their associations with hosts in a European urbanized environment is crucial to quantify parameters necessary for risk pre-assessment and identification of public health strategies for control and prevention of tick-borne diseases.
Collapse
Affiliation(s)
- Annapaola Rizzoli
- Fondazione Edmund Mach, Research and Innovation Centre, San Michele all'Adige , Trento , Italy
| | - Cornelia Silaghi
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Vetsuisse-Faculty, Swiss National Centre for Vector Entomology, Institute for Parasitology, University of Zurich , Zürich , Switzerland
| | - Anna Obiegala
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität , Munich , Germany ; Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig , Germany
| | - Ivo Rudolf
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Zdeněk Hubálek
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, v.v.i. , Brno , Czech Republic
| | - Gábor Földvári
- Department of Parasitology and Zoology, Faculty of Veterinary Science, Szent István University , Budapest , Hungary
| | - Olivier Plantard
- INRA, UMR1300 BioEpAR , Nantes , France ; LUNAM Université, Oniris, Ecole nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique, UMR BioEpAR , Nantes , France
| | - Muriel Vayssier-Taussat
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Sarah Bonnet
- USC BIPAR, INRA, ANSES - French Agency for Food, Environmental and Occupational Health and Safety , Maisons-Alfort , France
| | - Eva Spitalská
- Institute of Virology, Slovak Academy of Sciences , Bratislava , Slovakia
| | - Mária Kazimírová
- Institute of Zoology, Slovak Academy of Sciences , Bratislava , Slovakia
| |
Collapse
|
11
|
Koebel C, Kern A, Edouard S, Hoang AT, Celestin N, Hansmann Y, Jaulhac B, Brouqui P, De Martino SJ. Human granulocytic anaplasmosis in eastern France: clinical presentation and laboratory diagnosis. Diagn Microbiol Infect Dis 2012; 72:214-8. [PMID: 22321996 DOI: 10.1016/j.diagmicrobio.2011.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 11/15/2011] [Accepted: 12/10/2011] [Indexed: 11/25/2022]
Abstract
Human granulocytic anaplasmosis (HGA) is a tick-borne infection characterised by an acute, nonspecific febrile illness. To date, few clinical cases have been supported by both a positive polymerase chain reaction (PCR) assay and subsequent seroconversion against Anaplasma phagocytophilum antigen all over Europe. We report here 3 consecutive cases of HGA that occurred during the summer of 2009 which fulfilled the epidemiologic, clinical, and biological criteria for HGA. These data highlight PCR assay on ethylenediaminetetraacetic acid blood rather than serology as the diagnostic test of choice during the acute phase of the disease. In endemic areas, HGA should be investigated in patients presenting an undifferentiated febrile illness with cytopenia, elevated rates of liver enzymes, and increased C-reactive protein values.
Collapse
Affiliation(s)
- Christelle Koebel
- Laboratoire de Bactériologie, Hôpitaux Universitaires de Strasbourg, 1, rue Koeberlé, Strasbourg Cedex, France
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Jin H, Wei F, Liu Q, Qian J. Epidemiology and Control of Human Granulocytic Anaplasmosis: A Systematic Review. Vector Borne Zoonotic Dis 2012; 12:269-74. [DOI: 10.1089/vbz.2011.0753] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hongtao Jin
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun, Jilin Province, People's Republic of China
| | - Feng Wei
- College of Life Science, Jilin Agricultural University, Changchun, Jilin Province, People's Republic of China
| | - Quan Liu
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun, Jilin Province, People's Republic of China
| | - Jun Qian
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun, Jilin Province, People's Republic of China
| |
Collapse
|
13
|
Ayllón T, Diniz PPVP, Breitschwerdt EB, Villaescusa A, Rodríguez-Franco F, Sainz A. Vector-borne diseases in client-owned and stray cats from Madrid, Spain. Vector Borne Zoonotic Dis 2011; 12:143-50. [PMID: 22022820 DOI: 10.1089/vbz.2011.0729] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The role of various vector-borne pathogens as a cause of disease in cats has not been clearly determined. The current study evaluated risk factors, clinical and laboratory abnormalities associated with Ehrlichia spp., Anaplasma spp., Neorickettsia spp., Leishmania spp., and Bartonella spp. infection or exposure in 680 client-owned and stray cats from Madrid, Spain. Our results indicate that a large portion (35.1%) of the cat population of Madrid, Spain, is exposed to at least one of the five vector-borne pathogens tested. We found seroreactivity to Bartonella henselae in 23.8%, to Ehrlichia canis in 9.9%, to Anaplasma phagocytophilum in 8.4%, to Leishmania infantum in 3.7%, and to Neorickettsia risticii in 1% of the feline study population. About 9.9% of cats had antibody reactivity to more than one agent. L. infantum DNA was amplified from four cats (0.6%), B. henselae DNA from one cat (0.15%), and B. clarridgeiae DNA from another cat (0.15%).
Collapse
Affiliation(s)
- Tania Ayllón
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avenida Puerta de Hierro s/n, Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
14
|
Human anaplasmosis in Belgium: a 10-year seroepidemiological study. Ticks Tick Borne Dis 2011; 2:156-9. [PMID: 21890069 DOI: 10.1016/j.ttbdis.2011.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 06/16/2011] [Accepted: 06/16/2011] [Indexed: 11/23/2022]
Abstract
Human granulocytic anaplasmosis (HGA) is a tick-borne rickettsial infection of neutrophils caused by Anaplasma phagocytophilum. Although the pathogen was known as a veterinary agent as early as 1932, the link with human disease was first established in 1990. In the past decennium, the involvement of HGA as an important and frequent cause of fever with a history of tick bite was increasingly recognized in many regions of Europe. This paper presents a 10-year A. phagocytophilum serosurveillance (2000-2009), wherein 1672 serum samples were tested and 418 were found positive. A total of 111 patients had a history of tick bite, fever, and at least a 4-fold rise in titre and are thus considered to be confirmed cases. These findings suggest that Belgium is a hot spot for HGA infections.
