Tick-Bite "Meteo"-Prevention: An Evaluation of Public Responsiveness to Tick Activity Forecasts Available Online.

Until causal prophylaxis is available, the avoidance of ticks and personal protection provide the best insurance against contracting a tick-borne disease (TBD). To support public precaution, tick-activity forecasts (TAFs) based on weather projection are provided online for some regions/countries. This study-aimed at evaluating the efficacy of this preventative strategy-was conducted between 2015 and 2019, and included two countries where TAFs are issued regularly (Czech Republic, Germany) and two neighbouring countries for reference (Austria, Switzerland). Google Trends (GT) data were used to trace public concern with TAFs and related health information. GTs were compared with epidemiological data on TBD cases and tick bites, wherever available. Computer simulations of presumable effectiveness under various scenarios were performed. This study showed that public access to TAFs/preventive information is infrequent and not optimally distributed over the season. Interest arises very early in midwinter and then starts to fall in spring/summer when human-tick contacts culminate. Consequently, a greater number of TBD cases are contracted beyond the period of maximum public responsiveness to prevention guidance. Simulations, nevertheless, indicate that there is a potential for doubling the prevention yield if risk assessment, in addition to tick activity, subsumes the population's exposure, and a real-time surrogate is proposed.

Global varus malalignment increase from double-leg to single-leg stance due to intra-articular changes.

PURPOSE: Preoperatively planned correction for tibial osteotomy surgery is usually based on weightbearing long-leg Xrays, while the surgery is performed in a supine non-weightbearing position. The purpose of this study was to assess the differences in lower limb alignment in three different weightbearing conditions: supine position, double-leg (DL) stance and single-sleg (SL) stance prior to performing a medial opening wedge high tibial osteotomy (MOWHTO) for varus malalignment. The hypothesis of this study was that progressive limb-loading would lead to an increased preoperative varus deformity. MATERIAL AND METHODS: This retrospective study included 89 patients (96 knees) with isolated medial knee osteoarthritis (Ahlbäck grade I or II) and significant metaphyseal tibial vara (> 6°). The differences between supine position, DL stance and SL stance were analysed for the hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), weight-bearing line ratio (WBL) and joint line convergence angle (JLCA). RESULTS: From a supine position to DL stance, the HKA angle slightly increased from 175.5° ± 1.1° to 176.3° ± 1.1° and JLCA changed from 2.0° ± 0.3° to 1.8° ± 0.3° without a statistically significant difference. From DL to SL stances, the HKA angle decreased from 176.3° ± 1.1° to 174.4° ± 1.1° (p < 0.05) and the JLCA increased from 1.8° ± 0.3° to 2.6° ± 0.3° (p < 0.05). A significant correlation was found between ΔHKA and ΔJLCA between the DL and the SL stances (R2 = 0.46; p = 0.01). CONCLUSION: Varus malalignment increases with weight-bearing loading from double-leg to single-leg stances with an associated JLCA increase. Thus, single-leg stance radiographs may be useful to correct preoperative planning considering patient-specific changes in JLCA. LEVEL OF CLINICAL EVIDENCE: III, retrospective comparative study.

Three-Layer PdO/CuWO4/CuO System for Hydrogen Gas Sensing with Reduced Humidity Interference.

The growing hydrogen industry is stimulating an ongoing search for new materials not only for hydrogen production or storage but also for hydrogen sensing. These materials have to be sensitive to hydrogen, but additionally, their synthesis should be compatible with the microcircuit industry to enable seamless integration into various devices. In addition, the interference of air humidity remains an issue for hydrogen sensing materials. We approach these challenges using conventional reactive sputter deposition. Using three consequential processes, we synthesized multilayer structures. A basic two-layer system composed of a base layer of cupric oxide (CuO) overlayered with a nanostructured copper tungstate (CuWO4) exhibits higher sensitivity than individual materials. This is explained by the formation of microscopic heterojunctions. The addition of a third layer of palladium oxide (PdO) in forms of thin film and particles resulted in a reduction in humidity interference. As a result, a sensing three-layer system working at 150 °C with an equalized response in dry/humid air was developed.

Evaluation of primary hip arthroscopy complications in mid-term follow-up: a multicentric prospective study.

