1
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Reynolds BD, Nagel HG, Perry E, Whittaker CJ, Caruso KA, Annear MJ, Irving WM, McCarthy PM, Dion A, Yi JMS, Hall E, Smith JS. Ophthalmic findings associated with Australian tick paralysis (holocyclotoxicity) in hospitalized domestic dogs and cats. Vet Ophthalmol 2024. [PMID: 38468143 DOI: 10.1111/vop.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE To describe ophthalmic findings in hospitalized canine and feline patients with tick paralysis (TP) and investigate possible predisposing factors. ANIMALS STUDIED Forty-seven dogs and 28 cats hospitalized with TP assessed with an ophthalmic examination performed by an ABVO resident. METHODS Dogs and cats were hospitalized with TP from October 2021 to January 2022 and had an ophthalmic examination performed by an ABVO resident. Patient signalment data, information regarding tick number and location, hospitalization duration, medications used, and patient paralysis grades were recorded. Statistical analysis was performed to correlate findings. RESULTS Corneal ulcers developed in up to 34.8% of dogs and up to 42.9% of cats hospitalized with TP. An absent palpebral reflex ipsilaterally increased the odds of a concurrent corneal ulcer being present by 14.7× in dogs and 20.1× in cats (p < .0001). Palpebral reflexes were absent in 38.3% of dogs and 35.7% of cats hospitalized with TP and were correlated with more severe gait paralysis (p = .01) and respiratory paralysis (p = .005) in dogs, and respiratory paralysis in cats (p = .041). STT-1 findings <10 mm/min were present in 27.7% of dogs and 57.1% of cats examined and were associated with increasing gait paralysis (p = .017) and respiratory paralysis (p = .007) in dogs, and increasing gait paralysis in cats (p = .017). CONCLUSIONS Simple corneal ulcers, loss of a complete palpebral reflex, and reduced STT-1 scores frequently occurred in dogs and cats hospitalized for TP. The frequency of these findings increased as the degree of patient paralysis increased.
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Affiliation(s)
- B D Reynolds
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - H G Nagel
- Terrey Hills Animal Hospital, Sydney, New South Wales, Australia
| | - E Perry
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - C J Whittaker
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - K A Caruso
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - M J Annear
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - W M Irving
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - P M McCarthy
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - A Dion
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - J M S Yi
- Northside Emergency Veterinary Service, Sydney, New South Wales, Australia
| | - E Hall
- University of Sydney, Sydney, New South Wales, Australia
| | - J S Smith
- Eye Clinic for Animals, Sydney, New South Wales, Australia
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2
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Atwell R, Vankan D. Prospective Study of 506 Dogs with Tick Paralysis: Investigating Measures of Severity and Clinical Signs as Predictors of Mortality and Assessing the Benefits of Different Therapeutics. Animals (Basel) 2024; 14:188. [PMID: 38254357 PMCID: PMC10812437 DOI: 10.3390/ani14020188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
Survey data from 42 Australian eastern seaboard veterinary practices involving 506 cases are reported with regard to clinical signs, disease severity, mortality, use of pharmaceuticals, and recovery times. New measures of disease severity (visual analogue scales (VAS) and facial expressions) were tested alongside "gold standard" measures (neuromuscular junction (NMJ) scores). Univariable and multivariable logistic regression analyses were conducted to evaluate associations between variables. The VAS scores were progressive, prognostic (especially the respiratory scores) and correlated with the NMJ scores. The presence of inspiratory dyspnoea and crackles on the day of hospitalisation, progressing to expiratory dyspnoea and an expiratory wheeze 24 h later, were highly predictive of mortality. Altered facial features on hospital admission were also highly predictive of mortality. The previously used respiratory score (using various clinical signs) was not predictive of mortality. Older animals had a higher mortality rate, and no gender or breed susceptibility was found. The only pharmaceuticals that were positively associated with mortality were tick antiserum and, in severe cases, antibiotics. The use of many pharmaceutical products (acepromazine, atropine, steroids, antihistamines, antiemetics, diuretics, and S8 anti-anxiety and sedation drugs) had no effect on mortality. More drug classes were used with increasing clinical severity and specific factors (e.g., vomiting/retching, hydration) affected the period of hospitalisation. Geographic variation in respiratory signs and toxicity scores was evident, whereas mortality and disease severity were not different across regions.
