Cases Of Tick Paralysis Research Articles

Ultrasonographic evaluation of the thorax in dogs with tick paralysis

Tick paralysis is a rapidly progressing motor paralysis caused by a neurotoxin in the saliva of certain tick species. Delayed diagnosis can lead to increased mortality due to respiratory failure. Thus, the aim of this study is to describe thoracic ultrasonography lesions in dogs with tick paralysis and to identify potential patterns that could aid in diagnosis and prognosis prediction. The animal material consisted of 58 dogs in total, 10 of which were healthy and 48 of which were suspected to be affected by tick paralysis. Clinical, laboratory and thoracic ultrasonographic examinations were performed. Expiratory dyspnea with sinus tachycardia; fine crackles, polyphonic wheezing, and pleural rub on lung auscultation were observed in the tick–paralyzed dogs. The most common abnormal thoracic ultrasonography patterns were, in order of prevalence: B–lines > 3, wet lung, pulmonary nodule, confluent B–lines, loss of A–lines, consolidation, fibrosis, and isolated B–lines. In addition, the pleural thickness of the tick–paralyzed dogs was higher than that of the healthy ones. Among these findings, B–lines > 3 were interpreted as indicative of possible pulmonary parenchymal damage, while the loss of A–lines was attributed to decreased aeration. The presence of pulmonary nodule and fibrosis might be due to bronchopneumonia and aspiration pneumonia due to regurgitation. The wet lung pattern was associated with a predisposition to lung congestion. It was concluded that recognizing thoracic ultrasonography findings may assist in identifying the presence and grading the extent of lung damage, as well as determining the necessity of lung decongestion treatment in tick paralysis cases.

The weather determined how ‘hot’ the tick paralysis season was in eastern Australia: 2018–2024

The eastern paralysis tick, Ixodes holocyclus, is a tick of much veterinary importance in Australia. Each year, thousands of dogs and cats present to veterinary clinics and hospitals with signs of tick paralysis. In a previous paper, we constructed two models to explain prevalence and temporal distributions of tick paralysis cases presenting to emergency veterinary hospitals in South East Queensland (2009–2020) and the Northern Beaches of Sydney (1999–2017). The first model accounted for the intensity of the clinical burden of tick paralysis based on the prevalence of cases of tick paralysis in the tick paralysis season whereas the second model accounted for the start of the tick paralysis season. In the present paper, we test our models further, with much additional data from 2021 to 2023 (South East Queensland) and from 2018 to 2023 (Northern Beaches of Sydney). During the defined tick paralysis season in these locations, 10.3 % (3207 of 31,217) of veterinary-consultations were for tick paralysis. On average, predictions for the prevalence of cases of tick paralysis were 1.3 % (0.013) away from the actual prevalence whereas predictions for the start of the tick paralysis season were 1.7 weeks away from the actual start of the season. The prediction of the prevalence of tick paralysis cases was most accurate for Brisbane and least accurate for the Northern Beaches of Sydney whereas, curiously, the prediction for the start of the tick paralysis season was most accurate for the Northern Beaches of Sydney and least accurate for Brisbane. We re-fitted the models with the new data. We predict that about 10 % (Sunshine Coast), 5 % (Brisbane), 7 % (Gold Coast) and 12 % (Northern Beaches of Sydney) of veterinary-consultations in the tick paralysis season of 2024 will be cases of tick paralysis, resulting in a tick paralysis clinical burden intensity of similar magnitude to previous years. Such predictions allow for timely public education campaigns around the importance of prevention and appropriate resource planning for veterinary clinics.

Tick paralysis induced by Ixodes gibbosus: enigmatic cases in domestic mammals from Cyprus.

