Neurological manifestation of Brazilian spotted fever in childhood

ABSTRACT Rocky Mountain Spotted Fever is a rickettsial disease caused by the bacteria Rickettsia rickettsii. In Brazil, the disease is known as Brazilian spotted fever (BSF), being the most significant tick-borne disease in the country. Among the affected patients, only 5% of cases occur in children aged one to nine years. Typical symptoms of the disease are fever, rash, headache and digestive symptoms. Neurological manifestations such as seizures, aphasia and hemiparesis have been described in few patients. This study aimed to describe the case of an infant diagnosed with BSF who presented severe signs of neurological manifestation.

The research advances of clinical characteristics and experimental detection of emerging tick-borne viral diseases in China / 中华检验医学杂志

As the second largest vector of infectious diseases, ticks carry and transmit various pathogens that cause human infections and pose a serious public health hazard. In recent years, there has been an ongoing epidemic of tick-borne fever with thrombocytopenia syndrome virus (SFTSV), as well as the occurrence of human infections by brand-new viruses such as Jingmen tick virus (JMTV) and Alongshan virus (ALSV) in China. This paper will review the advancement of disease clinical characteristics, laboratory methods of virus isolation, immunology and molecular biology of these emerging tick-borne viral diseases in China.

A case of Mediterranean spotted fever mimicking severe sepsis

Mediterranean spotted fever (MSF) is a tick-borne acute endemic infectious disease caused by Rickettsia conorii. While MSF may progress asymptomatically, it may lead to clinical pictures like severe hemorrhagic fever. In this article, we are presenting an MSF case with signs of high fever, headache, nausea, weakness and generalized maculopapular rash. The diagnosis of the female patient who had a history of contact with a tick-infested dog was confirmed with her clinical and laboratory data. The clinical and laboratory findings of the patient who was given doxycycline by 200 mg/day for 7 days were improved in a short time. Rickettsia conorii serology by indirect immunofluorescence assay method confirmed the diagnosis of MSF. In cases of severe sepsis accompanied by high fever and generalized maculopapular rash where the source of the infection cannot be determined in the short term, carefully questioning exposure to ticks by considering the existing geographical, seasonal and endemic environmental factors may be life-saving in terms of early diagnosis and treatment of MSF, which may become fatal even in the absence of eschars (tache noire). The symptomatology of hemorrhagic fever associated with Rickettsia conorii may be confused with that of sepsis in clinical practice.

Diversity of tick species (Acari: Ixodidae) in military training areas in Southeastern Brazil / Diversidade de espécies de carrapatos (Acari: Ixodidae) em áreas de instrução militar na região Sudeste do Brasil

Abstract Tick-borne pathogens belong to one of the two main groups of occupational biohazards, and occupational exposure to such agents puts soldiers at risk of zoonotic infections, such as those caused by rickettsiae. There are few studies on acarological fauna and occupational risk in military areas in Brazil. Thus, the present study aimed to analyze the diversity of ticks present in the military training areas of municipalities in the Southeast Region of Brazil. The ticks were collected from the selected areas using the dragging and flagging techniques as well as by visual detection on the operators' clothing, and environmental information was also recorded. A total of ten species were collected from the 66 surveyed areas, belonging to five genera and nine species: Amblyomma sculptum, Amblyomma dubitatum, Amblyomma brasiliense, Amblyomma longirostre, Amblyomma aureolatum, Dermacentor nitens, Rhipicephalus spp., Ixodes spp. and Haemaphysalis spp. The frequent presence of tick species in military training areas along with traces and sightings of wild animals, most commonly capybaras (Hydrochoerus hydrochaeris), in most of the studied areas, indicates high levels of exposure of the military to tick vectors of spotted fever group rickettsiae and the possible occurrence of infections among the troops.

