Diseases from North America: focus on tick-borne infections

Abstract

Tick-borne infections are seen throughout the United States, with varying geographical locations. Many of these infections are also increasingly seen in Europe. Certain ticks (eg Ixodes) can transmit more than one infection. Diagnosis, particularly in early infection, can be challenging and therefore knowledge of the distinguishing clinical features and epidemiology of these diseases is important. Testing for Lyme disease often causes confusion for patients and medical providers, as serological tests may be negative in early infection and conversely may be positive for years after infection. Newer tests, such as the C6 ELISA, may play a role in Lyme diagnosis. Additionally, the value of a simple blood fi lm should not be underestimated for diagnosing babesiosis and anaplasmosis. In certain situations, empiric therapy may be required for tick-borne infections as severe illness with multiorgan failure can occur, particularly in older and immunocompromised hosts. This review describes the more commonly seen tick-borne infections: Lyme, babesiosis, anaplasmosis and Rocky Mountain Spotted Fever. More recently identifi ed tick-borne infections, such as southern tick-associated rash illness and Borrelia miyamotoi, are also covered.Tick-borne infections are seen throughout the United States, with varying geographical locations. Diagnosis, particularly in early infection, can be challenging and severe illness can occur. In addition, certain ticks (eg Ixodes scapularis) can transmit more than one infection. This review describes the more commonly seen tick-borne infections. Lyme diseaseIn the United States, Lyme disease is the most common reportable vector-borne disease. 1 It is caused by Borrelia burgdorferii, which is transmitted by the Ixodes tick. This is in contrast to Lyme disease in Europe and Asia that is primarily caused by B afzelii and B garinii. In the US, the Centers for Disease Control and Prevention (CDC) estimates the incidence of Lyme disease to be as high as 300,000 cases per year. 2 The ABSTRACT Authors:

Revenge of the Tick: Tick-Borne Diseases and the Eye in the Age of Climate Change and Globalisation

“…Thus, in such patients with suggestive exposure history, closer follow up and perhaps a lower threshold for workup is advised. It has been suggested that doses of antibiotics be augmented in the immunocompromised as well [249].…”

Human Babesiosis: Pathogens, Prevalence, Diagnosis, and Treatment

“…It is also suggested that chronic B. microti parasite-positive but asymptomatic infection lasting more than 3 months are also treated with this same combination [95]. However, in immunocompromised individuals or any severe case with symptoms of severe hemolysis, renal or hepatic distress, compromised respiratory function, or a parasitemia greater than 10%, regardless of species, a 10 day course of intravenous clindamycin plus quinine coupled with exchange transfusion is the recommended course of treatment [41, 44, 96]. The additive measure of exchange transfusion swiftly removes the parasitized RBCs from the host circulation, resolving any pathologies arising from anemia, such as low hematocrit and circulating toxic metabolites which released into the host’s circulatory system from the cyclical destruction of the RBCs.…”

Integrative analysis highlights molecular and immune responses of tick Amblyomma americanum to Escherichia coli challenge

“…For instance, in the case of Lyme disease, the tick-borne bacterium Borrelia burgdorferi possesses mechanisms to evade the host’s immune system by altering its surface proteins, antigenic variation, and immune modulatory factors. This allows the bacterium to establish persistent infection and cause the characteristic symptoms of Lyme disease ( Brites-Neto et al., 2015 ; Nathavitharana and Mitty, 2015 ; Sparagano et al., 2022 ). Interestingly, ticks have developed remarkable strategies to coexist with these diverse disease-causing pathogen challenges.…”