Tick Research Articles

Tick Bite and Super-High Magnification Dermoscopy

Tick Bite and Super-High Magnification Dermoscopy

Increasing prevalence of galactose-α-1,3-galactose sensitization in the Danish general adult population.

Alpha-gal syndrome is a novel food allergy to the oligosaccharide galactose-α-1,3-galactose (alpha-gal) present in mammalian meat. Tick bites are considered an important route of sensitization to alpha-gal. Data on alpha-gal sensitization in the general population is scant. We utilized a unique data source of repeated population-based health examination studies to assess prevalence, time trends, risk factors, and characteristics of alpha-gal sensitization. Alpha-gal sensitization was assessed in >11.000 adults from four health examination studies of randomly invited residents in the Copenhagen region conducted in 1990-1991, 2011-2012, 2012-2015, and 2016-2017. Alpha-gal sensitization was defined as serum specific IgE (sIgE) to alpha-gal ≥0.1 kUA/L; ≥0.35 kUA/L; ≥0.7 kUA/L; ≥3.5 kUA/L. The population was characterized according to genetically determined ABO blood group, aeroallergen sensitization, and pets at home. The prevalence of sIgE to alpha-gal ≥0.1 kUA/L was 1.3% in 1990-1991, 3.7% in 2012-2015 and 3.2% in 2016-2017. Of those sensitized to alpha-gal >97% reported to consume red meat at least once a week, even for sIgE to alpha-gal ≥3.5 kUA/L. Male sex, older age, aeroallergen sensitization, cat at home, and blood group A were associated with increased odds of alpha-gal sensitization. The known protective effect of blood group B was confirmed. In this general adult population, the prevalence of alpha-gal sensitization had doubled from 1990-1991 to 2016-2017. This could potentially be due to increased tick exposure and an increased atopic predisposition.

Comprehensive analysis of the global impact and distribution of tick paralysis, a deadly neurological yet fully reversible condition.

SUMMARYTick paralysis is a potentially fatal condition caused by neurotoxins secreted by the salivary glands of certain ticks. Documented cases have been reported worldwide, predominantly in the United States, Canada, and Australia, with additional reports from Europe and Africa. This condition also affects animals, leading to significant economic losses and adverse impacts on animal health and welfare. To date, 75 tick species, mostly hard ticks, have been identified as capable of causing this life-threatening condition. Due to symptom overlap with other conditions, accurate diagnosis of tick paralysis is crucial to avoid misdiagnosis, which could result in adverse patient outcomes. This review provides a comprehensive analysis of the current literature on tick paralysis, including the implicated tick species, global distribution, tick toxins, molecular pathogenesis, clinical manifestations, diagnosis, treatment, control, and prevention. Enhancing awareness among medical and veterinary professionals is critical for improving the management of tick paralysis and its health impacts on both humans and animals.

Evaluation of the Epitogen Lyme Detect IgG ELISA: a novel peptide multiplexing approach.

Lyme Borreliosis (LB), or Lyme disease, is a growing health concern caused by Borrelia burgdorferi sensu lato (Bbsl) bacteria transmitted through tick bites, and untreated cases can lead to severe health complications. Existing serology tests, while valuable, have low sensitivity in early infection stages where diagnosis is vital, interpretation variability, and false positives from cross-reactivity, while direct detection methods also suffer from low sensitivity, due to the inconsistent presence of Bbsl components in clinical samples. This study validated the diagnostic performance of the novel Epitogen Lyme Detect IgG enzyme-linked immunosorbent assay (ELISA) based on scaffold-displayed peptide antigens, using 120 specific immunodominant epitopes selected from 37 antigenic bacterial proteins corresponding to the main pathogenic Bbsl genospecies. Using 220 serum samples from Scottish patients with early, late, and disseminated LB, the assay's sensitivity was compared with that of the LIAISON Borrelia IgG CLIA, while specificity was assessed with 198 control samples, including healthy individuals and patients with diseases that are humorally similar. The Epitogen Lyme Detect IgG assay demonstrated comparable performance to the LIAISON Borrelia IgG in disseminated and late LB (Lyme neuroborreliosis, acrodermatitis chronica atrophicans, and Lyme arthritis). Notably, the Epitogen Lyme Detect IgG showed significantly higher sensitivity in patients with suspected erythema migrans, while maintaining high specificity. The Epitogen Lyme Detect IgG ELISA offers a promising advancement in LB diagnostics, demonstrating its potential for more accurate and timely diagnosis, particularly in the early stages of LB infection.IMPORTANCELyme Borreliosis (LB), caused by Borrelia burgdorferi sensu lato bacteria, poses significant health risks if undiagnosed or diagnosed late. Current diagnostic tests have limitations, especially in early-stage detection. This study validates the Epitogen Lyme Detect IgG enzyme-linked immunosorbent assay, demonstrating superior sensitivity in early LB detection while maintaining high specificity. The Epitogen Lyme Detect IgG comprises a suite of 120 immunodominant IgG epitopes/peptides from 37 bacterial antigens, covering the main LB-causing species: Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii, and Borrelia mayonii. The novel design of multiplexing peptide antigens onto a scaffold to facilitate expression, correct folding, and orientation of the relevant peptides offers a promising advancement, potentially leading to more accurate and timely LB diagnoses and improving patient outcomes.