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Affiliation(s)
| | - Dianne Vankan
- School of Veterinary Science, The University of Queensland, Gatton 4343, Australia;
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3
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Holland CT. Static anisocoria in cats and dogs with naturally occurring tick paralysis (Ixodes holocyclus). Aust Vet J 2023; 101:383-390. [PMID: 37574813 DOI: 10.1111/avj.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/27/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To characterise the novel occurrence and neuro-ophthalmological features of static anisocoria in cats and dogs with tick paralysis (TP) (Ixodes holocyclus) due to a single tick located remote from the head and neck. DESIGN Observational case series with retrospective analysis. METHODS Medical records were reviewed from 69 cats and 169 dogs treated for TP from a suburban veterinary hospital in Newcastle, New South Whales, between September 2005 and October 2021. RESULTS Anisocoria was observed in 2/18 (11.1%) cats and 3/30 (10.0%) dogs with a single tick located remote from the head and neck. These proportions were not different when compared within species to 4 of 28 (14.3%) cats and 16 of 98 (16.3%) dogs with aniscocoria with a single tick located on the head and neck region (P = 1 and 0.56 respectively). Anisocoria arose from pupillary efferent dysfunction and included unilateral oculoparasympathetic dysfunction (internal ophthalmoplegia) in one dog, unilateral oculosympathetic dysfunction (Horner's syndrome) in one cat and one dog, and a combination of bilateral, but asymmetric, oculosympathetic and oculoparasympathetic dysfunction in one cat and one dog. CONCLUSION It is proposed that anisocoria in cases of TP with a tick located remote from the head and neck is due to an intrinsic latent asymmetry in the safety factor for pupillary efferent function that is unmasked by a systemically distributed holocyclotoxin inhibiting neural transmission within this system, and this is the prevailing pathomechanism, rather than a direct local effect, underscoring anisocoria with a tick located on the head or neck.
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Affiliation(s)
- C T Holland
- Merewether Veterinary Hospital, Merewether, New South Wales, Australia
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4
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Ireland EM, Heller J, Leister EM, Padula AM. Reduced incidence of tick paralysis cases in dogs and cats at two emergency clinics in South-East Queensland since 2015: new generation prophylactics as possible explanatory variables. Aust Vet J 2023; 101:356-365. [PMID: 37503789 DOI: 10.1111/avj.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 02/16/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION This study aimed to determine the incidence of canine and feline tick paralysis cases presenting to two veterinary emergency hospitals before and after the introduction of new generation prophylactic acaricides. METHODS This was a retrospective study, investigating the number of tick paralysis cases presenting to two emergency and critical care veterinary hospitals in South-East Queensland, from 2008 to 2021. A total of 10,914 dogs and 3696 cats were included over the course of the study. To assess if the introduction of new generation prophylactics in 2015 has coincided with any variation in case numbers, data for each species were analysed graphically and numerically in the first instance, then interrupted time series analyses were performed for the dog and cat data independently. RESULTS Accounting for seasonal and climatic variation, we estimated a 54.8% reduction in dog (95% CI 45.3%-62.7%) and 44% reduction in cat (95% CI 19.5%-46%) tick paralysis cases presenting to these two clinics. This reduction corresponded with the timing of new generation prophylactic agents being introduced, including isoxazolines and imidacloprid/flumethrin impregnated collars. CONCLUSION In the population studied, a significant reduction in the incidence of tick paralysis cases treated by veterinarians has occurred from 2015 onwards and was found to be associated with the timing of the release of new generation acaricidal products.
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Affiliation(s)
- E M Ireland
- Animal Emergency Service, Underwood, Australia
- Pet Intensive Care Unit, Underwood, Australia
| | - J Heller
- Heller Consulting, Wagga Wagga, NSW, Australia
- Gulbali Research Institute, Charles Sturt University, Wagga Wagga, NSW, Australia
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - E M Leister
- Pet Intensive Care Unit, Underwood, Australia
| | - A M Padula
- Padula Serums, Bairsndale, VIC, Australia
- Australian Venom Research Unit, University of Melbourne, Parkville, VIC, Australia
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5
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Salman F, Atlantawi A, Maraqa N. Tick Paralysis: A Thorough Examination May Prevent Unnecessary Harm. Cureus 2023; 15:e43932. [PMID: 37746431 PMCID: PMC10513347 DOI: 10.7759/cureus.43932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/10/2023] [Indexed: 09/26/2023] Open
Abstract
Tick paralysis is a relatively uncommon tick-borne illness that is often overlooked and misdiagnosed. Therefore, it is not unusual for cases to undergo unnecessary work-up and interventions that may delay correct diagnosis and treatment, placing the patient at risk for catastrophic consequences. We present the case of a four-year-old female who developed ascending flaccid paralysis, initially misdiagnosed with Guillain-Barré syndrome (GBS). She was placed in the pediatric intensive care unit (PICU) for mechanical ventilation after failing to respond to intravenous immunoglobulin (IVIG) administration and plasmapheresis. Later in her hospital course, she was correctly diagnosed to have tick paralysis.
