Tick Contact Research Articles

A short review on ticks and Crimean-Congo hemorrhagic fever disease in emergency department perspective in endemic regions

Crimean-Congo hemorrhagic fever (CCHF) is a lethal disease caused by the CCHF virus of the Bunyaviridae family. The virus is transmitted to humans through tick bites or contact with blood and tissues of infected animals. Various domestic and wild animals have been identified as a reservoir for this virus, including cattle, sheep, goats, hedgehogs and hares. Numerous species of ticks can carry the virus; however, very few of them have been implicated as vectors. The most important tick vector is the Hyalomma spp., as the virus was isolated from it and its geographic distribution coincides with that of the disease. In Turkey, especially since 2002, CCHF has been a serious public health problem threatening lives of thousands of people. A regional epidemic has occurred in Turkey in 2003 and since then, when considering the number of CCHF cases reported worldwide, the highest number has been reported in Turkey. The majority of cases in our country were from 15 cities in a region called Kelkit Canyon and its environs in the middle and North Anatolia, particularly the cities of Corum, Tokat, Sivas, Yozgat and Erzurum from which two-thirds of cases were reported. In this article, our aim was to guide physicians for CCHF in endemic regions in the World and share our experiences. Being aware of the disease is the mainstay for prevention from the disease and reduce morbidity and mortality related to it.

First Indications of Omsk Haemorrhagic Fever Virus beyond Russia.

Omsk haemorrhagic fever virus (OHFV) is the agent leading to Omsk haemorrhagic fever (OHF), a viral disease currently only known in Western Siberia in Russia. The symptoms include fever, headache, nausea, muscle pain, cough and haemorrhages. The transmission cycle of OHFV is complex. Tick bites or contact with infected small mammals are the main source of infection. The Republic of Kazakhstan is adjacent to the endemic areas of OHFV in Russia and febrile diseases with haemorrhages occur throughout the country—often with unclear aetiology. In this study, we examined human cerebrospinal fluid samples of patients with suspected meningitis or meningoencephalitis with unknown origins for the presence of OHFV RNA. Further, reservoir hosts such as rodents and ticks from four Kazakhstan regions were screened for OHFV RNA to clarify if this virus could be the causative agent for many undiagnosed cases of febrile diseases in humans in Kazakhstan. Out of 130 cerebrospinal fluid samples, two patients (1.53%) originating from Almaty city were positive for OHFV RNA. Screening of tick samples revealed positive pools from different areas in the Akmola region. Of the caught rodents, 1.1% out of 621 were positive for OHFV at four trapping areas from the West Kazakhstan region. In this paper, we present a broad investigation of the spread of OHFV in Kazakhstan in human cerebrospinal fluid samples, rodents and ticks. Our study shows for the first time that OHFV can not only be found in the area of Western Siberia in Russia, but can also be detected up to 1.600 km away in the Almaty region in patients and natural foci.

Crimean-Congo Hemorrhagic Fever in Differential Diagnosis During the Coronavirus Disease-2019 Pandemic

Crimean-Congo Hemorrhagic Fever (CCHF) is a disease of the viral hemorrhagic fever group and is endemic in certain regions in Turkey. Here, the demographic, clinical, and laboratory findings of patients diagnosed with CCHF during the Coronavirus disease-2019 (COVID-19) pandemic were examined, and differential diagnosis was stressed. This study comprised 12 patients over the age of 18 who were admitted to our clinic after the onset of the COVID-19 pandemic on March 11, 2020 and whose CCHF diagnosis was confirmed by reverse transcription-polymerase chain reaction with viral-RNA or enzyme-linked immunosorbent assay with immunoglobulin M antibodies. Epidemiological, clinical, and laboratory findings as well as treatment and prognosis of the patients were investigated. Of the 12 cases, 10 (83.3%) were men and 2 (16.7%) were women. The median (interquartile range) age was 51 (27-64) years. Eleven (91.7%) patients lived in rural regions, and seven (58.3%) had a history of tick contact. Five patients were hospitalized in an external center with a preliminary diagnosis of COVID-19 and transferred to our center due to clinical and laboratory deterioration. Loss of appetite, headache, fever, weakness, and muscle-joint pain were the most common complaints of the patients. Following the suspicion of COVID-19, thoracic computed tomography (CT) was performed in six patients, five of whom were transferred to an external center. None of the patients had any pathological findings following thoracic CT. Although it is thought that the COVID-19 pandemic will end in the following months owing to vaccine applications, it can be predicted that sporadic cases will still occur for a long time. Therefore, clinicians should take CCHF into consideration in their differential diagnosis. Also, it should be remembered that co-infections can be observed in endemic areas.