Collapse
|
15
|
Vieira RFDC, Biondo AW, Guimarães AMS, Dos Santos AP, Dos Santos RP, Dutra LH, Diniz PPVDP, de Morais HA, Messick JB, Labruna MB, Vidotto O. Ehrlichiosis in Brazil. ACTA ACUST UNITED AC 2011; 20:1-12. [PMID: 21439224 DOI: 10.1590/s1984-29612011000100002] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 11/03/2010] [Indexed: 11/21/2022]
Abstract
Ehrlichiosis is a disease caused by rickettsial organisms belonging to the genus Ehrlichia. In Brazil, molecular and serological studies have evaluated the occurrence of Ehrlichia species in dogs, cats, wild animals and humans. Ehrlichia canis is the main species found in dogs in Brazil, although E. ewingii infection has been recently suspected in five dogs. Ehrlichia chaffeensis DNA has been detected and characterized in mash deer, whereas E. muris and E. ruminantium have not yet been identified in Brazil. Canine monocytic ehrlichiosis caused by E. canis appears to be highly endemic in several regions of Brazil, however prevalence data are not available for several regions. Ehrlichia canis DNA also has been detected and molecularly characterized in three domestic cats, and antibodies against E. canis were detected in free-ranging Neotropical felids. There is serological evidence suggesting the occurrence of human ehrlichiosis in Brazil but its etiologic agent has not yet been established. Improved molecular diagnostic resources for laboratory testing will allow better identification and characterization of ehrlichial organisms associated with human ehrlichiosis in Brazil.
Collapse
|
16
|
Portillo A, Pérez-Martínez L, Santibáñez S, Santibáñez P, Palomar AM, Oteo JA. Anaplasmaspp. in Wild Mammals andIxodes ricinusfrom the North of Spain. Vector Borne Zoonotic Dis 2011; 11:3-8. [DOI: 10.1089/vbz.2009.0214] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Aránzazu Portillo
- Área de Enfermedades Infecciosas (Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores), Hospital San Pedro-CIBIR, Logroño, Spain
| | - Laura Pérez-Martínez
- Área de Enfermedades Infecciosas (Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores), Hospital San Pedro-CIBIR, Logroño, Spain
| | - Sonia Santibáñez
- Área de Enfermedades Infecciosas (Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores), Hospital San Pedro-CIBIR, Logroño, Spain
| | - Paula Santibáñez
- Área de Enfermedades Infecciosas (Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores), Hospital San Pedro-CIBIR, Logroño, Spain
| | - Ana M. Palomar
- Área de Enfermedades Infecciosas (Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores), Hospital San Pedro-CIBIR, Logroño, Spain
| | - José A. Oteo
- Área de Enfermedades Infecciosas (Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores), Hospital San Pedro-CIBIR, Logroño, Spain
| |
Collapse
|
17
|
First described case of human granulocytic anaplasmosis in a patient in Eastern Austria. Wien Med Wochenschr 2010; 160:91-93. [PMID: 20300926 DOI: 10.1007/s10354-009-0733-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 11/18/2009] [Indexed: 10/19/2022]
Abstract
A 64-year-old otherwise healthy patient presented with high fever, thrombocytopenia, elevated liver enzymes and an erythema on the belly. The patient remembered a tick bite four weeks ago when walking with his dog before the specific symptoms started. A meningococcal disease or hematological illness was excluded. The serological results for tick-borne diseases showed a high IgG antibody titer for Anaplasma phagocytophila. All symptoms and laboratory parameters normalized after one week of hospitalization. The patient received no treatment and recovered completely. This is the first confirmed case of human granulocytic anaplasmosis (HGA) in Eastern Austria.
Collapse
|
18
|
Heyman P, Cochez C, Hofhuis A, van der Giessen J, Sprong H, Porter SR, Losson B, Saegerman C, Donoso-Mantke O, Niedrig M, Papa A. A clear and present danger: tick-borne diseases in Europe. Expert Rev Anti Infect Ther 2010; 8:33-50. [PMID: 20014900 DOI: 10.1586/eri.09.118] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ticks can transmit a variety of viruses, bacteria or parasites that can cause serious infections or conditions in humans and animals. While tick-borne diseases are becoming an increasing and serious problem in Europe, tick-borne diseases are also responsible for major depressions in livestock production and mortality in sub-Saharan Africa, Latin America and Asia. This review will focus on the most important circulating tick-transmitted pathogens in Europe (Borrelia spp., Anaplasma phagocytophilum, Babesia spp., tick-borne encephalitis virus, Rickettsia spp. and Crimean-Congo hemorrhagic fever virus).
Collapse
Affiliation(s)
- Paul Heyman
- Research Laboratory for Vector Borne Diseases, Queen Astrid Military Hospital, Bruynstraat 1, B-1120 Brussels, Belgium.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Tomanović S, Radulović Ž, Masuzawa T, Milutinović M, Stanisavljević L. Potential infectivity of Anaplasma phagocytophilum strains in Ixodes ricinus ticks from Serbia. Acta Vet Hung 2010; 58:231-42. [PMID: 20460222 DOI: 10.1556/avet.58.2010.2.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Anaplasma phagocytophilum strains from different geographical regions are characterised by diverse potential infectivity for humans and domesticated animals. We investigated the potential pathogenicity of A. phagocytophilum strains in Ixodes ricinus ticks from 11 geographically different localities in Serbia. Sequences obtained in this study showed a high variability of p44 paralogues. Some of them, however, formed groups with similarities greater than 86% ('similarity groups'). Previous studies showed that 'similarity groups' were nearly always country specific. Our results correlated with this observation, and we also observed significant clustering of paralogues according to vector and reservoir origin of A. phagocytophilum strains. According to the high genetic similarity of sequences isolated from ticks collected in four localities, namely Avala, Batrovci, Hajducka cesma and Ljubovija, with paralogues with proven pathogenicity isolated from human granulocytic anaplasmosis (HGA) patients and A. phagocytophilum infected sheep, we could assume that strains with potential infectivity for humans and domestic animals were present in Serbia.
