Explanatory models for tick-borne disease incidence (Astrakhan rickettsial fever and Crimean-Congo hemorrhagic fever)

Introduction. The study focuses on methods providing mathematical substantiation of discrepancies between actual incidence rates of Astrakhan rickettsial fever (ARF) and Crimean-Congo hemorrhagic fever (CCHF) and predicted rates due to the indirect impact of weather conditions during the current epidemic season. The purpose of the study was to develop explanatory models for ARF and CCHF incidence using satellite monitoring (remote sensing) data and to present the results of their practical evaluation in the Stavropol Territory and Astrakhan Region. Materials and methods. The materials included climate data provided by the Space Research Institute of the Russian Academy of Sciences as well as epidemiological data on CCHF and ARF incidence from 2005 to 2021. The explanatory models incorporated the Bayes theorem and Wald sequential analysis. All the calculations were completed using the Microsoft Excel 2010-based program developed by the authors. Results. It has been found that the greatest indirect effect on development of the CCHF epidemiological situation is produced by the normalized difference vegetation index and relative air humidity in June-July in the Stavropol Territory and by the maximum, minimum and average air temperature in October as well as the minimum air temperature in July in the Astrakhan Region. ARF incidence rates depend on the indirect effect of the annual average and average annual maximum temperature, maximum temperature and the normalized difference vegetation index in April-July. The match between explanatory model-based results and prediction model-based results ranged within 46.2-100%. Discussion. In addition to projecting incidence rates, which could be reached with the observed values of climatic factors in the current year, the explanatory models can be used for indirect verification of prediction models and for identification of factors causing differences in results. Conclusion. The practical evaluation of explanatory models confirms the prospects and benefits of the study that should be continued, involving other regions highly endemic for tick-borne infections

Humans Infected with Relapsing Fever Spirochete Borrelia miyamotoi, Russia

Disease may occur throughout the world because of the widespread prevalence of this pathogen in ixodid ticks

Multi-Locus Sequence Analysis Reveals Profound Genetic Diversity among Isolates of the Human Pathogen Bartonella bacilliformis

Bartonella bacilliformis is the aetiological agent of human bartonellosis, a potentially life threatening infection of significant public health concern in the Andean region of South America. Human bartonellosis has long been recognised in the region but a recent upsurge in the number of cases of the disease and an apparent expansion of its geographical distribution have re-emphasized its contemporary medical importance. Here, we describe the development of a multi-locus sequence typing (MLST) scheme for B. bacilliformis and its application to an archive of 43 isolates collected from patients across Peru. MLST identified eight sequence types among these isolates and the delineation of these was generally congruent with those of the previously described typing scheme. Phylogenetic analysis based on concatenated sequence data derived from MLST loci revealed that seven of the eight sequence types were closely related to one another; however, one sequence type, ST8, exhibited profound evolutionary divergence from the others. The extent of this divergence was akin to that observed between other members of the Bartonella genus, suggesting that ST8 strains may be better considered as members of a novel Bartonella genospecies

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Borrelia miyamotoi Disease in an Immunocompetent Patient, Western Europe

Borrelia miyamotoi disease is a hard tick–borne relapsing fever illness that occurs across the temperate climate zone. Human B. miyamotoi disease in immunocompetent patients has been described in Russia, North America, and Japan. We describe a case of B. miyamotoi disease in an immunocompetent patient in western Europe

Draft Whole-Genome Sequences of Two Western European Borrelia miyamotoi Isolates.

We report the draft whole-genome sequences of two Borrelia miyamotoi strains isolated in The Netherlands. Using next-generation sequencing, we determined the complete sequence of the chromosomes and several plasmids. The two strains show a genotype typical of European strains, distinct from the genomes of strains from Asia or the United States