Optimising Transformation Efficiency in Borrelia: Unravelling the Role of the Restriction-Modification System of Borrelia afzelii and Borrelia garinii

Borrelia spp. are transmitted to humans by the bite of an infected tick. In Europe, Borrelia afzelii and Borrelia garinii are the main causative agents of Lyme borreliosis, one of the most prevalent tick-borne diseases in the northern hemisphere. In bacteria such as Borrelia spp., a restriction-modification system (RMS) protects against the harmful introduction of foreign DNA. The RMS comprises two activities: methyltransferase and endonuclease. This study is aimed to characterize the RMS of B. afzelii and B. garinii. First, we identified potential RMS genes. The predicted genes were cloned into a methylase-deficient Escherichia coli strain and digested with methylation-sensitive restriction enzymes to verify methyltransferase activity. Additionally, the RMS proteins were purified to evaluate endonuclease activity. Subsequently, methylated and unmethylated plasmids were used to investigate the effect of methylation on endonuclease activity and transformation efficiency. We identified four possible RMS genes in B. afzelii and four RMS genes in B. garinii. We analyzed the presence of these genes in patient isolates and observed a high degree of heterogeneity. The restriction pattern of DNA methylated by each of the four recombinantly expressed genes provided strong evidence that all encode adenine-specific methyltransferases. After 24 h of incubation with purified RMS proteins, we observed complete digestion of unmethylated plasmid DNA, demonstrating endonuclease activity. Finally, we proved that methylation protects against endonuclease activity and increases transformation efficiency.

Complete genome sequence of Borrelia miyamotoi strain MN18-0001, an Am-East-2 strain type isolate derived from an Ixodes scapularis tick (Minnesota).

We report the genomic sequence of the hard tick relapsing fever spirochete Borrelia miyamotoi strain MN18-0001. B. miyamotoi causes human illness and is geographically widespread in Ixodes spp. (Acari: Ixodidae) ticks. This is a chromosome- and plasmid-resolved genome assembly of an Am-East-2 strain type isolate from the midwestern United States.

Serological evidence of tick-borne Crimean-Congo haemorrhagic fever and Dugbe orthonairovirus infections in cattle in Kwara State in northern Nigeria indicate independent endemics.

Crimean-Congo haemorrhagic fever orthonairovirus (CCHFV) and Dugbe orthonairovirus (DUGV) are zoonotic viruses transmitted by ticks. Whereas CCHFV has caused numerous human cases, DUGV, although less reported, shares ticks and ruminants as hosts. Since its first discovery in Nigeria in 1964, there has been no detailed sero-epidemiological investigation on DUGV in sub-Saharan Africa. This study is aimed at assessing the current seroprevalence and associated risk factors of CCHFV and DUGV infections in Nigerian cattle. Using a cross-sectional design with random sampling method, blood samples were collected from 877 cattle on pastoralist farms and at abattoirs in Kwara State, North-Central Nigeria. CCHFV IgG antibodies were detected in extracted sera using three panels of in-house indirect enzyme-linked immunosorbent assay (ELISA) based on bacteria-expressed recombinant nucleoprotein (rNP), the cattle-adapted VectoCrimean ELISA and the ID Screen CCHF double antigen multi-species ELISA, while DUGV IgG antibodies were detected using in-house indirect ELISA with bacteria-expressed rNP, indirect immunofluorescence assay and micro-Virus Neutralization test. Overall seroprevalence rates of 71.9% (631/877) and 52.8% (451/854) were obtained for CCHFV and DUGV, respectively. It was observed that 37.9% (314/829) of the cattle were co-exposed to both CCHFV and DUGV while 34.5% (286/829), 14.8% (123/829) and 12.8% (106/829) were exposed to single infections with CCHFV, DUGV or none of the two viruses, respectively. Multivariate analysis showed that only location, sex, age and tick infestation score were the risk factors that significantly affected CCHFV seroprevalence in cattle, while DUGV seroprevalence was significantly influenced by month of the year, location, cattle breed and sex (p<0.05). This is the first comprehensive sero-epidemiological surveillance for DUGV in sub-Saharan Africa. Our findings reveal widely distributed independent CCHFV and DUGV infections in cattle in Kwara State, Nigeria.