Collapse
Affiliation(s)
- Snežana Tomanović
- 1 University of Belgrade Laboratory for Medical Arachnoentomology, Centre for Parasitic Zoonoses, Institute for Medical Research Dr. Subotića 4 P.O. Box 102 11129 Belgrade Serbia
| | - Željko Radulović
- 1 University of Belgrade Laboratory for Medical Arachnoentomology, Centre for Parasitic Zoonoses, Institute for Medical Research Dr. Subotića 4 P.O. Box 102 11129 Belgrade Serbia
| | - Toshiyuki Masuzawa
- 2 Chiba Institute of Science (CIS) Laboratory of Microbiology and Immunology, Faculty of Pharmaceutical Sciences Chiba Japan
| | - Marija Milutinović
- 1 University of Belgrade Laboratory for Medical Arachnoentomology, Centre for Parasitic Zoonoses, Institute for Medical Research Dr. Subotića 4 P.O. Box 102 11129 Belgrade Serbia
| | | |
Collapse
|
20
|
First detection of the Anaplasma phagocytophilum groEL-A genotype in man. J Infect 2010; 60:300-5. [DOI: 10.1016/j.jinf.2009.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 12/15/2009] [Accepted: 12/17/2009] [Indexed: 11/19/2022]
|
21
|
Abstract
Anaplasma phagocytophilum is the recently designated name replacing three species of granulocytic bacteria, Ehrlichia phagocytophila, Ehrlichia equi and the agent of human granulocytic ehrlichiosis, after the recent reorganization of the families Rickettsiaceae and Anaplasmataceae in the order Rickettsiales. Tick-borne fever (TBF), which is caused by the prototype of A. phagocytophilum, was first described in 1932 in Scotland. A similar disease caused by a related granulocytic agent was first described in horses in the USA in 1969; this was followed by the description of two distinct granulocytic agents causing similar diseases in dogs in the USA in 1971 and 1982. Until the discovery of human granulocytic anaplasmosis (HGA) in the USA in 1994, these organisms were thought to be distinct species of bacteria infecting specific domestic animals and free-living reservoirs. It is now widely accepted that the agents affecting different animal hosts are variants of the same Gram-negative obligatory intracellular bacterium, which is transmitted by hard ticks belonging to the Ixodes persulcatus complex. One of its fascinating features is that it infects and actively grows in neutrophils by employing an array of mechanisms to subvert their bactericidal activity. It is also able to survive within an apparently immune host by employing a complex mechanism of antigenic variation. Ruminants with TBF and humans with HGA develop severe febrile reaction, bacteraemia and leukopenia due to neutropenia, lymphocytopenia and thrombocytopenia within a week of exposure to a tick bite. Because of the severe haematological disorders lasting for several days and other adverse effects on the host's immune functions, infected animals and humans are more susceptible to other infections.
Collapse
Affiliation(s)
- Zerai Woldehiwet
- University of Liverpool, Department of Veterinary Pathology, Veterinary Teaching Hospital, Leahurst, Neston, South Wirral CH64 7TE, UK.
| |
Collapse
|
22
|
Thomas RJ, Stephen Dumler J, Carlyon JA. Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and Ehrlichia ewingii ehrlichiosis. Expert Rev Anti Infect Ther 2009; 7:709-22. [PMID: 19681699 PMCID: PMC2739015 DOI: 10.1586/eri.09.44] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anaplasma phagocytophilum, Ehrlichia chaffeensis and Ehrlichia ewingii are emerging tick-borne pathogens and are the causative agents of human granulocytic anaplasmosis, human monocytic ehrlichiosis and E. ewingii ehrlichiosis, respectively. Collectively, these are referred to as human ehrlichioses. These obligate intracellular bacterial pathogens of the family Anaplasmataceae are transmitted by Ixodes spp. or Amblyomma americanum ticks and infect peripherally circulating leukocytes to cause infections that range in clinical spectra from asymptomatic seroconversion to mild, severe or, in rare instances, fatal disease. This review describes: the ecology of each pathogen; the epidemiology, clinical signs and symptoms of the human diseases that each causes; the choice methods for diagnosing and treating human ehrlichioses; recommendations for patient management; and is concluded with suggestions for potential future research.
Collapse
Affiliation(s)
- Rachael J Thomas
- Department of Microbiology and Immunology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - J Stephen Dumler
- Division of Medical Microbiology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MA, USA
| | - Jason A Carlyon
- Department of Microbiology and Immunology, Virginia Commonwealth University School of Medicine, Molecular Medicine Research Building, 1220 East Broad Street, Room 4052, PO Box 980678, Richmond, VA 23298-0678, USA Tel.: +1 804 628 3382 Fax: +1 804 828 9946
| |
Collapse
|
23
|
Sikutová S, Rudolf I, Golovchenko M, Rudenko N, Grubhoffer L, Hubálek Z. Detection of Anaplasma dna in Ixodes ricinus ticks: pitfalls. Folia Parasitol (Praha) 2008; 54:310-2. [PMID: 18303773 DOI: 10.14411/fp.2007.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A total of 150 nymphal Ixodes ricinus (L., 1758) (Acari: Ixodidae) from the Czech Republic were examined for Anaplasma phagocytophilum (Foggie, 1949) Dumler et al., 2001 by PCR using EHR521/747 primers: 22 of 50 pools were positive (minimum prevalence, 14.7%). However, sequencing of the PCR products did not show complete homology with A. phagocytophilum (91%) while the closest relationship (95%) was found to "Candidatus Ehrlichia walkefii". The results indicate a need for care in interpretation of Anaplasma PCR results and for PCR optimization for detecting A. phagocytophilum in ticks.
