Factors Associated With the Spatial Distribution of Severe Fever With Thrombocytopenia Syndrome in Zhejiang Province, China: Risk Analysis Based on Maximum Entropy.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was first identified in mainland China in 2009 and has been reported in Zhejiang Province, China, since 2011. However, few studies have focused on the association between ticks, host animals, and SFTS. Objective: In this study, we analyzed the influence of meteorological and environmental factors as well as the influence of ticks and host animals on SFTS. This can serve as a foundational basis for the development of strategic policies aimed at the prevention and control of SFTS. Methods: Data on SFTS incidence, tick density, cattle density, and meteorological and environmental factors were collected and analyzed using a maximum entropy-based model. Results: As of December 2019, 463 laboratory-confirmed SFTS cases were reported in Zhejiang Province. We found that the density of ticks, precipitation in the wettest month, average temperature, elevation, and the normalized difference vegetation index were significantly associated with SFTS spatial distribution. The niche model fitted accurately with good performance in predicting the potential risk areas of SFTS (the average test area under the receiver operating characteristic curve for the replicate runs was 0.803 and the SD was 0.013). The risk of SFTS occurrence increased with an increase in tick density, and the response curve indicated that the risk was greater than 0.5 when tick density exceeded 1.4. The risk of SFTS occurrence decreased with increased precipitation in the wettest month, and the risk was less than 0.5 when precipitation exceeded 224.4 mm. The relationship between elevation and SFTS occurrence showed a reverse V shape, and the risk peaked at approximately 400 m. Conclusions: Tick density, precipitation, and elevation were dominant influencing factors for SFTS, and comprehensive intervention measures should be adjusted according to these factors to reduce SFTS incidence in Zhejiang Province.

A review of Hepatozoonosis caused by Hepatozoon canis in dogs.

Hepatozoon canis is a type of single-celled organism is spread by ticks and commonly affects dogs. It is responsible for causing one of the most significant parasitic diseases in dogs, called Hepatozoonosis. It is considered one of the most common causes of canine vector-borne diseases because it is closely linked to Rhipicephalus sanguineus (the brown dog tick), a species found worldwide. Hepatozoonosis caused by H. canis is prevalent in regions such as South Europe, South America, Asia, and Africa. H. canis often causes emaciation, anemia, and intermittent fever in infected dogs. The drugs used to treat H. canis infection in dogs include the combination of imidocarb dipropionate with doxycycline, toltrazoril, tetracycline hydrochloride, and the combination of trimethoprim-sulfamethoxazole.The primary solution to prevent the spread of infections caused by H. canis is to control the population of R. sanguineus ticks because H. canis is spread through ticks. This review aims to provide a brief overview of various studies conducted on the morphology, life cycle, hosts, epidemiology, clinical symptoms, laboratory diagnosis, autopsy findings, differential diagnosis, treatment, and prevention methods of H. canis.

Molecular detection of Anaplasma, Babesia, Theileria, and Trypanosoma infection in cattle and buffaloes in India.

Tick-borne pathogens pose a significant global threat, causing substantial economic losses to the dairy industry. In India, tropical theileriosis, anaplasmosis, babesiosis, and trypanosomiasis are major hemo-parasitic diseases affecting bovines. A cross-sectional study was conducted to determine the prevalence of hemo-parasites in different farms in India. PCR assays were employed to detect carrier status, using gene targets msp1b, tams1, rap-1, ama1, and ITS1 for A. marginale, T. annulata, B. bovis, B. bigemina, and Trypanosoma species, respectively. Out of the 578 apparently healthy animals screened, 30.45% (95% CI: 26.84-34.32%) were infected with at least one hemo-parasite. Cattle showed an overall positivity of 32.87%, while buffaloes had a prevalence of 15.19%, which was statistically significant (p < 0.001). Interestingly, prevalence was higher in indigenous cattle (47.81%) compared to cross-breeds (25.53%) and exotics (14.62%), with a statistically significant difference (p < 0.001). The prevalence of hemo-parasites varied widely among the farms, ranging from 5.77 to 100%. A. marginale was the most prevalent parasite (23.70% of animals), followed by T. annulata (13.67%), Babesia species (1.90%), and Trypanosoma species (1.56%). Enzootic instability was observed in six of the eight farms, indicating a potential for future outbreaks. Co-infection was detected in 60 out of 176 animals positive for hemo-parasites, with 59 animals co-infected with A. marginale and T. annulata, and only one cross-breed cattle infected with both Anaplasma marginale and Babesia bigemina. The findings highlight the prevalence of hemo-parasites in farms, underscoring the need for whole-herd screening, treatment of infected animals, and improvement in farm management practices to prevent production losses caused by these pathogens. Supplementary Information: The online version contains supplementary material available at 10.1007/s12639-024-01673-3.

