What's eating you? Ixodes tick and related diseases, part 2: diagnosis and treatment of regional tick-borne diseases.

The Ixodes tick is an important arthropod vector in the transmission of human disease. Although Lyme disease is the most prevalent zoonosis transmitted by Ixodes ticks, other less common diseases may be encountered, including human granulocytic anaplasmosis, babesiosis, Powassan virus infection, tick-borne encephalitis, Borrelia miyamotoi disease, and tick paralysis. In part 2 of this review, disease presentation, diagnosis, and treatment of these less commonly encountered tick-borne diseases are discussed.

What's eating you? Ixodes tick and related diseases, part 1: life cycle, local reactions, and lyme disease.

The Ixodes tick is an important arthropod vector in the transmission of human disease. This 3-part review highlights the biology of the Ixodes tick and manifestations of related diseases. Part 1 addresses the Ixodes tick biology and life cycle; local reactions; and Lyme disease, the most prevalent of associated diseases. Part 2 will address human granulocytic anaplasmosis, babesiosis, Powassan virus infection, Borrelia miyamotoi disease, tick-borne encephalitis, and tick paralysis. Part 3 will address coinfection with multiple pathogens as well as methods of tick-bite prevention and tick removal.

[Tick Infestation of the Eyelid: Case Report and Literature Review]. / Parasitose Palpebral por Carraça: Caso Clínico e Revisão da Literatura.

Tick infestation is rarely seen in ophthalmological practice. We report the case of a 73-year-old woman who presented with edema and erythema of her right upper eyelid. Biomicroscopic examination revealed a tick firmly attached to the eyelid margin. The tick was successfully removed using fine tweezers, and within a few days, the patient had fully recovered without sequelae. Ticks are a threat to public health as they are known vectors of numerous infectious agents responsible for serious pathologies such as Lyme disease. Ticks may also induce cutaneous local reactions, and more rarely, tick paralysis. Since morbidity increases substantially with the duration of the infestation, the tick should be completely removed as soon as possible, and patients should be aware about possible signs of tick related diseases.

No âmbito da prática clínica oftalmológica, as parasitoses por carraças são incomuns. Os autores descrevem o caso clínico de uma doente de 73 anos observada por edema e eritema da pálpebra superior direita. O exame oftalmológico revelou uma carraça aderente à margem palpebral. A carraça foi removida usando uma pinça fina, e poucos dias após, houve regressão total dos sinais inflamatórios, sem registo de complicações. O parasitismo por carraças representa uma ameaça para a Saúde Pública, pois as carraças são vetores de inúmeros agentes infeciosos responsáveis por patologias potencialmente graves, como a doença de Lyme. As carraças podem também induzir reações cutâneas locais e, mais raramente, paralisia neuromuscular. A morbilidade associada à picada da carraça aumenta com a duração da parasitação, pelo que a carraça deve ser removida o mais rápido possível, e os doentes devem ser alertados para os sinais de possíveis complicações locais e sistémicas.

Important knowledge gaps among pastoralists on causes and treatment of udder health problems in livestock in southern Ethiopia: results of qualitative investigation.

