Aerosolic Application of Phages Against S. infantis on Plates and Chicken Skin.

Phages are known as a promising method to combat antimicrobial resistance (AMR) in the human and veterinary sector. Use of phage aerosols enormously increases the application field, although the impact on the infectivity of phages during nebulization needs to be evaluated. In this study S. infantis was treated on plates and chicken skin with nebulized phage particles of the Myoviridae type, identified by transmission electron microscopy, using a commercial nebulizer primarily used for H2O2 disinfection. The reduction of bacterial number by aerosol applied phage particles was evaluated. It could clearly be shown that the phage particles were able to infect Salmonella after being nebulized using ultrasound technology. Further studies on other types of phages as well as other conditions must be performed to standardize the aerosolic application of phages.

Hyalomma marginatum - A silent stowaway after vacation at the Adriatic Sea.

Hyalomma marginatum is an invasive tick species capable of transmitting pathogens that cause severe diseases such as Crimean-Congo hemorrhagic fever. In Austria, H. marginatum occurs sporadically, and migratory birds are believed to bring H. marginatum from distant regions. We report several incidents of H. marginatum imported by travelers in private cars from Croatia to Austria. One tick was positive for Rickettsia aeschlimannii. Tourist traffic may play a significant role in the northward expansion of this tick species aside from introduction by birds.

Occurrence of Thelazia callipaeda and its vector Phortica variegata in Austria and South Tyrol, Italy, and a global comparison by phylogenetic network analysis.

The zoonotic nematode Thelazia callipaeda infects the eyes of domestic and wild animals and uses canids as primary hosts. It was originally described in Asia, but in the last 20 years it has been reported in many European countries, where it is mainly transmitted by the drosophilid fruit fly Phortica variegata. We report the autochthonous occurrence of T. callipaeda and its vector P. variegata in Austria. Nematodes were collected from clinical cases and fruit flies were caught using traps, netting, and from the conjunctival sac of one dog. Fruit flies and nematodes were morphologically identified and a section of the mitochondrial cytochrome c oxidase subunit I gene (COI) was analysed. A DNA haplotype network was calculated to visualize the relation of the obtained COI sequences to published sequences. Additionally, Phortica spp. were screened for the presence of DNA of T. callipaeda by polymerase chain reaction. Thelazia callipaeda and P. variegata were identified in Burgenland, Lower Austria, and Styria. Thelazia callipaeda was also documented in Vienna and P. variegata in Upper Austria and South Tyrol, Italy. All T. callipaeda corresponded to haplotype 1. Twenty-two different haplotypes of P. variegata were identified in the fruit flies. One sequence was distinctly different from those of Phortica variegata and was more closely related to those of Phortica chi and Phortica okadai. Thelazia callipaeda could not be detected in any of the Phortica specimens.

Molecular pathogen screening of louse flies (Diptera: Hippoboscidae) from domestic and wild ruminants in Austria.