Resumo As doenças transmitidas por carrapatos estão entre os dois principais grupos de riscos biológicos ocupacionais. Tal exposição ocupacional de militares os colocam sob maior risco de adquirirem doenças zoonóticas, como infecções rickettsiais, entre outras. No Brasil, há raros estudos sobre fauna acarológica e o risco ocupacional em áreas militares. Neste sentido, o presente estudo teve por objetivo analisar a diversidade de carrapatos presentes em áreas de treinamento militar de municípios da região Sudeste do Brasil. Os carrapatos foram coletados nas áreas através de arrasto de flanela, bandeiramento e/ou coleta nas vestimentas do operador, sendo registradas também informações ambientais. Das 66 áreas pesquisadas, foram coletados 9.374 carrapatos, com uma diversidade de cinco gêneros, distribuídos em dez espécies: Amblyomma sculptum, Amblyomma dubitatum, Amblyomma brasiliense, Amblyomma longirostre, Amblyomma aureolatum, Amblyomma spp., Dermacentor nitens, Rhipicephalus spp., Ixodes spp. e Haemaphysalis spp. A presença frequente de espécies de carrapatos nas áreas de instrução militar, associada aos vestígios e à presença de animais silvestres, mais comumente de capivaras na maioria das áreas estudadas, evidencia uma grande exposição dos militares a carrapatos vetores de rickettsias do Grupo da Febre Maculosa e a possível ocorrência de casos humanos nas tropas.

Seroprevalence and hematological abnormalities associated with Ehrlichia canis in dogs referred to a veterinary teaching hospital in central-western Brazil / Soroprevalência e alterações hematológicas associadas com Ehrlichia canis em cães encaminhados a um hospital veterinário-escola no centro-oeste do Brasil

Ticks are significant parasites of dogs in the tropics, where tick-borne pathogens are highly prevalent, especially in areas where tick control measures are frequently neglected. This study investigated the seroprevalence and hematological abnormalities associated with Ehrlichia canis in dogs referred to a veterinary teaching hospital in Central-western Brazil. Out of 264 dogs tested for anti-Ehrlichia canis antibodies by an indirect immunofluorescence assay (IFA), 59.1% (156/264) were positive. Seropositivity was significantly associated to anemia and thrombocytopenia, alone or in combination, and to leukopenia. Conversely, there were no differences in terms of seroprevalence according to sex, breed and age. This study demonstrated that dogs referred to a veterinary teaching hospital in Central-western Brazil are highly exposed to E. canis and that seropositive dogs are more likely to present hematological abnormalities, particularly anemia, thrombocytopenia and leukopenia. To our knowledge, this is the first study on detection of anti-E. canis antibodies by means of IFA among dogs in the state of Goiás. These findings highlighted the need for increasing awareness among dog owners regarding tick control measures in Central-western Brazil, ultimately to reduce the risk of exposure to E. canis and other tick-borne pathogens.

Carrapatos são importantes parasitos de cães nos trópicos, onde patógenos transmitidos por carrapatos são altamente prevalentes, especialmente em áreas onde as medidas de controle de carrapatos são frequentemente negligenciadas. O estudo investigou a soroprevalência e as anormalidades hematológicas associadas à Ehrlichia canis em cães encaminhados para um hospital veterinário-escola no Centro-oeste do Brasil. Dos 264 cães testados para anticorpos anti-Ehrlichia canis por meio da reação de imunofluorescência indireta (RIFI), 59.1% (156/264) foram positivos. A soropositividade foi associada significativamente à anemia e trombocitopenia, isoladamente ou em combinação, e à leucopenia. Por outro lado, não houve diferenças quanto à soroprevalência segundo sexo, raça e idade. Este estudo demonstrou que cães encaminhados a um hospital veterinário-escola na região Centro-oeste do Brasil são altamente expostos à E. canis, e que cães soropositivos têm maior probabilidade de apresentar alterações hematológicas, principalmente anemia, trombocitopenia e leucopenia. Para o nosso conhecimento, este é o primeiro estudo sobre a detecção de anticorpos anti-E. canis por meio da RIFI em cães do estado de Goiás. Essas descobertas destacam a necessidade de aumentar a conscientização entre os proprietários de cães em relação às medidas de controle do carrapato no Centro-oeste do Brasil, em última análise, para reduzir o risco de exposição ao E. canis e outros patógenos transmitidos por carrapatos.