Tick paralysis is a potentially fatal condition caused by toxins produced and secreted by tick salivary glands. This survey presents clinical and epidemiological observations of tick paralysis cases in domestic animals in Cyprus. Local veterinarians report typical tick paralysis cases occurring in goats, sheep, dogs, and cats. The animals suffering from paralysis are free from other neurological diseases, have blood and biochemical parameters within normal ranges, and recover fast by simply removing the ticks found predominantly on the head and around the neck. Tick paralysis cases occur in a specific geographic area of Cyprus (Akamas peninsula), from September through March, but not every year. Instead, the phenomenon has 2 periodic cycles of occurrence, a 3- and a 7-year cycle. The 2 cycles are differentiated by severity based on the number of affected animals and the resulting losses. As described for other tick-borne diseases, these cyclic patterns may be attributed to external factors, self-oscillations of the disease system, or the combined action of these mechanisms. Ticks collected from a recent paralysis case in a goat were morphologically and molecularly identified as Ixodes gibbosus. Efforts should be made to characterize the specific toxins involved in tick paralysis and to develop a vaccine, which could prevent significant losses of small ruminants, especially in free-ranging farming systems, a prevalent management approach observed in Cyprus and various regions worldwide.

The weather determines the number of cases of tick paralysis in dogs and cats in eastern Australia, caused by Ixodes holocyclus, the eastern paralysis tick.

We studied over 222,000 cases of emergency veterinary consultations in four regions along the eastern coast of Australia. We found that cases of tick paralysis (TP) caused by the eastern paralysis tick, Ixodes holocyclus, accounted for 7.5% of these cases: >16,000 cases. The season of TP and the number (prevalence) of TP cases varied among regions and over the years. Our study of the association between weather and (i) the start of the season of TP, and (ii) the number of TP cases revealed much about the intricate relationship between the weather and I. holocyclus. We studied the effect of the hypothetical availability of isoxazoline-containing tick-preventative medicines and found that an increase in the availability of these medicines had significantly contributed to the decrease in TP cases. We found that the weather in winter accounted for the time of the year the season of TP starts whereas the weather in summer accounted for the number of TP cases in the TP season. Last, through a study of the effects of shifts in the climate under four hypothetical scenarios (warmer/cooler and drier/wetter than average), we propose that the start of the season of TP depends on how soon the weather in winter becomes suitable for the activity (e.g. host-seeking) and the development of I. holocyclus nymphs, and that the number of TP cases during the TP season depends on how many engorged female ticks and their eggs survive during summer.

Reduced incidence of tick paralysis cases in dogs and cats at two emergency clinics in South-East Queensland since 2015: new generation prophylactics as possible explanatory variables.

This study aimed to determine the incidence of canine and feline tick paralysis cases presenting to two veterinary emergency hospitals before and after the introduction of new generation prophylactic acaricides. This was a retrospective study, investigating the number of tick paralysis cases presenting to two emergency and critical care veterinary hospitals in South-East Queensland, from 2008 to 2021. A total of 10,914 dogs and 3696 cats were included over the course of the study. To assess if the introduction of new generation prophylactics in 2015 has coincided with any variation in case numbers, data for each species were analysed graphically and numerically in the first instance, then interrupted time series analyses were performed for the dog and cat data independently. Accounting for seasonal and climatic variation, we estimated a 54.8% reduction in dog (95% CI 45.3%-62.7%) and 44% reduction in cat (95% CI 19.5%-46%) tick paralysis cases presenting to these two clinics. This reduction corresponded with the timing of new generation prophylactic agents being introduced, including isoxazolines and imidacloprid/flumethrin impregnated collars. In the population studied, a significant reduction in the incidence of tick paralysis cases treated by veterinarians has occurred from 2015 onwards and was found to be associated with the timing of the release of new generation acaricidal products.

Two seasons of tick paralysis in Victoria yet one season in Queensland and New South Wales, Australia

We studied 22,840 cases of tick paralysis in dogs and cats that were attributable to infestation with the eastern paralysis tick, Ixodes holocyclus. We report that the mortality rates from the holocyclotoxins of the tick or from euthanasia due to complications arising from tick paralysis in dogs and cats were 10% and 8%, respectively. The distribution of cases of tick paralysis among the 52 weeks of 22 years (1999 to 2020, inclusive) in four regions along the eastern coast of Australia revealed much about how the life-cycle of this tick varied among regions. The four regions in our study were: (i) Cairns, Innisfail, and surrounding postcodes in Far North Queensland; (ii) South East Queensland; (iii) Northern Beaches of Sydney in New South Wales; and (iv) the Shire of East Gippsland in Victoria. We found that the season of tick paralysis started earlier in more northerly latitudes than in more southerly latitudes. We also found that Victoria has two seasons of tick paralysis, one from approximately the third week of February to the first week of May, and another from approximately the third week of September to the third week of December, whereas all of the other regions we studied in eastern Australia only had one season of tick paralysis. When we studied the two seasons of tick paralysis in Victoria, we found a statistically significant negative correlation between the number of cases of tick paralysis between the two seasons: the more cases in one season, the fewer the cases in the next season. One possible explanation for the negative correlation may be immunity to I. holocyclus acquired by dogs and cats in the first season.