Abundance Trends of Immature Stages of Ticks at Different Distances from Hiking Trails from a Natural Park in North-Western Italy.

Hiking trails may act as hotspots at the wildlife-human interface, posing an acarological risk for people and their pets. Ticks that are maintained in the environment by wild animals may quest on people walking along the trails. Assessing the risk of tick bites for people involved in outdoor activities is a further step in mitigating the risk of tick-borne diseases. This work describes the variation of tick abundance along a gradient of distances from hiking trails, where wildlife passage is favored by higher accessibility. Hiking trails with dense vegetation on the sides were sampled for ticks along a 100 m dragging transect, located in a natural park in North-Western Italy. Additional transects were replicated at 1, 2 and 4 m away from the trail on both sides. After morphological identification, descriptive statistics and modeling were applied to determine the abundance patterns across distances. Larvae were most abundant near the trail, peaking at 1 m and dropping sharply at further distances. Nymphs showed a more gradual and consistent decrease at progressing distance from the trail. Few adults were collected, preventing the identification of a clear trend. With higher tick abundance, the immediate vicinity of hiking trails may represent a source of acarological risk for humans and pets.

Description of Ixodeslanigeri sp. nov., a new hard tick species (Acari, Ixodidae) collected from mouse-eared bats (Vespertilionidae, Myotis) in Vietnam.

Historically, for more than one and a half centuries, only one so-called "long-legged bat tick" species, i.e., Ixodesvespertilionis Koch was known to science. However, during the past decade, it was recognized on a molecular basis that long-legged ixodid ticks associated with bats may represent at least six species. Of these, until recently, five have been morphologically described. In this study, Ixodes ticks were collected from two Myotis species in southeastern Asia, Vietnam. Based on the morphological and molecular characteristics of the female, nymph and larva, Ixodeslanigeri Hornok, sp. nov. is described here. The male is unknown. Like other members of the Ixodesariadnae complex, I.lanigeri Hornok apparently shows a preference for vesper bats as its typical hosts. In this context, host-association and geographical separation may explain the evolutionary divergence of I.lanigeri Hornok from its closest relative occurring on Murinahilgendorfi Peters in East Asia, Japan, because no Myotis or Murina spp. have overlapping distribution between Vietnam and the main islands of Japan. On the other hand, supposing that (similarly to I.ariadnae) I.lanigeri Hornok probably occurs on other myotine bats and knowing that several Myotis species indigenous in Vietnam have a broad geographical range in southern and southeastern Asia, the new tick species most likely has a widespread distribution in this area.

Dual detection of Neoehrlichia mikurensis and Anaplasma phagocytophilum: How biplex PCR led in France to the diagnosis of neoehrlichiosis in post-tick bite fever

ObjectivesNeoehrlichia mikurensis (NM) is an emerging intracellular bacterium member of the Anaplasmatacecae family. So far, only four cases have been described in France, all of them retrospectively. MethodsThis study describes two new cases of NM discovered following implementation of a biplex PCR targeting both Anaplasma and NM. ResultsTwo immunocompetent patients developed a flu-like illness within 14 days after an identified tick bite. Both had negative Anaplasma PCR, but by using this biplex PCR NM, infection was diagnosed in both cases. One patient recovered spontaneously while the second was successfully treated by a seven-day course of doxycycline. ConclusionPresent in Eastern France, NM is underdiagnosed. Biplex PCR screening of NM with A.phagocytophilum could effectively address this issue.

