Single Dose of Doxycycline for the Prevention of Tick-borne Relapsing Fever

Binenbaum, Yoav; Ben‐Ami, Ronen; Baneth, Gad; Langford, Boaz; Negev, Yoav; Friedlander, Edwa; Shasha, David; Tau, Luba; Paran, Yael

doi:10.1093/cid/ciaa034

Cited by 10 publications

(5 citation statements)

References 6 publications

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“…The use of antibiotic medications from 3 months prior to sample collection was recorded in the studied animals since B. persica is sensitive to several antibiotics, possibly leading to negative PCR results, if animals were treated recently [ 10 , 28 , 29 ]. Both the dogs and cats that had received antibiotics close to the time of sampling showed significantly lower seropositivity rates and also lower combined seropositivity or PCR-positivity rates than untreated animals infected with B. persica , probably reflecting the spirochete’s sensitivity to antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…Both the dogs and cats that had received antibiotics close to the time of sampling showed significantly lower seropositivity rates and also lower combined seropositivity or PCR-positivity rates than untreated animals infected with B. persica , probably reflecting the spirochete’s sensitivity to antibiotics. In different studies, it was shown that even one preventive treatment with doxycycline after a tick bite was sufficient to prevent disease in humans [ 29 ] and that the disappearance of spirochetemia in a treated cat was evident 1 day after initial treatment with ciprofloxacin [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Infection and seroprevalence of Borrelia persica in domestic cats and dogs in Israel

et al. 2022

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Background Relapsing fever borreliosis is an infectious disease caused by bacteria of the genus Borrelia, inflicting recurrent episodes of fever and spirochetemia in humans. Borrelia persica, the causative agent of relapsing fever in Israel, is prevalent over a broad geographic area that extends from India to Egypt. It is transmitted by the soft tick Ornithodoros tholozani and causes disease in humans as well as domestic cats and dogs. The goal of this study was to survey domestic dogs and cats in Israel for infection with B. persica. Methods Blood, sera and demographic and clinical data were collected from dogs and cats brought for veterinary care in central Israel. PCR followed by DNA sequencing was used to detect B. persica DNA in blood samples, and an enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies reactive with B. persica antigens in sera from the same animals. This is the first serological survey of B. persica in dogs and the first survey for antibodies reactive with a relapsing fever Borrelia sp. in cats globally. Results Four of the 208 dogs (1.9%) and three of 103 cats (2.9%) sampled were positive by PCR for B. persica DNA, and 24 dogs (11.5%) and 18 cats (17.5%) were seropositive for B. persica antigen by ELISA. The ratio between PCR-positivity and seropositivity in both the dog and cat populations was 1:6. All four PCR-positive dogs and two of three PCR-positive cats were seronegative, suggesting a probable recent infection. Thrombocytopenia showed significant association with seropositivity in dogs (P = 0.003). In cats, anemia had a significant association with seropositivity (P = 0.0001), and thrombocytopenia was associated with the combined prevalence of seropositivity or PCR-positivity (P = 0.022). Conclusions Borrelia persica infection is more prevalent and widespread in domestic canine and feline populations in Israel than previously thought. Dogs and cats may play a role as reservoirs and sentinels for human infection. Precautions should be taken to prevent transfusion-transmitted infection between blood donor and recipient animals. Graphic Abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infection and seroprevalence of Borrelia persica in domestic cats and dogs in Israel

et al. 2022

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“…Studies on preemptive therapy with a short course of doxycycline (day 1: 200mg/d, day 2-5: 100mg/d) were found to be highly effective in this regard [40,232,233]. A more recent study suggests, that even a single dose of doxycycline is sufficient and as effective [234].…”

Section: Treatmentmentioning

confidence: 99%

Tick borne relapsing fever - a systematic review and analysis of the literature

et al. 2022

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Tick borne relapsing fever (TBRF) is a zoonosis caused by various Borrelia species transmitted to humans by both soft-bodied and (more recently recognized) hard-bodied ticks. In recent years, molecular diagnostic techniques have allowed to extend our knowledge on the global epidemiological picture of this neglected disease. Nevertheless, due to the patchy occurrence of the disease and the lack of large clinical studies, the knowledge on several clinical aspects of the disease remains limited. In order to shed light on some of these aspects, we have systematically reviewed the literature on TBRF and summarized the existing data on epidemiology and clinical aspects of the disease. Publications were identified by using a predefined search strategy on electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of TBRF published in English, French, Italian, German, and Hungarian were included. Maps showing the epidemiogeographic mosaic of the different TBRF Borrelia species were compiled and data on clinical aspects of TBRF were analysed. The epidemiogeographic mosaic of TBRF is complex and still continues to evolve. Ticks harbouring TBRF Borrelia have been reported worldwide, with the exception of Antarctica and Australia. Although only molecular diagnostic methods allow for species identification, microscopy remains the diagnostic gold standard in most clinical settings. The most suggestive symptom in TBRF is the eponymous relapsing fever (present in 100% of the cases). Thrombocytopenia is the most suggestive laboratory finding in TBRF. Neurological complications are frequent in TBRF. Treatment is with beta-lactams, tetracyclines or macrolids. The risk of Jarisch-Herxheimer reaction (JHR) appears to be lower in TBRF (19.3%) compared to louse-borne relapsing fever (LBRF) (55.8%). The overall case fatality rate of TBRF (6.5%) and LBRF (4–10.2%) appears to not differ. Unlike LBRF, where perinatal fatalities are primarily attributable to abortion, TBRF-related perinatal fatalities appear to primarily affect newborns.

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“…In summary, multiple clinical trials have demonstrated that single-dose doxycycline for PEP effectively prevents Lyme disease, both in the United States 6 and Europe 12 after a tick bite and prevents at least 2 other spirochetal infections, syphilis 13 and tick-borne relapsing fever caused by Borrelia persica. 14 The updated Lyme disease guidelines explicitly state that the use of PEP does not guarantee the prevention of infection. 2 Clinicians need to provide appropriate education on the signs and symptoms of the infections that may potentially arise following an I. scapularis tick bite, whether due to Lyme disease or another infection potentially transmitted by this tick species, such as babesiosis.…”

Section: Lettermentioning

confidence: 99%