Near-term forecasting of companion animal tick paralysis incidence: An iterative ensemble model.

Tick paralysis resulting from bites from Ixodes holocyclus and I. cornuatus is one of the leading causes of emergency veterinary admissions for companion animals in Australia, often resulting in death if left untreated. Availability of timely information on periods of increased risk can help modulate behaviors that reduce exposures to ticks and improve awareness of owners for the need of lifesaving preventative ectoparasite treatment. Improved awareness of clinicians and pet owners about temporal changes in tick paralysis risk can be assisted by ecological forecasting frameworks that integrate environmental information into statistical time series models. Using an 11-year time series of tick paralysis cases from veterinary clinics in one of Australia's hotspots for the paralysis tick Ixodes holocyclus, we asked whether an ensemble model could accurately forecast clinical caseloads over near-term horizons. We fit a series of statistical time series (ARIMA, GARCH) and generative models (Prophet, Generalised Additive Model) using environmental variables as predictors, and then combined forecasts into a weighted ensemble to minimise prediction interval error. Our results indicate that variables related to temperature anomalies, levels of vegetation moisture and the Southern Oscillation Index can be useful for predicting tick paralysis admissions. Our model forecasted tick paralysis cases with exceptional accuracy while preserving epidemiological interpretability, outperforming a field-leading benchmark Exponential Smoothing model by reducing both point and prediction interval errors. Using online particle filtering to assimilate new observations and adjust forecast distributions when new data became available, our model adapted to changing temporal conditions and provided further reduced forecast errors. We expect our model pipeline to act as a platform for developing early warning systems that can notify clinicians and pet owners about heightened risks of environmentally driven veterinary conditions.

Survey of cases of tick-paralysis and the presence of the eastern paralysis tick, Ixodes holocyclus, and the southern paralysis tick, Ixodes cornuatus, in the Greater Melbourne Area.

The objective of this study was to test the hypothesis that the paralysis ticks, Ixodes holocyclus and Ixodes cornuatus, are epizootic and/or enzootic in the Greater Melbourne Area (GMA). We examined the ticks in the museum collections of Australia, wrote to, phoned and visited veterinarians and other colleagues in the GMA to gather information about the cases of tick paralysis and to request the ticks for identification. We present evidence of I. holocyclus at 24 postcodes and I. cornuatus at 28 postcodes in the GMA. We found evidence that I. holocyclus is epizootic at four postcodes in the GMA: at East Melbourne, Williamstown, Moonee Ponds and Hoppers Crossing. We did not find evidence that I. holocyclus is enzootic in the GMA. I. cornuatus is apparently enzootic in the GMA at Bullengarook, Kinglake, Chum Creek and Healesville. Our hypothesis is that I. cornuatus is also enzootic at Mt Macedon, Gisborne and at other bushy postcodes in the GMA. Since this tick is apparently enzootic in the GMA, it may also be epizootic at postcodes adjacent to busy postcodes such as Bullengarook, Kinglake, Chum Creek and Healesville. The concept of hitch-hiker larvae, nymphs and adult female ticks may explain many of the cases of tick paralysis due to I. holocyclus in the GMA. The accurate assessment of the risk of tick paralysis in dogs and cats in the GMA requires a more detailed map of the distribution of I. holocyclus and I. cornuatus in Victoria.

Unravelling the epidemiology of tick paralysis in Australia: Application of passive surveillance and GIS

Unravelling the epidemiology of tick paralysis in Australia: Application of passive surveillance and GIS

Are recreational areas a risk factor for tick paralysis in urban environments?