Molecular detection of Coxiella burnetii in blood and hard tick-infested Egyptian camels and the possibility of coinfections

Coxiella burnetii, a bacterium that causes Q fever. It can infect mammals and has a global geographical distribution, but data on its occurrence in Egyptian dromedaries and the associated ticks are limited. Therefore, this study aims to detect C. burnetii in the blood of infested camels and associated ticks collected from Egypt by using molecular techniques and to examine the possibility of coinfections with C. burnetii. A total of 133 blood samples and 1260 hard ticks infesting these camels were collected from Egyptian slaughterhouses. Nested PCR and sequencing were used based on the IS1111 gene for molecular detection of C. burnetii. The identification of tick species at the molecular level was performed using the COX1 gene. C. burnetii was detected in Hyalomma (H) dromedarii, H. anatolicum, H. marginatum, Amblyomma (Am) lipidium, and Am. cohaerens with an overall prevalence rate of 1.3% (16/1260), while in the camel blood samples, it was 15.8% (21/133). Out of C. burnetii-positive ticks, there were double infections by Borrelia species and C. burnetii in H. dromedarii and Am. lipidium and triple infections at one Am. cohaerens tick (C. burnetii, Borrelia spp., and Babesia microti). In addition, two positive camel blood samples were found to carry C. burnetii with Borrelia spp. Our research findings indicate the presence of Coxiella burnetii among camels and their associated ticks in Egypt and emphasize the potential of having coinfection. To prevent the transmission of this infection to other animal species or humans, appropriate control measures should be implemented.

Rocky Mountain Spotted Fever Encephalitis and "Starry Sky" Pattern on MRI: A Case Report.

Rocky Mountain Spotted Fever (RMSF) is a tick-borne disease caused by Rickettsia rickettsii (R. rickettsii). RMSF presents after a tick bite with fever, rash, and headache but can also cause more serious neurological manifestations. We report a case of RMSF encephalitis presenting with altered sensorium and rapid progression to coma, fever, and petechial rash, and an magnetic resonance imaging (MRI) brain notable for a "starry sky" pattern. A 61-year-old woman presented with confusion and fever and was diagnosed with a urinary tract infection. Two days later, she became comatose. MRI brain revealed lacunar infarcts in the right centrum semiovale and splenium of the corpus callosum. Lumbar puncture was notable for neutrophilic pleocytosis and elevated protein with negative bacterial and viral cultures. Empiric meningitis therapy was initiated, and she was transferred to our institution. On transfer, she was febrile, comatose, and had a diffuse petechial rash. Repeat MRI brain demonstrated diffuse, innumerable punctate foci of diffusion restriction with susceptibility-weighted signal attenuation throughout cerebral hemispheres in a "starry sky" pattern. Skin biopsy revealed perivascular lymphocytic infiltrates. Serologic RSMF antibody titers were obtained, and doxycycline was initiated for presumed RMSF encephalitis. The family opted to pursue palliative measures, given no clinical improvement. RSMF titers and postmortem PCR from brain tissue were positive for R. rickettsii. This case report highlights the clinical presentation of RMSF encephalitis. RMSF encephalitis should be suspected in a patient presenting with encephalopathy, fever, petechial rash, and MRI brain findings of diffuse punctate foci of diffusion restriction and susceptibility-weighted signal attenuation in a "starry-sky" pattern.

Molecular detection of lumpy skin disease virus in naturally infected cattle and buffaloes: unveiling the role of tick vectors in disease spread.

