Spotted Fever Group Rickettsioses in Israel, 2010-2019

The first direct detection of spotted fever group Rickettsia spp. diversity in ticks from Ningxia, northwestern China

BACKGROUND

Tick-borne infectious diseases caused by the spotted fever group Rickettsia (SFGR) have continuously emerging, with many previously unidentified SFGR species reported. The prevalence of SFGRs in northwestern China remains unclear. This study aimed to examine the prevalence of SFGRs and Anaplasma species by analyzing tick samples collected from the Ningxia region.

METHODS

During 2022-2023, ticks were collected from Ningxia, northwestern China, and screened using PCR to amplify target genes (16S rRNA, gltA, ompA and groEL). The amplicons were confirmed by Sanger sequencing. Single-gene sequences and concatenated sequences were used to infer phylogenetic relationships for identifying Rickettsia species.

RESULTS

Out of the 425 DNA samples, a total of 210 samples tested positive for SFGRs in ticks from Ningxia, China, with a relatively high positive rate of 49.4% (210/425). Eight spotted fever group rickettsiae and one Anaplasma species were identified and characterized, including Rickettsia raoultii (102, 24.0%), R. aeschlimannii (65, 15.3%), R. sibirica (12, 2.8%), R. slovaca (4, 0.9%), R. heilongjiangensis (1, 0.2%), Cadidatus Rickettsia hongyuanensis (4, 0.9%), Ca. R. jingxinensis (11, 2.6%), Ca. R. vulgarisii (11, 2.6%) and Anaplasma ovis (98, 23.1%). The positive rate of bacterial species ranged from 0.2% to 24.0%. Interestingly, one novel Rickettsia species, provisionally named "Candidatus Rickettsia vulgarisii", was detected in Argas ticks from Zhongwei city, which suggests the possibility of local transmission to other areas through birds. Genetic and phylogenetic analysis based on the 16S rRNA, gltA, ompA, and 17kDa genes indicated that it was divergent from all known SFG Rickettsia species but mostly related to R. vini. Different SFGR species were associated with specific tick species or genera. In addition, Anaplasma ovis was detected in two Dermacentor species, and co-infection with SFGRs was observed in 14.6% (62/425) of samples.

CONCLUSIONS

This study describes the prevalence and diversity of SFGRs in ticks from Ningxia for the first time by direct detection, reveals that Rickettsia diversity related to tick species. This data suggests that surveillance for tick-borne SFGR infections among human populations should be enhanced in this region, and further investigations on their pathogenicity to humans and domestic animals are still needed.

A systematic review and meta-analysis of the prevalence of tick-borne SFGR in China from 2000 to 2022

BACKGROUND

Ticks carry and transmit a wide range of pathogens (bacteria, viruses, and protozoa) that pose significant threats to human and animal health worldwide. Only few meta-analyses have been conducted on the distribution of ticks and tick-borne spotted fever group rickettsia (SFGR). Therefore, this study aims to examine the tick species and SFGR positivity in China in order to provide support for further research and improvements in the prevention and control of tick-borne diseases.

METHODOLOGY

This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant Chinese and English studies were retrieved from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), VIP database, Chinese Biomedical literature database (CBM) and Wanfang database from inception to January 9, 2023. Pooled SFGR positive rate was meta-analyzed using a random effects model and heterogeneity was assessed by the I2 index. Publication bias was also evaluated by funnel plot and Egger's test. The meta-analysis was performed on R studio 4.0.4.

PRINCIPAL FINDINGS

Meta-analysis of 57 studies published between 2000 and 2022 involving 39,380 ticks revealed a pooled SFGR positive rate of 21.4% (Q = 6423.74, I2 = 99%, Q-p<0.001, 95% CI: 15.0-29.6). Most studies of tick-borne SFGR infection rate were conducted in forest areas and developed animal husbandry areas in the northern region. There were slightly more tick species in the southern region, but the differences in tick species (Feeding tick 31.5%, 95%CI: 15.7-53.2, Questing tick 11.5%, 95%CI: 4.4-26.7, Q = 3.29, Q-p = 0.19) between areas (Northern area 20.4%, 95%CI: 14.1-28.7, Southern area 25.5%, 95%CI: 15.0-29.6, Q = 0.21, Q-p = 0.64) were not statistically significant. The most common tick species were Dermacentor silvarum (13%), Ixodes persulcatus (11%) and Haemaphysalis Iongicornis (10%), and the most prevalent SFGR species were Rickettsia raoultii (20%), Rickettsia heilongjiangiensis (11%), and some uncultured species (18%).