INTRODUCTION: Hip arthroscopy is a common procedure in hip preservation surgery. Its complication rate is relatively low. This prospective multicentric study evaluates complication rate in patients undergoing primary hip arthroscopy. MATERIALS AND METHODS: The study cohort consisted of 908 patients mean age of 37 years (14-67 years). Patients were prospectively included in the study in the years 2009-2017. All complications were recorded and evaluated. The minimum follow-up was 36 months. Results were statistically evaluated and risk factors for complications were identified. RESULTS: The overall complication rate was 7.3% (67/908 cases), the minor complication rate of 4.9% (45/908 cases) and the major complication rate 2.4% (22/908 cases). The most common severe complications were iatrogenic cartilage damage and instrument breakage, while the most common minor complications were perineal hypoaesthesia and heterotopic ossifications. The conversion rate to total hip replacement was 4.2% (39/908 patients). CONCLUSION: Hip arthroscopy is a safe procedure with low complication rates. Surgeon training and experience greatly influence the complication rates.

Tuning Stoichiometry and Structure of Pd-WO3-x Thin Films for Hydrogen Gas Sensing by High-Power Impulse Magnetron Sputtering.

By tuning the deposition parameters of reactive high-power impulse magnetron sputtering, specifically the pulse length, we were able to prepare WO3-x films with various stoichiometry and structure. Subsequently, the films were annealed in air at moderate temperature (350 °C). We demonstrate that the stoichiometry of the as-deposited films influences considerably the type of crystalline phase formed in the annealed films. The appropriate sub-stoichiometry of the films (approx. WO2.76) enabled crystallization of the monoclinic phase during the annealing. This phase is favorable for hydrogen sensing applications. To characterize the sensory behavior of the films, the tungsten oxide films were decorated by Pd nanoparticles before annealing and were assembled as a conductometric gas sensor. The sensory response of the films that crystallized in the monoclinic structure was proven to be superior to that of the films containing other phases.

COMPARISON OF LCP AND INTRAMEDULLARY NAIL OSTEOSYNTHESIS IN CALCANEAL FRACTURES.

OBJECTIVE: This study compared groups of patients with calcaneal fractures of Sanders types II and III. One group was treated with ORIF using an LCP (plate), while the second was treated with a minimally invasive method using a C-Nail. METHODS: The study included 217 patients in the ORIF group and 19 patients in the minimally invasive nail osteosynthesis group. RESULTS: In the LCP group, the outcomes were excellent for 35.7% of the patients; good, 38.9%; satisfactory, 19.7%; and poor, 5.7%. In the C-Nail group, the outcomes were excellent for 36.9% of the patients; good; 31.6%; satisfactory, 21%; and poor, 10.2%. The mean values of the restoration of Böhler's angle from post-injury were 6.8° to 32.3° in the LCP group and 7.1° to 33.3° in the C-Nail group. After 12 months, there was only a minimal decrease in Böhler's angle to 29.2° in both the LCP and C-Nail groups. CONCLUSION: The outcomes obtained with C-Nail fixation are statistically identical to those obtained with LCP fixation. We conclude that osteosynthesis with a C-Nail is suitable as the first-choice treatment for Sanders types II and III fractures. Level of evidence IV, retrospective observational study.

OBJETIVO: Comparar grupos de pacientes com fratura intra-articular do calcâneo tipos II e III de Sanders. MÉTODOS: Estudo retrospectivo que incluiu 217 pacientes no grupo tratado por redução aberta e fixação interna com placa de compressão (Grupo PC) e 19 pacientes que seguiram um método minimamente invasivo com C-Nail. RESULTADOS: No Grupo PC, os resultados foram excelentes em 35,7%, bons em 38,9%, satisfatórios em 19,17% e ruins em 5,7%. Os resultados registados no grupo que recebeu implante de unha foram excelentes em 36,9%, bons em 31,6%, satisfatórios em 21% e ruins em 10,2% Os valores médios do restauro do ângulo de Böhler desde o pós-ferimento variaram entre 6,8° e 32,3°, no Grupo PC, e entre 7,1° e 33,3°, no grupo tratado com C-Nail. Ao fim de 12 meses, apenas se observou redução mínima do ângulo de Böhler para 29,2° nos dois grupos. CONCLUSÃO: Os resultados do método recentemente introduzido de osteossíntese minimamente invasiva com C-Nail são estatisticamente idênticos aos obtidos pela redução aberta e fixação interna com placa de compressão. Assim, o novo tipo de osteossíntese com C-Nail é adequado como primeira escolha em fraturas do tipo Sanders II e III. Nível de evidência IV, Estudo retrospectivo de observação.