Lumpy skin disease (LSD) is a viral disease that affects cattle and buffaloes in Egypt, causing considerable economic losses in the animal sector. This study aimed to investigate the recent outbreak of LSDV in cattle and buffaloes and evaluate the potential role of the hard tick Rhipicephalus annulatus in their transmission through isolation and molecular characterization by multiplex PCR (mPCR) and real-time quantitative PCR (rt-qPCR) assays. A total of 50 skin biopsies (cattle n = 30, buffaloes n = 20), 110 nasal swabs (cattle n = 76, buffaloes n = 44), and 129 blood samples (cattle n = 84, buffaloes n = 45) were collected. In addition, 145 hard ticks of different stages were collected from cattle and buffaloes of different breeds and ages in different governorates in Egypt from November 2021 to June 2022. Multiplex PCR and real-time quantitative PCR (rt-qPCR) assays based on SYBR Green and targets (P32, VP32, G protein, and viral fusion protein) were used. We identified positive results in 17 out of 30 cattle skin biopsies (56.6%), 1 out of 7 buffalo skin scabs (14.3%), and 5 out of 45 buffalo blood samples (11.11%) using mPCR and RT-qPCR methods. We successfully isolated LSDV from hard ticks and cattle infested with ticks and exhibited characteristic signs of LSD on the chorioallantois membrane (CAM) of specific pathogen-free embryonated chicken eggs (SPF-ECE). The isolates were confirmed by multiplex PCR and RT-qPCR. The cyclic threshold (Ct) with correlation-slandered curve values of rt-qPCR ranging from 10.2 to 36.5 showed the amount of LSDV-DNA in different samples. The study's findings demonstrated the widespread circulation of LSDV in both cattle and buffaloes in Egypt and provided strong evidence that hard ticks R. annulatus play a role in the transmission of LSDV in susceptible animals.

Mysterious Allergy Caused by Tick Bite: Alpha-Gal Syndrome.

Alpha-Gal syndrome (AGS) manifests as an intricate allergic response characterised by the formation of specific immunoglobulin E (IgE) antibodies targeting a carbohydrate termed galactose-a-1.3-galactose (a-Gal). Alpha-Gal antigens, which play a role in AGS, have been detected in the salivary glands and saliva of various tick species, especially Amblyomma americanum. Identifying these antigens in tick saliva underlines the potential role of tick bites in sensitising individuals to a-Gal and contributes to the complex immunological processes associated with AGS. When people with a-Gal allergy eat beef, pork, lamb, or the flesh of other mammals, they experience an allergic reaction that causes various symptoms, including rash, nausea, vomiting, and diarrhoea. In some cases, AGS can be life-threatening requiring emergency medical attention. Moreover, these reactions do not occur only due to red meat; intake of medical drugs, vaccines, and antidotes containing a-Gal epitopes can also trigger allergies. The fact that the symptoms causing IgE antibodies are directed against a carbohydrate moiety the unusual delay between food consumption and the onset of symptoms, and the differences in the reactions shown by a-Gal allergy make a-Gal syndrome an unprecedented allergic disease and distinguish it from other food allergies. Interestingly, a-Gal antigens involved in the development of AGS have been discovered in salivary secretions of different tick species in several continents. However, the underlying causes of a-Gal-specific IgE production and immune responses to tick bites are not fully understood. This complex system is crucial for identifying and developing new therapies for the disease. This article reviews the evolution of a-Gal, the current understanding of AGS and its relationship to tick species.

Analysis of the species composition and infection of ticks with pathogens of Lyme disease in the territory of the Republic of Tatarstan for the period 2012–2022

BACKGROUND: The role of ixodid ticks in the transmission of pathogens of a number of natural focal infections can hardly be overestimated. Analysis of the manifestations of the epizootic process is important for planning preventive and anti-epidemic measures and is an integral component of epidemiological surveillance of natural focal infections. AIM: To analyze the species composition of ticks and the infection of ticks with borreliosis pathogens in the Republic of Tatarstan for the period 2012–2022. MATERIALS AND METHODS: An analysis of the species composition of ticks collected by the zoological group of the Center for Hygiene and Epidemiology in the Republic of Tatarstan from environmental objects during the period 2012–2022 was carried out. Testing of the ticks for Borrelia burgdorferi and Borrelia miyamotoi was carried out using the polymerase chain reaction method with hybridization-fluorescent detection. An analysis of statistical observation form No. 2 “Information on infectious and parasitic diseases” (the section “Tick bites”) for the Republic of Tatarstan from 2012 to 2022 was carried out. Statistical processing was performed using descriptive statistics methods in Microsoft Excel. RESULTS: The total number of people who applied for tick bites in the Republic of Tatarstan in 2012–2022 was 77,703, of which 59,168 (76.2%) were people over 18 years of age. During the study period, 5536 ticks were collected for research on the territory of the Republic of Tatarstan from environmental objects. The species composition of ticks was distributed as follows: Dermacentor reticulatus — 75.4%, Ixodes ricinus — 14.1%, Ixodes persulcatus — 10.5%. Infection of different types of ticks with Borrelia was not the same and was 20.4% for I. persulcatus, 14% for I. ricinus, 4.4% for D. reticulatus. In 4 regions of the republic, from ticks of the species I. ricinus pathogenic genomospecies B. miyamotoi were found (the infestation of this type of tick with B. miyamotoi was 0.4%). Indicators of morbidity of the population with ixodid tick-borne borreliosis and indicators of infection rates for ticks vary in different regions of the republic. CONCLUSIONS: The dominant species of ixodid ticks in natural epitopes of the Republic of Tatarstan in 2012–2022 were D. reticulatus (75.4% of the total number of collected ticks). For ticks of this species, the lowest level of infection with Borrelia was demonstrated (4.4% of ticks). This may be one of the factors responsible for the low, in comparison with other regions, incidence rates of tick-borreliosis in the Republic of Tatarstan. The identification of ticks of the species I. ricinus infected with B. miyamotoi confirms the need for targeted molecular genetic and serological examination for recurrent fever in patients with non-erythematous forms of febrile illness after an episode of tick bite.