BACKGROUND: Hippoboscid flies (Diptera: Hippoboscidae), also known as louse flies or keds, are obligate blood-sucking ectoparasites of animals, and accidentally of humans. The potential role of hippoboscids as vectors of human and veterinary pathogens is being increasingly investigated, but the presence and distribution of infectious agents in louse flies is still unknown in parts of Europe. Here, we report the use of molecular genetics to detect and characterize vector-borne pathogens in hippoboscid flies infesting domestic and wild animals in Austria. METHODS: Louse flies were collected from naturally infested cattle (n = 25), sheep (n = 3), and red deer (n = 12) across Austria between 2015 and 2019. Individual insects were morphologically identified to species level and subjected to DNA extraction for molecular pathogen screening and barcoding. Genomic DNA from each louse fly was screened for Borrelia spp., Bartonella spp., Trypanosomatida, Anaplasmataceae, Filarioidea and Piroplasmida. Obtained sequences of Trypanosomatida and Bartonella spp. were further characterized by phylogenetic and haplotype networking analyses. RESULTS: A total of 282 hippoboscid flies corresponding to three species were identified: Hippobosca equina (n = 62) collected from cattle, Melophagus ovinus (n = 100) from sheep and Lipoptena cervi (n = 120) from red deer (Cervus elaphus). Molecular screening revealed pathogen DNA in 54.3% of hippoboscids, including infections with single (63.39%), two (30.71%) and up to three (5.90%) distinct pathogens in the same individual. Bartonella DNA was detected in 36.9% of the louse flies. Lipoptena cervi were infected with 10 distinct and previously unreported Bartonella sp. haplotypes, some closely associated with strains of zoonotic potential. DNA of trypanosomatids was identified in 34% of hippoboscids, including the first description of Trypanosoma sp. in H. equina. Anaplasmataceae DNA (Wolbachia spp.) was detected only in M. ovinus (16%), while < 1% of the louse flies were positive for Borrelia spp. and Filarioidea. All hippoboscids were negative for Piroplasmida. CONCLUSIONS: Molecular genetic screening confirmed the presence of several pathogens in hippoboscids infesting domestic and wild ruminants in Austria, including novel pathogen haplotypes of zoonotic potential (e.g. Bartonella spp.) and the first report of Trypanosoma sp. in H. equina, suggesting a potential role of this louse fly as vector of animal trypanosomatids. Experimental transmission studies and expanded monitoring of hippoboscid flies and hippoboscid-associated pathogens are warranted to clarify the competence of these ectoparasites as vectors of infectious agents in a One-Health context.

Diversity of Hepatozoon species in wild mammals and ticks in Europe.

BACKGROUND: Hepatozoon spp. are tick-borne parasites causing subclinical to clinical disease in wild and domestic animals. Aim of this study was to determine Hepatozoon prevalence and species distribution among wild mammals and ticks in Europe. METHODS: Samples of wild mammals and ticks, originating from Austria, Bosnia and Herzegovina, Croatia, Belgium and the Netherlands, were tested with PCR to amplify a ~ 670-bp fragment of the small subunit ribosomal RNA gene. RESULTS: Of the 2801 mammal samples that were used for this study, 370 (13.2%) tested positive. Hepatozoon canis was detected in samples of 178 animals (3 Artiodactyla, 173 Carnivora, 1 Eulipotyphia, 1 Lagomorpha), H. martis in 125 (3 Artiodactyla, 122 Carnivora), H. sciuri in 13 (all Rodentia), Hepatozoon sp. in 47 (among which Hepatozoon sp. Vole isolate, all Rodentia) and H. ayorgbor in 4 (all Rodentia). Regarding origin, 2.9% (6/208) tested positive from Austria, 2.8% (1/36) from Bosnia and Herzegovina, 14.6% (173/1186) from Croatia and 13.9% (190/1371) from Belgium/the Netherlands. Of the 754 ticks collected, 0.0% (0/35) Hyalomma sp., 16.0% (4/25) Dermacentor spp., 0.0% (0/23) Haemaphysalis spp., 5.3% (24/50) Ixodes and 1.4% (3/221) Rhipicephalus spp. tested positive for Hepatozoon (4.2%; 32/754), most often H. canis (n = 22). CONCLUSIONS: Hepatozoon canis is most present in mammals (especially in Carnivora such as gray wolves and golden jackals) and ticks, followed by H. martis, which was found merely in stone martens and pine martens. None of the rodent-associated Hepatozoon spp. were detected in the ticks, suggesting the possible implication of other arthropod species or non-vectorial routes in the transmission cycle of the hemoprotozoans in rodents. Our findings of H. canis in ticks other than R. sanguineus add to the observation that other ticks are also involved in the life cycle of Hepatozoon. Now that presence of Hepatozoon has been demonstrated in red foxes, gray wolves, mustelids and rodents from the Netherlands and/or Belgium, veterinary clinicians should be aware of the possibility of spill-over to domestic animals, such as dogs.

Dermacentor reticulatus - a tick on its way from glacial refugia to a panmictic Eurasian population.