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Affiliation(s)
- Farah Salman
- General Pediatrics, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Abdallah Atlantawi
- General Pediatrics, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Nizar Maraqa
- Pediatric Infectious Diseases, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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6
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Sarwar Z, Osborne AF, Shah C, Rathore MH. Neuroimaging in Tick Paralysis: Looking Outside the Box. Infect Dis Rep 2022; 14:837-40. [PMID: 36412743 DOI: 10.3390/idr14060085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Tick paralysis is a rare but potentially deadly form of muscle paralysis caused by a neurotoxin transmitted through the saliva of gravid, engorged female ticks of various species. Often, there is an initial misdiagnosis or delay in diagnosis due to the rarity of the diagnosis, the obscure location of the tick, and the disease's clinical similarity to Guillain-Barre syndrome. We report the case of a 4-year-old girl with tick paralysis in whom the tick was not found until 2 days after hospital admission. Upon the review of the imaging, it was discovered that the tick was visible on the MRI of the brain that had been reported as normal.
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7
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Padula AM. Safety and efficacy of a purified canine immunoglobulin G formulation for treatment of 76 cats clinically affected by the Australian paralysis tick (Ixodes holocyclus). Aust Vet J 2022; 100:476-478. [PMID: 35788553 PMCID: PMC9795890 DOI: 10.1111/avj.13194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/22/2022] [Accepted: 06/11/2022] [Indexed: 12/30/2022]
Abstract
Acute adverse reactions in cats administered unrefined canine paralysis tick (Ixodes holocyclus) antiserum are commonly observed by veterinarians and can lead to significant morbidity and potentially fatal. A purified antiserum canine IgG concentrate was chromatographically prepared and aseptically formulated in single doses containing the equivalent of 5 mL of unrefined tick antiserum (TAS). The IgG was used for slow intravenous infusion into clinically affected cats at multiple veterinary clinics on the eastern seaboard of Australia. Overall, 72/76 (95%) of cats survived hospital discharge, an efficacy comparable to published data. A subset of 22 cats previously treated with unrefined TAS and considered high risk were included in the dataset. The safety profile was excellent with 0/76 acute adverse reactions although 2/76 (2.6%) developed mild facial swelling within 2 h of infusion that responded to the antihistamine. In conclusion, cats intravenously infused with purified IgG from canine TAS did not exhibit the expected frequency of acute adverse reactions during infusion and it was both safe and effective for the treatment of tick paralysis in cats.
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Affiliation(s)
- AM Padula
- Padula Serums Pty LtdBairnsdaleVictoria3875Australia,Australian Venom Research Unit, Department of Pharmacology and Therapeutics, Faculty of Medicine, Dentistry and Health ScienceUniversity of MelbourneParkvilleVictoria3010Australia
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8
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Hardjo S, Nash KJ, Day SK, Haworth MD. Elective cricothyrotomy in a dog with transient laryngeal paralysis secondary to Australian paralysis tick (Ixodes holocyclus) envenomation. Aust Vet J 2022; 100:440-445. [PMID: 35615962 PMCID: PMC9546364 DOI: 10.1111/avj.13175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
The tube cricothyrotomy (CTT) has recently been introduced to small animal medicine as a viable surgical airway access procedure; however, there are no reports documenting its clinical use. The author's objective is to describe the clinical application, complications, and management of an elective CTT in a dog. Furthermore, the characteristics of CTT that may be clinically advantageous over temporary tube tracheostomy (TT) will be discussed. A 2‐year‐old female spayed German shepherd dog required mechanical ventilation (MV) due to unsustainable work of breathing as a result of tick paralysis and aspiration pneumonia. After successful weaning from MV, the dog was diagnosed with laryngeal paralysis. A surgical airway was performed using CTT to allow extubation and patient management whilst conscious. Complications included frequent tube suctioning due to accumulation of airway secretions in the tube and a single dislodgement event. The dog made an uneventful recovery with complete stoma healing by the second intention within 15 days. To the authors' knowledge, this is the first clinical report of an elective CTT performed to successfully manage upper airway obstruction in the dog. Its efficacy, clinical management and patient outcome are described.
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Affiliation(s)
- S Hardjo
- UQ VETS, School of Veterinary Science, The University of Queensland, Gatton, Queensland
| | - K J Nash
- UQ VETS, School of Veterinary Science, The University of Queensland, Gatton, Queensland
| | - S K Day
- UQ VETS, School of Veterinary Science, The University of Queensland, Gatton, Queensland
| | - M D Haworth
- UQ VETS, School of Veterinary Science, The University of Queensland, Gatton, Queensland
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9
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Abstract
The existence of tick toxins is an old enigma that has intrigued scientists for a long time. The adaptive value of using deadly toxins for predatory animals is obvious: they try to kill the prey in the most effective way or protect themselves from their natural enemies. Ticks, however, are blood-sucking parasites, and it seems paradoxical that they have toxins similar to spiders, scorpions and snakes. Based on published data, here we examine the potential adaptive function of different types of toxins produced by soft and hard ticks. We hypothesize that there are diverse evolutionary roles behind (a) to attack and reduce the tick-transmitted pathogens inside the vertebrate host systemically to protect the tick, (b) to paralyse the host to stop grooming, (c) to speed up host heartbeat to improve blood supply and (d) to inhibit the process of necroptosis to prevent the rejection of hard ticks. We will provide published evidence that supports the above-mentioned hypotheses, and we will give an outlook how these new scientific results might be applied in modern pharmacology and medicine.