Epidemiological and clinical characteristics of cases and detection of pathogens’ markers of tick-borne infections in the Tomsk region

BACKGROUND: Among the spectrum of the tick-borne infections, Lyme borreliosis and tick-borne encephalitis are most often recorded in the Tomsk region, however it is obviously that possible range of the pathogens is not limited to these ones. AIM: To make epidemiological and clinical characteristics of cases and detect frequencies of pathogen’s markers of tick-borne infections among adult patients applying serological and molecular genetic techniques in the Tomsk region during 2020–2023. METHODS: A single-center prospective sample study was conducted applying a comprehensive approach in peripheral blood specimens obtained from 197 patients with suspected tick-borne infections hospitalized during 2020–2023. To verify the diagnoses of tick-borne encephalitis or Lyme borreliosis, specific immunoglobulins of classes M and G to the antigens of virus of tick-borne encephalitis and Borrelia burgdorferi s.l. were determined in paired blood serum samples applying enzyme-linked immunosorbent assay. Additionally, the polymerase chain reaction was used to detect genetic markers of virus of tick-borne encephalitis, B. burgdorferi s.l., B. miyamotoi, Rickettsia spp., Coxiella burnetii, and Francisella tularensis. Epidemiological surveillance data of incidence rates of tick-borne infections obtained from official reports were analyzed as well. MS Office Excel 2010 software was used to calculate frequency morbidity measures. RESULTS: We verified the final diagnosis of tick-borne encephalitis in 52 (26.4%) patients, Lyme borreliosis in 116 (58.9%) patients, co-infection of tick-borne encephalitis and Lyme borreliosis 15 (7.6%) patients, hard tick relapsing fever caused by B. miyamotoi in 8 (4.1%) patients, coinfection of Q fever caused by C. burnetii with tick-borne encephalitis or Lyme borreliosis in 4 (2.0%) patients, and coinfection of tularemia with tick-borne encephalitis or Lyme borreliosis in 2 (1.0%) cases. We identified markers of tick-borne encephalitis and Lyme borreliosis pathogens by polymerase chain reaction in 3.6% and 4.1% of the patients. Most number of individuals with tick bites, and the highest incidence rates of Lyme borreliosis and tick-borne encephalitis were recorded in the suburbs of Tomsk. The age groups of 40–59 years, and elderly people 60 years and older were predominated among the patients. CONCLUSIONS: It was found out that, in addition to Lyme borreliosis and tick-borne encephalitis, there were such tick-borne infections as tick relapsing fever, Q fever, and tularemia in the Tomsk region in the 2020–2023 period.

Clinical Findings, Laboratory Results, Electrocardiography and Echocardiography Findings in Dairy Buffaloes with Theileriosis.