The ornate dog tick (Dermacentor reticulatus) shows a recently expanding geographic distribution. Knowledge on its intraspecific variability, population structure, rate of genetic diversity and divergence, including its evolution and geographic distribution, is crucial to understand its dispersal capacity. All such information would help to evaluate the potential risk of future spread of associated pathogens of medical and veterinary concern. A set of 865 D. reticulatus ticks was collected from 65 localities across 21 countries, from Portugal in the west to Kazakhstan and southern Russia in the east. Cluster analyses of 16 microsatellite loci were combined with nuclear (ITS2, 18S) and mitochondrial (12S, 16S, COI) sequence data to uncover the ticks' population structures and geographical patterns. Approximate Bayesian computation was applied to model evolutionary relationships among the found clusters. Low variability and a weak phylogenetic signal showing an east-west cline were detected both for mitochondrial and nuclear sequence markers. Microsatellite analyses revealed three genetic clusters, where the eastern and western cluster gradient was supplemented by a third, northern cluster. Alternative scenarios could explain such a tripartite population structure by independent formation of clusters in separate refugia, limited gene flow connected with isolation by distance causing a "bipolar pattern", and the northern cluster deriving from admixture between the eastern and western populations. The best supported demographic scenario of this tick species indicates that the northern cluster derived from admixture between the eastern and western populations 441 (median) to 224 (mode) generations ago, suggesting a possible link with the end of the Little Ice Age in Europe.

Hyalomma spp. in Austria-The Tick, the Climate, the Diseases and the Risk for Humans and Animals.

Recently, ticks of Hyalomma spp. have been found more often in areas previously lacking this tick species. Due to their important role as a vector of different diseases, such as Crimean-Congo-hemorrhagic fever (CCHF), the occurrence and potential spread of this tick species is of major concern. So far, eight Hyalomma sp. ticks were found between 2018 and 2021 in Austria. A serological investigation on antibodies against the CCHF virus in 897 cattle as indicator animals displayed no positive case. During observation of climatic factors, especially in the period from April to September, the year 2018 displayed an extraordinary event in terms of higher temperature and dryness. To estimate the risk for humans to come in contact with Hyalomma sp. in Austria, many parameters have to be considered, such as the resting place of birds, availability of large livestock hosts, climate, density of human population, etc.

Origins, phylogenetic relationships and host-parasite interactions of Troglotrematoidea since the cretaceous.

In the current study, we raise the issue concerning origins and historical relationships of the trematodes from the families Troglotrematidae and Paragonimidae using phylogenetic analysis and molecular-clock method for estimating evolutionary rates. For the first time we provided 28S rRNA gene fragment (1764 bp) for the type species Troglotrema acutum - zoonotic trematodes that cause cranial lesions (troglotremiasis) in mustelid and canid mammals of the Central Europe, Iberian Peninsula, and North-West Caucasus. Molecular genetic analysis revealed that T. acutum belongs to the monophyletic family Troglotrematidae sister with the family Paragonimidae. The family Troglotrematidae includes five genera: Nanophyetus, Troglotrema, Skrjabinophyetus, Nephrotrema, and Macroorchis; and the family Paragonimidae is monotypic including the only genus Paragonimus. We recover the superfamily Troglotrematoidea for these two families. Divergence of the common ancestor of the superfamily Troglotrematoidea (common troglotrematoid ancestor) likely occurred during the Cretaceous period of the Mesozoic Era and potentially originated in the Asiatic region. The lineage of the family Troglotrematidae is much closer to the common troglotrematoid ancestor than the species of the family Paragonimidae. The radiation time of the common troglotrematoid ancestor (126 Ma, the Early Cretaceous), and formation of the families Troglotrematidae and Paragonimidae (96 Ma and 73 Ma respectively, the Late Cretaceous) corresponds to the time of settling in East Asia by many species of mammaliaforms (about 130-70 Ma).

Novel Protozoans in Austria Revealed through the Use of Dogs as Sentinels for Ticks and Tick-Borne Pathogens.

