First Report of Human Granulocytic Ehrlichiosis from Southern Europe (Spain)

Oteo, José A.; Blanco, José Ramón; Artola, V. Martínez de; Ibarra, Valvanera

doi:10.3201/eid0604.000425

Cited by 53 publications

(42 citation statements)

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“…Thereafter, seroepidemiologic surveys have found a prevalence of antibodies in a range of 0%-2.9% in blood donors and 1.5%-21% of tick-exposed people throughout northern and central Europe [18]. To date a total of 20 cases have been reported in Europe including Slovenia [7,80], the Netherlands [147], Spain [100], Sweden [16,64], Norway [14], Croatia [90], Poland [145], Italy [131], Austria [149], and France [124]. The majority of cases occurred between June and August [18].…”

Section: Epidemiological and Clinical Aspectsmentioning

confidence: 99%

Tick- and flea-borne rickettsial emerging zoonoses

2005

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- Between 1984 and2004, nine more species or subspecies of spotted fever rickettsiae were identified as emerging agents of tick-borne rickettsioses throughout the world. Six of these species had first been isolated from ticks and later found to be pathogenic to humans. The most recent example is Rickettsia parkeri, recognized as a human pathogen more than 60 years after its initial isolation from ticks. A new spotted fever rickettsia, R. felis was also found to be associated with fleas and to be a human pathogen. Similarly, bacteria within the family Anaplasmataceae have been considered to be of veterinary importance only, yet three species have been implicated in human diseases in recent years, including Ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis, Anaplasma phagocytophilum, the agent of human anaplasmosis (formerly known as "human granulocytic ehrlichiosis agent", E. equi and E. phagocytophila), and finally Ehrlichia ewingii, which causes granulocytic ehrlichiosis in humans. We present here an overview of the various tick-and flea-borne rickettsial zoonoses described in the last 20 years, focusing on the ecological, epidemiological and clinical aspects.

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Section: Epidemiological and Clinical Aspectsmentioning

confidence: 99%

Tick- and flea-borne rickettsial emerging zoonoses

2005

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“…There have been several reports that described the presence of the HGE agent in ticks in Europe (3,12,20,27). However, there seems to be a paucity of reports of confirmed cases of HGE in Europe, and most of these cases are found in Slovenia where Lyme borreliosis is highly prevalent (14,17,19,20,30).…”

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confidence: 99%

Identification ofEhrlichiaspp. andBorrelia burgdorferiinIxodesTicks in the Baltic Regions of Russia

Alekseev

Dubinina

Pol³

et al. 2001

J Clin Microbiol

195

121

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The presence and distribution of Ehrlichia spp. and Borrelia burgdorferi sensu lato was demonstrated among ixodid ticks collected in the Baltic regions of Russia, where Lyme borreliosis is endemic. A total of 3,426 Ixodes ricinus and 1,267 Ixodes persulcatus specimens were collected, and dark-field microscopy showed that 265 (11.5%) I. ricinus and 333 (26.3%) I. persulcatus ticks were positive. From these samples, 472 dark-field-positive and 159 dark-field-negative ticks were subjected to PCR and subsequent reverse line blot hybridization. Fifty-four ticks (8.6%) carried Ehrlichia species, and 4 (0.6%) carried ehrlichiae belonging to the Ehrlichia phagocytophila complex, which includes the human granulocytic ehrlichiosis agent. The E. phagocytophila complex and an Ehrlichia-like species were detected only in I. ricinus whereas Ehrlichia muris was found exclusively in I. persulcatus, indicating a possible vector-specific infection. Borrelia garinii was found predominantly in I. persulcatus, but Borrelia afzelii was evenly distributed among the two tick species. Only two I. ricinus ticks carried B. burgdorferi sensu stricto, while Borrelia valaisiana and a newly identified B. afzelii-like species were found in 1.7 and 2.5% of all ticks, respectively. Of the dark-field-positive ticks, only 64.8% yielded a Borrelia PCR product, indicating that dark-field microscopy may detect organisms other than B. burgdorferi sensu lato. These observations show that the agent of human granulocytic ehrlichiosis may be present in ticks in the Baltic regions of Russia and that clinicians should be aware of this agent as a cause of febrile disease.

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“…Since 1995, serological evidence of HGE has been demonstrated in several European countries (3,7,11,15,16,20,23,40,49,50), including Switzerland (9,29,45), in areas of known endemicity for Lyme borreliosis. Clinical and laboratory-confirmed HGE cases have been reported to occur in patients from Slovenia (42), The Netherlands (51), and Sweden (6).…”

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confidence: 99%

PCR Detection and Serological Evidence of Granulocytic Ehrlichial Infection in Roe Deer ( Capreolus capreolus ) and Chamois ( Rupicapra rupicapra )

et al. 2002

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The role of wild mammals, such as roe deer (Capreolus capreolus) and chamois (Rupicapra rupicapra), in the epidemiology of granulocytic ehrlichiae in Switzerland was investigated. We tested blood samples for Ehrlichia phagocytophila genogroup 16S rRNA gene sequences by PCR and for immunoglobulin G antibodies against granulocytic ehrlichiae by indirect fluorescent-antibody assay (IFA). Overall means of 60.9% of 133 roe deer serum samples and 28.2% of 39 chamois serum samples were seroreactive by IFA. PCR results were positive for 18.4% of 103 roe deer serum samples as well. None of the 24 chamois blood samples tested were positive by PCR. Partial 16S rRNA gene and groESL heat shock operon sequences of three roe deer samples tested showed strong degrees of homology (>99.7 and >98.6%, respectively) with the sequences of granulocytic ehrlichiae isolated from humans. These results confirm that chamois, and particularly roe deer, are commonly infected with granulocytic ehrlichiae and provide evidence that these wild mammals are potential reservoirs for granulocytic ehrlichiae in Switzerland.

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First Report of Human Granulocytic Ehrlichiosis from Southern Europe (Spain)

Cited by 53 publications

References 0 publications

Tick- and flea-borne rickettsial emerging zoonoses

Tick- and flea-borne rickettsial emerging zoonoses

Identification ofEhrlichiaspp. andBorrelia burgdorferiinIxodesTicks in the Baltic Regions of Russia

PCR Detection and Serological Evidence of Granulocytic Ehrlichial Infection in Roe Deer ( Capreolus capreolus ) and Chamois ( Rupicapra rupicapra )

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