Prolongation of Tick-Borne Encephalitis Cycles in Warmer Climatic Conditions.

Tick-borne encephalitis exhibits profound inter-annual fluctuations in incidence. Previous studies showed that three-fifths of the variation can be explained in terms of four superimposed oscillations: a quasi-biennial, triennial, pentennial, and a decadal cycle. This study was conducted to determine how these cycles could be influenced by climate change. Epidemiological data, spanning from the 1970s to the present, and originating from six regions/countries bridging Scandinavia and the Mediterranean, represented a temporal/latitudinal gradient. Spectral analysis of time series was used to determine variation in the cycles' length/amplitude with respect to these gradients. The analysis showed that-whereas the lengths of the shorter cycles do not vary substantially-cycles in the decadal band tend to be longer southwards. When comparing the disease's oscillations before- and after the mid-1990s, a shift towards longer oscillations was detected in the pentennial-decadal band, but not in the biennial- triennial band. Simultaneously, oscillations in the latter band increased in intensity whereas the decadal oscillations weakened. In summary, the rhythm of the cycles has been altered by climate change. Lengthened cycles may be explained by prolonged survival of some animal hosts, and consequently greater inertia in herd immunity changes, slowing down a feedback loop between the herd immunity and amount of virus circulating in nature.

Comparison of lcp and intramedullary nail osteosynthesis in calcaneal fractures / Comparação entre placa de osteossíntese e haste intramedular em fratura do calcâneo

ABSTRACT Objective: This study compared groups of patients with calcaneal fractures of Sanders types II and III. One group was treated with ORIF using an LCP (plate), while the second was treated with a minimally invasive method using a C-Nail. Methods: The study included 217 patients in the ORIF group and 19 patients in the minimally invasive nail osteosynthesis group. Results: In the LCP group, the outcomes were excellent for 35.7% of the patients; good, 38.9%; satisfactory, 19.7%; and poor, 5.7%. In the C-Nail group, the outcomes were excellent for 36.9% of the patients; good; 31.6%; satisfactory, 21%; and poor, 10.2%. The mean values of the restoration of Böhler's angle from post-injury were 6.8° to 32.3° in the LCP group and 7.1° to 33.3° in the C-Nail group. After 12 months, there was only a minimal decrease in Böhler's angle to 29.2° in both the LCP and C-Nail groups. Conclusion: The outcomes obtained with C-Nail fixation are statistically identical to those obtained with LCP fixation. We conclude that osteosynthesis with a C-Nail is suitable as the first-choice treatment for Sanders types II and III fractures. Level of evidence IV, retrospective observational study.

RESUMO Objetivo: Comparar grupos de pacientes com fratura intra-articular do calcâneo tipos II e III de Sanders. Métodos: Estudo retrospectivo que incluiu 217 pacientes no grupo tratado por redução aberta e fixação interna com placa de compressão (Grupo PC) e 19 pacientes que seguiram um método minimamente invasivo com C-Nail. Resultados: No Grupo PC, os resultados foram excelentes em 35,7%, bons em 38,9%, satisfatórios em 19,17% e ruins em 5,7%. Os resultados registados no grupo que recebeu implante de unha foram excelentes em 36,9%, bons em 31,6%, satisfatórios em 21% e ruins em 10,2% Os valores médios do restauro do ângulo de Böhler desde o pós-ferimento variaram entre 6,8° e 32,3°, no Grupo PC, e entre 7,1° e 33,3°, no grupo tratado com C-Nail. Ao fim de 12 meses, apenas se observou redução mínima do ângulo de Böhler para 29,2° nos dois grupos. Conclusão: Os resultados do método recentemente introduzido de osteossíntese minimamente invasiva com C-Nail são estatisticamente idênticos aos obtidos pela redução aberta e fixação interna com placa de compressão. Assim, o novo tipo de osteossíntese com C-Nail é adequado como primeira escolha em fraturas do tipo Sanders II e III. Nível de evidência IV, Estudo retrospectivo de observação.