We previously isolated and cultivated the novel Rickettsia raoultii strain Jongejan. This prompted us to ask whether this strain is unique or more widely present in Austria. To assess this issue, we retrospectively screened ticks collected from dogs in 2008. Of these collected ticks, we randomly selected 75 (47 females and 28 males) Dermacentor reticulatus, 44 (21 females, 7 males, and 16 nymphs) Haemaphysalis concinna, and 55 (52 females and 3 males) ticks of the Ixodes ricinus complex. Subsequently, these ticks were individually screened for the presence of tick-borne pathogens using the reverse line blot hybridization assay. In our current study, we detected DNA from the following microbes in D. reticulatus: Anaplasma phagocytophilum, Borrelia lusitaniae, Borrelia spielmanii, Borrelia valaisiana, and R. raoultii, all of which were R. raoultii strain Jongejan. In H. concinna, we found DNA of a Babesia sp., Rickettsia helvetica, and an organism closely related to Theileria capreoli. Lastly, I. ricinus was positive for Anaplasma phagocytophilum, Borrelia afzelii, Borrelia burgdorferi sensu stricto, Borrelia garinii/Borrelia bavariensis, B. lusitaniae, B. spielmanii, B. valaisiana, Candidatus Neoehrlichia mikurensis, Rickettsia helvetica, Rickettsia monacensis, and Theileria (Babesia) microti DNA. The detection of DNA of the Babesia sp. and an organism closely related to Theileria capreoli, both found in H. concinna ticks, is novel for Austria.

A potential zoonotic threat: First detection of Baylisascaris procyonis in a wild raccoon from Austria.

Baylisascaris procyonis is a common gastrointestinal parasite of raccoons (Procyon lotor) in their native range, and both have been introduced to Europe. Humans may ingest ascarid eggs shed via the racoons' faeces, and this could lead to severe infections affecting the central nervous system. Here, we report the first occurrence of B. procyonis in Austria. The parasite was detected in a two-year-old male raccoon that was road-killed in November 2019 near Hittisau (Vorarlberg). Genetic profiling provided strong evidence that the raccoon (and its parasite) originated from the nearest German raccoon population. The first finding in Austria highlights the need for monitoring the parasite and information of the public and practitioners.

Zoonotic Pathogens in Ticks from Migratory Birds, Italy.

Migratory birds can transport infected ticks across continents. We evaluated pathogens in ticks collected from migratory birds in Italy. We found DNA from Rickettsia aeschlimannii, R. africae, and R. raoultii bacteria, all of which can cause disease in humans. Bird migrations might facilitate the spread of these pathogens into new areas.

Infection with Toxocara canis Inhibits the Production of IgE Antibodies to α-Gal in Humans: Towards a Conceptual Framework of the Hygiene Hypothesis?

α-Gal syndrome (AGS) is a type of anaphylactic reaction to mammalian meat characterized by an immunoglobulin (Ig)E immune response to the oligosaccharide α-Gal (Galα1-3Galß1-4GlcNAc-R). Tick bites seems to be a prerequisite for the onset of the allergic disease in humans, but the implication of non-tick parasites in α-Gal sensitization has also been deliberated. In the present study, we therefore evaluated the capacity of helminths (Toxocara canis, Ascaris suum, Schistosoma mansoni), protozoa (Toxoplasma gondii), and parasitic fungi (Aspergillus fumigatus) to induce an immune response to α-Gal. For this, different developmental stages of the infectious agents were tested for the presence of α-Gal. Next, the potential correlation between immune responses to α-Gal and the parasite infections was investigated by testing sera collected from patients with AGS and those infected with the parasites. Our results showed that S. mansoni and A. fumigatus produce the terminal α-Gal moieties, but they were not able to induce the production of specific antibodies. By contrast, T. canis, A. suum and T. gondii lack the α-Gal epitope. Furthermore, the patients with T. canis infection had significantly decreased anti-α-Gal IgE levels when compared to the healthy controls, suggesting the potential role of this nematode parasite in suppressing the allergic response to the glycan molecule. This rather intriguing observation is discussed in the context of the 'hygiene hypothesis'. Taken together, our study provides new insights into the relationships between immune responses to α-Gal and parasitic infections. However, further investigations should be undertaken to identify T. canis components with potent immunomodulatory properties and to assess their potential to be used in immunotherapy and control of AGS.