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Affiliation(s)
- Péter Apari
- Institute of EvolutionCentre for Ecological ResearchBudapestHungary
| | - Gábor Földvári
- Institute of EvolutionCentre for Ecological ResearchBudapestHungary
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10
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Panda S, Sharma S, Bajpai N, Gopalakrishnan M, Kombade SP, Nag VL. A Rare Fatal Cause of Acute Areflexic Quadriparesis in the Tropics. Neurol India 2020; 68:1196-1200. [PMID: 33109875 DOI: 10.4103/0028-3886.299153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Crimean-Congo hemorrhagic fever is a sporadic zoonotic viral illness recently becoming endemic in regions in the western parts of India. It usually presents as a viral hemorrhagic fever with severe liver and kidney failure. CASE REPORT An 18-year-old male from the western part of Rajasthan presented with rapidly progressing areflexic weakness of limbs a week after brief fever. He deteriorated rapidly with drowsiness, fulminant liver failure, and acute kidney injury with high creatine kinase. He also developed thrombocytopenia and hemorrhage from various sites. Workup for viral hemorrhagic fever revealed IgM positivity for Crimean-Congo hemorrhagic fever. The patient kept worsening and died of multiorgan failure and diffuse alveolar bleeding after 14 days. CONCLUSIONS This report highlights the need to expand the differential diagnoses in the commonly encountered presentation of acute quadriparesis to include the possibility of tick-borne diseases like Crimean-Congo hemorrhagic fever in the setting of bleeding diathesis and acute hepatorenal syndrome.
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Affiliation(s)
- Samhita Panda
- Department of Neurology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sanjiv Sharma
- Department of Neurology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitin Bajpai
- Department of Nephrology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Maya Gopalakrishnan
- Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Sarika P Kombade
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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11
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Latas P, Auckland LD, Teel PD, Hamer SA. ARGAS ( PERSICARGAS) GIGANTEUS SOFT TICK INFECTION WITH RICKETTSIA HOOGSTRAALI AND RELAPSING FEVER BORRELIA ON WILD AVIAN SPECIES OF THE DESERT SOUTHWEST, USA. J Wildl Dis 2020; 56:113-125. [PMID: 31567038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Changing climatic conditions and the northward expansion of ticks and pathogens are of immense importance to human, animal, and environmental health assessment and risk management. From 2014 through 2015, a wildlife rehabilitation center in south-central Arizona, US noted soft ticks (Argasidae) infesting 23 birds, including Cooper's Hawks (Accipiter cooperii), Gray Hawks (Buteo plagiatus), Harris's Hawks (Parabuteo unicinctus), Red-tailed Hawks (Buteo jamaicensis), Great Horned Owls (Bubo virginianus), Common Ravens (Corvus corax), and a Greater Roadrunner (Geococcyx californianus), during the late summer seasonal rainy seasons. The parasites numbered in the hundreds on individual birds. Infested birds were moribund, obtunded, or paralyzed on presentation, with no prior histories of illness or evidence of trauma. Tick and avian blood samples were collected for vector-borne pathogen analysis focusing on the molecular detection of Rickettsia and Borrelia species. Ticks were identified as the neotropical species of soft tick, Argas (Persicargas) giganteus; their occurrence in the southern US on raptors represented an expansion of host range. Pathogen testing of ticks showed that 41% of 54 ticks were infected with Rickettsia hoogstraalii and 23% of 26 ticks were infected with a relapsing fever Borrelia; both agents are associated with uncertain health consequences. Among the blood samples, one was infected with the same Borrelia spp.; this Red-tailed Hawk also had Borrelia-positive ticks. With supportive therapy, the majority of birds, 74% (17/23), recovered and were released or permanent residents. The management of soft tick-infested birds and mitigation of future disease risk will require additional characterizations of these poorly studied soft ticks and their associated pathogens.