Histochemical and histological changes of paraspinal muscles in patients with thoracic and lumbar spine fractures treated with open and minimally invasive stabilisation.

BACKGROUND: Histological and histochemical analyses of muscle samples were used to determine the intensity of paraspinal muscle injury during open (OPEN) and minimally invasive (MIS) procedures due to spinal trauma. OBJECTIVE: A randomised prospective study design was chosen. According to our hypothesis, OPEN procedures will lead to more intensive microscopic changes than MIS. METHODS: Muscle samples were collected during the primary surgery - fracture surgery (FRS) from the left and during material extraction (EXS) from the right side. Complete samples were acquired from 17 OPEN and 18 MIS subjects. We compared them histochemically and histologically; muscle fibre typing and statistical analysis were performed. RESULTS: We statistically confirmed that the increase in fibrosis in the OPEN EXS sample was significantly higher than in the MIS EXS sample, with p< 0.05 (p= 0.000322453). Fibre types in MIS did not differ almost at all in both samples; the changes were statistically insignificant.In OPEN samples, the number of type I fibres differed significantly. In EXS, it was significantly lower (46.23%) than in FRS (60.63%), at a statistically significant level, p< 0.05 (p= 0.0234375000) especially with the increase of the type IIA fibres, less in IIB fibres. CONCLUSIONS: These microscopic findings provide a statistically significant confirmation that OPEN procedures in spinal fracture lead, in most cases, to significant changes in the structure of the corset muscle at the fracture site and surgical access point than MIS procedures.

Hip arthroscopy learning curve: a prospective single-surgeon study.

PURPOSE: Arthroscopy of the hip joint is considered a demanding procedure with long learning curve. There are only a few studies that concentrate on this topic. This prospective clinical study evaluates the learning curve of the hip arthroscopy based on clinical outcomes, surgical time, and complication rate. MATERIALS: In this study, we first evaluated 150 hip arthroscopy procedures performed by a single surgeon. The patient group consisted of 86 females and 64 males with mean age 37 years (range 16-69). Study cohorts were divided into groups of 50 patients. Surgical time, complication rate and clinical results based on NAHS score were recorded for each group. Statistical analysis of differences between groups was performed using the ANOVA method and paired t-test. RESULTS: We found a statistically significant decrease of complication rate with more procedures performed. There were significantly better clinical outcomes after at least 100 procedures. No difference in surgical time was found, but towards the end of the learning curve, more complex procedures were performed. The only statistical difference was the portal setup time. The learning curves were constructed based on these results. CONCLUSIONS: Hip arthroscopy provides very good clinical outcomes if precisely indicated and performed. It is, however, a demanding procedure with many possible pitfalls and complications. According to our study, at least 100 procedures are needed to gain basic technical and indication skills. The presence of a more skilled surgeon in the beginning of the learning curve is advised to reduce the complication rate.

Epicardial clip occlusion of the left atrial appendage during cardiac surgery provides optimal surgical results and long-term stability.

OBJECTIVES: Occlusion of the left atrial appendage (LAA) has become an integral and important part of the surgical treatment of atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with varying levels of short- and long-term success for closure. The purpose of this study was to evaluate long-term results of epicardial placement and endocardial occlusion in patients undergoing cardiac operative procedures. METHODS: A total of 101 patients (average age 65.7 years) undergoing cardiac operative procedures with the epicardial AtriClip Exclusion System of the LAA were enrolled in the study. The AtriClip was placed via a sternotomy or a thoracotomy or from a thoracoscopic approach. Postoperative variables, such as thromboembolic events, clip stability and endocardial leakage around the device, were examined by transoesophageal echocardiography (TEE) and/or computed tomography. RESULTS: Perioperative clip implantation was achieved in 98% of patients. TEE and/or computed tomography conducted during the follow-up period, comprising 1873 patient-months with a mean duration of 18 ± 11 months, revealed no clip migration, no leakage around the device and no clot formation near the remnant cul-de-sac. During the follow-up period, 4 of the cardiac patients experienced transitory ischaemic attacks, whereas no patient experienced a cerebrovascular attack. CONCLUSIONS: The Epicardial AtriClip Exclusion System of the LAA appears to be a feasable and safe operative method with a high success rate. Long-term follow-up confirmed clip stability, complete occlussion of the LAA and absence of any atrial fibrilation-related thromboembolic events. These results need to be confirmed by a larger, multicentre study.