BACKGROUND: Ethiopia has high prevalences of udder health problems including clinical and subclinical mastitis across production systems in different livestock species. Previous studies on udder health problems have largely focused on identification of mastitis causing microbial pathogens and associated risk factors. However, relatively little is known about the knowledge and beliefs of livestock keepers regarding udder health problems. An understanding of the beliefs on the other hand would facilitate effective communication between livestock keepers and animal health professionals. Therefore, this study aimed at exploring the knowledge and belief surrounding the causes, clinical signs and treatments for udder health problems in (agro-) pastoral communities in southern Ethiopia using qualitative investigation. RESULTS: The result showed that udder health problem, locally known as 'dhukkuba muchaa', which translates to 'disease of teats', was classified into three main types: (1) tick infestation (dirandisa), (2) swelling of udder often with pus discharge (nyaqarsa) and (3) acute mastitis caused by evil eye (buda) with 'bloody milk'. Tick infestation was perceived to directly cause mechanical damage to udder tissue or to resulting in swelling leading to nyaqarsa. Our analysis also revealed the strong misperception that acute and severe swelling of udder was caused by evil eye. According to the pastoralists, cows with large udders in the late pregnancy are prone to evil eye infliction upon giving birth. The pastoralists often treat udder health problems by combining both modern and traditional methods. Removal of ticks by hand and acarcide application were the preferred methods for limiting tick infestation while swelling and evil eye cases were treated with antibiotics (e.g. oxytetracycline). The study also revealed that specific herbs, only known by the herbalists, were used for traditional treatment of udder health. Although this information could not be divulged at the time, it should form the subject of further investigation. Traditional treatment for evil eye was often administered through nostrils, raising questions about its effectiveness. CONCLUSION: The narration given by the pastoralists in associating tick infestation with udder health problems was compatible with existing scientific evidences. In this respect, such local knowledge can be better utilized for the educational messages targeting control and management of tick infestation in livestock. However, the misperception of causes for acute udder swelling as evil eye can be problematic as far as the application of appropriate treatment and management of the problem is concerned. The misperception can significantly impact the welfare of animals and highlights the need for capacity building of the pastoralists on the causes and treatment of udder health problems.

Human otoacariasis caused by Amblyomma testudinarium: Diagnosis and management: Case report.

RATIONALE: Tick infestation of the external auditory canal (EAC) constitutes <1% of all patients presenting with ear complaints. Consequently, parameters for the diagnosis and management of ticks in the EAC have not been established. PATIENT CONCERNS: We report 2 cases of EAC infestation by Amblyomma testudinarium in 2 female patients, aged 12- and 72 years old. DIAGNOSES INTERVENTIONS AND OUTCOMES: In both patients, otoscopic examination revealed engorged ticks attached to the ear canal. The 12-year-old girl had a narrow EAC, necessitating slight dislodging of the tick to determine if its mouth parts were embedded in the EAC skin. The tick's mouth parts were confirmed to be free, enabling complete removal of the tick. The 72-year-old woman had a wide EAC, enabling tick removal using Hartman's forceps because the tick's mouth parts were confirmed to be free of the skin. Prophylactic tetracycline (200 mg/day) was administered to each patient for 7 days; neither showed any signs of fever or rash. LESSONS: This report describes 2 patients with A testudinarium infestation of the EAC, and proposes a simple, noninvasive protocol for determining if the tick is anchored to the ear canal.

Effective methods for tick removal: A systematic review.

AIM: Providing evidence-based first aid training to lay people is a cost-effective intervention. This systematic review aimed to collect the best available evidence on effective methods to remove a tick, performed by lay people. METHODS: A systematic search was performed searching the Cochrane Library (via Wiley), MEDLINE (via the PubMed interface), and Embase (via the Embase.com interface) to identify studies with evidence on tick removal strategies. Study selection was performed by two independent reviewers and data extraction was achieved in a tabular format. GRADE was used to determine the quality of evidence. RESULTS: Out of 2046 articles, six experimental animal studies were included. These studies compared different chemical treatments (gasoline, petroleum jelly, clear fingernail polish, or methylated spirit) or mechanical techniques (forceps or commercial devices) for tick removal. The available studies were all of very low quality and suggest that there is limited evidence in favor of pulling with commercial devices and in favor of pulling with forceps compared to rotation with forceps to remove ticks. CONCLUSIONS: Limited evidence was found in favor of pulling with commercial tick removal devices or pulling with forceps. The evidence of the included studies is of very low quality and results of these studies are imprecise due to limited sample size, large variability of results, and/or lack of data. Since large high-quality studies are lacking, more rigorous studies are warranted to enable strong evidence-based recommendations.

Evaluation of knowledge of the healthcare personnel working in Giresun province regarding Crimean-Congo hemorrhagic fever before and after educational training.