Collapse
Affiliation(s)
- Silvie Sikutová
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, Kvĕtná 8, 603 65 Brno, Czech Republic
| | | | | | | | | | | |
Collapse
|
24
|
Vorou RM, Papavassiliou VG, Tsiodras S. Emerging zoonoses and vector-borne infections affecting humans in Europe. Epidemiol Infect 2007; 135:1231-47. [PMID: 17445320 PMCID: PMC2870710 DOI: 10.1017/s0950268807008527] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The purpose of this study was to assess and describe the current spectrum of emerging zoonoses between 2000 and 2006 in European countries. A computerized search of the Medline database from January 1966 to August 2006 for all zoonotic agents in European countries was performed using specific criteria for emergence. Fifteen pathogens were identified as emerging in Europe from 2000 to August 2006: Rickettsiae spp., Anaplasma phagocytophilum, Borrelia burgdorferi, Bartonella spp., Francisella tularensis, Crimean Congo Haemorrhagic Fever Virus, Hantavirus, Toscana virus, Tick-borne encephalitis virus group, West Nile virus, Sindbis virus, Highly Pathogenic Avian influenza, variant Creutzfeldt-Jakob disease, Trichinella spp., and Echinococus multilocularis. Main risk factors included climatic variations, certain human activities as well as movements of animals, people or goods. Multi-disciplinary preventive strategies addressing these pathogens are of public health importance. Uniform harmonized case definitions should be introduced throughout Europe as true prevalence and incidence estimates are otherwise impossible.
Collapse
Affiliation(s)
- R M Vorou
- Hellenic Center for Disease Control and Prevention, Athens, Greece.
| | | | | |
Collapse
|
25
|
Abstract
The agent that causes tick-borne fever (TBF) in sheep was first described in 1940, 8 years after the disease was first recognized in Scotland. The same agent was soon shown to cause TBF in sheep and pasture fever in cattle in other parts of the UK, Scandinavia, and other parts of Europe. After the initial use of the name Rickettsia phagocytophila, the organism was given the name Cytoecetes phagocytophila to reflect its association with granulocytes and its morphological similarity with Cytoecetes microti. This name continued to be used by workers in the UK until the recent reclassification of the granulocytic ehrlichiae affecting ruminants, horses, and humans as variants of the same species, Anaplasma phagocytophilum. TBF and pasture fever are characterized by high fever, recurrent bacteremia, neutropenia, lymphocytopenia, thrombocytopenia, and general immunosuppression, resulting in more severe secondary infections such as tick pyemia, pneumonic pasteurellosis, listeriosis, and enterotoxemia. During the peak period of bacteremia as many as 90% of granulocytes may be infected. The agent is transmitted transtadially by the hard tick Ixodes ricinus, and possibly other ticks. After patent bacteremia, sheep, goats, and cattle become persistently infected "carriers," perhaps playing an important role in the maintenance of infection, in the flock/herd. Little is known about how efficiently ticks acquire and maintain infection in ruminant populations or whether "carrier" domestic ruminants play an important role as reservoirs of infection, but deer, other free-living ruminants, and wild rodents are also potential sources of infection. During the late 1990s serological evidence of infection of humans was demonstrated in several European countries, creating a renewed interest and increased awareness of the zoonotic potential of TBF variants. More recently, a few cases of human granulocytic anaplasmosis (HGA) have been reported in some European countries, but it remains to be established whether the variants causing HGA in Europe are genetically and biologically different from those causing TBF in ruminants. TBF is readily diagnosed by demonstrating intracytoplasmic inclusions in peripheral blood granulocytes or monocytes of febrile animals or by detecting specific DNA by polymerase chain reaction (PCR), and TBF variants of A. phagocytophilum can be cultivated in tick cell lines, but the differentiation of TBF variants from HGA variants awaits further investigations.
Collapse
Affiliation(s)
- Zerai Woldehiwet
- Veterinary Teaching Hospital, Leahurst, Neston, South Wirral, UK.
| |
Collapse
|
26
|
García JC, Núñez MJ, Castro B, Fraile FJ, López A, Mella MC, Blanco A, Sieira C, Loureiro E, Portillo A, Oteo JA. Human Anaplasmosis: The First Spanish Case Confirmed by PCR. Ann N Y Acad Sci 2006; 1078:545-7. [PMID: 17114773 DOI: 10.1196/annals.1374.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report a case of human anaplasmosis (HA) fulfilling the confirmation criteria: epidemiologic data and clinical picture compatible with HA; presence of a morulae within polymorphonuclear leukocyte; and positive PCR assay for Anaplasma phagocytophilum: This case report shows the presence of HA in Spain.
Collapse
Affiliation(s)
- J C García
- Servicio de Medicina Interna, F.P. Hospital Do Salnés, C/Estromil Ande Rubians, 36600-Vilagarcía de Arousa (Pontevedra), Spain.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Lillini E, Macrì G, Proietti G, Scarpulla M. New Findings on Anaplasmosis Caused by Infection withAnaplasma phagocytophilum. Ann N Y Acad Sci 2006; 1081:360-70. [PMID: 17135539 DOI: 10.1196/annals.1373.053] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Ixodes ricinus (I. ricinus) is one of the vectors of Anaplasma phagocytophilum (A. phagocytophilum) in Europe, in which rates of infection range from 1.9% to 34%. In 1998, human granulocytic ehrlichiosis-like (HGE-like) Ehrlichia DNA was detected in Italy, by PCR technique in one I. ricinus nymph out of 55 ticks that were examined. In 1996, 6.3% of 310 human sera in high-risk subjects from Italy were found positive for antibodies to Ehrlichia phagocytophila (E. phagocytophila). In the same year, the authors reported the first case of equine granulocytic ehrlichiosis. In 1997, only 2 out of 563 equine blood samples examined were found positive for antibodies to E. phagocytophila in the Latium region. In 1998, serological positivity was not observed in 14 symptomatic race horses. In 2002, a symptomatic horse living in Rome was found positive for Ehrlichia equi (E. equi) antibodies, as confirmed by PCR. E. equi was also demonstrated in horses by detection of specific antibodies from two asymptomatic ponies. We tested 128 sera from sheep in different flocks, and antibodies to E. phagocytophila were detected in 17 sera (13.3%) of these sheep. From 2000 to 2004, 147 dog sera were tested for antibodies against A. phagocytophilum, and 7 of these sera were positive (4.8%). These data confirm the presence of the infection in human, domestic animals, and pets in Italy. Studies are under way to correlate the distributions of the disease and tick vector, I. ricinus.
