Assessment of Coxiella burnetii presence after tick bite in north-eastern Poland.

PURPOSE: The aim of the study is to assess anti-Coxiella burnetii antibodies presence in inhabitants of north-eastern Poland, to assess the risk of Q fever after tick bite and to assess the percentage of co-infection with other pathogens. METHODS: The serological study included 164 foresters and farmers with a history of tick bite. The molecular study included 540 patients, hospitalized because of various symptoms after tick bite. The control group consisted of 20 honorary blood donors. Anti-Coxiella burnetii antibodies titers were determined by Coxiella burnetii (Q fever) Phase 1 IgG ELISA (DRG International Inc. USA). PCR was performed to detect DNA of C. burnetii, Borrelia burgdorferi and Anaplasma phagocytophilum. RESULTS: Anti-C. burnetii IgG was detected in six foresters (7.3%). All foresters with the anti-C. burnetii IgG presence were positive toward anti-B. burgdorferi IgG and anti-TBE (tick-borne encephalitis). Anti-C. burnetii IgG was detected in five farmers (6%). Four farmers with anti-C. burnetii IgG presence were positive toward anti-B. burgdorferi IgG and two with anti-TBE. Among them one was co-infected with B. burgdorferi and TBEV. Correlations between anti-C. burnetii IgG and anti-B. burgdorferi IgG presence and between anti-C. burnetii IgG presence and symptoms of Lyme disease were observed. C. burnetii DNA was not detected in any of the 540 (0%) patients. CONCLUSIONS: C. burnetii is rarely transmitted by ticks, but we proved that it is present in the environment, so it may be a danger to humans. The most common co-occurrence after tick bite concerns C. burnetii and B. burgdorferi.

Tick Bites on Humans in Southwestern Region of Turkey: Species Diversity

Objective: The aim of the present study was to determine tick species found on humans who suffered from tick bite in the Southwestern Anatolia Region, Turkey. Methods: Between January and October 2007, ticks were collected from people admitted to the city and/or town hospitals with complaints of tick bites in nine different provinces of Turkey. Genus and/or species of the ticks in adult, larva and nymph stages were identified microscopically. Identification was done using related taxonomic keys. Results: A total of 2.610 ticks were collected from humans who were admitted to the hospitals with complaints of tick bites in the Southwestern Anatolia Region in the present study. Of these, 1.858 samples were collected from the Aegean Region and the remaining 752 from the Mediterranean Region of the country. The ticks were identified as Hyalomma spp. (78.58%), Rhipicehalus spp. (18.89%), Ixodes spp. (0.88%), Dermacentor spp. (0.77%), Haemaphysalis spp. (0.61%), Argas spp. (0.23%), and Ornithodoros spp. (0.04%). Results indicated that the majority of the ticks were nymphs of Hyalomma spp. (n=1.582). Nymphal stage was most commonly encountered from the Aegean Region and the Mediterranean Region with a prevalence of 46.13% (n=1.204) and 14.48% (n=378) respectively. Within the collected adult ticks (n=913), the majority of the samples were identified as H. marginatum (n=233, 26.09%). Conclusion: The results indicate the high diversity of tick species infesting humans in the Southwestern Anatolia Region, Turkey. So, it is crucial to publish information on tick bite prevention, which would play an important role in reducing the incidence of tick-borne diseases.

The use of syndromic surveillance to monitor the incidence of arthropod bites requiring healthcare in England, 2000-2013: a retrospective ecological study.

Climate change experts predict the number of nuisance-biting arthropods in England will increase but there is currently no known surveillance system in place to monitor or assess the public health impact of arthropod bites. This retrospective ecological study utilized arthropod bites requiring healthcare from five national real-time syndromic surveillance systems monitoring general practitioner (GP) consultations (in-hours and out-of-hours), emergency department (ED) attendances and telephone calls to remote advice services to determine baseline incidence in England between 2000 and 2013 and to assess the association between arthropod bites and temperature. During summer months (weeks 20-40) we estimated that arthropod bites contribute a weekly median of ~4000 GP consultations, 750 calls to remote advice services, 700 ED and 1300 GP out-of-hours attendances. In all systems, incidence was highest during summer months compared to the rest of the year. Arthropod bites were positively associated with temperature with incidence rate ratios (IRRs) that ranged between systems from 1·03 [95% confidence interval (CI) 1·01-1·06] to 1·14 (95% CI 1·11-1·16). Using syndromic surveillance systems we have established and described baseline incidence of arthropod bites and this can now be monitored routinely in real time to assess the impact of extreme weather events and climate change.

A brown dog tick (Rhipicephalus sanguineus) bite at sea.

Medical Officers (MOs) and Medical Branch Ratings (MBRs) must maintain an awareness of the risk of vector-borne diseases among deployed personnel. Personnel working in the maritime environment may not expect to be at risk of tick bites, as ticks typically occupy habitats with dense vegetation such as forests or scrub land. However, tick-borne pathogens can cause serious and sometimes fatal disease, and therefore the risk of tick bites and associated diseases should be recognised. We present a case of a tick bite in a member of a ship's company eight days after leaving port. The tick was identified as a brown dog tick (Rhipicephalus sanguineus), a species known to thrive indoors. We describe several important tick-borne diseases which can be transmitted by R. sanguineus and explore best practice for tick removal and aftercare. Finally, we outline the appropriate management of suspected tick-borne disease in deployed personnel in the maritime environment.