Ehrlichiosis and anaplasmosis in solid organ transplantation: A case series and review of the literature.

Ehrlichiosis and anaplasmosis are rising tickborne infections posing significant risks to solid-organ transplant (SOT) patients. We present three cases highlighting clinical presentations, diagnostic challenges, and the benefits of microbial cell-free DNA (mcfDNA) sequencing. Emphasizing early diagnosis and preventive measures, we advocate for advanced diagnostic modalities to improve outcomes in this vulnerable population.

Environmental and host factors underlying tick infestation in invasive raccoons (Procyon lotor) in Hokkaido, Japan.

Revealing interactions between ticks and wild animals is vital for gaining insights into the dynamics of tick-borne pathogens in the natural environment. We aimed to elucidate the factors that determine tick infestation in wild animals by investigating ticks on invasive raccoons (Procyon lotor) in Hokkaido, Japan. We first examined the composition, intensity, and seasonal variation of ticks infesting raccoons in six study areas in Hokkaido from March 2022 to August 2023. In one study area, ticks infesting tanukis (raccoon dog, Nyctereutes procyonoides albus) were collected in May to July in both 2022 and 2023, and questing ticks were collected from the vegetation by flagging every other week in the same period. Next, we screened 17 environmental and host variables to determine factors that affect the number of ticks infesting raccoons using generalized linear (mixed) models. From 245 raccoons, we identified a total of 3,917 ticks belonging to eight species of two genera: the most prominent species were Ixodes ovatus (52.9 %), followed by Haemaphysalis megaspinosa (14.4 %), Ixodes tanuki (10.6 %), and Ixodes persulcatus (9.5 %). Ixodes ovatus was also predominant among questing ticks and ticks infesting tanukis. Although I. tanuki was frequently collected from raccoons and tanukis, it was rarely collected in the field. The variables that significantly affected the infestation on raccoons differed by genus, species and developmental stage of the tick. For instance, the infestation of adult I. ovatus was significantly affected by four variables: night-time temperature during nine days before capturing the raccoon, the size of forest area around the capture site, sex of the raccoon, and sampling season. The first two variables were also responsible for the infestation on raccoons of almost all species and stages of ticks. Our study revealed that the number and composition of ticks infesting raccoons can be affected not only by landscape of their habitats but also by weather conditions in several days before capturing.

Molecular detection of some zoonotic tick-borne pathogens in ticks collected from camels (Camelus dromedarius) as hosts and wild rodents as potential reservoirs.

Ticks and tick-borne pathogens pose a great threat to human and animal health. The present study aimed to determine the prevalence of ticks that infest camels and investigate the presence of tick-borne pathogens in the blood of camels, associated ticks, and surrounding rodents as reservoirs. From 100 inspected camels, from different localities in the Giza governorate, 1000 ixodid ticks were collected; these ticks belonged to three genera: Hyalomma, Amblyomma, and Rhipicephalus. The genus Hyalomma was represented by four species, Hyalomma dromedarii was the most prevalent species (55.4%), followed by Hyalomma excavatum (22%), Hyalomma impeltatum (11.6%) and Hyalomma rufipes (2.8%). The genus Amblyomma was represented by two species, Amblyomma gemma (2.8%) and Amblyomma marmoreum (2.7%), while the genus Rhipicephalus was represented by only one species, Rhipicephalus pulchellus (2.7%). Ticks, camel blood, and rodents (total number 100 brown rats) are screened for tick-borne pathogens (Borrelia burgdorferi, Borrelia miyamotoi, Babesia sp., and Coxiella burnetii) using PCR. Camel blood was found to be infected with Borrelia burgdorferi (66.6%), Borrelia miyamotoi (55%), and Babesia sp. (11.6%). Coxiella burnetii DNA was detected in all the collected ticks but was not detected in the blood of camels or rodents. Borrelia miyamotoi was detected in 12.5% of H. impeltatum, 55% of Camels, and 6% of the rodents, which may indicate a proposed risk of dispersal of B. miyamotoi, the agent of tick-borne relapsing fever.

