The prevalence and clinical characteristics of tick-borne diseases at One Sentinel Hospital in Northeastern China

Abstract

Northeastern China is a region of high tick abundance, multiple tick-borne pathogens and likely human infections. The spectrum of diseases caused by tick-borne pathogens has not been objectively evaluated in this region for clinical management and for comparison with other regions globally where tick-transmitted diseases are common. Based on clinical symptoms, PCR, indirect immunofluorescent assay and (or) blood smear, we identified and described tick-borne diseases from patients with recent tick bite seen at Mudanjiang Forestry Central Hospital. From May 2010 to September 2011, 42% (75/180) of patients were diagnosed with a specific tick-borne disease, including Lyme borreliosis, tick-borne encephalitis, human granulocytic anaplasmosis, human babesiosis and spotted fever group rickettsiosis. When we compared clinical and laboratory features to identify factors that might discriminate tick-transmitted infections from those lacking that evidence, we revealed that erythema migrans and neurological manifestations were statistically significantly differently presented between those with and without documented aetiologies (P < 0.001, P = 0.003). Twelve patients (6.7%, 12/180) were co-infected with two tick-borne pathogens. We demonstrated the poor ability of clinicians to identify the specific tick-borne disease. In addition, it is necessary to develop specific laboratory assays for optimal diagnosis of tick-borne diseases.

Systematic Review and Meta-analysis of Lyme Disease Data and Seropositivity for Borrelia burgdorferi, China, 2005‒2020

“…Among the seroconversions that resulted in clinical manifestations, these included erythema migrans (85%), Borrelia lymphocytoma (3%), nervous system disease (6%), or nonspecific symptoms of Lyme disease (6%). A study conducted in China documenting clinical manifestations after tick bite reported a lower proportion of erythema migrans (69%) and a higher proportion of nervous system disease (21%) and arthralgia (21%), among other manifestations ( 32 ). In the United States, a randomized controlled trial of a vaccine candidate documented an asymptomatic proportion of <10%, potentially arising from the shorter duration of follow-up for symptoms compared with that in Europe ( 33 ).…”

Emergence of human infection with Jingmen tick virus in China: A retrospective study

“…Data for clinical manifestations, underlying conditions, laboratory tests, treatment, and outcomes were retrieved from medical records. Other tick-borne pathogens, such as Anaplasma phagocytophilum , “ Anaplasma capra ”, Candidatus Neoehrlichia mikurensis, Ehrlichia chaffeensis , Spotted Fever Group Rickettsiae (SFGR), Borrelia burgorferi sensu lato, Borrelia miyamotoi, Babesia , tick-borne encephalitis virus (TBEV) and severe fever with thrombocytopenia syndrome virus were recorded or identified by previous testing [[8], [9], [10], [11], [12], [13], [14], [15], [16]].…”

Nucleic Acid Prevalence of Zoonotic Babesia in Humans, Animals and Questing Ticks, a Systematic Review and Meta-Analysis

“…Only China has reported human infections of B. venatorum . The reported nucleic acid prevalence was 1.65% in people with tick bite history from Northeast China ( Table S1 ) [ 31 ].…”

“… Flow diagram of study selection. * In the included studies, a total of 18 studies reported dual infection of humans, animals or ticks, of which four studies reported the infection of human and ticks [ 31 , 32 , 33 , 34 ], and 14 studies reported the infection of ticks and animals [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. In addition, some studies reported more than one zoonotic Babesia infection.…”