Epidemiology, Diagnosis, and Control of Canine Infectious Cyclic Thrombocytopenia and Granulocytic Anaplasmosis: Emerging Diseases of Veterinary and Public Health Significance.

This review highlights the diagnostic methods used, the control strategies adopted, and the global epidemiological status of canine cyclic thrombocytopenia and granulocytic anaplasmosis at the animal–human interface. Canine anaplasmosis is an important worldwide disease, mainly caused by Anaplasma platys and A. phagocytophilum with zoonotic implications. A. platys chiefly infects platelets in canids, while A. phagocytophilum is the most common zoonotic pathogen infecting neutrophils of various vertebrate hosts. Diagnosis is based on the identification of clinical signs, the recognition of intracellular inclusions observed by microscopic observation of stained blood smear, and/or methods detecting antibodies or nucleic acids, although DNA sequencing is usually required to confirm the pathogenic strain. Serological cross-reactivity is the main problem in serodiagnosis. Prevalence varies from area to area depending on tick exposure. Tetracyclines are significant drugs for human and animal anaplasmosis. No universal vaccine is yet available that protects against diverse geographic strains. The control of canine anaplasmosis therefore relies on the detection of vectors/reservoirs, control of tick vectors, and prevention of iatrogenic/mechanical transmission. The control strategies for human anaplasmosis include reducing high-risk tick contact activities (such as gardening and hiking), careful blood transfusion, by passing immunosuppression, recognizing, and control of reservoirs/vectors.

Tularaemia - a diagnostic challenge.

Tularaemia is an infrequently occurring disease in Poland. It has therefore rarely been taken into account in the differential diagnosis of skin lesions, lymphadenitis, or soft tissue abscesses. This fact, accompanied by non-specific initial presentation, may lead to a delay in diagnosis and a more severe course of the disease. Objective. The aim of the study is to present the current state of knowledge on tularaemia and convince medical professionals to take it into consideration in the diagnosis of skin lesions, lymphadenitis, and tissue abscesses. A literature review using PubMed and other online resources, using terms including 'tularaemia', 'lymphadenitis', etc., was undertaken. Papers were reviewed for relevance and scientific merit. Tularaemia, also known as 'rabbit fever', is a zoonotic infection caused by Francisella tularensis, an aerobic, facultative intracellular, gram-negative bacteria. In Europe, it is mainly spread via tick bites and contact with wild animals such as lagomorphs and rodents. Clinical presentation may differ depending on the transmission route; the ulceroglandular and glandular forms of disease predominate. An early diagnosis and implementation of appropriate antibiotic therapy are the cornerstones of successful treatment and make it possible to avoid a surgical incision and drainage of suppurative complications. Raised awareness and knowledge on tularaemia among health care professionals are required for timely diagnosis and treatment. Arrival from endemic areas, contact with wild animals, tick bites, and exclusion of more common etiologies of presenting signs should prompt consideration of tularaemia. More research is needed for a better understanding of the burden of the disease and its impact on public health in Poland.

Determination of Seroprevalence and Risk Factors of Crimean-Congo Haemorrhagic Fever (CCHF) in the Endemic Region in Turkey: A Population-Based Cross-Sectional Study.