Distribution of tick-borne diseases at Bulgan province, Mongolia / Монголын Анагаах Ухаан

Background@#Tick-borne encephalitis is human viral infection involving the nervous system and transmitted by the bite of infected tick. The TBE Virus is distributed in different geographical areas by three widespread subtypes of the virus: The Far East, Europe, and Siberia. The Far East type has a mortality rate was 30-35%, the European type has a mortality rate of 2.2%, and the Siberian type has a mortality rate of 6-8% (A.G. Pletnev, 1998) [2]. </br>In recent years, human cases of tick-borne infections have been reported in 19 European countries and four Asian countries (Mongolia, China, Japan, and South Korea) [3]. </br>Human cases of tick-borne encephalitis, tick-borne rickettsiosis, and tick-borne borreliosis have been registered in Mongolia since 2005. Deaths have been reported year by year [5]. </br>During 2005 to 2021, tick-borne rickettsiosis (71.6%), tick-borne encephalitis (17.3%) and tick-borne borreliosis (52.9%) were confirmed by epidemiological, clinical and laboratory tests at the NCZD. </br>Tick-borne encephalitis was registered in 63 soums of 15 provinces and 9 districts of the capital city, of which 90% were infected with tick bites in Selenge and Bulgan provinces. The average mortality rate is 4.9% (14), of which 28.6% in Bulgan province and 2.7% in Selenge province. </br>Tick-borne encephalitis is the leading cause of death in Bugat soum of Bulgan province and more infected men about 40 years of age [7]. @*Purpose @#Collect ticks from selected soums of the provinces, identify tick species, species composition, distribution, tick densities, pathogens of tick-borne diseases, conduct population surveys to assess the risk of tick-borne infections, and identify tick-borne infections.@*Material and Method@#Ticks were collected by flag from birch trees in birch forests and meadows with biotope and overgrown berries, determined morphological analyze and molecular biological investigation for detecting tickborne pathogens. </br>Questionnaires were collected from selected soum residents according to a specially designed randomized epidemiological and clinical survey card, collected information and forms were submitted to soum hospitals with a history of tick bites (according to clinical criteria). Serological tests were performed to detect IgG-specific antibodies to the collected serum mites.@*Result and conclusion@#Collected 121 ticks (120 I. persulcatus and 1 D. nuttalli) and not wound egg, larvae, nymphs. By molecular biological investigation detected 3.5% of I.persulcatus from Khutag-Undur soum of Bulgan province, 3.5% of anaplasmosis, and 14.1% of I.persulcatus mites from Bugat soum. 1.5% borreliosis, 3.1% anaplasmosis. </br>Detected DNA of 100% tick-borne rickettsiosis from D.nutalli ticks and determined circulation of infection among tick in Bugat and Khutag-Undur soums of Bulgan province. </br>247 people were surveyed, 56 blood serum from cases. Detected Q fever, erysipelas, and anaplasmosis, tick-borne borreliosis 3 (5.4%), tick-borne rickettsiosis 26 (46.4%), Japanese encephalitis 3 (5.4%), tick-borne encephalitis tick-borne rickettsiosis 6 (13.0%), tick-borne rickettsiosis tick-borne borreliosis 1 (1.8%), tick’s rickettsiosis Japanese encephalitis 1 (1.8%), tick-borne encephalitis tick-borne borreliosis 1 (1.8%). </br>By investigation, vaccination (88%) and wearing long-sleeved shirts and pants (81%) were the most effective ways to prevent tick bites (81%) [15]. According to our research, the percent of population knowledge in Bulgan province was insufficient (40.9%) which there is a lack of information, training and advertisement among the population in the province.

Research progress in epidemiology and clinical characteristics of major tick-borne infectious diseases in Xinjiang / 中华临床感染病杂志

Ticks belong to arthropods and and the second largest vector of pathogens. Ticks can spread a variety of pathogens and cause diseases, threatening human health and livestock production. Although tick-borne diseases can be found almost in all regions in China, they are mainly distributed in Xinjiang, Inner Mongolia, Heilongjiang and other border areas. Tick-borne diseases in Xinjiang are rising year by year with a serious situations recently, and there are specific features in the distribution and characteristics of pathogens. This article reviews the etiology, epidemic status and clinical manifestations of major tick-borne infectious diseases in Xinjiang.