CONCLUSIONS

This study examined the distribution of tick-borne SFGR in China. Our findings revealed that the main tick species were D. silvarum, I. persulcatus and H. iongicornis, and the common SFGR species were R. raoultii, R. heilongjiangiensis, and some uncultured species. Further studies are warranted to identify the potential vectors of SFGR and to better understand the epidemiology and pathogenesis of tick-borne diseases in China.

Rickettsiales in the WHO European Region: an update from a One Health perspective

BACKGROUND

The availability of molecular techniques has significantly increased our understanding of bacteria of the order Rickettsiales, allowing the identification of distinct species in both vector and host arthropods. However, the literature lacks studies that comprehensively summarize the vast amount of knowledge generated on this topic in recent years. The purpose of this study was to conduct a comprehensive analysis of the distribution of Rickettsiales in arthropod vectors, animals and humans in the WHO European Region in order to provide useful information to predict the emergence of certain diseases in specific geographical areas and to formulate hypotheses regarding the possible pathogenetic role of some rickettsial species in the etiology of human pathological conditions.

METHODS

A systematic review of the literature in the PubMed and EMBASE databases was conducted following the PRISMA methodology using the search terms "Spotted fever" OR "rickettsiosis" OR "ricketts*" AND all the countries of the WHO European Region, from 1 January 2013 to 12 February 2022. Only studies that identified rickettsiae in human, animal or arthropod samples using molecular techniques were included in the review.

RESULTS

A total of 467 articles considering 61 different species of Rickettsiales with confirmed or suspected human pathogenicity were analyzed in the review. More than 566 identifications of Rickettsiales DNA in human samples were described, of which 89 cases were assessed as importation cases. A total of 55 species of ticks, 17 species of fleas, 10 species of mite and four species of lice were found infected. Twenty-three species of Rickettsiales were detected in wild and domestic animal samples.

CONCLUSION

The routine use of molecular methods to search for Rickettsiales DNA in questing ticks and other blood-sucking arthropods that commonly bite humans should be encouraged. Molecular methods specific for Rickettsiales should be used routinely in the diagnostics of fever of unknown origin and in all cases of human diseases secondary to an arthropod bite or animal contact.

Identification of Tick-Borne Pathogens and Genotyping of Coxiella burnetii in Rhipicephalus microplus in Yunnan Province, China

Rhipicephalus microplus, a vector that can transmit many pathogens to humans and domestic animals, is widely distributed in Yunnan province, China. However, few reports on the prevalence of tick-borne pathogens (TBPs) in Rh. microplus in Yunnan are available. The aim of this study was to detect TBPs in Rh. microplus in Yunnan and to analyze the phylogenetic characterization of TBPs detected in these ticks. The adult Rh. microplus (n = 516) feeding on cattle were collected. The pooled DNA samples of these ticks were evaluated using metagenomic next-generation sequencing (mNGS) and then TBPs in individual ticks were identified using genus- or group-specific nested polymerase chain reaction (PCR) combined with DNA sequencing assay. As a result, Candidatus Rickettsia jingxinensis (24.61%, 127/516), Anaplasma marginale (13.18%, 68/516), Coxiella burnetii (3.10%, 16/516), and Coxiella-like endosymbiont (CLE) (8.33%, 43/516) were detected. The dual coinfection with Ca. R. jingxinensis and A. marginale and the triple coinfection with Ca. R. jingxinensis, A. marginale, and CLE were most frequent and detected in 3.68% (19/516) and 3.10% (16/516) of these ticks, respectively. The results provide insight into the diversity of TBPs and their coinfections in Rh. microplus in Yunnan province of China, reporting for the first time that C. burnetii had been found in Rh. microplus in China. Multilocus variable number tandem repeat analysis with 6 loci (MLVA-6) discriminated the C. burnetii detected in Rh. microplus in Yunnan into MLVA genotype 1, which is closely related to previously described genotypes found primarily in tick and human samples from different regions of the globe, indicating a potential public health threat posed by C. burnetii in Rh. microplus in Yunnan.