UNLABELLED: BACKGROUNDS & OBJECTIVES: Crimean-Congo hemorrhagic fever (CCHF) is a highly fatal and contagious tick-borne viral disease. Healthcare workers (HCWs) should know how and with which symptoms can CCHF patients attend to hospitals, and be aware of nosocomial transmission capability. The aim of this study was to investigate the knowledge of HCWs working in Giresun province regarding CCHF. METHODS: This research was carried out during an educational programme arranged for healthcare personnel working in district state hospitals in June 2012. In total, 428 workers completed a self-administered questionnaire including personal demographic characteristics, general knowledge of CCHF disease, knowledge of nosocomial transmission and infection control during hospitalization. RESULTS: Almost all participants (95.3%) knew that the workers in livestock and agriculture were at risk. About 93.5% of participants knew that tick bite is the cause of CCHF transmission. In contrast to this high ratio, only 73 and 77% workers knew that CCHF can be transmitted by direct contact with animal's or patient's blood and body fluids, but after imparting relevant information in the form of one hour lecture given by a doctor expertised in infectious diseases, 92% gave correct answers. Nearly, all healthcare workers were aware that ticks should be removed by using fine-tipped tweezers without crushing (90.7%). Doctors were the most and the laboratory personnel the least well-informed groups. The knowledge degree significantly increased from 67.48 ± 13.89 to 80.92 ± 10.80 points after providing the CCHF related information (p<0.05). INTERPRETATION & CONCLUSION: It was observed that the healthcare personnel working in district state hospitals of the province were moderately aware of CCHF disease. There is possibility of achieving improvement in their knowledge by educating them regarding CCHF and such educational programmes should be conducted from time-to-time.

Integrated control of an acaricide-resistant strain of the cattle tick Rhipicephalus microplus by applying Metarhizium anisopliae associated with cypermethrin and chlorpyriphos under field conditions.

The efficacy of the fungus Metarhizium anisopliae to control ticks has been shown in several in vitro experiments. However, few studies have been undertaken in field conditions in order to demonstrate the applicability of its use as a biological control of ticks and its combination with chemical acaricides. The aim of the present study was to evaluate the efficacy of M. anisopliae to control an acaricide-resistant strain of Rhipicephalus microplus under laboratory and field conditions. First, the compatibility of M. anisopliae strain (TIS-BR03) with commercial acaricides and its potential to control the cattle tick were evaluated in vitro. In general, acaricide treatments had mild effects on fungus viability. In the field experiment, the median of treatment efficacy with acaricide only, M. anisopliae only and combination of M. anisopliae with acaricide were 71.1%, 56.3% and 97.9%, respectively. There is no statistical difference between groups treated with M. anisopliae and acaricide alone. Thus, in this work we have demonstrated the applicability of M. anisopliae use associated or not with chemical acaricides on field conditions in order to control an acaricide-resistant strain of the cattle tick R. microplus.

Infestaciones por garrapatas: a propósito de un caso / Tick infestation: report of a case

Las garrapatas son parásitos hematófagos que afectan la piel de muchos animales vertebrados, transmitiéndose al ser humano por contacto directo con animales infestados. La infestación por garrapata se manifiesta como una mácula, pápula o placa eritematosa y pruriginosa, que aparece 1 a 3 días después de la exposición con el parásito. Además, puede estar asociada con infección local secundaria en el sitio de la mordedura, granuloma a cuerpo extraño, parálisis ascendente e incluso anafilaxia. Estos parásitos también pueden transmitir agentes patógenos capaces de producir enfermedades en el ser humano como bacterias, virus y protozoos. La garrapata debe ser extirpada, teniendo especial precaución de no comprimir demasiado el cuerpo del parásito durante el procedimiento. Reportamos el caso de un hombre de 63 años que presentó una placa eritematosa y pruriginosa en la espalda, cuya imagen dermatoscópica reveló la presencia de una garrapata.

Ticks are blood-sucking, opportunistic parasites that can attach to the skin of a variety of vertebrate hosts. Humans become infested by coming into close contact with infested animals. Tick infestation may present as erythematous pruritic macule, papule, or finely elevated plaque within 1­3 days following tick exposure. Also tick bites may be associated with local, secondary infection at the bite site, foreign body granuloma, ascending paralysis, and even anaphylaxis. In addition, these parasites may transmit a number of different pathogens that cause human diseases including bacteria, viruses, and protozoan. Ticks may be removed, although the body of the tick should not be squeezed during the removal process. We report a 63-year old man who presented with an itchy erythematous plaque on the back, which, upon closer inspection, revealed a partially embedded tick.