Tick-borne pathogens in Iran: A meta-analysis

Objective: Different studies have been performed on the prevalence of tick-borne pathogens in different areas of Iran; however, as far as our knowledge, there is no regional meta-analysis available for consideration and estimation of tick species infected with different pathogens in Iran. Methods: In this review, among different databases, a total of 95 publications were included, and the infection of different tick species to different tick-borne pathogens was determined; furthermore, presence of pathogens (with 95% confidence intervals) in tick vectors was calculated separately for each province, using Comprehensive Meta-Analysis version 2 (Biostat, USA). Results: Totally, among all 95 studies, 5 673 out of 33 521 investigated ticks were positive according to different detection methods. Overall estimated presence of pathogens in tick vectors in Iran was 8.6% (95% CI 7.0%-10.6%, P 0.001). Of all 46 species of ticks in 10 genera in Iran, 28 species in 9 genera, including Alveonasus, Argas, Boophilus, Dermacentor, Haemaphysalis, Hyalomma, Ixodes, Ornithodoros, and Rhipicephalus were infected with at least 20 pathogens in 10 genera including Aegyptianella, Anaplasma, Babesia, Borrelia, Brucella, Orthonairovirus [CrimeanCongo hemorrhagic fever virus (CCHFV)], Coxiella, Ehrlichia, Rickettsia and Theileria in 26 provinces of Iran. The presence of pathogens in ticks collected in western Iran was more than other regions. Hyalomma anatolicum (20.35%), Rhipicephalus sanguineus (15.00%), and Rhipicephalus bursa (14.08%) were the most prevalent infected ticks for different pathogens. In addition, most literatures were related to CCHFV and Theileria/Babesia spp. Conclusions: Public health and veterinary professionals should be aware of diagnosing possible diseases or outbreaks in vertebrates.

Serological survey of canine vector-borne diseases in two animal shelters in central Peninsular Malaysia

@#Canine vector-borne diseases (CVBDs) are increasingly becoming a cause for global concern because of their high morbidity and mortality rates in dogs. However, information on their occurrence in Malaysia is still scanty. In this study, a total of 103 dog blood samples were collected from two animal shelters in central Peninsular Malaysia and tested for the antibodies against Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi, and the antigen of Dirofilaria immitis. Of the 103 tested dogs, 44.7% (46) were found to be seropositive for Ehrlichia spp., 30.1% (31) for Anaplasma spp. and 13.6% (14) for D. immitis. Co-infections of Anaplasma spp. + Ehrlichia spp. (18.5%, 19) were most prevalent, followed by Anaplasma spp. + D. immitis (1.9%; two) and D. immitis + Ehrlichia spp. (1.0%; one). Furthermore, three dogs (2.9%) were also found to have triple infection, testing seropositive for Ehrlichia spp., Anaplasma spp. and D. immitis. The dogs which were found to be seropositive with at least one pathogen were 66.7% (32/51) at shelter A, and 55.8% (29/52) at shelter B. Serological evidence showed that the exposure of major vector-borne diseases in dogs in shelters was relatively high in the surveyed areas. Routine detection and control of vector-borne diseases are of paramount importance for reducing the risk of CVBDs transmission in dogs and humans.

Detection of tick-borne rickettsial pathogens in naturally infected dogs and dog-associated ticks in Medellin, Colombia / Detecção de patógenos rickettsiais transmitidos por carrapatos em cães naturalmente infectados e carrapatos associados a cães em Medellin, Colômbia

Abstract Tick-borne rickettsial pathogens (TBRP) are important causes of infections in both dogs and humans. Dogs play an important role as a biological host for several tick species and can serve as sentinels for rickettsial infections. Our aim was to determine the presence of TBRP in dogs and in dog-associated ticks and their potential risk to human diseases in Medellin, Colombia. DNA for E. canis (16S rRNA and dsb) and A. platys (groEl) was detected in 17.6% (53/300) and 2.6% (8/300) of dogs, respectively. Antibodies against Ehrlichia spp. 82 (27.3%) and Anaplasma spp. 8 (2.6%) were detected in dogs. Antibody reactivity against both agents were found in 16 dogs (5.3%). Eight dogs showed antibody for Rickettsia spp. with titers that suggest 3 of them had a probable exposure to R. parkeri. Rhipicephalus sanguineus s.l. (178/193) was the main tick in dogs, followed by R. microplus (15/193). The minimum infection rates (MIR) in R. sanguineus were 11.8% for E. canis and 3.4% for A. platys. E. canis and A. platys are the main TBRP infecting dogs and ticks and R. sanguineus s.l. is likely involved in the transmission of both agents. Interestingly, we found serological evidence of exposure in dogs for spotted fever group rickettsiae.