Objectives Turkey is one of the countries that has the most cases of CCHF in recent years among the endemic countries. The disease also poses an important health threat with high mortality rate. The aim of the study was to determine the seroprevalence and risk factors of CCHF in adults aged ≥20 years in Tokat in the endemic region, Turkey. Methods In this population-based cross-sectional study, a total of 85 Family Medicine Units (FMUs), from over 170 in Tokat, were randomly selected using 50% sampling. The sample size was determined among the subjects aged ≥20 who registered with the FMUs, due to gender, age group, and the urban/rural population size of Tokat using the stratified cluster sampling method. Subjects were invited to the FMUs. A questionnaire was performed face to face. The blood samples were taken, and anti-CCHFV IgG antibodies were measured with ELISA method. Results 1272 (54.9%) out of 2319 participants were female, and the mean age was 47.3 ± 15.3. Anti-CCHFV IgG seropositivity was 5.6% (n = 130). Seropositivity rates in terms of adjusted odds ratios (AOR) were higher 2.53 times (95% CI: 1.57–4.08; p=0.001) in males; 4.05 (95% CI: 2.14–7.65; p < 0.001) in age group ≥65; 0.33 (95% CI: 0.14–0.76; p < 0.001) in graduates of high school and above; 0.71 (95%CI: 0.33–1.52; p < 0.001) in ones with good income; 1.84 (95%CI: 1.18–2.86; p < 0.001) in farmers; 1.64 (95% CI: 1.04–2.27; p < 0.001) in people dealing with animal husbandry; and 1.02 (95% CI: 1.03–2.29; p < 0.001) in those with history of tick contact. Conclusions CCHF seroprevalence is still a common public health problem in Tokat, Turkey. Male gender, advanced age group, low-educated, low-income, farmers, animal husbandry, and history of tick contact were found to be risk factors for CCHF. The importance of this kind of community-based studies to identify the seroprevalence in regional and national level increases even more.

The presence of Tularemia infection in patients with Japanese spotted fever.

In our previous study, by measuring serum cytokine levels in the acute and recovery stage of Japanese spotted fever (JSF), IFN-ɤ and IL-6 were proved to be the critical immunological cytokines against Rickettsia japonica (R. japonica) infection. Tularemia is an infectious disorder caused by tick biting or contact with infected animals, and is also known as rabbit fever. There have been no confirmed cases in the recent two decades in Japan. We measured serum anti Francisella tularensis (F. tularensis) IgG titer using indirect enzyme-linked immunosorbent assay (ELISA) kit in the acute and recovery stage of three patients with JSF. The result of the IgG titer was compared with the cytokine concentrations of IFN-ɤ, IL-6, IL-4, IL-5, IL-9, and IL-33, eosinophil count, and CRP quoted from our previous report. Two of three cases have anti F. tularensis IgG, and the IgG levels between acute and recovery stage were unchanged. These two cases showed low IFN-ɤ concentration and CRP, but IL-4, IL-5, IL-9, IL-33 levels and eosinophils were high compared to those in the F. tularensis IgG-negative patient. IL-6 concentration was unchanged between the three patients. Residents living in the endemic area of JSF in Mie prefecture, Japan, may have antibodies against F. tularensis, although tularemia has never been reported. The cases of having the F. tularensis antibody showed a mild inflammatory response of JSF and might skew to type 2 immunological condition even in the acute phase of JSF.

First detection of Borrelia miyamotoi infections in ticks and humans from the northeast of Inner Mongolia, China

Borrelia miyamotoi is a relapsing fever spirochete that can cause chills, fatigue, headache, myalgia, arthralgia, and even meningitis, damaging human health. B. miyamotoi has a wide distribution since its discovery in Ixodes persulcatus in 1994. The human B. miyamotoi disease was first described in Russia in 2011. However, the epidemiological information in China is limited. Here, we report the molecular detection of B. miyamotoi in the northeast of Inner Mongolia, China. A total of 774 adult ticks and 771 blood samples of patients were collected, from April 2017 to August 2019 in the northeast of Inner Mongolia, and tested for B. miyamotoi using real time-PCR. Gene sequences of 16S rRNA, fla, and glpQ were obtained to reconstruct the phylogenetic relationship of B. miyamotoi from humans and ticks. The results showed the total prevalence of B. miyamotoi in ticks was 1.3% of 774 ticks, with rates of 2.6% in I. persulcatus, 0.78% in Dermacentor nuttalli, 1.3% in D. silvarum, and 0.4% in Haemaphysalis longicornis. Thirteen (1.7%) patients were confirmed as positive for B. miyamotoi. Patients were mainly 50-60-years old and had a history of tick contact. They presented flu-like symptoms, including fever, headache, poor spirit, dizziness, nausea, vomiting, hypodynamic, chest distress, and myalgia. Phylogenetic analysis showed that the B. miyamotoi in the present study belonged to the Siberian type, distinct from European and American types and the I. ovatus isolate from Japan. This is the first report of B. miyamotoi detection in both ticks and humans in the northeast of Inner Mongolia, China, indicating B. miyamotoi is present in the area. These findings suggest that people have a risk of infection with B. miyamotoi in this region, where it should be included the differential diagnosis of tick-borne diseases.