Vaccination to Prevent Lyme Disease: A Movement Towards Anti-Tick Approaches.

Lyme disease is caused by the spirochete, Borrelia burgdorferi, which is transmitted by Ixodes spp ticks. The rise in Lyme disease cases since its discovery in the 1970s has reinforced the need for a vaccine. A vaccine based on B burgdorferi outer surface protein A (OspA) was approved by the Food and Drug Administration (FDA) several decades ago, but was pulled from the market a few years later, reportedly due to poor sales, despite multiple organizations concluding that it was safe and effective. Newer OspA-based vaccines are being developed and are likely to be available in the coming years. More recently, there has been a push to develop vaccines that target the tick vector instead of the pathogen to inhibit tick feeding and thus prevent transmission of tick-borne pathogens to humans and wildlife reservoirs. This review outlines the history of Lyme disease vaccines and this movement to anti-tick vaccine approaches.

Tick fever agents in Holstein calves grazing in a tropical region: predisposing factors, impact on milk production, productivity, and role of Rhipicephalus microplus in epidemiology.

The present study aimed to evaluate under dairy farm conditions the predisposing factors, impact on milk production and productivity, and the role of Rhipicephalus microplus in the epidemiology of tick fever agents in Holstein calves grazing in a tropical region. A total of 4292 pure female Holsteins were evaluated at a commercial farm. Until April 2020, calves had contact with R. microplus for between 3 and 24 months, while after April 2020, no animal had further contact with ticks. Three times a week the rectal temperature (RT) of all animals was determined, and blood samples were collected for evaluation of tick fever (TF) agents from those that showed RT >39.3 °C. Specific treatment was performed against Anaplasma marginale, Babesia bigemina and Babesia bovis when these TF agents were diagnosed in the blood smears. The number of relapses and treatments for TF agents were sub-classified into scales (1, 2, 3, 4, 5, 6 or 7-10 treatments or relapses, and animals that received blood transfusions). Within each sub-class, the health data of calves during lactation along with productivity data were analyzed. Based in the results, whether an animal received colostrum enriched with powdered colostrum substitute, whether the animal was an embryo transfer calf, and the weight at which each calf was weaned were ascertained as factors leading to more recurrences or treatments against TF agents in post-weaned calves. On average, each recurrence of TF agents that a heifer presented between three and seven months decreased milk production by 213.5 liters in the first lactation. Calves that received a blood transfusion had lower milk production at first lactation; lower weight at first fixed-time artificial insemination (FTAI); older age at first FTAI; older age at first, second, and third calving; and delayed age at third calving by 140 days compared to the farm average. R. microplus was the main agent causing clinical cases of TF on the farm, and 10,770 treatments against TF agents were carried out when calves aged between three and seven months had contact with this tick species (2018 and 2019). When the animals no longer had contact with ticks (2022 and 2023), there were no recurrences or treatments against TF agents despite the presence on the farm of S. calcitrans, which can maintain the transmission of A. marginale to the herd.

The influence of forest habitat type on Ixodes ricinus infections with Rickettsia spp. in south-western Poland.

This study investigates the prevalence of Rickettsia spp. in Ixodes ricinus tick populations in different forest habitat types (broadleaf forest, mixed broadleaf and coniferous forest, and coniferous forest) in south-western Poland. During the survey periods from April to June 2018 and 2019 a total of 494 I. ricinus ticks, including 374 nymphs, 60 females and 60 males, were tested for Rickettsia infections by nested PCR targeting the gltA gene. The overall infection rate was 42.3%; however, we observed statistically significant year-to-year variation. Infection rates varied between tick developmental stages and were significantly influenced by forest habitat type. As assessed by a generalized linear mixed model (GLMM), the highest infection rates were observed in mixed broadleaf and coniferous forests, while coniferous forests had a significant negative effect on infection prevalence. DNA sequencing of selected samples confirmed the predominance of Rickettsia helvetica (91.2%) and less frequent Rickettsia monacensis (8.8%). This study suggests that the forest habitat types can influence Rickettsia spp. infection in tick populations; however, a comprehensive understanding of all factors influencing the level of infection requires future study.