In Australia, tick paralysis in dogs (caused by a toxin in the saliva of Ixodes species during feeding) is a serious, distressing condition, and untreated it is often fatal. The aim of this study was to quantify the association between parkland (recreational or natural) in an urban area and the occurrence of canine tick paralysis. Brisbane, as a large urban centre located within the zone of paralysis tick habitat along the east coast of Australia, was selected as the study area. Postcodes selected for inclusion were those defined as being of an urban character (Australian Bureau of Statistics). The number of natural and recreational parkland polygons and total land area per postcode were derived. Tick paralysis case data for the selected postcodes were extracted from a national companion animal disease surveillance database. Between October 2010 and January 2017, 1650 cases of tick paralysis in dogs were reported and included in this study. Significant correlations were found between the number of reported cases per postcode and parklands: natural counts, 0.584 (P < 0.0001); natural area, 0.293 (P = 0.0075); recreational counts, 0.297 (P = 0.0151); and recreational area, 0.241 (P = 0.0286). Four disease clusters were also detected within the study area. All of these were located on the edges of the study area – either coastal or on the urban fringe; no clusters were identified within the core urban zone of the study area. Of the disease cases included in this study, strong seasonality was evidence: 68% of all cases were identified in spring. Within urban environments, areas of natural vegetation in particular appear to pose a risk for tick paralysis in dogs. This evidence can be used by veterinarians and dog owners to reduce the impact of tick paralysis by raising awareness of risk areas so as to enhance prevention via chemoprophylaxis and targeted searches of pet dogs for attached ticks.

A Retrospective Cohort Study of Tick Paralysis in British Columbia.

Tick paralysis is a frequently overlooked severe disease characterized by bilateral ascending flaccid paralysis caused by a neurotoxin produced by feeding ticks. We aimed to characterize suspected tick paralysis cases documented at the BC Centre for Disease Control (BCCDC) in British Columbia (BC) from 1993 to 2016 and reviewed prevention, diagnosis, and treatment considerations. Demographic, geographic, and clinical data from test requisition forms for ticks submitted to the BCCDC Public Health Laboratory (PHL) from patients across BC between 1993 and 2016 for suspected human and animal tick paralysis were reviewed. Descriptive statistics were generated to characterize tick paralysis cases in BC, including tick species implicated, seasonality of disease, and regional differences. From 1993 to 2016, there were 56 cases of suspected tick paralysis with at least one tick specimen submitted for testing at the BCCDC PHL. Humans and animals were involved in 43% and 57% of cases, respectively. The majority of cases involved a Dermacentor andersoni tick (48 cases or 86%) and occurred between the months of April and June (49 cases or 88%). Among known locations of tick acquisition, the Interior region of BC was disproportionately affected, with 25 cases (69%) of tick bites occurring in that area. Tick paralysis is a rare condition in BC. The region of highest risk is the Interior, particularly during the spring and summer months. Increasing awareness of tick paralysis among healthcare workers and the general public is paramount to preventing morbidity and mortality from this rare disease.