Tropical theileriosis is a tick-borne haemoprotozoan disease, and cardiac function assessment in buffaloes with theileriosis was poorly documented. The Present study was carried out from April 2022 to December 2022. Theileriosis was confirmed by microscopic examination of stained blood smears and lymphnode smearsfurther confirmed by PCR assay. Electrocardiography was performed byusing the base apex lead system, and echocardiography was performed byusing the right parasternal view. The incidence of theileriosis was 16.25% by examination of stained blood smears, and 30.42% by PCR examination in 240 buffaloes. Repeatedly noted clinical signs were the absence of rumination, anorexia, loss of milk yield, depressed demeanour, emaciation, hyperthermia, lymphadenopathy, tick infestation, tachycardia, cardiac arrhythmia, and increased intensity of heartbeat. Haematological findings disclosed decreased haemoglobin, packed cell volume, total erythrocyte count, and neutrophils; increased eosinophils and monocytes. Serum biochemical findings revealed decreased albumin, albumin/globulin ratio, glucose, calcium, phosphorous, sodium, potassium, and chloride; increased globulin, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, cholesterol, lactate dehydrogenase, gamma-glutamyl transferase, and creatine kinase myocardial band isoenzymes. Electrocardiography explorations were sinus tachycardia, broad T wave, and sinus arrhythmia. Echocardiography examination showed ventricular wall thickening, cardiac chamber dilatation, valvular defects/valvular regurgitation, and pericarditis/cardiac tamponade. The present research proposes the changes in the electrocardiography and echocardiography findings in buffaloes with theileriosis, which are essential in clinics to identify the secondary complications during theileriosis and formulate therapeutics.

Ecological and epidemiological characteristics of tick-borne encephalitis and ixodic tick-borne borreliosis incidence according to the data of the Arkhangelsk region for 2012–2022

BACKGROUND: The increase of ticks infected with borrelia and tick-borne encephalitis virus, as well as the impact of anthropogenic factor on the ecosystem of the northern region determines the need to study possible risk factors and epidemiological trends in the incidence of tick-borne encephalitis and ixoid tick-borreliosis. AIM: To conduct a retrospective ecological and epidemiological analysis of regional peculiarities of the epidemic process of tick-borne encephalitis and ixoid tick-borreliosis in the Arkhangelsk region in comparison with similar indicators in the North-West Federal District and Russia for 2012–2022. MATERIALS AND METHODS: The work was carried out in accordance with the ecological research design. Statistical data of the Unified Interdepartmental Information and Statistical System, as well as statistical annual forms of the Department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Russia and the Arkhangelsk region were used as the information base. The registered cases of tick-borne encephalitis and ixoid tick-borreliosis morbidity in the Arkhangelsk region, as well as in Russia and the Northwestern Federal District as a whole for 2012–2022 were evaluated. Time series analysis was performed using Microsoft Excel 2019. The study also analyzes the dynamics of climatic factors in the Arkhangelsk region and its possible impact on the distribution and migration of ixodid ticks across the territory of the European North of Russia. Correlations were assessed by evaluating Pearson’s correlation criterion using the Google Collaboratory interface. RESULTS: The number of tick bites in the Arkhangelsk region throughout the entire study period significantly exceeds the similar indicator (per 100 thousand population) in Russia. The incidence of tick-borne encephalitis in the Arkhangelsk region significantly exceeds that in both the Russian Federation and the Northwestern Federal District, and exceeded the average annual rate in Russia more than 3 times, although it had a faster rate of decline (5.7% vs. 3.7% annually). The incidence of ixoid tick-borreliosis has a paradoxical character due to the fact that throughout almost the whole period it is below the all-Russian level (3.19 per 100,000 population in Arkhangelsk region against 4.41 in the Russian Federation), while the incidence in the Northwestern Federal District is 1.3 times higher on average. CONCLUSIONS: During the last decade the incidence of tick-borne encephalitis in the Arkhangelsk region remains stably high in comparison with both the Russian Federation and the Northwestern Federal District. The incidence of ixoid tick-borreliosis corresponds to the long-term average for Russia, with a more pronounced downward trend (4.7% vs. 1.7%). The territory of the Arkhangelsk region is subject to the trend of increasing average annual temperatures, and anthropogenic interventions, in particular, abundant deforestation, lead to the destruction of established ecosystems and open new opportunities and territories for ticks, which in the future may negatively affect the established trends of morbidity. The analysis confirms the need to develop and adopt organizational measures aimed at the development of epidemiological and epizootological monitoring.

