Tick-Borne Diseases.

Ticks are responsible for the vast majority of vector-borne illnesses in the United States. The number of reported tick-borne disease (TBD) cases has more than doubled in the past 20 years. The majority of TBD cases occur in warm weather months in individuals with recent outdoor activities in wooded areas. The risk of contracting a TBD is also highly dependent on geographic location. Between 24 and 48 hours of tick attachment is required for most disease transmission to occur. Only 50% to 70% of patients with a TBD will recall being bitten by a tick, and TBDs are often initially misdiagnosed as a viral illness. Most TBDs are easily treated when diagnosed early in their course.

Tick-borne diseases in the North Sea region-A comprehensive overview and recommendations for diagnostics and treatment.

As part of the NorthTick project, co-funded by the European Union through the European Regional Development Fund and the North Sea Region Programme, specialists in the field of tick-borne diseases from seven North Sea countries co-operated with patient organisations and governmental health care institutions to provide this comprehensive overview of diagnostics and treatment recommendations in the region for Lyme borreliosis, Borrelia miyamotoi infection, tick-borne encephalitis, human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis and babesiosis. The main conclusion is that the recommendations in these northern countries are essentially the same, with very few differences. This overview presents the current diagnostics and provides useful clinical guidance.

What Is Alpha-Gal Syndrome?

This JAMA Patient Page describes alpha-gal syndrome, a type of food allergy to red meat products, and its symptoms, diagnosis, and treatment.

Fiebre y exantema tras picadura de garrapata / Fever and rash after tick bite

Las garrapatas duras se han convertido en los principales vectores de enfermedades infecciosas en el mundo industrializado, pudiendo transmitir a través de su picadura bacterias, virus y protozoos, además de causar procesos alérgicos y tóxicos. Dentro de las enfermedades transmitidas por garrapatas, las más frecuentes en nuestro medio son: la fiebre botonosa mediterránea, la enfermedad de Lyme y la enfermedad de Debonel/Tibola. La fiebre botonosa mediterránea es la rickettsiosis más frecuente en Europa. Se ha observado un aumento de los casos en los últimos años, en probable relación con el aumento de temperatura global. (AU)

Hard ticks have become the main vectors of infectious diseases in the industrialized world, being able to transmit bacteria, viruses and protozoa through their bite, as well as causing allergic and toxic processes. Among the tick-borne disease the most frequent in our setting are boutonneuse fever, Lyme disease and Debonel/Tibola disease. Boutonneuse fever is the most common rickettsiosis in Europe. An increase in cases has been observed in recent years, probably related to the increase in global temperature. (AU)

Recognition of Cutaneous Symptoms of Common Tick-Borne Illness in the Emergency Department.

Tick-borne diseases occur throughout the United States, with a disease burden that ranges from mild to severe. As temperatures rise with climate change, the active season for ticks increases, and more tick-borne illness is seen (Centers for Disease Control and Prevention, 2022a). Many patients present to the ED for suspected tick bites, rashes, and generalized medical complaints that may be related to a tick-borne disease, so it is important for the emergency nurse practitioner (ENP) to accurately diagnose these conditions. Because of this increasing disease burden, it has become vital for these illnesses to be recognized early, as early diagnosis can reduce possible complications of chronic illness. Familiarity with the cutaneous rashes present in several tick-borne diseases can aid the ENP to effectively diagnose and treat these conditions.

Recent Progress on Tick-Borne Animal Diseases of Veterinary and Public Health Significance in China.

Ticks and tick-borne diseases pose a growing threat to human and animal health, which has brought great losses to livestock production. With the continuous expansion of human activities and the development of natural resources, there are more and more opportunities for humans to contract ticks and tick-borne pathogens. Therefore, research on ticks and tick-borne diseases is of great significance. This paper reviews recent progress on tick-borne bacterial diseases, viral diseases, and parasitic diseases in China, which provides a theoretical foundation for the research of tick-borne diseases.

Tickborne Illnesses.

Over the past two decades, tickborne diseases have demonstrated a steady rise in the United States, with several novel tickborne pathogens discovered. Tickborne illnesses vary by geography and seasonality secondary to the associated tick vector. Interestingly, the geographic range of these tick vectors are also expanding with many more counties reporting cases than the previous 20 years. The clinical presentation of tickborne infections can range from mild to fatal, thus early identification and empiric treatment is of utmost importance. This article reviews the most common tick-borne infections in the US, including epidemiology, clinical presentation, diagnosis, treatment, and prevention. [Pediatr Ann. 2021;50(9):e350-e355.].

Negative impact of the COVID-19 pandemic on the timely diagnosis of tick-borne infections.