Delineation of an endemic tick paralysis zone in southeastern Australia

Tick paralysis has a major impact on pet dog and cat populations in southeastern Australia. It results from envenomation by Ixodes holocyclus and Ixodes cornuatus ticks, the role of Ixodes cornuatus in the epidemiology of this disease in Australia being unclear. The aim of this study was to describe the geographical distribution of tick paralysis cases in southeastern Australia using data from a national disease surveillance system and to compare characteristics of “endemic” cases with those reported outside this endemic zone (“sporadic” cases). Data were collated and a proportional symbol map of all cases by postcode was created. A 15-case isopleth was developed based on descriptive spatial statistics (directional ellipses) and then kernel smoothing to distinguish endemic from sporadic cases. During the study period (January 2010–December 2015) 12,421 cases were reported, and 10,839 of these reported by clinics located in 434 postcodes were included in the study. Endemic cases were predominantly reported from postcodes in coastal southeastern Australia, from southern Queensland to eastern Victoria. Of those cases meeting selection criteria, within the endemic zone 10,767 cases were reported from 351 (88%) postcodes and outside this zone 72 cases were reported from 48 (12%) postcodes. Of these latter 48 postcodes, 18 were in Victoria (26 cases), 16 in New South Wales (28 cases), 7 in Tasmania (9 cases), 5 in South Australia (7 cases) and 2 in Queensland (2 cases). Seasonal distribution in reporting was found: 62% of endemic and 52% of sporadic cases were reported in spring. The number of both endemic and sporadic cases reported peaked in October and November, but importantly a secondary peak in reporting of sporadic cases in April was found. In non-endemic areas, summer was the lowest risk season whilst in endemic areas, autumn was the lowest risk season. Two clusters of sporadic cases were identified, one in South Australia (P=0.022) during the period 22 May to 2 June 2012 and another in New South Wales (P=0.059) during the period 9 October to 29 November 2012. Endemic and sporadic cases did not differ with respect to neuter status (P=0.188), sex (P=0.205), case outcome (P=0.367) or method of diagnosis (P=0.413). However, sporadic cases were 4.2-times more likely to be dogs than cats (P<0.001). The endemic tick paralysis zone described is consistent with previous anecdotal reports. Sporadic cases reported outside this zone might be due to a history of pet travel to endemic areas, small foci of I. holocyclus outside of the endemic zone, or in the case of southern areas, tick paralysis caused by I. cornuatus.

Rare Cause of Facial Palsy: Case Report of Tick Paralysis by Ixodes Holocyclus Imported by a Patient Travelling into Singapore from Australia

BackgroundTicks are blood-sucking arachnids that feed on all classes of vertebrates, including humans. Ixodes holocyclus, also known as the Australian Paralysis Tick, is capable of causing a myriad of clinical issues in humans and companion animals, including the transmission of infectious agents, toxin-mediated paralysis, allergic and inflammatory reactions, and mammalian meat allergies in humans. The Australian Paralysis Tick is endemic to Australia, and only two other exported cases have been reported in the literature. Case ReportWe report the third exported case of tick paralysis caused by I. holocyclus, which was imported on a patient into Singapore. We also discuss the clinical course of the patient, the salient points of management, and the proper removal of this tick species. Why Should An Emergency Physician Be Aware of This?With increasing air travel, emergency physicians need to be aware of and to identify imported cases of tick paralysis to institute proper management and advice to the patient. We also describe the tick identification features and proper method of removal of this tick species.

Use of big data in the surveillance of veterinary diseases: early detection of tick paralysis in companion animals.

BackgroundTick paralysis, resultant from envenomation by the scrub-tick Ixodes holocyclus, is a serious threat for small companion animals in the eastern coast of Australia. We hypothesise that surveillance systems that are built on Internet search queries may provide a more timely indication of high-risk periods more effectively than current approaches.MethodsMonthly tick paralysis notifications in dogs and cats across Australia and the states of Queensland (QLD) and New South Wales (NSW) were retrieved from Disease WatchDog surveillance system for the period 2011–2013. Internet search terms related to tick paralysis in small companion animals were identified using Google Correlate, and corresponding search frequency metrics were downloaded from Google Trends. Spearman’s rank correlations and time series cross correlations were performed to assess which Google search terms lead or are synchronous with tick paralysis notifications.ResultsMetrics data were available for 24 relevant search terms at national level, 16 for QLD and 18 for NSW, and they were all significantly correlated with tick paralysis notifications (P < 0.05). Among those terms, 70.8, 56.3 and 50 % showed strong Spearman’s correlations, at national level, for QLD, and for NSW respectively, and cross correlation analyses identified searches which lead notifications at national or state levels.ConclusionThis study demonstrates that Internet search metrics can be used to monitor the occurrence of tick paralysis in companion animals, which would facilitate early detection of high-risk periods for tick paralysis cases. This study constitutes the first application of the rapidly emerging field of Internet-based surveillance to veterinary science.