First detection and molecular identification of Anaplasma phagocytophilum in an introduced population of Reeve's muntjac (Muntiacus reevesi) in United Kingdom.

In the present study, we investigated blood samples of 196 invasive Reeve's muntjac (Muntiacus reevesi) and 91 native roe deer (Capreolus capreolus) originating from the same area in Thetford Forest in Eastern England for the occurrence of blood pathogens such as Anaplasmatacae, Rickettsiales and Piroplasmida (Babesia spp., Theileria spp.) by using PCR. Babesia spp., Rickettsia spp. and Theileria spp. were not detected. Only two male (1%) Reeve's muntjacs and six (6.6%) roe deer were positive for Anaplasma phagocytophilum with 100% identity among their sequences. However, it is not clear whether Reeve's muntjac is less susceptible to infection, less susceptible to infestation by I. ricinus, or an infection in Reeve's muntjac is more lethal and therefore less positive animals are taken during hunting events.

Molecular survey of tick-borne pathogens reveals a high prevalence and low genetic variability of Hepatozoon canis in free-ranging grey wolves (Canis lupus) in Germany.

Wild carnivores are important hosts for ixodid ticks and presumed reservoirs for several tick-borne pathogens (TBPs) of medical and veterinary importance. However, little is known about the role that the European grey wolf (Canis lupus) plays in the enzootic cycle of TBPs. The recent recolonization of Central European lowland, including some regions in Germany, by the grey wolf, opened up an excellent opportunity for studying the impact of the wolf population on pathogen diversity and transmission dynamics. Therefore, in the present study, we investigated spleen samples collected from 276 grey wolves in 11 federal states in Germany for common TBPs by molecular methods. In total, 127 grey wolves (46.0 %) were found to be positive for Hepatozoon canis. Only two genetic variants of this protozoan parasite (herein designated as G1 and G2) were found to circulate among the grey wolves, which can be potentially shared between populations of domestic and other wild carnivores in the country. Two grey wolves were positive for Anaplasma phagocytophilum (0.7 %), and both were co-infected with H. canis G1 genotype. The presence of other pathogens could not be confirmed by PCR and sequencing. This study represents the first one reporting H. canis in a grey wolf population worldwide, and it provides highly relevant information, which may contribute to a better understanding of the epidemiology of TBPs and the pathogen transmission dynamics among the reintroduced population of grey wolves and other carnivores.

Current trends in canine dirofilariosis in Austria-do we face a pre-endemic status?

A retrospective study based on cases of canine dirofilariosis presented to the University of Veterinary Medicine, Vienna or diagnosed by private practitioners throughout Austria, from 1998 to 2018 was conducted to investigate the long-term development and current state of canine dirofilarial infections in Austria. Included in this study were 146 dogs which were tested positive for D. immitis and/or D. repens. The most commonly used diagnostic methods and the probable geographical origins of the infections were evaluated and the treatment protocols applied were compared with each other and with the literature. The results show that most infections were found due to screening for common travel infections using antigen-ELISA or PCR-testing, or by the incidental finding of microfilariae. Remarkably, only 24.3% of all cases presented showed clinical signs indicating canine dirofilariosis. Regarding the origin and travel history of the dogs, thirteen different countries could be identified. The three treatment protocols used showed a similar outcome after 8 months of treatment and minor side effects, which is consistent with the literature. An alarming increase in reported infections with both D. immitis and D. repens in Austria was noted since 2014. The number of documented cases had almost tripled by 2018, raising severe concerns about the threat of it becoming endemic in Austria. Therefore, the existing recommendations in current guidelines regarding canine dirofilariosis should be widely publicised and more strictly enforced. Prophylactic measures for dogs travelling abroad and diagnostic and therapeutic strategies for dogs imported from endemic countries should be obligatorily established throughout Europe, to reduce the risk of further spread of canine filarial infections to non-endemic regions.

Population structure of Borrelia turcica from Greece and Turkey.

