A review on the eco-epidemiology and clinical management of human granulocytic anaplasmosis and its agent in Europe

Anaplasma phagocytophilum is the agent of tick-borne fever, equine, canine and human granulocytic anaplasmosis. The common route of A. phagocytophilum transmission is through a tick bite, the main vector in Europe being Ixodes ricinus. Despite the apparently ubiquitous presence of the pathogen A. phagocytophilum in ticks and various wild and domestic animals from Europe, up to date published clinical cases of human granulocytic anaplasmosis (HGA) remain rare compared to the worldwide status. It is unclear if this reflects the epidemiological dynamics of the human infection in Europe or if the disease is underdiagnosed or underreported. Epidemiologic studies in Europe have suggested an increased occupational risk of infection for forestry workers, hunters, veterinarians, and farmers with a tick-bite history and living in endemic areas. Although the overall genetic diversity of A. phagocytophilum in Europe is higher than in the USA, the strains responsible for the human infections are related on both continents. However, the study of the genetic variability and assessment of the difference of pathogenicity and infectivity between strains to various hosts has been insufficiently explored to date. Most of the European HGA cases presented as a mild infection, common clinical signs being pyrexia, headache, myalgia and arthralgia. The diagnosis of HGA in the USA was recommended to be based on clinical signs and the patient’s history and later confirmed using specialized laboratory tests. However, in Europe since the majority of cases are presenting as mild infection, laboratory tests may be performed before the treatment in order to avoid antibiotic overuse. The drug of choice for HGA is doxycycline and because of potential for serious complication the treatment should be instituted on clinical suspicion alone

Exposure and risk factors to Coxiella burnetii, spotted fever group and typhus group rickettsiae, and Bartonella henselae among volunteer blood donors in Namibia

Background: The role of pathogen-mediated febrile illness in sub-Saharan Africa is receiving more attention, especially in Southern Africa where four countries (including Namibia) are actively working to eliminate malaria. With a high concentration of livestock and high rates of companion animal ownership, the influence of zoonotic bacterial diseases as causes of febrile illness in Namibia remains unknown.Methodology/Principal Findings: The aim of the study was to evaluate exposure to Coxiella burnetii, spotted fever and typhus group rickettsiae, and Bartonella henselae using IFA and ELISA (IgG) in serum collected from 319 volunteer blood donors identified by the Blood Transfusion Service of Namibia (NAMBTS). Serum samples were linked to a basic questionnaire to identify possible risk factors. The majority of the participants (64.8%) had extensive exposure to rural areas or farms. Results indicated a C. burnetii prevalence of 26.1% (screening titre 1:16), and prevalence rates of 11.9% and 14.9% (screening titre 1:100) for spotted fever group and typhus group rickettsiae, respectively. There was a significant spatial association between C. burnetii exposure and place of residence in southern Namibia (P0.012), especially cattle (P>0.006), were also significantly associated with C. burnetii exposure. Males were significantly more likely than females to have been exposed to spotted fever (P<0.013) and typhus (P<0.011) group rickettsiae. Three (2.9%) samples were positive for B. henselae possibly indicating low levels of exposure to a pathogen never reported in Namibia.Conclusions/Significance: These results indicate that Namibians are exposed to pathogenic fever-causing bacteria, most of which have flea or tick vectors/reservoirs. The epidemiology of febrile illnesses in Namibia needs further evaluation in order to develop comprehensive local diagnostic and treatment algorithms.Peer reviewedEntomology and Plant Patholog

Ocena wystepowania kretkow Borrelia burgdorferi sensu lato w kleszczach Ixodes ricinus na terenie wybranych rejonow Lubelszczyzny przy zastosowaniu metody lancuchowej reakcji polimerazy [PCR]

Evaluation of occurrence of spirochetes Borrelia burgdorferi sensu lato in Ixodes ricinus ticks in selected areas of the Lublin Region by polimerase chain reaction method (PCR). During the period 2001-2002, 1098 Ixodes ricinus ticks were collected at forest sampling sites and the degree of their infection with Borrelia burgdorferi spirochetes was determined by means of polimerase chain reaction (PCR). The presence of Borrelia burgdorferi genetic material was noted in 69 cases (6.3%). lt was confirmed that the frequency of infection of adult forms of ticks (males and females) was nearly twice as high as nymphs. The highest degree of infection was observed in females – 9.5%. The degree of infection among males and nymphs was smaller - 5.9% and 4.4% respectively in individual provinces. The percentage of infected females ranged from 7.9% in the Zamość Province to 13.6% in the Włodawa Province. In males, the percentage of infected ticks remained within the range from 3.1% in the Lublin Province to 13.3% in the Lubartów Province

Ocena narazenia na zakazenie wirusem kleszczowego zapalenia mozgu osob zawodowo eksponowanych na kontakt z kleszczami

The paper presents the results of seroepidemiologic studies concerning tick-borne encephalitis (TBE) in 1583 persons (1261 forestry workers and 233 farmers) from the Lublin region (eastern Poland) occupationally exposed to ticks and in 130 healthy blond donors (a control group). The mean percentage of seropositive reactions in forestry workers amounted 19.8% and in farmers 32.0%. Based on 5-year research (1994-1998) conducted in 5 districts of the Lublin region, an existence of endemic foci of TBE was detected in the district of Biała Podlaska. on the areas of Radzyń Podlaski and Parczew, where the percentage of seropositive reactions in forestry workers exceeded 50%. Statistical analysis showed that the frequency of seropositive reactions in forestry workers and farmers was significantly greater compated to control group (p<0.001 and p<0.05, respectively). It indicates that these groups are occupationally exposed to TBE wirus. Totally, in the years 1994-98 nine clinical cases of TBE (acute neuroinfection) in forestry workers and fourteen clinical cases in farmers were confirmed serologically. The effectiveness of specific immunization againstTBE was proved on the brie of 100% seroconversion in 56 earlier seronegative forestry workers. The obtained results proved that forestry workers and farmers in Poland are under increased risk of infection with TBE virus

Detecting centres of family Toxoplasmosis in rural environment

In order to detect centres of family toxoplasmosis in rural environment 24.546 patients, suspected of invasion of T. gondii, 504 healthy persons coming from villages and 1.681 live stock were examined. Among persons suspected of infection of T. gondii, 65 cases of congenital family toxoplasmosis and 19 cases of environment family toxoplasmosis, involving several members of the family were detected. In animals a comparatively high percentage with positive reaction in the direct agglutination test (cattle 55.5%, swine 27.90/o, sheep 23.4%) was detected. The following serological tests were applied to humans: complement-binding test (OWD), indirect immunofluorescence test (OIF), direct agglutination test with 2-mercaptoethanol (CA), ELISA IgM and, selectively, immunoperoxidase test IgM (OIP). The results suggest that the environment conditions can play an important role in the occurrence of family toxoplasmosis in our country, especially in the countryside. Detecting active toxoplasmosis in a family member should be a signal to start serological-epidemiological examination of the remaining family members and live stock