Toward an Understanding of the Perpetuation of the Agent of Tularemia

The epidemiology of tularemia has influenced, perhaps incorrectly skewed, our views on the ecology of the agent of tularemia. In particular, the central role of lagomorphs needs to be reexamined. Diverse observations, some incidental, and some that are more generally reproducible, have not been synthesized so that the critical elements of the perpetuation of Francisella tularensis can be identified. Developing a quantitative model of the basic reproduction number of F. tularensis may require separate treatments for Type A and Type B given the fundamental differences in their ecology

Urban residential infrastructure networks.

Massachusetts Institute of Technology. Dept. of Architecture. Thesis. 1970. M.Arch.Bibliography: leaves 191-193.M.Arch

Prevalence of Ehrlichia muris in Wisconsin Deer Ticks Collected During the Mid 1990s

Human ehrlichiosis is due to infection by tick transmitted bacteria of the genus Ehrlichia. Based on a hypothesis for the biogeography of deer tick transmitted infections, we undertook a focused search for the Eurasian E. muris in North American deer ticks. The search was stimulated by anecdotal reports of E. muris-like infection in human ehrlichiosis patients from Wisconsin. We analyzed archived adult deer ticks collected in northern Wisconsin during the 1990s by specific polymerase chain reaction for evidence of infection, and sequenced amplification products to identify E. muris. About 1% of 760 adult deer ticks collected from Spooner, Wisconsin in the 1990s contained E. muris DNA. We conclude that E. muris was present in North American deer ticks a decade ago and is likely to infect this human biting vector elsewhere in the U.S. Biogeographic theory and molecular phylogenetic methods can facilitate a targeted search for potential zoonoses

Incrimination of shrews as a reservoir for Powassan virus

Powassan virus lineage 2 (deer tick virus) is an emergent threat to American public health, causing severe neurologic disease. Its life cycle in nature remains poorly understood. We use a host-specific retrotransposon-targeted real time PCR assay to test the hypothesis that white-footed mice, considered the main eastern U.S. reservoir of the coinfecting agent of Lyme disease, is the reservoir for deer tick virus. Of 20 virus-infected host-seeking nymphal black-legged ticks 65% fed on shrews and none on mice. The proportion of ticks feeding on shrews at a site is positively associated with prevalence of viral infection, but not the Lyme disease agent. Viral RNA is detected in the brain of one shrew. We conclude that shrews are a likely reservoir host for deer tick virus and that host bloodmeal analysis can provide direct evidence to incriminate reservoir hosts, thereby promoting our understanding of the ecology of tick-borne infections

Metapopulation structure for perpetuation of Francisella tularensis tularensis

<p>Abstract</p> <p>Background</p> <p>Outbreaks of Type A tularemia due to <it>Francisella tularensis tularensis </it>are typically sporadic and unstable, greatly hindering identification of the determinants of perpetuation and human risk. Martha's Vineyard, Massachusetts has experienced an outbreak of Type A tularemia which has persisted for 9 years. This unique situation has allowed us to conduct long-term eco-epidemiologic studies there. Our hypothesis is that the agent of Type A tularemia is perpetuated as a metapopulation, with many small isolated natural foci of transmission. During times of increased transmission, the foci would merge and a larger scale epizootic would occur, with greater likelihood that humans become exposed.</p> <p>Methods</p> <p>We sampled questing dog ticks from two natural foci on the island and tested them for tularemia DNA. We determined whether the force of transmission differed between the two foci. In addition, we examined the population structure of <it>F. tularensis </it>from ticks by variable number tandem repeat (VNTR) analysis, which allowed estimates of diversity, linkage disequilibrium, and eBURST analysis.</p> <p>Results</p> <p>The prevalence of tularemia DNA in ticks from our two field sites was markedly different: one site was stable over the course of the study yielding as many as 5.6% positive ticks. In contrast, infected ticks from the comparison site markedly increased in prevalence, from 0.4% in 2003 to 3.9% in 2006. Using 4 VNTR loci, we documented 75 different haplotypes (diversity = 0.91). eBURST analysis indicates that the stable site was essentially clonal, but the comparison site contained multiple unrelated lineages. The general bacterial population is evolving clonally (multilocus disequilibrium) and the bacteria in the two sites are reproductively isolated.</p> <p>Conclusion</p> <p>Even within an isolated island, tularemia natural foci that are no more than 15 km apart are uniquely segregated. One of our sites has stable transmission and the other is emergent. The population structure at the stable site is that of a clonal complex of circulating bacteria, whereas the emerging focus is likely to be derived from multiple founders. We conclude that the agent of tularemia may perpetuate in small stable natural foci and that new foci emerge as a result of spillover from such stable sites.</p

Diversity of Francisella Species in Environmental Samples from Martha’s Vineyard, Massachusetts