Borrelia turcica, a member of the reptile-associated Borrelia clade, is vectored by Hyalomma aegyptium. The only suggested reservoir hosts of B. turcica are tortoises of the genus Testudo. Borrelia turcica has been described to occur in several Southeastern European countries including Turkey, Romania, Bulgaria and Greece but so far nothing is known about the relationship of these populations and whether or how they are structured. Using multilocus sequence typing (MLST) on eight chromosomally located housekeeping loci (clpA, clpX, nifS, pepX, pyrG, recG, rplB and uvrA) we analyzed 43 B. turcica isolates from Serres, Greece (n = 15) collected in 2017 and Izmir, Turkey (n = 28) collected in 2018. To understand their relationship a maximum-likelihood phylogenetic tree and goeBURST analysis were done based on MLST sequence data and allelic profiles, respectively. The data we generated confirmed that the samples of B. turcica investigated here were divergent from Lyme disease (LD) and relapsing fever (RF) species. Within the B. turcica clade, samples of different geographic origin (Greece, Turkey) clustered together in terminal branches; no obvious differences between the Greek and Turkish samples were noticeable. A goeBURST analysis using triple-locus variants revealed very few clonal complexes with the majority of samples appearing as singletons. Minor clonal complexes (consisting of two sequence types) comprised only Greek isolates, only Turkish isolates or both, so no pattern of clustering of isolates from the two geographical regions was observed. Interestingly, very little population structure was discerned in our study. This was surprising in view of the large geographic distance between collection sites of B. turcica and raises questions about the evolution or spatial spread of this species.

Unnoticed arrival of two dipteran species in Austria: the synanthropic moth fly Clogmia albipunctata (Williston, 1893) and the parasitic bird louse fly Ornithoica turdi (Olivier in Latreille, 1811).

In the framework of a mosquito-monitoring program conducted from 2014 to 2018, non-culicid dipteran bycatch was identified to species-level with a focus on Diptera of medical and veterinary importance as part of a biodiversity initiative and barcoding project ("Austrian Barcode of Life"). Two species hitherto not known from Austria, the regularly sampled synanthropic moth fly Clogmia albipunctata (Psychodidae) and a single specimen of the louse fly Ornithoica turdi (Hippoboscidae), were collected in Vienna and Lower Austria. We confirmed identification results using a barcoding approach and provide the first reference sequence for O. turdi.

Survey on tick-borne pathogens in ticks removed from humans in Northwestern Italy.

Ticks are able to transmit several pathogens to the host while feeding, and thus are considered the most important vectors of infectious agents together with mosquitos. The global incidence of tick-borne diseases (TBDs) is rising, due to increased interactions between pathogens, hosts and vectors, linked to global changes. Given that information about the prevalence of tick-borne pathogens in ticks removed from humans in Italy are scarce, the aim of the present study was to identify the species of ticks biting humans in Northwestern Italy and tick-borne pathogens they harbour. An overall number of 128 ticks from 92 patients were collected from April to October 2018, almost 98% of which belonging to the Ixodes ricinus species. Molecular analysis showed the presence of Babesia spp. in 29 out of 93 analysed tick pools, with a Minimum Infection Rate (MIR) of 31.18% (29/93; CI95% 22.67-41.19%), while 1 out of 93 pools tested positive for SFG Rickettsiae (MIR = 1.08%; CI95% 0.19-5.84%). No samples tested positive for A. phagocytophilum and Borrelia spp. Sequencing revealed the presence of Babesia venatorum (28 pools), Theileria buffeli/orientalis complex (1 pool) and Rickettsia monacensis. Among these, B. venatorum and R. monacensis are zoonotic pathogens able to cause from moderate to severe infections in humans. These data highlight the importance of passive surveillance to assess the epidemiology of TBDs that pose a threat to human health.

Tick Bites Induce Anti-α-Gal Antibodies in Dogs.