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Affiliation(s)
- Patricia Latas
- Awe Pono Avian Health, 7223 E Camino Valle Verde, Tucson, Arizona 85715, USA
| | - Lisa D Auckland
- Department of Veterinary Integrative Biosciences, Texas A&M University, 4458 TAMU, College Station, Texas 77843, USA
| | - Pete D Teel
- Department of Entomology, Texas A&M AgriLife Research, 2475 TAMU, College Station, Texas 77843, USA
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, 4458 TAMU, College Station, Texas 77843, USA
- Schubot Exotic Bird Health Center, Texas A&M University, 4467 TAMU, College Station, Texas 77843, USA
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12
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Padula AM, Leister EM, Webster RA. Tick paralysis in dogs and cats in Australia: treatment and prevention deliverables from 100 years of research. Aust Vet J 2019; 98:53-59. [PMID: 31762008 DOI: 10.1111/avj.12891] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 02/02/2023]
Abstract
This review of tick paralysis caused by Ixodes holocyclus in Australia addresses the question: What are the key discoveries that have enabled effective treatment and prevention of tick paralysis in dogs and cats? Critical examination of 100 years of literature reveals that arguably only three achievements have advanced treatment and prevention of tick paralysis in animals. First, the most significant treatment advance was the commercial availability of tick antiserum in the 1930s. Hyperimmune serum currently remains the only specific anti-paralysis tick therapy available to veterinarians in Australia. Second, advances in veterinary critical care have increased survival rates of the most severely affected dogs and cats. Critical care advancements have been enabled through specialised veterinary hospitals that can provide appropriate care 24 h a day, and advanced training of veterinarians, veterinary nurses and technicians. Third, perhaps that biggest advance of all in the last 100 years of research has been the commercial availability of the isooxazoline class of acaricidal preventatives in Australia specifically for I. holocyclus. This highly effective class of preventatives offers long duration of action, low cost, spot-on or oral formulations and a low rate of adverse reactions. Animal owners and veterinarians now have the most useful tool of all - a reliable preventative. This review reveals the key events in research over the last 100 years and the tortuous pathway to delivering better treatment and preventative options for this enigmatic Australian parasite.
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Affiliation(s)
- A M Padula
- Australian Venom Research Unit, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia.,Padula Serums Pty Ltd, Bairnsdale, Victoria, Australia
| | - E M Leister
- Pet Intensive Care Unit (Pet ICU), Underwood, Queensland, 4119, Australia
| | - R A Webster
- Pet Intensive Care Unit (Pet ICU), Underwood, Queensland, 4119, Australia
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13
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Dehhaghi M, Kazemi Shariat Panahi H, Holmes EC, Hudson BJ, Schloeffel R, Guillemin GJ. Human Tick-Borne Diseases in Australia. Front Cell Infect Microbiol 2019; 9:3. [PMID: 30746341 PMCID: PMC6360175 DOI: 10.3389/fcimb.2019.00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 01/07/2019] [Indexed: 12/26/2022] Open
Abstract
There are 17 human-biting ticks known in Australia. The bites of Ixodes holocyclus, Ornithodoros capensis, and Ornithodoros gurneyi can cause paralysis, inflammation, and severe local and systemic reactions in humans, respectively. Six ticks, including Amblyomma triguttatum, Bothriocroton hydrosauri, Haemaphysalis novaeguineae, Ixodes cornuatus, Ixodes holocyclus, and Ixodes tasmani may transmit Coxiella burnetii, Rickettsia australis, Rickettsia honei, or Rickettsia honei subsp. marmionii. These bacterial pathogens cause Q fever, Queensland tick typhus (QTT), Flinders Island spotted fever (FISF), and Australian spotted fever (ASF). It is also believed that babesiosis can be transmitted by ticks to humans in Australia. In addition, Argas robertsi, Haemaphysalis bancrofti, Haemaphysalis longicornis, Ixodes hirsti, Rhipicephalus australis, and Rhipicephalus sanguineus ticks may play active roles in transmission of other pathogens that already exist or could potentially be introduced into Australia. These pathogens include Anaplasma spp., Bartonella spp., Burkholderia spp., Francisella spp., Dera Ghazi Khan virus (DGKV), tick-borne encephalitis virus (TBEV), Lake Clarendon virus (LCV), Saumarez Reef virus (SREV), Upolu virus (UPOV), or Vinegar Hill virus (VINHV). It is important to regularly update clinicians' knowledge about tick-borne infections because these bacteria and arboviruses are pathogens of humans that may cause fatal illness. An increase in the incidence of tick-borne infections of human may be observed in the future due to changes in demography, climate change, and increase in travel and shipments and even migratory patterns of birds or other animals. Moreover, the geographical conditions of Australia are favorable for many exotic ticks, which may become endemic to Australia given an opportunity. There are some human pathogens, such as Rickettsia conorii and Rickettsia rickettsii that are not currently present in Australia, but can be transmitted by some human-biting ticks found in Australia, such as Rhipicephalus sanguineus, if they enter and establish in this country. Despite these threats, our knowledge of Australian ticks and tick-borne diseases is in its infancy.