We determined whether Francisella spp. are present in water, sediment, and soil from an active tularemia natural focus on Martha’s Vineyard, Massachusetts, during a multiyear outbreak of pneumonic tularemia. Environmental samples were tested by polymerase chain reaction (PCR) targeting Francisella species 16S rRNA gene and succinate dehydrogenase A (sdhA) sequences; evidence of the agent of tularemia was sought by amplification of Francisella tularensis-specific sequences for the insertion element ISFTu2, 17-kDa protein gene tul4, and the 43-kDa outer membrane protein gene fopA. Evidence of F. tularensis subsp. tularensis, the causative agent of the human infections in this outbreak, was not detected from environmental samples despite its active transmission among ticks and animals in the sampling site. Francisella philomiragia was frequently detected from a brackish-water pond using Francisella species PCR targets, and subsequently F. philomiragia was isolated from an individual brackish-water sample. Distinct Francisella sp. sequences that are closely related to F. tularensis and Francisella novicida were detected from samples collected from the brackish-water pond. We conclude that diverse Francisella spp. are present in the environment where human cases of pneumonic tularemia occur

Infección por Theileria annae en un perro esplenectomizado

La babesiosis canina es una enfermedad infecciosa de distribución mundial debida a la proliferación en los hematíes del perro de unas babesias específicas transmitidas por garrapatas. Si bien ha sido tradicionalmente asumido que las únicas especies que causan enfermedad en la especie canina son Babesia canis y Babesia gibsoni, publicaciones recientes demuestran que una tercera especie (Theileria annae) también puede causar una enfermedad muy severa. Este trabajo presenta el segundo caso publicado de esta forma de Theileria annae en un perro de 14 años, de raza Basset Hound, esplenectomizado cinco meses antes, que se presentó en la clínica veterinaria con signos de hipertermia, hemoglobinuria, temblores y apatía. El estudio de laboratorio constató una acusada anemia hemolítica regenerativa y una intensa trombocitopenia como datos más característicos. En la extensión de sangre periférica se visualizaron múltiples merozoítos intra (22%) y extraeritrocitarios de pequeño tamaño (1-2 micras), forma anular y presentación única en la mayoría de hematíes. La prontitud del diagnóstico y del tratamiento específico con dipropionato de imidocarb hizo que el cuadro clínico evolucionase con rapidez hacia la curación, en contra de lo que es habitual en los animales esplenectomizados.

Entomologic and Serologic Evidence of Zoonotic Transmission of Babesia microti, Eastern Switzerland

We evaluated human risk for infection with Babesia microti at a site in eastern Switzerland where several B. microti–infected nymphal Ixodes ricinus ticks had been found. DNA from pooled nymphal ticks amplified by polymerase chain reaction was highly homologous to published B. microti sequences. More ticks carried babesial infection in the lower portion of the rectangular 0.7-ha grid than in the upper (11% vs. 0.8%). In addition, we measured seroprevalence of immunoglobulin (Ig) G antibodies against B. microti antigen in nearby residents. Serum from 1.5% of the 396 human residents of the region reacted to B. microti antigen (>1:64), as determined by indirect immunofluorescence assay (IgG). These observations constitute the first report demonstrating B. microti in a human-biting vector, associated with evidence of human exposure to this agent in a European site

Nonrandom Distribution of Vector Ticks (Dermacentor variabilis) Infected by Francisella tularensis

The island of Martha's Vineyard, Massachusetts, is the site of a sustained outbreak of tularemia due to Francisella tularensis tularensis. Dog ticks, Dermacentor variabilis, appear to be critical in the perpetuation of the agent there. Tularemia has long been characterized as an agent of natural focality, stably persisting in characteristic sites of transmission, but this suggestion has never been rigorously tested. Accordingly, we sought to identify a natural focus of transmission of the agent of tularemia by mapping the distribution of PCR-positive ticks. From 2004 to 2007, questing D. variabilis were collected from 85 individual waypoints along a 1.5 km transect in a field site on Martha's Vineyard. The positions of PCR-positive ticks were then mapped using ArcGIS. Cluster analysis identified an area approximately 290 meters in diameter, 9 waypoints, that was significantly more likely to yield PCR-positive ticks (relative risk 3.3, P = 0.001) than the rest of the field site. Genotyping of F. tularensis using variable number tandem repeat (VNTR) analysis on PCR-positive ticks yielded 13 different haplotypes, the vast majority of which was one dominant haplotype. Positive ticks collected in the cluster were 3.4 times (relative risk = 3.4, P<0.0001) more likely to have an uncommon haplotype than those collected elsewhere from the transect. We conclude that we have identified a microfocus where the agent of tularemia stably perpetuates and that this area is where genetic diversity is generated

Landscape Epidemiology of Tularemia Outbreaks in Sweden

Transmission sites of specific Francisella tularensis genotypes were highly localized during natural outbreaks of human tularemia