Due to the functional inactivation of the gene encoding for the enzyme that is involved in the oligosaccharide galactose-α-1,3-galactose (α-Gal) synthesis, humans and Old-World primates are able to produce a large amount of antibodies against the glycan epitope. Apart from being involved in the hyperacute organ rejection in humans, anti-α-Gal antibodies have shown a protective effect against some pathogenic agents and an implication in the recently recognized tick-induced mammalian meat allergy. Conversely, non-primate mammals, including dogs, have the ability to synthetize α-Gal and, thus, their immune system is not expected to naturally generate the antibodies toward this self-antigen molecule. However, in the current study, we detected specific IgG, IgM, and IgE antibodies to α-Gal in sera of clinically healthy dogs by an indirect enzyme-linked immunosorbent assay (ELISA) for the first time. Furthermore, in a tick infestation experiment, we showed that bites of Ixodes ricinus induce the immune response to α-Gal in dogs and that the resulting antibodies (IgM) might be protective against Anaplasma phagocytophilum. These findings may help lead to a better understanding of the underlying mechanisms involved in mammalian meat allergy and tick-host-pathogen interactions, but they also open up the question about the possibility that dogs could develop an allergy to mammalian meat after tick bites, similar to that in humans.

Environmental and Molecular Drivers of the α-Gal Syndrome.

The α-Gal syndrome (AGS) is a type of allergy characterized by an IgE antibody (Ab) response against the carbohydrate Galα1-3Galß1-4GlcNAc-R (α-Gal), which is present in glycoproteins from tick saliva and tissues of non-catarrhine mammals. Recurrent tick bites induce high levels of anti-α-Gal IgE Abs that mediate delayed hypersensitivity to consumed red meat products in humans. This was the first evidence that tick glycoproteins play a major role in allergy development with the potential to cause fatal delayed anaphylaxis to α-Gal-containing foods and drugs and immediate anaphylaxis to tick bites. Initially, it was thought that the origin of tick-derived α-Gal was either residual blood meal mammalian glycoproteins containing α-Gal or tick gut bacteria producing this glycan. However, recently tick galactosyltransferases were shown to be involved in α-Gal synthesis with a role in tick and tick-borne pathogen life cycles. The tick-borne pathogen Anaplasma phagocytophilum increases the level of tick α-Gal, which potentially increases the risk of developing AGS after a bite by a pathogen-infected tick. Two mechanisms might explain the production of anti-α-Gal IgE Abs after tick bites. The first mechanism proposes that the α-Gal antigen on tick salivary proteins is presented to antigen-presenting cells and B-lymphocytes in the context of Th2 cell-mediated immunity induced by tick saliva. The second mechanism is based on the possibility that tick salivary prostaglandin E2 triggers Immunoglobulin class switching to anti-α-Gal IgE-producing B cells from preexisting mature B cells clones producing anti-α-Gal IgM and/or IgG. Importantly, blood group antigens influence the capacity of the immune system to produce anti-α-Gal Abs which in turn impacts individual susceptibility to AGS. The presence of blood type B reduces the capacity of the immune system to produce anti-α-Gal Abs, presumably due to tolerance to α-Gal, which is very similar in structure to blood group B antigen. Therefore, individuals with blood group B and reduced levels of anti-α-Gal Abs have lower risk to develop AGS. Specific immunity to tick α-Gal is linked to host immunity to tick bites. Basophil activation and release of histamine have been implicated in IgE-mediated acquired protective immunity to tick infestations and chronic itch. Basophil reactivity was also found to be higher in patients with AGS when compared to asymptomatic α-Gal sensitized individuals. In addition, host resistance to tick infestation is associated with resistance to tick-borne pathogen infection. Anti-α-Gal IgM and IgG Abs protect humans against vector-borne pathogens and blood group B individuals seem to be more susceptible to vector-borne diseases. The link between blood groups and anti-α-Gal immunity which in turn affects resistance to vector-borne pathogens and susceptibility to AGS, suggests a trade-off between susceptibility to AGS and protection to some infectious diseases. The understanding of the environmental and molecular drivers of the immune mechanisms involved in AGS is essential to developing tools for the diagnosis, control, and prevention of this growing health problem.