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Affiliation(s)
- Mona Dehhaghi
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,Department of Microbial Biotechnology, School of Biology and Centre of Excellence in Phylogeny of Living Organisms, College of Science, University of Tehran, Tehran, Iran
| | - Hamed Kazemi Shariat Panahi
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,Department of Microbial Biotechnology, School of Biology and Centre of Excellence in Phylogeny of Living Organisms, College of Science, University of Tehran, Tehran, Iran
| | - Edward C Holmes
- Charles Perkins Centre, School of Life and Environmental Sciences and Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia
| | - Bernard J Hudson
- Department of Microbiology and Infectious Disease, Royal North Shore Hospital, Sydney, NSW, Australia
| | | | - Gilles J Guillemin
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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14
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Abstract
In comparison to other arachnids, ticks are major vectors of disease, but less than 8% of the known species are capable of inducing paralysis, as compared to the ~99⁻100% arachnids that belong to venomous classes. When considering the potential monophyly of venomous Arachnida, this review reflects on the implications regarding the classification of ticks as venomous animals and the possible origin of toxins. The origin of tick toxins is compared with scorpion and spider toxins and venoms based on their significance, functionality, and structure in the search to find homologous venomous characters. Phenotypic evaluation of paralysis, as caused by different ticks, demonstrated the need for expansion on existing molecular data of pure isolated tick toxins because of differences and discrepancies in available data. The use of in-vivo, in-vitro, and in-silico assays for the purification and characterization of paralysis toxins were critically considered, in view of what may be considered to be a paralysis toxin. Purified toxins should exhibit physiologically relevant activity to distinguish them from other tick-derived proteins. A reductionist approach to identify defined tick proteins will remain as paramount in the search for defined anti-paralysis vaccines.
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Affiliation(s)
- Ronel Pienaar
- Epidemiology, Parasites and Vectors, Agricultural Research Council⁻Onderstepoort Veterinary Research, Onderstepoort, Pretoria 0110, South Africa.
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Pretoria 0110, South Africa.
| | - Albert W H Neitz
- Division of Biochemistry, University of Pretoria, Hatfield, Pretoria 0028, South Africa.
| | - Ben J Mans
- Epidemiology, Parasites and Vectors, Agricultural Research Council⁻Onderstepoort Veterinary Research, Onderstepoort, Pretoria 0110, South Africa.
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Pretoria 0110, South Africa.
- Department of Life and Consumer Sciences, University of South Africa, Florida, Johannesburg 1710, South Africa.
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Borawski K, Pancewicz S, Czupryna P, Zajkowska J, Moniuszko-Malinowska A. Tick paralysis. Przegl Epidemiol 2018; 72:17-24. [PMID: 29667376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Tick paralysis is caused by neurotoxins secreted by adult female ticks, primarily in North America and on the east coast of Australia. Sporadic illness is also recorded in Europe and Africa. In the European countries, including Poland, there are 6 species of ticks capable of causing tick paralysis. The disease occurs in people of all ages, but is most commonly diagnosed in children under 8 years of age. Paralysis can take different forms - from rare isolated cranial nerve infections to quadriplegia and respiratory muscles paralysis. After the tick remove, the symptoms resolve spontaneously. In severe cases with paralysis of respiratory muscles, when there is no possibility of mechanical ventilation, the disease may lead to death.
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Affiliation(s)
- Karol Borawski
- Medical University in Białystok, Department of Infectious Diseases and Neuroinfections
| | - Sławomir Pancewicz
- Medical University in Białystok, Department of Infectious Diseases and Neuroinfections
| | - Piotr Czupryna
- Medical University in Białystok, Department of Infectious Diseases and Neuroinfections
| | - Joanna Zajkowska
- Medical University in Białystok, Department of Infectious Diseases and Neuroinfections
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16
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Abstract
BACKGROUND Tick paralysis is a frequently overlooked severe disease characterized by bilateral ascending flaccid paralysis caused by a neurotoxin produced by feeding ticks. We aimed to characterize suspected tick paralysis cases documented at the BC Centre for Disease Control (BCCDC) in British Columbia (BC) from 1993 to 2016 and reviewed prevention, diagnosis, and treatment considerations. METHODS Demographic, geographic, and clinical data from test requisition forms for ticks submitted to the BCCDC Public Health Laboratory (PHL) from patients across BC between 1993 and 2016 for suspected human and animal tick paralysis were reviewed. Descriptive statistics were generated to characterize tick paralysis cases in BC, including tick species implicated, seasonality of disease, and regional differences. RESULTS From 1993 to 2016, there were 56 cases of suspected tick paralysis with at least one tick specimen submitted for testing at the BCCDC PHL. Humans and animals were involved in 43% and 57% of cases, respectively. The majority of cases involved a Dermacentor andersoni tick (48 cases or 86%) and occurred between the months of April and June (49 cases or 88%). Among known locations of tick acquisition, the Interior region of BC was disproportionately affected, with 25 cases (69%) of tick bites occurring in that area. CONCLUSIONS Tick paralysis is a rare condition in BC. The region of highest risk is the Interior, particularly during the spring and summer months. Increasing awareness of tick paralysis among healthcare workers and the general public is paramount to preventing morbidity and mortality from this rare disease.