Infective Endocarditis Due to Q Fever From a Tick Bite: A Case Report.

Infection from Coxiella burnetti causes Q fever that manifests with vague symptoms. We report a case of an individual admitted to the hospital with recurrent fevers with a history of multiple tick bites. Further workup revealed examination and laboratory findings consistent with Q fever endocarditis. Fevers resolved with doxycycline and hydroxychloroquine. Our case highlights that suspicion for Q fever should be maintained in patients presenting to the hospital with fevers of unknown origin for prompt recognition and appropriate treatment.

Annual number of generations and biology of non-parasitic phase of Rhipicephalus microplus in irrigated and non-irrigated pasture in a tropical region.

This study aimed to verify the number of R. microplus annual generations in irrigated and non-irrigated pastures compared to the constant ideal environment. It also sought to evaluate the biology of the non-parasitic phase of this tick for each generation in these different areas of pasture; assess the larvae population dynamics in the pasture of each tick generation, and evaluate the R. microplus population dynamics parasitizing cattle in non-irrigated pasture. In the field experiment, two sub-areas were subjected to artificial irrigation (IRRI-A and IRRI-B) with artesian water, while the other two remained non-irrigated (NIRRI-A and NIRRIG-B). When more than 75 % of the total surviving engorged females from all 90 repetitions of each area (irrigated or non-irrigated) produced mature larvae within one tick generation, two cattle were infested with approximately 10,000 R. microplus larvae from the tick colony used in this study. On the 22nd day post-infestation, a new tick generation was started by releasing these females in different areas (IRRI-B and NIRRIG-B). This procedure was repeated successively, and each year was analyzed independently. In both the non-irrigated and irrigated areas, there were five generations of R. microplus per year. It can be observed that there the number of annual generations of ticks in this region has increased when compared to 30 years ago. Under the constant ideal temperature and humidity conditions (B.O.D. chamber), R. microplus completed an average of 6.59 generations. In the environment, the longest generation was the first (July to October), while the 2nd, 3rd and 4th (December to March) were the most similar to B.O.D. conditions. Although the number of generations was the same in the different areas, the population density of R. microplus larvae was higher in the irrigated area, probably because the irrigation provided milder temperatures, higher relative humidity and lower saturation deficit values during about eight hours per day. Between the 3rd and 5th generation of ticks, there was an overlap of larvae in the pastures, belonging to different generations, and at each peak of infestation observed in cattle between these generations, there were up to 30 % of larvae from the previous generation, and consequently up to 70 % of larvae from the new generation.

Impact of vaccination with the Anaplasma phagocytophilum MSP4 chimeric antigen on gene expression in the rabbit host.

There are currently no vaccines available to prevent and control of Anaplasma phagocytophilum, an intracellular bacterial pathogen transmitted by ticks that occurs in many regions of the world and causes disease in a wide range of domestic and wild hosts, including humans. Vaccines induce long-lasting immunity and could prevent or reduce transmission of this pathogen. Understanding how vaccines induce a protective response can be difficult due to the complexity of the immune system, which operates at many levels throughout the organism. New perspectives in vaccinology, based on systems biology approaches, integrate many scientific disciplines to fully understand the biological responses to vaccination, where a transcriptomic approach could reveal relevant information of the host immune system, allowing profiling for rational design of vaccine formulations, administration, and potential protection. In the present study we report the gene expression profiles by RNA-seq followed by functional analysis using whole blood samples from rabbits immunized with a recombinant chimeric protein containing peptides from the MSP4 protein of A. phagocytophilum, which showed satisfactory results in terms of potential protection. Transcriptomic analysis revealed differential expression of 720 genes, with 346 genes upregulated and 374 genes downregulated. Overrepresentation of biological and metabolic pathways correlated with immune response, protein signaling, cytoskeleton organization and protein synthesis were found. These changes in gene expression could provide a complete and unique picture of the biological response to the epitope candidate vaccine against A. phagocytophilum in the host.

A case of tick bite on the perianal region.