Mechanical tools for the removal of Ixodes ricinus female ticks--differences of instruments and pulling or twisting?

The fast and safe removal of ticks is of medical and veterinary importance since many tick-borne pathogens require time to be transmitted. In the past, many tools and applications were used to remove ticks from the skin of humans and pets. Choking the ticks by blocking their respiratory system with chemicals cannot be recommended due to the low respiratory rate of ticks. Mechanical devices to remove ticks are usually recommended; however, they vary with regard to their mechanism of seizing and holding the tick and in the way of extraction (pulling or twisting). In this study, five commercial tick removal devices with different mechanisms were tested on pets according to their practicability, injury of the mouthparts, and the idiosoma of female Ixodes ricinus ticks. Therefore, 22 veterinarians and four pet owners removed 596 ticks from various animals by using the different devices and filled in a questionnaire for each case. The tick species and instars were determined, and for the female I. ricinus ticks (n = 527) the condition of the mouthparts as well as the idiosoma was evaluated. Twisting of the female I. ricinus ticks reduced the force required for extraction, the adverse reaction of the animal and the time needed for removal. The device with a "V"-shaped slot which allows a grabbing of the mouthparts delivered the best results according to the condition of the mouthparts and the intactness of the female I. ricinus tick's body. Therefore, grabbing the mouthparts and twisting can be recommended for removal of I. ricinus females from pets.

Longistatin is an unconventional serine protease and induces protective immunity against tick infestation.

Classical serine proteases use the conserved Ser/His/Asp catalytic triad to hydrolyze substrates. Here, we show that longistatin, a salivary gland protein with two EF-hand domains from the vector tick Haemaphysalis longicornis, does not have the conserved catalytic triad, but still functions as a serine protease. Longistatin was synthesized in and secreted from the salivary glands of ticks, and is injected into host tissues during the acquisition of blood-meals. Longistatin hydrolyzed fibrinogen, an essential plasma protein in the coagulation cascade, and activated plasminogen, into its active form plasmin, a serine protease that dissolves fibrin clots. Longistatin efficiently hydrolyzed several serine protease-specific substrates showing its specificity to the amide bond of Arg. Longistatin did not hydrolyze synthetic substrates specific for other groups of proteases. The enzyme was active at a wide range of temperatures and pHs, with the optimum at 37°C and pH 7. Its activity was efficiently inhibited by various serine protease inhibitors such as phenylmethanesulfonyl fluoride (PMSF), aprotinin, antipain, and leupeptin with the estimated IC(50) of 278.57 µM, 0.35 µM, 41.56 µM and 198.86 µM, respectively. In addition, longistatin was also potently inhibited by Zinc (Zn(2+)) in a concentration-dependent manner with an IC(50) value of 275 µM, and the inhibitory effect of Zn(2+) was revived by ethylenediaminetetra acetic acid (EDTA). Immunization studies revealed that longistatin sharply induced high levels of protective IgG antibodies against ticks. Immunization with longistatin reduced repletion of ticks by about 54%, post engorgement body weight by >11% and molting of nymphs by approximately 34%; thus, the vaccination trial was approximately 73% effective against tick infestation. Taken together, our results suggest that longistatin is a new potent atypical serine protease, and may be an interesting candidate for the development of anti-tick vaccines.

Aspectos produtivos e sanitários de vacas mestiças leiteiras tratadas com produtos homeopáticos / Productive and sanitary aspects of crossbred milking cows receiving homeopathic products

Nos dias de hoje, a população mundial exige o consumo de alimentos de qualidade, sem resíduos de produtos químicos. Desempenho (produção e qualidade do leite, peso e condição corporal) e sanidade (mastite e infestação por ecto e endoparasitas) foram acompanhados em oito vacas leiteiras mestiças de um rebanho de 40 (20%), que recebeu diariamente produtos homeopáticos comerciais no concentrado para o controle de endo e ectoparasitas e mastite. No período de nove meses, que correspondeu a toda uma lactação, não houve necessidade de medicar com produtos alopáticos nenhuma vaca do rebanho, o que demonstrou ser possível criar vacas leiteiras mestiças não utilizando produtos químicos para o combate a parasitas (carrapato, mosca-do-chifre e verminose), ou antibióticos para o controle de mastite, e sem interferir na produtividade dos animais.