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Affiliation(s)
- Muhammad Morshed
- 1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of Disease Control Public Health Laboratory , Vancouver, Canada .,2 Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver, Canada
| | - Lisa Li
- 1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of Disease Control Public Health Laboratory , Vancouver, Canada .,2 Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver, Canada
| | - Min-Kuang Lee
- 1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of Disease Control Public Health Laboratory , Vancouver, Canada
| | - Keerthi Fernando
- 1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of Disease Control Public Health Laboratory , Vancouver, Canada
| | - Teresa Lo
- 1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of Disease Control Public Health Laboratory , Vancouver, Canada
| | - Quantine Wong
- 1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of Disease Control Public Health Laboratory , Vancouver, Canada
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17
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Pek CH, Cheong CSJ, Yap YL, Doggett S, Lim TC, Ong WC, Lim J. Rare Cause of Facial Palsy: Case Report of Tick Paralysis by Ixodes Holocyclus Imported by a Patient Travelling into Singapore from Australia. J Emerg Med 2016; 51:e109-e114. [PMID: 27618477 DOI: 10.1016/j.jemermed.2016.02.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 11/04/2015] [Accepted: 02/17/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ticks are blood-sucking arachnids that feed on all classes of vertebrates, including humans. Ixodes holocyclus, also known as the Australian Paralysis Tick, is capable of causing a myriad of clinical issues in humans and companion animals, including the transmission of infectious agents, toxin-mediated paralysis, allergic and inflammatory reactions, and mammalian meat allergies in humans. The Australian Paralysis Tick is endemic to Australia, and only two other exported cases have been reported in the literature. CASE REPORT We report the third exported case of tick paralysis caused by I. holocyclus, which was imported on a patient into Singapore. We also discuss the clinical course of the patient, the salient points of management, and the proper removal of this tick species. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With increasing air travel, emergency physicians need to be aware of and to identify imported cases of tick paralysis to institute proper management and advice to the patient. We also describe the tick identification features and proper method of removal of this tick species.
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Affiliation(s)
- Chong Han Pek
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore
| | - Crystal Shuk Jin Cheong
- Department of Otolaryngology - Head and Neck Surgery, National University Health System, Singapore
| | - Yan Lin Yap
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore
| | - Stephen Doggett
- Department of Medical Entomology, Pathology West, Westmead Hospital, Westmead, NSW, Australia
| | - Thiam Chye Lim
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore
| | - Wei Chen Ong
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore
| | - Jane Lim
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore
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18
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Justice-Allen A, Orr K, Schuler K, McCarty K, Jacobson K, Meteyer C. Bald Eagle Nestling Mortality Associated with Argas radiatus and Argas ricei Tick Infestation and Successful Management with Nest Removal in Arizona, USA. J Wildl Dis 2016; 52:940-4. [PMID: 27479902 DOI: 10.7589/2015-10-271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Eight Bald Eagle ( Haliaeetus leucocephalus ) nestlings heavily infested with larval ticks were found in or under a nest near the confluence of the Verde and Salt rivers in Arizona in 2009-11. The 8-12-wk-old nestlings were slow to respond to stimuli and exhibited generalized muscle weakness or paresis of the pelvic limbs. Numerous cutaneous and subcutaneous hemorrhages were associated with sites of tick attachment. Ticks were identified as Argas radiatus and Argas ricei. Treatment with acaricides and infection with West Nile virus (WNV) may have confounded the clinical presentation in 2009 and 2010. However, WNV-negative birds exhibited similar signs in 2011. One nestling recovered from paresis within 36 h after the removal of all adult and larval ticks (>350) and was released within 3 wk. The signs present in the heavily infested Bald Eagle nestlings resembled signs associated with tick paralysis, a neurotoxin-mediated paralytic syndrome described in mammals, reptiles, and wild birds (though not eagles). Removal of the infested nest and construction of a nest platform in a different tree was necessary to break the cycle of infection. The original nesting pair constructed a new nest on the man-made platform and successfully fledged two Bald Eagles in 2012.