Key Clinical Message: Tickborne diseases have become the threats to the health of people worldwide, accounting for nearly 80% patients with vectorborne diseases in the United States. Early diagnosis and proper treatment play a significant role in the management. Close contacts should be screened for delayed symptoms associated with tickborne diseases. Abstract: This study describes a rare case of a 72-year-old Chinese man presented with a 5-day history of painful nodules on the perianal region, indicating tick bite. Tickborne diseases become the threats to the health of people worldwide. Untreated cases may result in several serious inflammatory complications. Manual removal of ticks with fine forceps is effective for preventing the transmission of tickborne infections. People (who have been bitten by a tick) and close contacts should be screened for delayed symptoms associated with tickborne diseases.

Long-term sequelae after viral meningitis and meningoencephalitis are frequent, even in mildly affected patients, a prospective observational study.

Introduction: An increasing number of studies demonstrate that viral meningitis and meningoencephalitis, even those with a mild course of meningitis, can result in residual sequelae. Methods: We aimed to investigate the long-term outcome in both viral meningitis and meningoencephalitis/encephalitis patients and impact of long-term sequelae on patients' social and professional daily lives in a prospective observational study with a follow-up period of 20 months. Results: A total of 50 patients (12% encephalitis, 58% meningoencephalitis and 30% meningitis) and 21 control persons participated in the study. The most common cause was the tick-borne encephalitis (TBE) virus. The most important persistent signs and symptoms after 2 years were subjective cognitive impairment (36%), fatigue and/or excessive daytime sleepiness (31%), disturbed nighttime sleep (31%) and headaches (13%), as well as feeling more rapidly exhausted after cognitive effort (53%). Independent of disease severity in the acute phase, almost one third of patients still reported mildly impaired social and/or professional life due to the long-term sequelae, with scores in the health status assessment still significantly lower compared to healthy controls. Discussion: Regardless of the severity of the acute illness and despite constant improvement within 2 years, 67% of patients still had persistent signs and symptoms, but these were only relevant to everyday social or professional life in about 30% of these patients.

A novel and low-cost cross-priming amplification assay for rapid detection of Babesia duncani infection.

Babesia duncani, responsible for human babesiosis, is one of the most important tick-borne intraerythrocytic pathogens. Traditionally, babesiosis is definitively diagnosed by detecting parasite DNA in blood samples and examining Babesia parasites in Giemsa-stained peripheral blood smears. Although these techniques are valuable for determining Babesia duncani, they are often time-consuming and laborious. Therefore, developing rapid and reliable B. duncani identification assays is essential for subsequent epidemiological investigations and prevention and control. In this study, a cross-priming amplification (CPA) assay was developed, combined with a vertical flow visualization strip, to rapidly and accurately detect B. duncani infection. The detection limit of this method was as low as 0.98 pg/µl of genomic DNA from B. duncani merozoites per reaction at 59 °C for 60 min. There were no cross-reactions between B. duncani and other piroplasms infective to humans and mammals. A total of 592 blood samples from patients bitten by ticks and experimental infected hamsters were accurately assessed using CPA assay. The average cost of the CPA assay is as low as approximately $ 0.2 per person. These findings indicate that the CPA assay may therefore be a rapid screening tool for detection B. duncani infection, based on its accuracy, speed, and cost-effectiveness, particularly in resource-limited regions with a high prevalence of human babesiosis.

Poor virus-specific T-cell responses early after tick-borne encephalitis virus infection correlate with disease severity.

Tick-borne encephalitis virus (TBEV) infection may cause acute central nervous system inflammation varying in clinical manifestations and severity. A possible correlation of TBEV-specific antibody and cell-mediated immune responses, shortly after infection, with clinical manifestations, severity and long-term outcome has been poorly investigated. In a cohort of thirty early tick-borne encephalitis (TBE) patients, we assessed the magnitude, specificity and functional properties of TBEV-specific T-cell and antibody responses. These responses early during disease were assessed in view of clinical manifestations, severity and long-term outcome. TBEV-specific T-cell responses to C, E, NS1, and NS5 proteins were significantly lower in patients with severe acute illness than in patients with mild TBE. Lower T-cell responses to E, NS1, and NS5 proteins also correlated with the development of meningoencephalomyelitis. Virus-specific antibody titres early after infection did not correlate with disease severity, clinical manifestations, or long-term outcome in this study, possibly due to the small number of patients of which matching serum and peripheral blood mononuclear cells were available. The findings suggest that virus-specific T cells afford a certain degree of protection against the development of severe TBEV-induced disease.