Collapse
Affiliation(s)
- Eugenio Lillini
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Via Appia Nuova 1411, 00187 Roma, Italy.
| | | | | | | |
Collapse
|
28
|
Portillo A, Santos AS, Santibáñez S, Pérez-Martínez L, Blanco JR, Ibarra V, Oteo JA. Detection of a Non-Pathogenic Variant of Anaplasma phagocytophilum in Ixodes ricinus from La Rioja, Spain. Ann N Y Acad Sci 2005; 1063:333-6. [PMID: 16481536 DOI: 10.1196/annals.1355.053] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Our aim was to identify variants of Anaplasma phagocytophilum 16S rRNA gene sequences among products amplified from Ixodes ricinus collected in La Rioja, Spain. A. phagocytophilum AP-variant 1, reported as non-pathogenic, was detected in 12 samples (two adults and ten nymphs). This finding could justify the low incidence of human anaplasmosis in our area, despite the high prevalence of A. phagocytophilum in ticks.
Collapse
Affiliation(s)
- A Portillo
- Area de Enfermedades Infecciosas, Hospitales San Millán-San Pedro-de La Rioja. Avda. Viana, No. 1. 26001, Logroño (La Rioja), Spain
| | | | | | | | | | | | | |
Collapse
|
29
|
Katsarolis I, Tsiodras S, Panagopoulos P, Giannitsioti E, Skarantavos G, Ioannidis T, Giamarellou H. Septic arthritis due to Salmonella enteritidis associated with infliximab use. ACTA ACUST UNITED AC 2005; 37:304-5. [PMID: 15804667 DOI: 10.1080/00365540410021171] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A unique case of septic arthritis caused by Salmonella enteritidis in a patient receiving infliximab for rheumatoid arthritis is presented. Antimicrobial chemotherapy with surgical intervention was necessary for eradication of the infection. Physicians should be aware of rare manifestations of Salmonella infections associated with infliximab use, especially in endemic areas.
Collapse
Affiliation(s)
- Ioannis Katsarolis
- Fourth Department of Internal Medicine, Attikon University General Hospital, Athens University Medical School, Athens, Greece.
| | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
Human ehrlichiosis and anaplasmosis are acute febrile tick-borne diseases caused by various species of the genera Ehrlichia and Anaplasma (Anaplasmataceae). To date, only cases of human granulocytic anaplasmosis (HGA) caused by Anaplasma phagocytophilum (formerly human granulocytic Ehrlichia, Ehrlichia phagocytophila, and E. equi) have been diagnosed in Europe. HGA and Lyme borreliosis are closely related diseases that share vector and reservoirs. In addition to HGA, human monocytic ehrlichiosis caused by E. chaffeensis has been reported in North America, as well as cases of infection due to E. ewingii in immunocompromised hosts. Ehrlichia spp. and A. phagocytophilum have tropism for blood cells, especially leukocytes and platelets, causing a considerable decrease of both components in these patients. HGA should be suspected in tick-bitten patients or those who have visited an endemic area and show symptoms of flu-like fever, leukopenia and thrombocytopenia.
Collapse
Affiliation(s)
- José Antonio Oteo
- Area de Enfermedades Infecciosas, Complejo Hospitalario San Millán-San Pedro-De La Rioja, Logroño, España.
| | | |
Collapse
|
31
|
Telford SR, Goethert HK. Emerging tick-borne infections: rediscovered and better characterized, or truly ‘new’? Parasitology 2005; 129 Suppl:S301-27. [PMID: 15940821 DOI: 10.1017/s0031182003004669] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The emergence of Lyme borreliosis as a public health burden within the last two decades has stimulated renewed interest in tick-borne infections. This attention towards ticks, coupled with advances in detection technologies, has promoted the recognition of diverse emergent or potentially emerging infections, such as monocytic and granulocytic ehrlichiosis, local variants of spotted fever group rickettsioses, WA-1 babesiosis, or a Lyme disease mimic (Masters' Disease). The distribution of pathogens associated with well-described tick-borne zoonoses such as human babesiosis due toBabesia microtiorB.divergensseems wider than previously thought. Bartonellae, previously known to be maintained by fleas, lice or sandflies, have been detected within ticks. Purported ‘new’ agents, mainly identified by sequencing of PCR products and comparison with those sequences present in GenBank, are being increasingly reported from ticks. We briefly review the diversity of these infectious agents, identify aetiological enigmas that remain to be solved, and provide a reminder about ‘old friends’ that should not be forgotten in our pursuit of novelty. We suggest that newly recognised agents or tick/pathogen associations receive careful scrutiny before being declared as potential public health burdens.
Collapse
Affiliation(s)
- S R Telford
- Tufts University School of Veterinary Medicine, Division of Infectious Diseases, 200 Westboro Road, North Grafton, MA 01536, USA.
| | | |
Collapse
|
32
|
Aguirre E, Sainz A, Dunner S, Amusategui I, López L, Rodríguez-Franco F, Luaces I, Cortés O, Tesouro MA. First isolation and molecular characterization of Ehrlichia canis in Spain. Vet Parasitol 2004; 125:365-72. [PMID: 15482892 DOI: 10.1016/j.vetpar.2004.08.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2004] [Revised: 07/29/2004] [Accepted: 08/10/2004] [Indexed: 11/23/2022]
Abstract
This paper reports the first isolation and culture of Ehrlichia canis in Spain from a naturally infected dog using the DH82 cell line. After DNA extraction and PCR amplification, a nearly complete (1412bp) sequence of the 16S rRNA gene of the new E. canis strain was obtained. The GenBank accession number for the nucleotide sequence of this strain is AY394465. This sequence was aligned with the 16S rRNA gene sequences of other Ehrlichia strains accessible in GenBank. The 16S rRNA gene sequence of the E. canis strain reported here showed a high percentage of similarity with the 16S rRNA gene sequence of E. canis from different geographic areas including Japan, Venezuela and Israel. These data confirm the presence of E. canis in Spain.