Increasing Residential Proximity of Lyme Borreliosis Cases to High-Risk Habitats: A Retrospective Study in Central Bohemia, the Czech Republic, 1987-2010.

An analysis of historical data on Lyme borreliosis in Central Bohemia between 1987-2010 has revealed that the rate of peri-domestic exposure, the proximity of patients' residences to high-risk habitats, and the number of disease cases have been interdependent variables and that their common upturn can be dated back to the start of the 1990s or earlier. The data indicate that the disease rise is attributable to translocation of part of the at-risk population nearer to natural environments, rather than to mere intensification of people's peri-domestic exposure at existing residential locations, or changes in the natural environment itself.

Concave impressio ligamenti costoclavicularis ("rhomboid fossa") and its prevalence and relevance to clinical practice.

PURPOSE: The incidence of fossa rhomboidea (RF) and its relevance to clinical practice were retrospectively studied in 1,017 cases of patients who endured clavicle fractures. The aim of the study was to determine the frequency of different types of insertion areas of costoclavicular ligament (LCC) in our group, as well as gender distribution. Furthermore, we wanted to investigate whether the RF represents a weakened part of clavicle where the fracture occurred. Several of our findings in our control group were quite interesting and worth mentioning. MATERIALS AND METHODS: 1,017 roentgenograms were analyzed from 1,027 clavicle fractures of patients from 2 to 90 years of age who were treated between 2007 and 2011. RESULTS: Using the Allman classification system, 79% of the examined clavicle fractures were identified as type 1, 18.4% as type 2, and 2.6% as type 3. Statistical analysis did not demonstrate a difference in fractures of the clavicle between the right and the left side (47, 53%, respectively; p = 0.0570). There was a statistically significant difference in the incidence of fractures between the genders (males 71%, females 29 %; p < 0.0001). The results for the insertion attachment area were as follows for the given percent of cases: flat (75.2%); concave (21.1%); convex (3.7%). Those 21.1% of concave insertions represent RF. 5.3% of RF cases were between 2 to 10 mm in depth. One of the patients with RF had a deepend insertion of the LCC on the superior surface of the first rib analogous to RF. The bilateral RF was asymmetrical in its appearance. One of the patients suffered from LCC enthesopathy. The difference of the distribution of RF throughout the genders was 10.5% in females and 89.5% in males, marking a difference that is statistically significant (p < 0.0001). Only in 0.3%, the fracture line occurred in RF, which did not prove the RF to be a weakened point of the fracture (p < 0.0001). CONCLUSIONS: RF represents a variety of LCC insertion that is predominantly found in male patients, which can be used in the determination of gender in forensic analysis. RF is not a weak point for fracture formation. Enthesopathy of the LCC together with RF can lead to suspicion concerning the osteolytic process. Biopsy of RF should be avoided. Insertion of LCC similar to RF can be exceptionally found on the first rib.

Peri-urbanisation, counter-urbanisation, and an extension of residential exposure to ticks: a clue to the trends in Lyme borreliosis incidence in the Czech Republic?

The incidence of tick-borne human diseases (TBD) in the Czech Republic (CZ) is on the increase, driven by infections increasingly acquired in residential locations, earlier in spring and later in autumn, and among children and the elderly. To interpret these trends, data on Lyme borreliosis (LB) incidence between 1997 and 2010 were analysed in the context of population migration flows registered in the CZ during the same period. Analysis showed that a migration stream of families with children, and of the elderly, flowed from more urbanized and densely populated localities to those more rural and less populated, where the chance of acquiring LB in the home vicinity was greater than in the urban settings. By contrast, a stream of people in the life phase between early adulthood and family formation flowed reversely, corresponding to a prominent absence of this age category from the patient spectrum. The data further showed that the more the residential exposure became prevalent, the more people were in year-round (rather than in summertime only) contact with ticks, which accounts for an extension of the cases' seasonal distribution as well as for an overall increase in case numbers. Finally, the fact that majority of the urban-to-rural migrants could be categorised as wealthier people could explain the previously noticed lack of low-status people among TBD patients in the CZ.