Resumo As riquétsias transmitidas por carrapatos (RTC) são causas importantes de infecção em cães e humanos. Os cães exercem um papel essencial como hospedeiros biológicos para diversas espécies de carrapatos, assim como podem ser úteis como sentinelas de infecções por riquétsias. O intuito deste estudo foi determinar a presença de RTC em cães, assim como em seus carrapatos, para determinar o risco potencial de doença humana em Medellín, Colômbia. DNA de Ehrlichia canis (16S rRNA e dsb) e Anaplasma platys (groEl) foi detectado em 17,6% (53/300) e 2,6% (8/300) dos cães, respectivamente. Anticorpos contra Ehrlichia spp. (82; 27,3%) e Anaplasma spp. (8; 2,6%) foram detectados nos cães. Reatividade de anticorpos contra ambos patógenos (Ehrlichia e Anaplasma) foi detectada em 16 cães (5,3%). Oito animais apresentaram anticorpos contra Rickettsia spp., e 3 deles sugerem uma provável exposição a Rickettsia parkeri. Rhipicephalus sanguineus s.l. (178/193) foi a principal espécie de carrapatos, seguida de R. microplus (15/193). A taxa de infecção mínima em R. sanguineus foi 11,8% para E. canis e 3,4% para A. platys. E. canis e A. platys são as principais RTC que infectam cãese R. sanguineus s.l. provavelmente está envolvido na transmissão de ambos os agentes. É evidente, porém, a exposição sorológica dos cães a riquétsias do grupo da febre maculosa.

Characterization of cattle tick fever in calves from the northwestern region of Minas Gerais, Brazil / Caracterização do complexo da Tristeza Parasitária Bovina em bezerros da região noroeste de Minas Gerais, Brasil

Abstract The present study aimed to characterize the importance of the Anaplasma marginale, Babesia bovis and Babesia bigemina in the genesis of cattle tick fever (CTF) among dairy calves in the northwest of Minas Gerais, Brazil. Blood samples from 300 calves were collected, followed by DNA extraction and nested PCR using oligonucleotide primers to amplify fragments of the semi-nested for the msp5 gene (A. marginale), sbp-4 (B. bovis) and rap-1a (B. bigemina) Among the examined calves, the prevalence of A. marginale was 55.6% (n=167/300), B. bovis was 4.0% (n=12/300) and B. bigemina was 15.3% (n=46/300), by PCR techniques. Parasitic forms of A. marginale and B. bigemina were found in 36,3% and 2,6% of the blood smears while B. bovis was not detected. There was a statistical difference between the positivity of infected animals in the age groups 1 (10-70 days) and (>70-300 days) for A. marginale and B. bigemina. A total of 15 calves with the classic symptoms of disease were examined, and the samples obtained were confirmed as a simple infection by A. marginale through semi-nested PCR. These results confirm bovine anaplasmosis as the primary cause of CTF among the calves of dairy cattle within the studied area.

Resumo O presente estudo teve como objetivo caracterizar a importância de Anaplasma marginale, Babesia bigemina e Babesia bovis na gênese da tristeza parasitária bovina em bezerros leiteiros do noroeste de Minas Gerais. Foram coletadas 300 amostras sanguíneas de bezerros, seguidas por extração de DNA e Nested- PCR utilizando oligonucleotídeos iniciadores que amplificam fragmentos dos genes sbp-4 (B. bovis) e rap-1a (B. bigemina) e a Semi-Nested para o gene msp5 (A. marginale). A prevalência de A. marginale foi 55,66% (167/300), B. bigemina, 15,33% (46/300) e B. bovis 4,0% (12/300) dos bezerros examinados. Formas parasitárias de A. marginale and B. bigemina foram encontradas em 36,33% e 2,66% dos esfregaços sanguíneos, enquanto B. bovis não foi detectado. Houve diferença estatística entre as prevalências de animais infectados nas faixas etárias 1 (10-70 dias) e 2 (>70-300 dias). Um total de 15 animais com sintomas clássicos da doença foram examinados, e as amostras foram confirmadas como uma infecção simples por A. marginale através da Nested-PCR. Esses resultados confirmam a anaplasmose bovina como a principal agente da tristeza parasitária bovina nos bezerros do rebanho estudado.