Collapse
Affiliation(s)
- Enara Aguirre
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Brouqui P, Bacellar F, Baranton G, Birtles RJ, Bjoërsdorff A, Blanco JR, Caruso G, Cinco M, Fournier PE, Francavilla E, Jensenius M, Kazar J, Laferl H, Lakos A, Lotric Furlan S, Maurin M, Oteo JA, Parola P, Perez-Eid C, Peter O, Postic D, Raoult D, Tellez A, Tselentis Y, Wilske B. Guidelines for the diagnosis of tick-borne bacterial diseases in Europe. Clin Microbiol Infect 2004; 10:1108-32. [PMID: 15606643 DOI: 10.1111/j.1469-0691.2004.01019.x] [Citation(s) in RCA: 250] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ticks are obligate haematophagous acarines that parasitise every class of vertebrate (including man) and have a worldwide distribution. An increasing awareness of tick-borne diseases among clinicians and scientific researchers has led to the recent description of a number of emerging tick-borne bacterial diseases. Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 11 tick-borne human bacterial pathogens have been described in Europe. Aetiological diagnosis of tick-transmitted diseases is often difficult and relies on specialised laboratories using very specific tools. Interpretation of laboratory data is very important in order to establish the diagnosis. These guidelines aim to help clinicians and microbiologists in diagnosing infection transmitted by tick bites and to provide the scientific and medical community with a better understanding of these infectious diseases.
Collapse
Affiliation(s)
- P Brouqui
- Unité des Rickettsies, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Parola P. Tick-borne rickettsial diseases: emerging risks in Europe. Comp Immunol Microbiol Infect Dis 2004; 27:297-304. [PMID: 15225980 DOI: 10.1016/j.cimid.2004.03.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2004] [Indexed: 11/28/2022]
Abstract
Ticks are currently considered the main vectors of human infectious diseases in Europe, particularly since their role in the transmission of the agent of Lyme borreliosis was demonstrated in the 1980s. In the recent years, ticks have also been shown to be the vectors of numerous emerging rickettsial diseases. Although Mediterranean spotted fever (MSF) due to Rickettsia conorii was thought for a long time to be the only tick-borne rickettsial disease prevalent in Europe, five more spotted fever rickettsiae have been described as emerging pathogens in the last decade. Further, cases of infection due to Anaplasma phagocytophilum, the agent of human anaplasmosis (previously known as human granulocytic ehrlichiosis), have been reported throughout Europe. We present here these emerging diseases and discuss other potential threat for the future.
Collapse
Affiliation(s)
- Philippe Parola
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Université de la Méditerranée, Faculté de Médecine, 27 Bd. Jean Moulin, 13385 Marseille Cedex 5, France.
| |
Collapse
|
35
|
Abstract
Human granulocytic ehrlichiosis (HGE) is a tick-borne zoonosis caused by Anaplasma phagocytophilum. A MEDLINE literature search revealed that the European story of HGE began in 1995 with an article on the presence of serum antibodies to A. phagocytophilum. At present, there is seroepidemiological information indicating the presence of infection with HGE agent(s) for several European countries; seroprevalence rates range from zero or very low to up to 28%. The proportion of seropositive persons increases with age and is higher in persons exposed to ticks. Knowledge of the causative agent of HGE and of animal reservoirs in Europe is limited. Ixodes ricinus is a recognized vector of A. phagocytophilum in Europe. Prevalence of the agent in questing I. ricinus is usually higher in adult ticks than in nymphs and ranges from zero or very low to > 30%. Pronounced differences between countries and marked variability by localities were established. Up to March 2003 about 65 human patients (all but one were adults) with confirmed HGE and several patients fulfilling criteria for probable HGE had been reported. The majority of them came from Central Europe (Slovenia) and Scandinavia (Sweden) but there are individual reports from several other European countries. The patients presented with an acute febrile illness that as a rule occurred after a tick bite; the majority had leukopenia and/or thrombocytopenia, elevated concentration of C-reactive protein and mild abnormalities of liver function test results. A small number of patients does not permit reliable conclusions on the clinical features of European HGE; however, there is an impression that at least in central Europe (but maybe not in Scandinavia) the disease is, from the clinical angle, only mild to moderately severe and (most likely) self-limited. The relatively high proportion of the population with HGE serum antibodies and the presence of A. phagocytophilum (like) agent(s) in ticks, small mammals and deer as found in several European countries are discordant with the rather low number of patients with proven HGE. The discordance may indicate inadequate awareness among European physicians, limited recording and reporting of the disease, and/or the presence of and the infection of humans with nonpathogenic A. phagocytophilum (like) strains present in ticks. Additional studies are needed to better define the biological and public health significance of HGE in Europe.
Collapse
Affiliation(s)
- Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia.
| |
Collapse
|
36
|
Oteo JA, Ibarra V, Blanco JR, Martínez de Artola V, Márquez FJ, Portillo A, Raoult D, Anda P. Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease. Clin Microbiol Infect 2004; 10:327-31. [PMID: 15059122 DOI: 10.1111/j.1198-743x.2004.00782.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper describes the epidemiological and clinical features of a tick-borne disease differing somewhat from other tick-borne diseases found previously in Spain. All patients were bitten by Dermacentor marginatus or a large tick. The clinical features include a crustaceous or necrotic lesion at the site of the tick's attachment, surrounded by an erythema (erythema migrans-like) and painful regional lymphadenopathies. The probable aetiological agent is Rickettsia slovaca. Similar cases have been reported in other European countries.