Spatial distribution of a population at risk: an important factor for understanding the recent rise in tick-borne diseases (Lyme borreliosis and tick-borne encephalitis in the Czech Republic).

Recent rise in tick-borne diseases in many parts of Europe is a phenomenon in need of an explanation. We analyzed temporal trends in spatial distribution of a population at risk of Lyme borreliosis, tick-borne encephalitis, and as a control, also of a 'non-tick-borne disease' in the Czech Republic in 1997-2010. Analysis revealed that the population's exposure had been increasingly confined to the nearest surroundings of residences or in totally residential locations and that the incidence of the diseases depended in some causal way on how close to residences people exposed themselves to the risk. The rise in Lyme borreliosis and tick-borne encephalitis was solely due to infections acquired at or near patients' homes (<5 km), while the number of cases acquired further away was decreasing. The detected patterns in the data question some of the hypotheses which may be applicable in explaining the rise in disease incidences in the Czech Republic including the effect of climate change. Potentially causal factors are discussed.

Seroprevalence of Anaplasma phagocytophilum in horses in the Czech Republic.

Anaplasma phagocytophilum is the aetiological agent of equine granulocytic anaplasmosis (EGA). The aim of this survey was to assess the prevalence of anti-A. phagocytophilum antibodies in the horse population of the Czech Republic (CZ) and to investigate possible links between seropositivity and the geographic origin, age, and/or sex of the tested horses. Antibodies against A. phagocytophilum were screened using an indirect fluorescent antibody method (IFA). Serum samples from 96 healthy horses from 8 localities (7 within the CZ and one control upland/tick-free locality in Ukraine) were examined. While the controls tested negative, the seroprevalence in the Czech localities was estimated at 73%, which suggests that subclinical EGA is common among horses in the CZ. Significant differences between seropositivity rates in individual stables were demonstrated (explicable by the different environment and/or management styles of the horses stabled therein). Horses in stables from which previous manifest cases had been reported tended to have higher average titres. Mares displayed a somewhat higher seropositivity rate than did stallions; age had no demonstrable effect upon the serological status of the examined horses.

Conditions for stable parapatric coexistence between Boophilus decoloratus and B. microplus ticks: a simulation study using the competitive Lotka-Volterra model.

The autochthonous tick Boophilus decoloratus, and the invasive species Bo. microplus, the tick most threatening the livestock industry in Africa, show complex interactions in their interspecific rivalry. This study was conducted to specify the conditions under which the two competitors can co-exist in equilibrium, and to provide insight into their climate-dependant parapatric distribution in Tanzania. A model of the Lotka-Volterra type was used, taking into account population dispersal and interactions of various kinds. If the model allowed for immunity-mediated competition on cattle, reproductive interference, and an external mortality factor, it explained fairly well the field observation that the borderline between these ticks loosely follows the 22-23°C isotherm and the 58 mm isohyet (i.e. ~700 mm of annual rainfall total). Simulations fully compatible with the pattern of real co-existing populations of Bo. decoloratus and Bo. microplus, characterized by a pronounced population density trough and mutual exclusion of the two ticks on cattle in an intermediary zone between their distributional ranges, were, however, achieved only if the model also implemented a hypothetical factor responsible for some mortality upon encounter of one tick with the other, interpretable as an interaction through a shared pathogen(s). This study also demonstrated the importance of non-cattle hosts, enabling the autochthon to avoid competition with Bo. microplus, for the behaviour of the modelled system. The simulations indicate that a substantial reduction of wildlife habitats and consequently of Bo. decoloratus refugia, may accelerate the replacement of Bo. decoloratus with Bo. microplus much faster than climatic changes might do.