A Comparative Meta-Analysis of Tick Paralysis in the United States and Australia

Context. Tick paralysis is a neurotoxic envenoming that mimics polio and primarily afflicts children, especially in hyperendemic regions of the Western United States of America (US) and Eastern Australia. Objective. To compare the epidemiology, clinical and electrodiagnostic manifestations, and outcomes of tick paralysis in the US versus Australia. Methods. A comparative meta-analysis of the scientific literature was conducted using Internet search engines to identify confirmed cases of tick paralysis in the US and Australia. Continuous variables including age, time to tick removal, and duration of paralysis were analyzed for statistically significant differences by unpaired t-tests; and categorical variables including gender, regional distribution, tick vector, tick attachment site, and misdiagnosis were compared for statistically significant differences by chi-square or Fisher exact tests. Results. Tick paralysis following ixodid tick bites occurred seasonally and sporadically in individuals and in more clusters of children than in adults of both sexes in urban and rural locations in North America and Australia. The case fatality rate for tick paralysis was low, and the proportion of misdiagnoses of tick paralysis as Guillain–Barré syndrome (GBS) was greater in the US than in Australia. Although electrodiagnostic manifestations were similar, the neurotoxidromes differed significantly with prolonged weakness and even residual neuromuscular paralysis following tick removal in Australian cases compared with US cases. Discussion. Tick paralysis was a potentially lethal envenoming that occurred in children and adults in a seasonally and regionally predictable fashion. Tick paralysis was increasingly misdiagnosed as GBS during more recent reporting periods in the US. Such misdiagnoses often directed unnecessary therapies including central venous plasmapheresis with intravenous immunoglobulin G that delayed correct diagnosis and tick removal. Conclusion. Tick paralysis should be added to and quickly excluded from the differential diagnoses of acute ataxia with ascending flaccid paralysis, especially in children living in tick paralysis-endemic regions worldwide.

The relationship between the Southern Oscillation Index, rainfall and the occurrence of canine tick paralysis, feline tick paralysis and canine parvovirus in Australia

The aim of this study was to describe the association between climate, weather and the occurrence of canine tick paralysis, feline tick paralysis and canine parvovirus in Australia. The Southern Oscillation Index (SOI) and monthly average rainfall (mm) data were used as indices for climate and weather, respectively. Case data were extracted from a voluntary national companion animal disease surveillance resource. Climate and weather data were obtained from the Australian Government Bureau of Meteorology. During the 4-year study period (January 2010–December 2013), a total of 4742 canine parvovirus cases and 8417 tick paralysis cases were reported.No significant (P ≥ 0.05) correlations were found between the SOI and parvovirus, canine tick paralysis or feline tick paralysis. A significant (P < 0.05) positive cross-correlation was found between parvovirus occurrence and rainfall in the same month (0.28), and significant negative cross-correlations (−0.26 to −0.36) between parvovirus occurrence and rainfall 4–6 months previously. Significant (P < 0.05) negative cross-correlations (−0.34 to −0.39) were found between canine tick paralysis occurrence and rainfall 1–3 months previously, and significant positive cross-correlations (0.29–0.47) between canine tick paralysis occurrence and rainfall 7–10 months previously. Significant positive cross-correlations (0.37–0.68) were found between cases of feline tick paralysis and rainfall 6–10 months previously.These findings may offer a useful tool for the management and prevention of tick paralysis and canine parvovirus, by providing an evidence base supporting the recommendations of veterinarians to clients thus reducing the impact of these diseases.

The association between landscape and climate and reported tick paralysis cases in dogs and cats in Australia

The aim of this study was to describe the association between landscape and climate factors and the occurrence of tick paralysis cases in dogs and cats reported by veterinarians in Australia. Data were collated based on postcode of residence of the animal and the corresponding landscape (landcover and elevation) and climate (precipitation, temperature) information was derived. During the study period (October 2010–December 2012), a total of 5560 cases (4235 [76%] canine and 1325 [24%] feline cases) were reported from 341 postcodes, mostly along the eastern seaboard of Australia and from the states of New South Wales and Queensland. Significantly more cases were reported from postcodes which contained areas of broadleaved, evergreen tree coverage (P=0.0019); broadleaved, deciduous open tree coverage (P=0.0416); and water bodies (P=0.0394). Significantly fewer tick paralysis cases were reported from postcodes which contained areas of sparse herbaceous or sparse shrub coverage (P=0.0297) and areas that were cultivated and managed (P=0.0005). No significant (P=0.6998) correlation between number of tick paralysis cases reported per postcode and elevation was found. Strong positive correlations were found between number of cases reported per postcode and the annual minimum (rSP=0.9552, P<0.0001) and maximum (rSP=0.9075; P=0.0001) precipitation. Correlations between reported tick paralysis cases and temperature variables were much weaker than for precipitation, rSP<0.23. For maximum temperature, the strongest correlation between cases was found in winter (rSP=0.1877; P=0.0005) and for minimum temperature in autumn (rSP=0.2289: P<0.0001). Study findings suggest that tick paralysis cases are more likely to occur and be reported in certain eco-climatic zones, such as those with higher rainfall and containing tree cover and areas of water. Veterinarians and pet owners in these zones should be particularly alert for tick paralysis cases to maximize the benefits of early treatment, and to be vigilant to use chemical prophylaxis to reduce the risk of tick parasitism.