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

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

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

Epidemiological and Clinical Characteristics of Confirmed Cases of Severe Fever With Thrombocytopenia Syndrome in Jeju Province, Korea, 2014-2018 / 예방의학회지

OBJECTIVES: Jeju Province is well known as the region showing the highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in South Korea. The aim of this study was to evaluate the epidemiological and clinical characteristics of SFTS patients in Jeju Province. METHODS: The primary data for this study were obtained from the Integrated Diseases and Health Control System of the Korea Centers for Disease Control and Prevention (KCDCIS). The selection criteria were confirmed cases of SFTS with a residence listed in Jeju Province at the time of diagnosis, reported to the KCDCIS between July 16, 2014 and November 30, 2018. RESULTS: Of 55 confirmed cases of SFTS, the case fatality rate was 10.9% (95% confidence interval [CI], 4.1 to 22.2). The most common presenting symptoms at diagnosis of severe fever, myalgia, and diarrhea had incidences of 83.6% (95% Cl, 71.2 to 92.2), 45.5% (95% Cl, 32.0 to 59.5), and 40.0% (95% CI, 27.0 to 54.1), respectively. CONCLUSIONS: Compared to SFTS patients nationwide in 2013-2015, the subjects of this study exhibited a lower case fatality rate and had a lower incidence of severe fever, myalgia, and confusion.

Differences of clinical manifestation of severe fever with thrombocytopenia syndrome between Korean and Chinese patients

Because the case fatality rate (CFR) between Chinese and Korean patients with severe fever with thrombocytopenia syndrome is different, a comparison of the distribution of clinical manifestations shown at diagnosis in Chinese and Korean patients is needed. In contrast to Chinese patients between 2010 and 2013, Korean patients between 2013 and 2015 showed more cases of diarrhea (54.3% vs. 35.8%) and confusion (25.6% vs. 21.1%). These facts might delay the diagnosis in Korean patients and result in a higher CFR.

Molecular detection of vector borne pathogens in anemic and thrombocytopenic dogs in southern Brazil / Detecção molecular de patógenos transmitidos por vetores em cães anemicos e trombocitopenicos no Sul do Brasil

Abstract Arthropod-borne pathogens are medically important because of their ability to cause diseases in their hosts. The purpose of this study was to detect the occurrence of Ehrlichia spp., piroplasmids and Hepatozoon spp. in dogs with anemia and thrombocytopenia in southern Brazil. EDTA-whole blood was collected from 75 domestic dogs presenting anemia or/and thrombocytopenia from Guarapuava, state of Paraná, Brazil. DNA samples were subjected to conventional PCR assays for Ehrlichia spp. (dsb), piroplasmids (18S rRNA) and Hepatozoon spp. (18S rRNA), followed by sequencing and phylogenetic analyses. Among the 75 dogs, one (1.33%) was positive for Hepatozoon sp. and six (8%) were positive for piroplasmids in 18S rRNA cPCR assays. None of the dogs showed positive results in Ehrlichia spp.-cPCR targeting dsb gene. The phylogenetic analyses revealed that three piroplasm sequences were clustered with Rangellia vitalii, while one sequence was grouped with B. vogeli. The only sequence obtained from Hepatozoon spp.-PCR protocol was pooled with H. canis. Therefore, there is urgent need for differential molecular diagnosis of the two piroplasm species cited as etiological agents in clinical cases of canine hemoparasitic diseases, given the higher pathogenic potential of R. vitalii than of B. vogeli.