Bilan d’adénopathies médiastinales : ne pas méconnaître une tularémie !

Mediastinal lymphadenopathy is a common cause of referral to the pulmonologist. In addition to more frequent aetiologies such as malignancy, sarcoidosis, tuberculosis and lymphoma, unusual causes must be considered, especially in specific contexts. We report the cases of three young patients referred to our pulmonology department for the assessment of hypermetabolic mediastinal lymphadenopathy. The context of the onset of symptoms (tick bite, contact with an infected animal) as well as paraclinical investigations (Francisella tularensis serology) made it possible to make a diagnosis of tularemia. The clinical and radiological evolution was favourable in all three cases. Tularemia is a rare but currently re-emerging infection caused by a Gram negative coccobacillus, Francisella tularensis. Human contamination occurs mainly through contact with infected animals or by tick bites. The diagnosis can be difficult because the symptoms (fever, diffuse myalgia) are non-specific, and is based on serology and an appropriate clinical context. Treatment is based on ciprofloxacin or doxycycline. The diagnosis of tularemia must be considered in the presence of lymphadenopathy occurring after a tick bite or contact with an infected animal.

Descriptive epidemiology of Crimean – Congo hemorrhagic fever cases admitted to Kabul main hospitals during 2015 to 2018

Crimean – Congo hemorrhagic fever (CCHF) is a deadly viral disease which is transmitted to humans by tick bites and contact with infected animal and humans’ fluids. This is a retrospective study designed to identify the descriptive epidemiology of registered CCHF cases and their related fatalities in Kabul’s 12 public and private hospitals during 2015 - 2018. Totally, 521 CCHF cases and 71 deaths have been registered in two public hospitals only (mainly in Antani hospital). These cases were from 28 out of 34 provinces of Afghanistan, with more than half of the cases (50.3%) from Kabul. More than 75% of cases were male and 24.8% were female (p &lt;0.001). The median age of the CCHF patients was 29 years old (range = 3 – 95), where majority of cases (74.8%) occurred in the patients between 15 – 45 years old. CCHF cases have been recorded in all four seasons of the year, where the cases were 11.9% (61), 55.85% (291), 27.1% (141) and 5.4% (28) (p &lt;0.05) in spring, summer, autumn and winter, respectively. Results of this study indicate that CCHF is a recurrent disease in Afghanistan and the prevalence of the disease has increased dramatically in recent years. Active surveillance to detect infected and infested animals with CCHF virus and hard ticks, and combat against ticks are essential to control and prevent the disease in human populations.

Kırım Kongo Kanamalı Ateşi Tanısıyla İzlenen Hastaların Epidemiyolojik ve Biyokimyasal Olarak Değerlendirilmesi

Aim: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral hemorrhagic fever. To evaluate the clinical, epidemiological and laboratory characteristics of patients with CCHF. &#x0D; Methods: This study was performed with adult patients under monitoring with diagnosis of CCHF at the Atatürk University Faculty of Medicine Infectious Diseases Clinic between April 2012 and August 2013. &#x0D; Results: Diagnosis of CCHF was based on presence of Enzyme-linked immunosorbent assay (ELISA) anti-CCFV IgM and/or virus antigen at Refik Saydam Hygiene Center (RSHM) in patient serum and/or real time Polymerase Chain Reaction (PCR). One hundred twenty-one cases were included. Fifty-eight (48.7%) of patients were male and 62(51.2%) female, with a mean age of 50.04 ± 18.22 (16-86) years. Contact with ticks was determined in 62.8% of patients. Length of incubation was 3.9±2.7 days. Five patients (4.1%) died. &#x0D; Conclusion: CCHF which is carried by ticks is a fatal viral infection. The most important factor in protection is the prevention of tick contact. People living in endemic regions must be educated and instructed how to perform daily tick checks. Patients have got high fever, myalgia, headache and tick bite must be asked in history. We believe that early diagnosis and treatment of CCHF cases may significantly reduce morbidity and mortality.