Publicly available surveillance data on tick-borne encephalitis in Europe, 2023.

The European Centre for Disease Prevention and Control (ECDC) defines a case of tick-borne encephalitis (TBE) as an infection by the TBE virus (TBEV) with clinical manifestations of central nervous system inflammation (e.g., meningitis, encephalitis). To better understand the TBE surveillance landscape, online searches were conducted to determine if cases of TBE, TBEV infection, acute meningitis or encephalitis, or viral meningitis or encephalitis were subject to statutory reporting in European countries in 2023. In countries with statutory reporting, notification responsibility and available information on surveillance-reported cases were determined. The number of TBE cases reported to ECDC were compared with the number of cases recorded in national surveillance reports. Of 44 countries of the Europe Region of the United Nations, 37 (84 %) mandated statutory reporting of cases of TBE, TBEV infection, or acute/viral meningitis/encephalitis. Twenty-six (87 %) of 30 countries with identified surveillance reports recorded TBE cases in 2020-2023. Of these countries, 17 (65 %) required TBE reporting by clinicians and laboratories, 5 (19 %) by clinicians only, and 4 (15 %) by laboratories only. Twenty-four countries reported on TBE cases to ECDC in 2020; however, surveillance for TBE in Europe is heterogeneous. Standardization of TBE surveillance would enhance the understanding of TBE disease burden in Europe.

Ten years of detecting Neoehrlichia mikurensis infections in Sweden: demographic, clinical and inflammatory parameters.

PURPOSE: To increase knowledge about the varied clinical manifestations of human infection with the emerging tick-borne pathogen Neoehrlichia mikurensis. METHODS: All patients diagnosed in Sweden with N. mikurensis infection during a 10-year period (2013-2023) were investigated regarding their demographic factors, risk factors, comorbidities, clinical signs and symptoms, and laboratory results. Multivariate models were generated using "Orthogonal Projections to Latent Structures-Discriminant Analysis" to identify clinical and immune parameters associated with N. mikurensis infection. RESULTS: During the 10-year period, 134 patients were diagnosed with N. mikurensis infection, 102 of whom were included in this study. Most of the patients (79%) were immunosuppressed. The main comorbidities were malignant B-cell lymphomas, multiple sclerosis, and rheumatoid arthritis. Rituximab therapy (59%) and splenectomy (14%) featured prominently. All patients resided in the southern tick-endemic part of Sweden, yet one-third of them were diagnosed in wintertime when ticks are inactive. Two asymptomatically infected blood donors were identified but transfusion-transmitted infection was not confirmed. Increased levels of C-reactive protein, orosomucoid, and total IgM in serum were associated with neoehrlichiosis. Previously unreported symptoms such as ankle edema, neck pain, numbness, and sudden deafness were detected in some patients. One case of aplastic anemia partially improved after eradication of the infection. CONCLUSIONS: Neoehrlichiosis is a multi-faceted emerging infectious disease.

Lyme Disease Surveillance and Epidemiology in the United States: A Historical Perspective.

In the 40 years since Steere and colleagues first described Lyme disease, the illness has increased in incidence and distribution to become the most common vector-borne disease in the United States. Public health officials have developed, implemented, and revised surveillance systems to describe and monitor the condition. Much has been learned about the epidemiology of the illness, despite practical and logistical constraints that have encumbered the collection and interpretation of surveillance data. Future development of automated data collection from electronic health records as a source of surveillance and clinical information will address practical challenges and help answer ongoing questions about complications and persistent symptoms. Robust surveillance will be essential to monitor the effectiveness and safety of future vaccines and other preventive measures.

Laboratory Testing for Powassan Virus: Past, Present, and Future.

Powassan virus is a tick-borne flavivirus that can cause severe neuroinvasive disease, with areas of endemicity in the Northeast and Midwest United States, Canada, and Russia. Diagnosis is challenging and relies on a high index of suspicion and choosing the right test based on duration of infection and the patient's immune status. This review covers laboratory testing for Powassan virus, including historical considerations, modern options, and methods being developed in the research space.