We describe 3 adult patients who did not have COVID-19 but instead had a treatable tick-borne infection. In each case, however, the duration of time until diagnosis was delayed due to issues that have arisen because of the COVID-19 pandemic. These issues need to be addressed to preserve patient well-being.

Diagnosis & management of alpha-gal syndrome: lessons from 2,500 patients.

INTRODUCTION: Alpha-gal Syndrome (AGS) is a unique allergy to non-primate mammalian meat (and derived-products) that is associated with tick bites and is due to a specific IgE antibody to the oligosaccharide galactose-α-1,3-galactose (alpha-gal). AGS has many novel features that broaden the paradigm of food allergy, including that reactions are delayed 3-6 hours after exposure and patients have frequently tolerated red meat for many years prior to the development of allergic reactions. Due to the ubiquitous inclusion of mammal-derived materials in foods, medications, personal products and stabilizing compounds, full avoidance is difficult to achieve. AREAS COVERED: This review describes the author's experience with diagnosis, management, and design of appropriate avoidance for patients with AGS and provides clinicians with practical advice for care of these patients. EXPERT OPINION: The number of patients with AGS is rising and may have exceeded awareness of the diagnosis amongst healthcare providers. In summarizing experience gained to thus far, we hope to create a resource for identifying and managing this unique allergic syndrome.

Management Options for Ixodes ricinus-Associated Pathogens: A Review of Prevention Strategies.

Ticks are important human and animal parasites and vectors of many infectious disease agents. Control of tick activity is an effective tool to reduce the risk of contracting tick-transmitted diseases. The castor bean tick (Ixodes ricinus) is the most common tick species in Europe. It is also a vector of the causative agents of Lyme borreliosis and tick-borne encephalitis, which are two of the most important arthropod-borne diseases in Europe. In recent years, increases in tick activity and incidence of tick-borne diseases have been observed in many European countries. These increases are linked to many ecological and anthropogenic factors such as landscape management, climate change, animal migration, and increased popularity of outdoor activities or changes in land usage. Tick activity is driven by many biotic and abiotic factors, some of which can be effectively managed to decrease risk of tick bites. In the USA, recommendations for landscape management, tick host control, and tick chemical control are well-defined for the applied purpose of reducing tick presence on private property. In Europe, where fewer studies have assessed tick management strategies, the similarity in ecological factors influencing vector presence suggests that approaches that work in USA may also be applicable. In this article we review key factors driving the tick exposure risk in Europe to select those most conducive to management for decreased tick-associated risk.

On the cause and consequences of IgE to galactose-α-1,3-galactose: A report from the National Institute of Allergy and Infectious Diseases Workshop on Understanding IgE-Mediated Mammalian Meat Allergy.

The mammalian meat allergy known as the "α-Gal syndrome" relates to IgE specific for galactose-α-1,3-galactose (α-Gal), an oligosaccharide that is present in cells and tissues of nonprimate mammals. The recognition of delayed reactions to food derived from mammals in patients with IgE to α-Gal and also the association with tick bites have been increasing worldwide. In 2018, the National Institute of Allergy and Infectious Diseases, Division of Allergy, Immunology and Transplantation, sponsored a workshop on this emerging tick-related disease. International experts from the fields of tick biology, allergy, immunology, infectious disease, and dermatology discussed the current state of our understanding of this emerging medical condition. The participants provided suggestions for specific research priorities and for the development of resources to advance our knowledge of the mechanisms, diagnosis, management, and prevention of this allergic disease. This publication is a summary of the workshop and the panel's recommendations are presented herein.

Fiebre manchada en Argentina. Descripción de dos casos clínicos / Spotted fever in Argentina. Description of two clinical cases

Resumen Las rickettsiosis son enfermedades zoonóticas transmitidas por artrópodos vectores, que en Argentina presentan 2 escenarios epidemiológicos diferenciados. Uno, en las yungas de Salta y Jujuy, involucra vectores pertenecientes al «complejo Amblyomma cajennense¼ (A. sculptum y A. toneliae) y a Rickettsia rickettsii como agente etiológico. En este escenario la forma clínica de la enfermedad se conoce como fiebre manchada (FM) y se presenta con manifestaciones cutáneas y sistémicas graves. El otro escenario incluye 2 zonas: una la del Delta del Río Paraná y Bahía de Samborombón, donde Amblyomma triste actúa como vector; otra, las provincias de Córdoba, La Rioja, San Luis y La Pampa, donde el vector es Amblyomma tigrinum. En este segundo escenario Rickettsia parkeri es el agente causal, y la FM se manifiesta con un cuadro benigno y autolimitado. En este trabajo describimos un caso fatal de FM por R. rickettsii en El Tunal, Salta, y el primer caso de FM por R. parkeri en San Juan.

