Update on tick-borne bacterial diseases in Europe

Socolovschi, Cristina; Mediannikov, Oleg; Raoult, Didier; Parola, Philippe

doi:10.1051/parasite/2009164259

Cited by 52 publications

(36 citation statements)

References 137 publications

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“…Moreover, 27 of the 40 patients in our study were adults, whereas previous studies focused exclusively on children. The clinical characteristics of the patients in our study did not differ between treatment groups and were similar to those in other series (16)(17)(18)(19)(20)(21)(22); all had fever and exanthema. None developed severe disease, and all had favorable outcomes.…”

Section: Discussionsupporting

confidence: 70%

Randomized Trial of Clarithromycin for Mediterranean Spotted Fever

Antón

Muñoz

Travería

et al. 2016

Antimicrob Agents Chemother

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The classic antibiotic treatment for Mediterranean spotted fever (MSF) is based on tetracyclines or chloramphenicol, but chloramphenicol's bone marrow toxicity makes tetracyclines the treatment of choice. However, it is convenient to have alternatives available for patients who are allergic to tetracyclines, pregnant women, and children <8 years old. We conducted a randomized clinical trial to compare clarithromycin with doxycycline or josamycin in the treatment of MSF. Forty patients were evaluated (23 male; mean age, 39.87 years); 13 patients were aged <14 years. Seventeen patients received clarithromycin, and 23 received doxycycline or josamycin. The interval between the onset of symptoms and the start of treatment was 4.04 ؎ 1.70 days in the clarithromycin group versus 4.11 ؎ 1.60 days in the doxycycline/josamycin group (P ‫؍‬ not significant [NS]). Time to the disappearance of fever after treatment was 2.67 ؎ 1.55 days in the clarithromycin group versus 2.22 ؎ 1.35 days in the doxycycline/ josamycin (P ‫؍‬ NS). The symptoms had disappeared at 4.70 ؎ 2.25 days in the clarithromycin group versus at 4.75 ؎ 3.08 days in the doxycycline/josamycin (P ‫؍‬ NS). There were no adverse reactions to treatment or relapses in either group. In conclusion, clarithromycin is a good alternative to doxycycline or josamycin in the treatment of MSF. Mediterranean spotted fever (MSF) is a spotted fever group rickettsiosis. Caused by Rickettsia conorii, MSF is endemic in the Mediterranean area. Clinically, MSF is characterized by fever, exanthema, and the inoculation eschar known as tache noire. MSF affects people of both sexes and all ages (1-3).Antibiotic therapy helps prevent progression to severe disease and the associated mortality (4). Classic antibiotic therapy consists of tetracyclines or chloramphenicol, although the use of chloramphenicol in developed countries is limited by its bone marrow toxicity (5).Both in vitro and in vivo studies have shown that doxycycline is highly efficacious in this group of rickettsiosis. Even short-course treatments with doxycycline are highly effective (6). Nevertheless, it would be useful to have alternative treatments for patients allergic to tetracyclines, pregnant women, and children Ͻ8 years old.In vitro studies have shown that rifampin, the fluoroquinolones, and some macrolides have good activity against R. conorii (7, 8); however, of these, only josamycin has proven efficacy in vivo (9). Although josamycin has been commercially available for years in some countries (e.g., France, Switzerland, Austria, Italy, South Africa, and Spain), it is unavailable in many others. Thus, it would be useful to have another antibiotic that can be obtained in most countries to treat MSF.Several studies showed that clarithromycin and its metabolite 14-hydroxyclarithromycin have excellent in vitro activity against R. conorii and Rickettsia rickettsii (10-12), and these results were confirmed in clinical studies, where clarithromycin was efficacious and safe in treating children with spotted fever group...