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19
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Lysyk TJ, Dergousoff SJ. Can Subclinical Infestation by Paralyzing Dermacentor andersoni (Acari: Ixodidae) Induce Immunity to Tick Paralysis in Sheep? J Med Entomol 2016; 53:496-499. [PMID: 26802171 DOI: 10.1093/jme/tjv248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
Cattle and sheep can develop immunity to paralysis caused by Dermacentor andersoni Stiles; however, this has been reported only in animals that were initially challenged with a high dose of ticks and exhibited clear symptoms of paralysis. Paralysis in sheep occurs in a dose-dependent fashion, with no paralysis occurring in sheep exposed to <0.2 ticks per kilogram sheep weight, and 100% paralysis in sheep exposed to >0.8 ticks per kilogram. This experiment was conducted to determine if sheep exposed to a low dose of ticks would also develop immunity to paralysis. Sheep were exposed to either a low (0.2 ticks per kilogram) or high dose of ticks (0.8 ticks per kilogram), then re-exposed to a second challenge of a paralyzing dose of ticks. All naïve sheep (eight of the eight) were paralyzed, while paralysis occurred in only four of the eight sheep previously exposed to a low dose, and one of the eight sheep previously exposed to a high dose. Results indicate that immunity can develop when sheep are exposed to a subclinical dose of paralyzing ticks, but in a smaller percentage of animals than those exposed to a high dose of ticks. Vaccine development perhaps remains the best option for nonacaricidal control of tick paralysis.
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Affiliation(s)
- T J Lysyk
- Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Avenue South, Lethbridge, AB, Canada T1J 4B1 (; ),
- Retired, and
| | - S J Dergousoff
- Research and Development Centre, Agriculture and Agri-Food Canada, 5403 1st Avenue South, Lethbridge, AB, Canada T1J 4B1 (; )
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20
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Taraschenko OD, Powers KM. Neurotoxin-induced paralysis: a case of tick paralysis in a 2-year-old child. Pediatr Neurol 2014; 50:605-7. [PMID: 24679414 DOI: 10.1016/j.pediatrneurol.2014.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/10/2014] [Accepted: 01/18/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Tick paralysis is an arthropod-transmitted disease causing potentially lethal progressive ascending weakness. The presenting symptoms of tick paralysis overlap those of acute inflammatory diseases of the peripheral nervous system and spinal cord; thus, the condition is often misdiagnosed, leading to unnecessary treatments and prolonged hospitalization. PATIENT A 2-year-old girl residing in northern New York and having no history of travel to areas endemic to ticks presented with rapidly progressing ascending paralysis, hyporeflexia, and intact sensory examination. Investigation included blood and serum toxicology screens, cerebrospinal fluid analysis, and brain imaging. With all tests negative, the child's condition was initially mistaken for botulism; however, an engorged tick was later found attached to the head skin. Following tick removal, the patient's weakness promptly improved with no additional interventions. CONCLUSION Our patient illustrates the importance of thorough skin examination in all cases of acute progressive weakness and the necessity to include tick paralysis in the differential diagnosis of paralysis, even in nonendemic areas.
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Affiliation(s)
| | - Karen M Powers
- Department of Neurology, Albany Medical College, Albany, New York
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21
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Westwood MN, Emery DL, Dhand NK. Clinical presentation and treatment of tick paralysis in dogs and cats in Sydney (2001-2010). Aust Vet J 2013; 91:491-498. [PMID: 31027394 DOI: 10.1111/avj.12130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate associations between clinical presentations and treatment of tick paralysis in dogs and cats, particularly the relationship between the dose of tick antiserum (TAS) and time to recovery. DESIGN A retrospective analysis of 325 cases of tick paralysis (227 dogs, 98 cats), from 2001 to 2010, was conducted using records from six practices in Sydney, New South Wales. RESULTS Doses of TAS in excess of 2 mL/animal, 0.30 mL/kg and 1.25 mL/tick in dogs, and 2 mL/animal, 0.45 mL/kg and 0.38 mL/tick in cats did not significantly alter the time to recovery. In dogs, a longer time to recovery was associated with cases in winter than in other seasons (P = 0.0099) and with more severe gait scores (P = 0.0002). There was a trend of longer recovery times in patients with higher respiratory scores (P = 0.0561). In cats, a longer time to recovery was associated with multiple ticks (P = 0.0133) and more severe gait scores (P < 0.0001). CONCLUSION Within this retrospective study, minimum doses of TAS were considered optimal, negating any association between dose rate and time to recovery.
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Affiliation(s)
- M N Westwood
- Faculty of Veterinary Science, The University of Sydney, 425Werombi Road, Camden, New South Wales, 2570, Australia
| | - D L Emery
- Faculty of Veterinary Science, The University of Sydney, 425Werombi Road, Camden, New South Wales, 2570, Australia
| | - N K Dhand
- Faculty of Veterinary Science, The University of Sydney, 425Werombi Road, Camden, New South Wales, 2570, Australia
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