Clinical presentation and treatment of tick paralysis in dogs and cats in Sydney (2001-2010).

To investigate associations between clinical presentations and treatment of tick paralysis in dogs and cats, particularly the relationship between the dose of tick antiserum (TAS) and time to recovery. A retrospective analysis of 325 cases of tick paralysis (227 dogs, 98 cats), from 2001 to 2010, was conducted using records from six practices in Sydney, New South Wales. Doses of TAS in excess of 2 mL/animal, 0.30 mL/kg and 1.25 mL/tick in dogs, and 2 mL/animal, 0.45 mL/kg and 0.38 mL/tick in cats did not significantly alter the time to recovery. In dogs, a longer time to recovery was associated with cases in winter than in other seasons (P = 0.0099) and with more severe gait scores (P = 0.0002). There was a trend of longer recovery times in patients with higher respiratory scores (P = 0.0561). In cats, a longer time to recovery was associated with multiple ticks (P = 0.0133) and more severe gait scores (P < 0.0001). Within this retrospective study, minimum doses of TAS were considered optimal, negating any association between dose rate and time to recovery.

Tick paralysis cases in Argentina

Tick paralysis (TP) occurs worldwide and is caused by a neurotoxin secreted by engorged female ticks that affects the peripheral and central nervous system. The clinical manifestations range from mild or nonspecific symptoms to manifestations similar to Guillain-Barré syndrome, bulbar involvement, and death in 10% of the patients. The diagnosis of TP is clinical. To our knowledge, there are no formal reports of TP in humans in South America, although clusters of TP among hunting dogs in Argentina have been identified recently. In this paper, clinical features of two cases of TP occurring during 1994 in Jujuy Province, Argentina, are described.

A 60-Year Meta-Analysis of Tick Paralysis in the United States: A Predictable, Preventable, and Often Misdiagnosed Poisoning

Tick paralysis (TP) is a neurotoxic poisoning primarily afflicting young girls in endemic regions. Recent case series of TP have described increasing misdiagnoses of TP as the Guillain-Barré syndrome (GBS). A meta-analysis of the scientific literature was conducted using Internet search engines to assess the evolving epidemiology of TP. Fifty well-documented cases of TP were analyzed over the period 1946-2006. Cases were stratified by demographics, clinical manifestations, and outcomes. Misdiagnoses were subjected to Yates-corrected chi-square analyses to detect statistically significant differences in proportions of misdiagnoses between earlier and later reporting periods. TP occurred seasonally and sporadically in individuals and in clusters of children and adults of both sexes in urban and rural locations. The case fatality rate (CFR) for TP was 6.0% over 60 years. The proportion of misdiagnoses of TP as GBS was significantly greater (chi(2) = 7.850, P = 0.005) in more recently collected series of TP cases, 1992-2006, than the proportion of misdiagnoses in earlier series, 1946-1996. TP was a potentially lethal poisoning that occurred in children and adults in a seasonally and regionally predictable fashion. TP was increasingly misdiagnosed as GBS during more recent reporting periods. Such misdiagnoses often directed unnecessary therapies such as central venous plasmapheresis with intravenous immunoglobulin G, delayed correct diagnosis, and tick removal, and could have increased CFRs. TP should be added to and quickly excluded from the differential diagnoses of acute ataxia and ascending flaccid paralysis, especially in children living in TP-endemic regions of the USA.