Crimean-Congo Hemorrhagic Fever: Retrospective Evaluation of Clinical Features and Laboratory Findings of 16 Cases

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease frequently transmitted by tick bite and accompanied by fever and bleeding. It may cause important public health problems. Besides clinical symptoms and epidemiological history, blood count and biochemical test results are the first clues for CCHF. In this study, we aimed to retrospectively evaluate 16 patients who were followed and treated due to CCHF in our hospital. Materials and Methods: The patients who were followed up and treated with CCHF between 2009-2019 in our clinic were evaluated retrospectively in terms of demographic characteristics, presenting complaints, presence of tick history, laboratory parameters, necessity of blood products replacement, hospitalization periods, ribavirin treatment and one-month survival. Results: Sixteen patients [ten females, six males, mean age 50.37 ± 18.01 (min: 18-max: 79)] with the diagnosis of CCHF were included into the study. Presenting complaints were fever (16/16, 100%), fatigue (16/16, 100%), bleeding (9/16, 56.2%), petechial rash (7/16, 43.7%). nausea and vomiting (6/16, 37.5%). There was a history of tick contact in 14 cases (87.5%) but not in two cases. Supportive treatment was applied to all cases, and droplet and contact isolation were applied. Blood product replacement was performed in five patients (31.2%), and ribavirin was administered in nine patients (56.2%). Mortality rate was 6.3% (1/16). Conclusion: Crimean-Congo Hemorrhagic Fever is an endemic disease in our country. Especially in spring and summer months, patients with fever and cytopenia on hemogram should be questioned, and tick contact should be sought.

Spotted fever outbreak with cases and deaths in the same family in a municipality in south eastern Brazil, 2019

Background: Brazilian Spotted Fever (BSF) is a highly lethal hemorrhagic febrile infectious disease whose etiological agent is the bacterium Rickettsia rickettsii, transmitted by the Amblyomma sculptum tick. Between May and June/2019 there was an outbreak of the disease in the municipality of Contagem, state of Minas Gerais, with previous identification of Rickettsia rickettsia in 2017. The objectives were to investigate the outbreak, describe cases and deaths and raise hypotheses for illness. Methods and materials: Was conducted a descriptive study, with a semi-structured questionnaire from May to June/2019. The population was individuals attended or notified by Contagem municipality as a possible exposed to the probable site of infection. Suspected Cases were individual with fever, headache, myalgia who reported tick bite and/or contact with domestic and/or wild animals and/or visited known area with transmission of BSF from April 28 to June/02, 2019. Confirmed cases were individuals with laboratory confirmation for BSF by Polymerase Chain Reaction. Results: Among the 10 individuals that attended to the suspected case definition, five were confirmed and four died (80% lethality). Median age of the cases were 40 years, four male and all had fever, myalgia and headache; three manifested rash and petechiae; four participated together in a weeding activity and three related tick bite. All deaths happened in the same family and had dengue as the first diagnostic hypothesis; three of these had first health assistance in a private medium complexity service and a seven days median between symptoms and death. Conclusion: There was a high lethality outbreak, with cases and deaths in the same family, possibly related to a weeding activity in a preserved forest area where cases developed all classic symptoms of the disease. It's recommended cleaning and maintenance routines in public spaces with grass and vegetation; local professionals training for the need to investigate BSF in the health assistance routine; investigation and diagnostic capacity increase for BSF and intensification of educational actions aimed in the transmission mode, disease control and prevention.

Evaluation and comparison of tick detachment techniques and technical mistakes made during tick removal.

Tick is among the important ectoparasites of humans and animals. Ticks may transmit disease-causing pathogens to humans. Tick contact may be resulted in several viral and bacterial infections, including Crimean-Congo Hemorrhagic Fever. Timely removal of ticks with appropriate methods is important in prevention of disease transmission. There are many methods reported for tick detachment. In this study, we aimed to evaluate two of them, suture lassoing and freezing and to compare both methods and to examine technical mistakes with these techniques. This study was designed as a prospective cross-sectional study, and included the ticks detached by healthcare professionals or directly by patients who presented to the emergency department due to tick contact. The ticks were recorded as larvae, nymphs, and adults according to their growth period. Ticks detachment types with surgical sutures and removal mistakes were recorded. The majority (77.4%) of the ticks were removed by healthcare professionals and a lower rate by patients themselves with hand (22.6%). No technical mistake was found in 72 (77.4%) patients, and the tick was detached as a whole, while detached broken in 15 (16.1%) patients, and the tick was detached as a whole, but the sutures were attached wrong in six (6.5%) patients. Tick broken off due to technical mistakes was most commonly seen in the ticks removed by the individuals themselves. The results of this study suggest that when appropriately and correctly used, both suture lassoing and tweezers are effective in tick removal. Public awareness-raising and training programs should be increased on this issue.