Resumo Agentes transmitidos por artrópodes têm grande importância na medicina veterinária devido à sua capacidade de causar doenças graves em seus hospedeiros. O presente estudo objetivou investigar a ocorrência de três patógenos transmitidos por vetores, Ehrlichia canis, Rangelia vitalii e Hepatozoon canis, em cães na região sul do Brasil. Foram coletadas amostras de sangue total de 75 cães domésticos que apresentavam anemia e/ou trombocitopenia, em Guarapuava, Paraná, Brasil. As amostras de DNA foram submetidas à técnica de PCR convencional para E. canis (dsb), piroplasmídeos (18S rRNA) e Hepatozoon spp. (18S rRNA), seguida de sequenciamento e análises filogenéticas. Das 75 amostras, uma (1,33%) foi positiva para Hepatozoon spp. e seis (8%) foram positivas para Babesia spp. Nenhuma amostra mostrou resultados positivos para Ehrlichia spp. utilizando a detecção pelo gene dsb. As análises filogenéticas revelaram que três sequências obtidas foram agrupadas no mesmo clado que R. vitalii , enquanto uma foi agrupada juntamente com B. vogeli. A única sequência obtida pelo protocolo de PCR para Hepatozoon spp. foi agrupada juntamente com H. canis. Assim, é justificada necessidade de diferenciação das espécies de piroplasmas, através do diagnóstico molecular, como agentes etiológicos nos casos clínicos de hemoparasitose canina, considerando o potencial patogênico de R. vitalii quando comparado à B. vogeli.

Caso autóctono de fiebre manchada por Rickettsia parkeri en Ensenada, Buenos Aires / Autochthonous case of spotted fever caused by Rickettsia parkeri in Ensenada, Buenos Aires

Se comunica un caso autóctono de fiebre manchada por Rickettsia parkeri en un adulto residente en Ensenada, Provincia de Buenos Aires ocurrido en el verano de 2016. El cuadro, secundario a una mordedura de garrapata en la pierna izquierda, se presentó como un síndrome febril agudo con deterioro del estado general, cefalea, mialgias, artralgias y exantema maculopapular. El sitio de la mordedura presentaba una úlcera con escara necrótica. El diagnóstico se confirmó por conversión serológica IgG anti-antígenos del género Rikettsia. La secuencia de un fragmento del gen gltA amplificado a partir de la lesión de piel presentó 100% identidad nucleotídica con las secuencias de cepas de R. parkeri aisladas en Argentina y en varios países de América. El paciente evolucionó favorablemente al tratamiento con doxiciclina.

We present a case of spotted fever occurred in an adult residing in Ensenada, Buenos Aires province in February 2016. The patient presented with an acute febrile syndrome associated with a skin necrotic lesion on the left leg secondary to a tick bite. The general symptoms were a maculopapular rash, headache, myalgia, and arthralgias. Seroconversion of anti-Rickettsia specific IgG antibodies confirmed recent infection. The nucleotidic and aminoacidic sequences of a gltA gen fragment matched 100% the sequences of R. parkeri strains from Argentina and other countries of America. The patient responded well to treatment with doxycycline.

Enfermedades virales transmitidas por garrapatas / Tick-borne viruses and their diseases

RESUMEN Los virus transmitidos por garrapatas (VTG) pertenecen a las familias Flaviviridae, Bunyaviridae, Reoviridae, Asfarviridae y Orthomyxoviridae y son agentes causales de diferentes enfermedades en humanos y animales. Debido a la creciente importancia epidemiológica que están teniendo los VTG, esta revisión pretende englobar el conocimiento actual de estos agentes y las enfermedades que producen, así como exponer las estrategias abordadas en prevención y tratamiento que se han implementado hasta el momento en diferentes países. Es evidente que para la región Neotropical hacen falta estudios sobre los VTG presentes en la región, ya que la gran mayoría de los artículos, tanto revisiones de tema como trabajos originales, presentan datos de las regiones Neártica y Paleártica. Considerando el panorama actual de los estudios de VTG en la región Neotropical y las particularidades de la misma, es muy probable que existan otros VTG aún no identificados que podrían tener algún impacto en salud pública.