Collapse
Affiliation(s)
- J A Oteo
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital de La Rioja, Logroño, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Human granulocytic ehrlichiosis is an emerging infectious disease, which is transmitted by the tick Ixodes ricinus in Europe, like other diseases: Lyme disease, tick-borne encephalitis, babesiosis... This tick lives in the forest and its hematophagic activity ranges from April to October. Flu and febrile symptoms ten days after tick bite should suggest diagnosing the disease. Disease evolution is generally favorable, even if serious complications may occur. Leukopenia, thrombocytopenia, and elevated serum transaminases are common laboratory findings. Complementary assays useful for the diagnosis are: blood smear, indirect immunofluorescence, and polymerase chain reaction. Biological diagnostic criteria are more and more accurate, with the evolution of knowledge and technique. Tetracycline treatment generally leads to clinical and biological recovery. Informing physicians and occupationally exposed people should reinforce current prevention measures against tick bites.
Collapse
Affiliation(s)
- C Amiel
- Hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110, Clichy, France.
| | | | | |
Collapse
|
38
|
Oteo JA, Ibarra V, Blanco JR, Metola L, Vallejo M, De Artola VM. Epidemiological and clinical differences among Rickettsia slovaca rickettsiosis and other tick-borne diseases in Spain. Ann N Y Acad Sci 2003; 990:355-6. [PMID: 12860652 DOI: 10.1111/j.1749-6632.2003.tb07389.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- José A Oteo
- Servicio de Enfermedades Infecciosas, Hospital de la Rioja, 26001 Logroño, Spain.
| | | | | | | | | | | |
Collapse
|
39
|
Oteo JA, Ibarra V, Blanco JR, Metola L, Vallejo M, De Artola VM. Epidemiological and clinical differences among DEBONEL-TIBOLA and other tick-borne diseases in Spain. Ann N Y Acad Sci 2003; 990:391-2. [PMID: 12860660 DOI: 10.1111/j.1749-6632.2003.tb07397.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- José A Oteo
- Servicio de Enfermedades Infecciosas, Hospital de La Rioja, ES-26001 Logroño, Spain.
| | | | | | | | | | | |
Collapse
|
40
|
Walder G, Falkensammer B, Aigner J, Tiwald G, Dierich MP, Würzner R, Lechleitner P. First documented case of human granulocytic ehrlichiosis in Austria. Wien Klin Wochenschr 2003; 115:263-6. [PMID: 12778780 DOI: 10.1007/bf03040326] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report the first documented case of human granulocytic ehrlichiosis (HGE) in Austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findings observed in other European adults with high fever, transient thrombocytopenia, elevated levels of CRP and LDH, arthralgias, myalgias, fatigue and subfebrile temperature. Flu-like symptoms started about seven days after a tick bite and lasted for ten days, followed by an asymptomatic interval of three days and an acute onset of fever up to 39.5 degrees C on day 20. On admission, the patient showed high antibody titres against Anaplasma phagocytophilum (IgG 1:1024, IgM 1:640); six weeks later the IgG-titre had risen to 1:2048, and IgM-levels had fallen below 1:40. The demonstration of anti-platelet antibodies in acute-phase serum was noteworthy. We conclude that also in Austria HGE should be considered in patients with febrile thrombocytopenia, especially when the medical history reveals recent tick exposure.
Collapse
Affiliation(s)
- Gernot Walder
- Institut für Hygiene und Sozialmedizin, Universität Innsbruck, Innsbruck, Austria.
| | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
Ehrlichiosis comprises a group of emerging tick-borne infectious diseases caused by obligate intracellular Gram-negative bacteria that infect leukocytes. Infections caused by members of the genus Ehrlichia have been described in animals and humans, but to date there are no convincing reports of the presence of other types of human ehrlichiosis different from human granulocytic ehrlichiosis (HGE) in Europe. The European vector is the same as that of Lyme borreliosis, the hard tick Ixodes ricinus, and HGE has a similar epidemiology to that of Borrelia burgdorferi infection. Across Europe, I. ricinus is infected to a variable extent (0.4-66.7%) with the causative agent Ehrlichia (Anaplasma) phagocytophila genogroup, and since its first description in Slovenia in 1997, details of 15 patients have been published. Diagnosis requires careful consideration of all circumstances and symptoms (history of tick bite and the presence of a flu-like syndrome with variable degrees of anemia, thrombocytopenia, and leukopenia, and elevated liver enzymes). Some differences can be seen between US and European HGE patients. European HGE cases have a less severe course, and the presence of morulae is uncommon. In Europe, verification of HGE has been based on PCR and immunofluorescence antibody tests, because no isolation from humans has been reported.
Collapse
Affiliation(s)
- J R Blanco
- Internal Medicine and Infectious Diseases Service, Hospital de La Rioja, Logroño, Spain
| | | |
Collapse
|
42
|
Abstract
Human ehrlichioses represent one of the best examples of newly emergent infectious diseases in which the classic triad of host, infectious agent, and environment are intertwined closely. These pathogens have existed for eons on the planet, and some were described as veterinary pathogens decades ago. Because of dramatic increases of deer and small mammal populations in certain areas and the subsequent increased populations of particular blood-feeding ticks, the risk of developing these diseases is higher than before. Increasing human populations in suburban areas and increased immunosuppressed populations (transplant patients, human immunodeficiency virus patients, and cancer survivors) also have increased risk of developing severe forms of these diseases.
Collapse
Affiliation(s)
- Juan P Olano
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | | |
Collapse
|
43
|
Liz JS, Sumner JW, Pfister K, Brossard M. PCR detection and serological evidence of granulocytic ehrlichial infection in roe deer (Capreolus capreolus) and chamois (Rupicapra rupicapra). J Clin Microbiol 2002; 40:892-7. [PMID: 11880411 PMCID: PMC120259 DOI: 10.1128/jcm.40.3.892-897.2002] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2001] [Revised: 09/24/2001] [Accepted: 12/04/2001] [Indexed: 11/20/2022] Open
Abstract
The role of wild mammals, such as roe deer (Capreolus capreolus) and chamois (Rupicapra rupicapra), in the epidemiology of granulocytic ehrlichiae in Switzerland was investigated. We tested blood samples for Ehrlichia phagocytophila genogroup 16S rRNA gene sequences by PCR and for immunoglobulin G antibodies against granulocytic ehrlichiae by indirect fluorescent-antibody assay (IFA). Overall means of 60.9% of 133 roe deer serum samples and 28.2% of 39 chamois serum samples were seroreactive by IFA. PCR results were positive for 18.4% of 103 roe deer serum samples as well. None of the 24 chamois blood samples tested were positive by PCR. Partial 16S rRNA gene and groESL heat shock operon sequences of three roe deer samples tested showed strong degrees of homology (> or =99.7 and > or =98.6%, respectively) with the sequences of granulocytic ehrlichiae isolated from humans. These results confirm that chamois, and particularly roe deer, are commonly infected with granulocytic ehrlichiae and provide evidence that these wild mammals are potential reservoirs for granulocytic ehrlichiae in Switzerland.