2310. No Recurrence in Recovered People with CCHF: A Cross-Sectional Study From Turkey, Preliminary Report

BackgroundCrimean-Congo hemorrhagic fever (CCHF) is a widespread, tick-borne disease of humans. CCHF is an endemic in Turkey, and since 2004 many cases have been reported from different regions in the country. CCHF infection in humans can lead to antibody responses that can be protective but there is limited data about the immunity of CCHF. The aim of this study was to investigate the possibility of recurrence of CCHF in people who previously had this disease.MethodsThe patients who were diagnosed with CCHF between 2005 and 2018 were followed up and contacted via phone in order to answer several survey questions about CCHF. Patients who still live in the same places, who have high risks of disease transmission because of husbandry or farming and high potential of contact with ticks were included in this study. Those who changed their living place and stopped husbandry or farming were excluded from this study. The questions in the survey are the following: Have you had CCHF after your discharge from the hospital?; Has there been any tick contact?; Did you ever get a tick removed from your body? Did you or your family members have CCHF at the same time or at different periods of time? Has anyone had CCHF in the area you live? Do your animals have ticks? Do you live in the same place? Have you changed your job?ResultsNinety-nine out of 351 patients who were contacted via phone had data eligible to be included in the criteria. The amount of time elapsed after the discharge of the patients was between 1 and 14 years in average. None of the patients had experienced CCHF disease again. Also, 6 of these patients were bitten by ticks repeatedly (2–5 times). An average of 7–10 years had passed since the transmission of the disease by the patients.ConclusionThe results show that the CCHF disease creates an immune response and this response continues for a long time. The findings will be more enlightening with the measurement of the serum antibody levels of patients.Disclosures All authors: No reported disclosures.

Crimean Congo Hemorrhagic Fever in Eastern Turkey: Epidemiological and Clinical Evaluation

The present study aimed to evaluate Crimean-Congo Haemorrhagic Fever (CCHF) in patients hospitalized in our hospital. A total of 61 adult patients who were diagnosed as having CCHF between January 2011 and August 2018, in whom the diagnosis was confirmed by detecting virus-specific IgM by ELISA and/or by showing viral RNA by RT-PCR and who were managed at our clinic were evaluated retrospectively for their epidemiological and clinical findings, treatment and prognosis. Of the 61 cases, 41 (67.2%) were male and 20 (32.8%) female. The mean age of the patients was 45.31±2.12 years. Sixty (98.4%) patients were living in rural area. Forty four patients (72.1 %) had a tick-bite history. According to months, most of the cases were seen in June, July and May, respectively. Fever, weakness and loss of appetite were the most common complaints of the patients. Treatment of ribavirin was started on the day of admission in all patients. One patient who was admitted in the late period died. The other 60 patients were discharged after being healed. Especially during summers when the disease is seen frequently, the history of tick contact should be questioned and tick should be searched in the examination in the patients with suspected clinical findings. A significant number of the patients do not have a known tick contact. Therefore, training meetings should be organized about the symptoms and findings of the disease in the endemic areas and awareness should be raised among the community and the doctors working in emergency services and primary care.

Using citizen science to describe the prevalence and distribution of tick bite and exposure to tick-borne diseases in the United States.

Tick-borne pathogens are increasing their range and incidence in North America as a consequence of numerous factors including improvements in diagnostics and diagnosis, range expansion of primary vectors, changes in human behavior, and an increasing understanding of the diversity of species of pathogens that cause human disease. Public health agencies have access to human incidence data on notifiable diseases e.g., Borrelia burgdorferi, the causative agent of Lyme disease, and often local pathogen prevalence in vector populations. However, data on exposure to vectors and pathogens can be difficult to determine e.g., if disease does not occur.We report on an investigation of exposure to ticks and tick-borne bacteria, conducted at a national scale, using citizen science participation. 16,080 ticks were submitted between January 2016 and August 2017, and screened for B. burgdorferi, B. miyamotoi, Anaplasma phagocytophilum, and Babesia microti. These data corroborate entomologic investigations of tick distributions in North America, but also identify patterns of local disease risk and tick contact with humans throughout the year in numerous species of ticks and associated pathogens.