SUMMARY Tick-borne viruses (TBVs) belong to the Flaviviridae, Bunyaviridae, Reoviridae, Asfarviridae and Orthomyxoviridae families and cause different diseases in humans and animals. Due to the epidemiologic relevance of TBVs, this review highlights the actual knowledge of these agents and the diseases they cause, besides of the prevention and treatment strategies implemented so far. It is evident that studies that address the TBVs present in the Neotropical region are missing, since most of the studies, both reviews and original articles, present data from the Nearctic and Palearctic regions. Considering the current picture of the TBVs studies in the Neotropical area and its peculiarities, is probable that other not yet identified TBVs exist in this zone and have an impact in public health.

Skin manifestations of tick bites in humans

Abstract: Ticks are blood-sucking arthropods that attach to human skin through oral devices causing diverse initial cutaneous manifestations, and may also transmit serious infectious diseases. In certain situations, the Health Teams (and especially dermatologists) may face difficulties in identifying the lesions and associating them to the parasites. To assist them in clinical diagnosis, we suggest a classification of the skin manifestations in primary lesions, which occur by the attachment the tick to the host (for toxicity and the anticoagulant substances in the saliva and/or marked inflammation by the penetration and permanence of the mouthparts) and secondary lesions that are manifestations of infections caused by rickettsia, bacteria, protozoa and fungi inoculated by the ticks.

The Most Common Mite- and Tick-borne Infectious Diseases in Korea: Scrub Typhus and Severe Fever Thrombocytopenia Syndrome / 대한내과학회지

The incidence of mite- and tick-borne infectious disease is increasing with climate change and the development of diagnostic tools. Tick-borne infectious diseases include Lyme disease, anaplasmosis, ehrlichiosis, severe fever with thrombocytopenia syndrome (SFTS), and Japanese spotted fever. Rickettsial pox and scrub typhus are mite-borne infectious diseases. Scrub typhus and SFTS are the most common mite- and tick-borne infectious diseases in Korea, respectively. They are often difficult to diagnose at an early stage of disease. To make a definite diagnosis of mite- and tick-borne infectious disease, polymerase chain reaction (PCR) tests or serologic testing for antibodies during the acute and convalescent periods are necessary. If patients with nonspecific symptoms, such as fever, headache, nausea, and vomiting, have a history of outdoor activity or a tick bite, it is reasonable to consider the possibility of mite- or tick-borne infectious diseases clinically. There are no vaccinations against mite- and tick-borne infectious diseases. Therefore, preventing mite or tick bites is the best way to prevent the diseases.

Enfermedad de Lyme: a propósito de un caso clínico importado / Lyme disease: about an imported case report

Resumen Presentamos el caso clínico de una mujer norteamericana que consultó en nuestro país por un eritema migrans múltiple, diagnosticándose una enfermedad de Lyme. Este cuadro infeccioso es causado por espiroquetas del complejo Borrelia burgdorferi sensu lato (Bbsl) y es transmitido por la mordedura de garrapatas. Tradicionalmente Bbsl había sido detectada en garrapatas sólo en el hemisferio norte. Sin embargo, desde el 2013 ha habido reportes en Sudamérica. En Chile, recientemente se describió Borrelia chilensis, la cual no tiene una enfermedad asociada en humanos. Se discuten aspectos del agente infeccioso, su epidemiología, sus vectores y nuevos hallazgos en Sudamérica. Además, se plantean los criterios diagnósticos clínicos, de laboratorio y tratamiento, de acuerdo a la etapa en su historia natural.

This is a case report of an american woman who consulted in our country for multiple erythema migrans, from which a Lyme disease was diagnosed. This infectious disease is caused by spirochetes from the Borrelia burgdorferi sensu lato complex (Bbsl) and is transmitted by the bite of ticks. Traditionally Bbsl had been detected in ticks only in the Northern Hemisphere. However, since 2013 there have been reports in South America. In Chile, Borrelia chilensis was recently described, which does not have an associated disease in humans. Aspects of the infectious agent, its epidemiology, its vectors and new findings in South America are discussed. Likewise, the clinical diagnostic criteria, laboratory and appropriate treatment are proposed, according to the stage in their natural history.