Collapse
Affiliation(s)
- Jorge S Liz
- Department of Immunology, Institute of Zoology, University of Neuchâtel, 2007 Neuchâtel, Switzerland.
| | | | | | | |
Collapse
|
44
|
Oteo JA, Blanco JR, Ibarra V. [Can we prevent tick-borne transmitted diseases?]. Enferm Infecc Microbiol Clin 2001; 19:509-13. [PMID: 11844465 DOI: 10.1016/s0213-005x(01)72718-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J A Oteo
- Servicio de Medicina Interna y Enfermedades Infecciosas. Hospital de La Rioja Logroño. Spain.
| | | | | |
Collapse
|
45
|
Lotric-Furlan S, Avsic-Zupanc T, Petrovec M, Nicholson WL, Sumner JW, Childs JE, Strle F. Clinical and serological follow-up of patients with human granulocytic ehrlichiosis in Slovenia. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:899-903. [PMID: 11527800 PMCID: PMC96168 DOI: 10.1128/cdli.8.5.899-903.2001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An evaluation of the clinical outcome and the duration of the antibody response of patients with human granulocytic ehrlichiosis (HGE) was undertaken in Slovenia. Adult patients with a febrile illness occurring within 6 weeks of a tick bite were classified as having probable or confirmed HGE based on the outcome of serological or PCR testing. Thirty patients (median age, 44 years) were enrolled, and clinical evaluations and serum collection were undertaken at initial presentation and at 14 days, 6 to 8 weeks, and 3 to 4, 6, 12, 18, and 24 months. An indirect immunofluorescence assay (IFA) was performed, and reciprocal titers of > or =128 were interpreted as positive. Patients presented a median of 4 days after the onset of fever and were febrile for a median of 7.5 days; four (13.3%) received doxycycline. Seroconversion was observed in 3 of 30 (10.0%) patients, and 25 (83.3%) showed >4-fold change in antibody titer. PCR results were positive in 2 of 3 (66.7%) seronegative patients but in none of 27 seropositive patients at the first presentation. IFA antibody titers of > or =128 were found in 14 of 29 (48.3%), 17 of 30 (56.7%), 13 of 30 (43.4%), and 12 of 30 (40.0%) patients 6, 12, 18, and 24 months after presentation, respectively. Patients reporting additional tick bites during the study had significantly higher antibody titers at most time points during follow-up. No long-term clinical consequences were found during follow-up.
Collapse
Affiliation(s)
- S Lotric-Furlan
- Department of Infectious Diseases, University Medical Centre, University of Ljubljana, Japljeva 2, 1525 Ljubljana, Slovenia.
| | | | | | | | | | | | | |
Collapse
|
46
|
Alekseev AN, Dubinina HV, Van De Pol I, Schouls LM. Identification of Ehrlichia spp. and Borrelia burgdorferi in Ixodes ticks in the Baltic regions of Russia. J Clin Microbiol 2001; 39:2237-42. [PMID: 11376063 PMCID: PMC88117 DOI: 10.1128/jcm.39.6.2237-2242.2001] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The presence and distribution of Ehrlichia spp. and Borrelia burgdorferi sensu lato was demonstrated among ixodid ticks collected in the Baltic regions of Russia, where Lyme borreliosis is endemic. A total of 3,426 Ixodes ricinus and 1,267 Ixodes persulcatus specimens were collected, and dark-field microscopy showed that 265 (11.5%) I. ricinus and 333 (26.3%) I. persulcatus ticks were positive. From these samples, 472 dark-field-positive and 159 dark-field-negative ticks were subjected to PCR and subsequent reverse line blot hybridization. Fifty-four ticks (8.6%) carried Ehrlichia species, and 4 (0.6%) carried ehrlichiae belonging to the Ehrlichia phagocytophila complex, which includes the human granulocytic ehrlichiosis agent. The E. phagocytophila complex and an Ehrlichia-like species were detected only in I. ricinus whereas Ehrlichia muris was found exclusively in I. persulcatus, indicating a possible vector-specific infection. Borrelia garinii was found predominantly in I. persulcatus, but Borrelia afzelii was evenly distributed among the two tick species. Only two I. ricinus ticks carried B. burgdorferi sensu stricto, while Borrelia valaisiana and a newly identified B. afzelii-like species were found in 1.7 and 2.5% of all ticks, respectively. Of the dark-field-positive ticks, only 64.8% yielded a Borrelia PCR product, indicating that dark-field microscopy may detect organisms other than B. burgdorferi sensu lato. These observations show that the agent of human granulocytic ehrlichiosis may be present in ticks in the Baltic regions of Russia and that clinicians should be aware of this agent as a cause of febrile disease.
Collapse
Affiliation(s)
- A N Alekseev
- Zoological Institute, Russian Academy of Sciences, St. Petersburg, Russia
| | | | | | | |
Collapse
|
47
|
Abstract
Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 11 tick-borne human bacterial pathogens have been described throughout Europe. These include five spotted fever rickettsiae, the agent of human granulocytic ehrlichiosis, four species of the B. burgdorferi complex and a new relapsing fever borrelia. We present these emerging diseases and focus on the factors that play a role in the recognition of new tick-borne diseases.
Collapse
Affiliation(s)
- P Parola
- Unité des Rickettsies, Université de la Méditerranée, Faculté de Médecine, Marseille, France
| | | |
Collapse
|