7045 A Rare Case of Lyme-Associated Thyroiditis in an Otherwise Healthy Patient

Abstract Disclosure: M. Windham: None. S.K. Majumdar: None. Introduction: Lyme disease, a common tick-borne illness, causes multiorgan inflammation and dysfunction. It commonly affects the musculoskeletal, neurologic, cardiovascular, and integumentary systems. The endocrine system is rarely involved. We report a case of Lyme-associated thyroiditis in an otherwise healthy 41-year-old man. Case: A 41-year-old man with a history of hypertension, gastroesophageal reflux and a known BRCA2 mutation presented to the emergency department due to one week of frequent palpitations, fatigue, dyspnea on exertion, and dry cough. Laboratory testing revealed thyrotoxicosis with an undetectable TSH (n 0.270—4.200 µIU/mL), FT4 of 7.04 ng/dL (n 0.80—1.70 ng/dL), and TT3 of 253 ng/dL (n 92.0—224 ng/dL). He denied any recent illnesses or pain in his thyroid. Further work up revealed negative TSI and TPO but did show an elevated high sensitivity CRP of 4.3 mg/L (n &amp;lt;1.0 mg/L) and a sedimentation rate of 33 mm/hr (n 0—20 mm/hr). A thyroid uptake and scan showed markedly decreased uptake suggestive of thyroiditis. The patient was started on a prednisone taper with improvement in his TFTs. At his follow up visit approximately one month later, he reported increasing stiffness in his bilateral jaw and continuing palpitations with movement despite near normalization in his FT4 and TT3, suggestive of possible underlying cardiac conduction defects. He did not recall a tick bite but lived in an area with endemic Lyme disease. Lyme antibodies were sent and returned with a positive Lyme IgG and an indeterminate Lyme IgM, which would be consistent with an active Lyme disease infection at the time of his initial presentation. Treatment for Lyme disease was prescribed. Conclusion: Between 1991 and 2021, the incidence of Lyme disease in the United States doubled due to the combined effects of climate change, increasing host species populations, and human encroachment on animal habitats. People who live in areas with endemic Lyme disease, such as the Northeast and upper Midwest regions of the United States, are at risk even if they do not recall a specific exposure. Although Lyme thyroiditis is extremely rare, its incidence is expected to increase as the overall incidence of Lyme disease increases. Therefore, it is important to consider Lyme disease in the differential when a patient from an endemic area presents with unexplained thyroiditis. Presentation: 6/2/2024

A-283 Serologic and molecular testing for the diagnosis of Rickettsia, Ehrlicha, and Anaplasma infections in patients in Maryland

Abstract Background Rickettsia, Anaplasma, and Ehrlichia are underrecognized tick-borne pathogens of increasing human importance. As tick habitats are expanding and populations are increasing, human exposure to these pathogens is also increased in recent years. Unfortunately, while treatment is usually simple, diagnosis can be difficult as it requires specialized testing for clinical diagnosis - generally performed only at reference laboratories. Methods To better understand the prevalence, diagnosis, and testing patterns for Rickettisal infections, Anaplasmosis, and Ehrlichiosis in Maryland, a retrospective analysis of all serologic and molecular testing for Rickettsia, Anaplasma, and Ehrlichia species performed for the University of Maryland Medical System from 2018-2022 was conducted. Eight hospitals within the University of Maryland Medical System (Central Maryland and Maryland’s Eastern Shore) diagnose Rickettsia, Anaplasma, and Ehrlichia infections using serologic and molecular testing. Results Between 2018-2022, an average of 413 individuals were tested for Rickettsia, Anaplasma, and Ehrlichia each year. On average 315 serologic tests for Rocky Mountain Spotted Fever (RMSF) group Rickettsia, 195 serologic tests for Ehrlichia chaffeensis (Anaplasma serology is not available), and 165 molecular tests for the detection of Anaplasma and Ehrlichia species were ordered each year. Clinical indications for testing included tick bite, fever, chills, severe headaches, muscle aches, and rash. Overall, 17% of individuals tested were positive for IgG antibodies to RMSF group Rickettsia, however only 1% were positive for IgM antibodies. Further, 20% of individuals tested were positive for IgG antibodies to Ehrlichia chaffeensis, while &amp;lt;1% were positive for IgM. Acute and convalescent samples were not tested for any individuals. Molecular evidence of infection was found in 8% of individuals tested. Nineteen precent were positive for Anaplasma phagocytophilum and the remaining 81% were positive for Ehrlichia chaffeensis. Interestingly, only two individuals had positive results from both molecular and serologic testing. Conclusions Results from serologic and molecular testing show that Rickettsia, Anaplasma, and Ehrlichia are important human pathogens with the potential to cause significant morbidity. However, lack of follow-up serology, and laboratory tests that confirm acute infection make definitive diagnosis difficult. Increased awareness of Rickettsial diseases and appropriate diagnostics is needed.