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Section: Discussionsupporting

confidence: 70%

Randomized Trial of Clarithromycin for Mediterranean Spotted Fever

Antón

Muñoz

Travería

et al. 2016

Antimicrob Agents Chemother

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“…The peak incidence of TIBOLA (in part caused by R. raoultii) was reported to be September-November and March to May both in Hungary (Lakos et al, 2012) and in other parts of Europe (Socolovschi et al, 2009). This has been explained by the peak activity of D. reticulatus.…”

Section: Resultsmentioning

confidence: 99%

Seasonally biased or single-habitat sampling is not informative on the real prevalence of Dermacentor reticulatus-borne rickettsiae — A pilot study

Hornok

Meli

Gönczi

et al. 2017

Acta Veterinaria Hungarica

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Dermacentor reticulatus is a tick species of high medical and veterinary importance, emerging in several parts of Europe. Up to now most studies focusing on zoonotic rickettsiae in D. reticulatus were based on ticks collected in a limited part of the questing period, and did not take into account the potential seasonal variations in the rate of infection with tick-borne rickettsiae. The aim of the present study was to investigate the latter phenomenon, i.e. to screen D. reticulatus adults, collected monthly in two urban habitats of Budapest, for the presence of three zoonotic Rickettsia spp. Altogether 852 D. reticulatus adults were collected, which showed significantly similar seasonal activity in the two evaluated habitats. Among the 413 molecularly analysed ticks, R. helvetica-infected D. reticulatus were only collected during autumn in habitat-1, in contrast to habitat-2. The overall prevalence of R. raoultii in D. reticulatus adults was significantly higher in habitat-1 than in habitat-2. In addition, the seasonal distribution of R. raoultiiinfected ticks was different between the two habitats (in habitat-2 significantly more R. raoultii-infected ticks were collected in the autumn, in comparison with winter and spring). Rickettsia slovaca was not detected in any of the molecularly analysed ticks. The results clearly indicate that a single-time or seasonally biased collection of D. reticulatus adults and their subsequent molecular analysis may not be informative on the real prevalence of rickettsiae. This is because the availability/activity of infected ticks shows significant seasonal fluctuations, both within and between habitats. Instead, for screening D. reticulatus-borne rickettsiae, it is important to collect monthly samples and then to assess seasonal prevalence and actual habitat-associated eco-epidemiological risks.

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“…However recently, Socolovschi et al (2009) report that 140 tick species in 12 genera can carry C. burnetii. Although the tortoises of the genus Testudo are the principal hosts for adults of H. aegyptium, this tick species posses three-host lifecycle, alternating between tortoises, other reptiles and mammals (Apanaskevich 2003;Hoogstraal 1956;Hoogstraal and Kaiser 1960;Široký et al 2006).…”

Section: Introductionmentioning

confidence: 98%

Tortoise tick Hyalomma aegyptium as long term carrier of Q fever agent Coxiella burnetii—evidence from experimental infection

et al. 2010

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The experimental study investigated the ability of tortoise tick Hyalomma aegyptium to play a role in forming and maintaining natural foci of Q fever. We tested the competence of H. aegyptium larvae to acquire Coxiella burnetii infection from mammals, serve as a C. burnetii vector between mammalian hosts, and be a long-term carrier of C. burnetii, including interstadial transmission. H. aegyptium larvae were allowed to feed on guinea pigs experimentally infected with C. burnetii. Engorged larvae molted to nymphs, some of which were preserved in 96% ethanol and later examined by polymerase chain reaction (PCR) using C. burnetii-specific primers (CBCOS, CBCOE). Prevalence of C. burnetii among these nymphs was 5.6% (n=235). Remaining nymphs then fed on other, C. burnetii-negative guinea pigs; and according to results of both, micro-agglutination reaction, and ELISA, they successfully transmitted C. burnetii to those new hosts. Detached engorged nymphs molted to adults, which were kept alive long term and then placed in 96% ethanol 383 days post-infection. Thereafter, they were examined by PCR in the same manner as were the nymphs. Prevalence of C. burnetii among adult H. aegyptium was 28.9% (n=90). According to our results, tortoise-specific ticks have indisputable potential in the epidemiology of Q fever natural foci.

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Update on tick-borne bacterial diseases in Europe

Cited by 52 publications

References 137 publications

Randomized Trial of Clarithromycin for Mediterranean Spotted Fever

Randomized Trial of Clarithromycin for Mediterranean Spotted Fever

Seasonally biased or single-habitat sampling is not informative on the real prevalence of Dermacentor reticulatus-borne rickettsiae — A pilot study

Tortoise tick Hyalomma aegyptium as long term carrier of Q fever agent Coxiella burnetii—evidence from experimental infection

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