Nowadays the world population demands food of good quality, without any residues from chemical products. Eight cows from a herd of 40, which were consuming commercial homeopathic medicines at the daily concentration for control of endoand ectoparasites, were monitored in terms of their performance (production and quality of milk, body score and body weight) and sanitary aspects (parasites infestation and mastitis) during the lactation period. It was not necessary to give any allopathic (conventional) medicines to control mastitis or parasites (ticks, horn-fly, verminosis) in any cow of the herd during the nine months of the lactation period. The results showed that it is possible to produce milk without using chemical products, and not interfering in the productivity of the crossbred animals.

Tick infestation of the eyelid: a case report in a child.

A three-year-old girl presented with a small brown lesion on the right upper eyelid margin. Close examination revealed an insect body attached to the eyelid margin. Microscopic examination of the specimen identified the species of the organism as Ixodes ricinus. The tick was completely removed with blunt forceps. She was treated with lid toilet, irrigation, and application of topical 0.3% ciprofloxacin four times daily to the affected eye. The lesion healed without scarring after one week. No systemic symptoms were observed. Mechanical removal with blunt forceps may be a quick, easy, safe and effective treatment for ticks located on the eyelids.

[Cryotherapy in treatment of skin demodecosis].

Demodecosis is wide spread chronic skin disorder caused by the mite - Demodex folliculorum. It frequently involves the mid facial region: nasolabial folder, the nose, the chin and eyes. The treatment depends on the severity of the inflammatory skin disorder and includes complex of oral and topical drug treatment. The aim of the study was to determine the efficiency of criotherapy in complex treatment of demodecosis. We have observed 38 patients of both sexes aged 19-54. The patients were divided into two groups - "A" and "B". Patients with erythematosquamose form of the disease were treated with Trichopol peros and oral antibiotics in case of inflammatory lesions. For topical treatment in group "A" Rosamet cream was used. In group "B" Rosamet cream and criotherapy were used. The results of our study have demonstrated effectiveness of criotherapy in combination with Rosamet cream. A significantly faster decrease of inflammatory lesions and reduce the erythema was observed in group "B". Therefore the usage of criotherapy with Rosamet cream is recommended to get quick therapeutic effect.

Larval tick infestation: a case report and review of tick-borne disease.

Tick-borne disease in the United States continues to be a threat as people interact with their natural surroundings. We present a case of an 8-year-old boy with a larval tick infestation. Ticks within the United States can carry Lyme disease, Rocky Mountain spotted fever (RMSF), ehrlichiosis, babesiosis, tularemia, tick-borne relapsing fever, and tick paralysis. These preventable diseases are treatable when accurately recognized and diagnosed; however, if left untreated, they can cause substantial morbidity and mortality. This article highlights the knowledge necessary to recognize, treat, and prevent tickborne disease.

Science and popular participation in the investigation of heartwater in South Africa, c. 1870-1950.

During the late nineteenth century, settler farmers in southern Africa identified heartwater as a damaging disease of small stock and cattle. They advanced various explanations of the disease, including the theory that it was caused by the bite of ticks. Around 1900, the American entomologist C.P. Lousbury demonstrated that heartwater was transmitted by the bont tick. He also worked out the life cycle and life habits of the tick. Subsequently, farmers developed methods of controlling ticks by dipping animals in solutions of arsenic. By 1910, the practice of dipping cattle had become very widespread over much of southern Africa. The expansion of the practice was greatly stimulated by the coming of the deadly tick-borne disease, East Coast fever. At this time, veterinary scientists attempted to develop a vaccine against heartwater, but with little success. Little further progress was made until the 1920s, when the American scientist E.V. Cowdry identified a causal agent, Rickettsia ruminantium, while on a research secondment to South Africa. By the 1940s, South African veterinary scientists had devised methods of immunising stock against heartwater, but there remained considerable technical difficulties and their use remained limited. Dipping in arsenic solutions to attack the tick on the animal thus remained the most important means of controlling disease in the first half of the twentieth century.