Spatio-temporal variation of tick-borne encephalitis (TBE) incidence in the Czech Republic: is the current explanation of the disease's rise satisfactory?

A marked increase in tick-borne encephalitis (TBE) incidence has been observed in Europe during the last 2 decades. Hypothetical causes include global climatic fluctuations, human-induced environmental changes, and socio-economic changes. These factors are thought to be disproportionately relevant in different geographical areas. To date, epidemiological studies of this phenomenon were based primarily on aggregated data, and little is known about TBE dynamics on the detailed geographical scale. This study is aimed at the subregional variations of incidence of TBE in the Czech Republic. The methodology of spatial statistics was applied. Over 13,000 cases of TBE, registered 1971-2007, were pinpointed on a GIS map and analysed for density variations in both time and space. Selected areas were studied in detail, using time series analysis. These analyses revealed that the incidence of TBE was highly variable both across the country and over the study period. Although the aggregate total of reported cases were generally increasing, local trends were divergent. A detailed study of one endemic area (that one with the highest case density level) showed that heterogeneities are detectable, even on a very fine geographical scale. There was no evident spatial coherence of the TBE trends; and some adjacent areas showed quite differing trends. However, countrywide coherence was demonstrated for quasi-octennial fluctuations in the TBE series, associable with the North Atlantic oscillation. The possible influences of both various climatic and population covariates upon TBE occurrence are discussed. However, the geographical heterogeneity of the disease trends, at such a fine spatial scale, cannot be explained satisfactorily by fluctuations in climatic or socio-economic conditions.

An entropy-optimized multilocus approach for characterizing the strains of Anaplasma phagocytophilum infecting horses in the Czech Republic.

Anaplasma phagocytophilum is a tick-borne rickettsial pathogen that has measurable genetic heterogeneity across its geographical range and reservoir spectrum. In the present study, publicly available sequences of the genes that have prevailingly been used for typing A. phagocytophilum were analysed to identify the segments giving the highest resolution with respect to the predictability of host and geographical provenances of the strains. Selected partial sequences of 16S rRNA, groL, msp4 and ank genes were then employed in a tentative multilocus typing scheme used to characterize the strains causing equine granulocytic anaplasmosis (EGA). We were able to both identify alleles characteristic for equine strains of A. phagocytophilum and distinguish two unique genetic variants infecting horses in the Czech Republic. This resolution far exceeded the discriminatory potential of any of the four sequenced genes when used singly. The two novel A. phagocytophilum variants appeared to be phylogenetically closer to the strains reported as causing human disease in Slovenia than to strains thus far isolated from other European EGA cases. A decline in the quality of recently deposited A. phagocytophilum sequences was also demonstrated.

Shifts in the distributional ranges of Boophilus ticks in Tanzania: evidence that a parapatric boundary between Boophilus microplus and B. decoloratus follows climate gradients.

Based on a national tick survey conducted in Tanzania between 1998 and 2001, predictive maps of tick distribution for B. microplus and B. decoloratus were computed and compared with historical maps that originated about 40 years ago. The new data collected showed that except for extremely cold and dry areas B. microplus has extended its distribution range and is now present in all the northern regions of Tanzania, and that high suitability is currently recorded for most of the previously non-occupied areas. In contrast, B. decoloratus, once abundant in Tanzania, has largely retreated to highlands in north and central Tanzania and several other high-altitude refuges. Geostatistical analysis revealed a dissimilar character of distribution for the two species at a local and regional scale, as well as an antagonistic relationship between them in a spatial context. The Tanzania data suggest that an equilibrium phase with a stable parapatric boundary that follows a climate gradient has been achieved. The zone of overlap in the distribution ranges of B. microplus and B. decoloratus is characterized by a decreased infestation rate as well as mutual exclusion on infested cattle. This finding matches studies on parapatry with hybrid zones, where the latter zones that separate species tend to rest in density troughs. Analysis of the Tanzania data shows that the critical factor for the advance of B. microplus and the retreat of B. decoloratus is associated with the 58 mm isohyet and the 22-23 degrees C isotherm and indicates a well developed higher-temperature tolerance for B. microplus. It can be anticipated that climate changes may enhance the spread of B. microplus and consequently Babesia bovis into new areas of the African continent.