Prevalence of Selected Zoonotic Diseases and Risk Factors at a Human-Wildlife-Livestock Interface in Mpumalanga Province, South Africa.

A lack of surveillance and diagnostics for zoonotic diseases in rural human clinics limits clinical awareness of these diseases. We assessed the prevalence of nine zoonotic pathogens in a pastoral, low-income, HIV-endemic community bordering wildlife reserves in South Africa. Two groups of participants were included: malaria-negative acute febrile illness (AFI) patients, called febrilers, at three clinics (n = 74) and second, farmers, herders, and veterinary staff found at five government cattle dip-tanks, called dip-tanksters (n = 64). Blood samples were tested using one PCR (Bartonella spp.) and eight antibody-ELISAs, and questionnaires were conducted to assess risk factors. Seventy-seven percent of febrilers and 98% of dip-tanksters had at least one positive test. Bartonella spp. (PCR 9.5%), spotted fever group (SFG) Rickettsia spp. (IgM 24.1%), Coxiella burnetii. (IgM 2.3%), and Leptospira spp. (IgM 6.8%) were present in febrilers and could have been the cause of their fever. Dip-tanksters and febrilers had evidence of past infection to Rickettsia spp. (IgG 92.2% and 63.4%, respectively) and C. burnetii (IgG 60.9% and 37.8%, respectively). No Brucella infection or current Bartonella infection was found in the dip-tanksters, although they had higher levels of recent exposure to Leptospira spp. (IgM 21.9%) compared to the febrilers. Low levels of West Nile and Sindbis, and no Rift Valley fever virus exposure were found in either groups. The only risk factor found to be significant was attending dip-tanks in febrilers for Q fever (p = 0.007). Amoxicillin is the local standard treatment for AFI, but would not be effective for Bartonella spp. infections, SFG rickettsiosis, Q fever infections, or the viral infections. There is a need to revise AFI treatment algorithms, educate medical and veterinary staff about these pathogens, especially SFG rickettsiosis and Q fever, support disease surveillance systems, and inform the population about reducing tick and surface water contact.

Ambush behavior of the tick Amblyomma sculptum (Amblyomma cajennense complex) (Acari: Ixodidae) in the Brazilian Pantanal

We herein describe the ambush behavior of Amblyomma sculptum (Berlese 1888), a widespread and epidemiologically important tick in Brazil. Along two years of sampling by visual search in the Brazilian Pantanal, A. sculptum ticks were observed on the vegetation and in the leaf litter. Most of the ticks were observed between 10 and 50cm above ground level and less than five percent of the total were positioned below 10cm, indicating that they are seeking for middle or large-sized hosts. In both seasons, vapor saturation deficit was low during the morning. No significant relationship was found between questing ticks and daytime interval of observation or saturation deficit. However, questing tick numbers seem be higher in the end of the morning, when saturation deficit reaches its peak. Behavioral patterns of A. sculptum ticks observed in Pantanal underscore the occurrence of this tick and human contact at green anthropogenic sites. Considering A. sculptum questing behavior, inferences on human behavioral patterns that enhance or avoid contact with ticks are discussed.

A Case-control Study of Risk Sources for Severe Fever with Thrombocytopenia Syndrome in Hubei Province, China

BackgroundSevere fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease caused by a novel bunyavirus, was discovered in rural areas of Central China in 2009. MethodsA case-control study based on hospital data was applied to detect the potential risk sources for SFTS in SFTS-endemic counties in Hubei Province. Cases were defined as hospitalized SFTSV confirmed patients. Controls were randomly selected from non-SFTSV patients in the same hospital ward within 2 weeks of inclusion of the cases, and they were matched by age (+/− 5 years) and gender according to 1:2 matching condition. Results68 cases and 136 controls participated in this study. In multivariate analysis, “Contact with cattle tick” was the major risk source (Conditional Logistic Regression OR-MH=8.62, 95% CI=1.79-41.51), outdoor activities and working in weeds or hillside fields could increase risk of cattle tick contact and SFTS infection (Conditional Logistic Regression OR-MH=8.82, 95% CI=1.69-46.05, P value=0.01). ConclusionOur results suggested cattle might be dominant hosts in SFTS-endemic regions in Hubei Province, which provided clues to transmission mechanism of “vectors, host animals, and humans”, thus more effectively preventing and controlling the disease.