Abstract Rickettsioses are zoonotic tick-borne diseases. In Argentina, there are two epidemiological scenarios: jungle of Salta and Jujuy, involving vectors from the "Amblyomma cajennense Complex" (A. sculptum, and A. toneliae) and Rickettsia rickettsii as the main etiological agent; and the second scene to Delta del Rio Paraná and Samborombón Bay, where Amblyomma triste acts as a vector; and the provinces of Córdoba, La Rioja, San Luis and La Pampa where Amblyomma tigrinum is the vector. In this second scenario, Rickettsia parkeri is the causal agent. The spotted fever (SF) due to R. rickettsii is responsible for a severe cutaneous and systemic disease. Contrarily, R. parkeri produces benign and self-limited clinical manifestation. Here we describe a fatal SF case by R. rickettsii, in El Tunal, Salta and the first SF case due to R. parkeri in San Juan.

Lyme borreliosis and other tick-borne diseases. Guidelines from the French scientific societies (II). Biological diagnosis, treatment, persistent symptoms after documented or suspected Lyme borreliosis.

The serodiagnosis of Lyme borreliosis is based on a two-tier strategy: a screening test using an immunoenzymatic technique (ELISA), followed if positive by a confirmatory test with a western blot technique for its better specificity. Lyme serology has poor sensitivity (30-40%) for erythema migrans and should not be performed. The seroconversion occurs after approximately 6 weeks, with IgG detection (sensitivity and specificity both>90%). Serological follow-up is not recommended as therapeutic success is defined by clinical criteria only. For neuroborreliosis, it is recommended to simultaneously perform ELISA tests in samples of blood and cerebrospinal fluid to test for intrathecal synthesis of Lyme antibodies. Given the continuum between early localized and disseminated borreliosis, and the efficacy of doxycycline for the treatment of neuroborreliosis, doxycycline is preferred as the first-line regimen of erythema migrans (duration, 14 days; alternative: amoxicillin) and neuroborreliosis (duration, 14 days if early, 21 days if late; alternative: ceftriaxone). Treatment of articular manifestations of Lyme borreliosis is based on doxycycline, ceftriaxone, or amoxicillin for 28 days. Patients with persistent symptoms after appropriate treatment of Lyme borreliosis should not be prescribed repeated or prolonged antibacterial treatment. Some patients present with persistent and pleomorphic symptoms after documented or suspected Lyme borreliosis. Another condition is eventually diagnosed in 80% of them.

[A "new" look at "old" borreliosis]. / "Nowe" spojrzenie na "stara" borelioze.

The threat of borreliosis is a growing medical problem. The number of cases is constantly increasing, and the diagnostic methods and recommended treatment methods do not bring new values in comparison to the findings from over 30 years ago. Among the pathogens transmitted by ticks, apart from Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia species, Neoehrlichia mikurensis, as well as fever caused by rickettsiae and others, are referred to as "emerging" or "rediscovered". Recently published new recommendations for the diagnosis and treatment of Lyme disease developed by specialists from the National Institute for Health and Care Excellence (NICE) in the United Kingdom did not bring significant changes to the existing recommendations for the diagnosis and treatment of patients with borreliosis. This study does not provide information about vaccine research, which, it turned out, was introduced in the 1990s and withdrawn from the market. Research is currently under wal into an anti-tick "vaccine" undertaken by the team under the EU project "ANTIDOTE" (Anti-tick Vaccines to Prevent Tick-borne Diseases in Europe). The first effects of the research are already presented, but we still have to wait for the final product.

Wilderness Dermatology: Bugs, Plants, and Other Nuisances That May Ruin Your Hike.

Spending time outdoors can be rewarding. However, exposure to the sun, insect bites, and plant exposures may result in a wide range of dermatologic manifestations. In this article, we describe potential cutaneous manifestations of common wilderness exposures in New England including photodermatoses from prolonged sun exposure, phytodermatoses from plant exposures, and arthropod-bite reactions from common insects (mosquitos, spiders, ticks, hymenoptera, mites and chiggers). The article will also address preventive and treatment strategies which may help physicians and their patients better prepare for spending time in the wilderness. [Full article available at http://rimed.org/rimedicaljournal-2019-02.asp].

Tick-borne illnesses: identification and management in the emergency department

Tick-borne illnesses are increasing in prevalence and geographic reach. Because the presentation of these illnesses is sometimes nonspecific, they can often be misdiagnosed, especially in the early stages of illness. A detailed history with questions involving recent activities and travel and a thorough physical examination will help narrow the diagnosis. While some illnesses can be diagnosed on clinical findings alone, others require confirmatory testing, which may take days to weeks to result. This issue reviews the emergency department presentation of 9 common tick-borne illnesses and evidence-based recommendations for identification, testing, and treatment.