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East Coast fever (theileriosis) is an animal disease in Africa caused by the protozoan parasite "Theileria parva". It excludes diseases caused by other "Theileria"
Half of all children and a quarter of previously healthy adults are asymptomatic with "Babesia" infection. When people do develop symptoms, the most common are fever and hemolytic anemia, symptoms that are similar to those of malaria. People with symptoms usually become ill 1 to 4 weeks after the bite, or 1 to 9 weeks after transfusion of contaminated blood products. A person infected with babesiosis gradually develops malaise and fatigue, followed by a fever. Hemolytic anemia, in which red blood cells are destroyed and removed from the blood, also develops. Chills, sweats, and thrombocytopenia are also common symptoms. Symptoms may last from several days to several months.
Less common symptoms and physical exam findings of mild-to-moderate babesiosis:
In more severe cases, symptoms similar to malaria occur, with fevers up to 40.5 °C (105 °F), shaking chills, and severe anemia (hemolytic anemia). Organ failure may follow, including adult respiratory distress syndrome. Severe cases occur mostly in people who have had a splenectomy. Severe cases are also more likely to occur in the very young, very old, and persons with immunodeficiency, such as HIV/AIDS patients.
A reported increase in human babesiosis diagnoses in the 2000s is thought to be caused by more widespread testing and higher numbers of people with immunodeficiencies coming in contact with ticks, the disease vector. Little is known about the occurrence of "Babesia" species in malaria-endemic areas, where "Babesia" can easily be misdiagnosed as "Plasmodium". Human patients with repeat babesiosis infection may exhibit premunity.
Anaemia may be severe and result in cardiovascular changes such as an increase in heart rate. Blood in the urine may occur due to the lysis of red blood cells. General systemic signs such as diarrhea, anorexia and weight loss may also be present. A blood smear stained with Giemsa should be observed for identification of infected red blood cells and will allow definitive diagnosis.
Babesiosis is a malaria-like parasitic disease caused by infection with "Babesia", a genus of Apicomplexa. Human babesiosis is an uncommon but emerging disease in the Northeastern and Midwestern United States and parts of Europe, and sporadic throughout the rest of the world. It occurs in warm weather. Ticks transmit the human strain of babesiosis, so it often presents with other tick-borne illnesses such as Lyme disease. After trypanosomes, "Babesia" is thought to be the second-most common blood parasite of mammals, and they can have a major impact on health of domestic animals in areas without severe winters. In cattle, a major host, the disease is known as Texas cattle fever, redwater, or piroplasmosis.
Anaplasmosis is a disease caused by a rickettsial parasite of ruminants, "Anaplasma" spp. The microorganism is gram-negative, and infects red blood cells. It is transmitted by natural means through a number of haematophagous species of ticks. Anaplasmosis can also be transmitted by the use of surgical, dehorning, castration, and tattoo instruments and hypodermic needles that are not disinfected between uses.
A tick infestation is a condition where a tick acts as an ectoparasite.
It is sometimes thought of as an animal disease. In humans, the primary concern from tick bites is often not the ectoparasitism itself, but the potential for the tick to transmit disease or tick paralysis. Still, in certain populations, it is possible for tick infestation to be clinically significant.
There is some evidence that "Ixodes ricinus" infected with "Borrelia burgdorferi" may become more efficient at infestation.
Home remedies (such as vaseline or matches) have been used in the past, but are not currently recommended.
Mortality can be up to 100%, with death occurring around 18–30 days after the initial attachment of infected ticks, because the incubation required is around 10–25 days, and the parasite spreads quickly and is rather aggressive.
Clinical signs for diagnosis include, but are not limited to, fever and enlarged lymph nodes near the tick bite(s). Smears and stains can also be done to check for the parasite. Schizonts (meronts, or segmentors) can be found in infected lymphocytes. Pathology includes anorexia, dyspnea, corneal opacity, nasal discharge, frothy nasal discharge, diarrhea, pulmonary edema, leukopenia, and anemia. Endemic cattle given medication sometimes recover to varying degrees, or death follows due to blocked capillaries and parasites infecting the central nervous system. Cattle that are endemic and manage to survive, tend to be carriers.
A form of East Coast fever called corridor disease is observed when the organism is transmitted from the African buffalo to cattle. Another form, called January disease, only occurs over the winter months in Zimbabwe due to the tick lifecycle.
For diagnosis, "post mortem" findings are characteristic and mainly include damage to the lymphoid and respiratory systems.
The acute stage of the disease, occurring most often in the spring and summer, begins one to three weeks after infection and lasts for two to four weeks. Clinical signs include a fever, petechiae, bleeding disorders, vasculitis, lymphadenopathy, discharge from the nose and eyes, and edema of the legs and scrotum. There are no outward signs of the subclinical phase. Clinical signs of the chronic phase include weight loss, pale gums due to anemia, bleeding due to thrombocytopenia, vasculitis, lymphadenopathy, dyspnea, coughing, polyuria, polydipsia, lameness, ophthalmic diseases such as retinal hemorrhage and anterior uveitis, and neurological disease. Dogs that are severely affected can die from this disease.
Although people can get ehrlichiosis, dogs do not transmit the bacteria to humans; rather, ticks pass on the "ehrlichia" organism. Clinical signs of human ehrlichiosis include fever, headache, eye pain, and gastrointestinal upset. It is quite similar to Rocky Mountain spotted fever, but rash is not seen in patients.
In general, specific laboratory tests are not available to rapidly diagnose tick-borne diseases. Due to their seriousness, antibiotic treatment is often justified based on clinical presentation alone.
Spotted fever can be very difficult to diagnose in its early stages, and even experienced doctors who are familiar with the disease find it hard to detect.
People infected with "R. rickettsii" usually notice symptoms following an incubation period of one to two weeks after a tick bite. The early clinical presentation of Rocky Mountain spotted fever is nonspecific and may resemble a variety of other infectious and non-infectious diseases.
Initial symptoms:
- Fever
- Nausea
- Emesis (vomiting)
- Severe headache
- Muscle pain
- Lack of appetite
- Parotitis in some cases (somewhat rare)
Later signs and symptoms:
- Maculopapular rash
- Petechial rash
- Abdominal pain
- Joint pain
- Conjunctivitis
- Forgetfulness
The classic triad of findings for this disease are fever, rash, and history of tick bite. However, this combination is often not identified when the patient initially presents for care. The rash has a centripetal, or "inward" pattern of spread, meaning it begins at the extremities and courses towards the trunk.
The rash first appears two to five days after the onset of fever, and it is often quite subtle. Younger patients usually develop the rash earlier than older patients. Most often the rash begins as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles. These spots turn pale when pressure is applied and eventually become raised on the skin. The characteristic red, spotted (petechial) rash of Rocky Mountain spotted fever is usually not seen until the sixth day or later after onset of symptoms, but this type of rash occurs in only 35 to 60% of patients with Rocky Mountain spotted fever. The rash involves the palms or soles in as many as 80% of the patients. However, this distribution may not occur until later on in the course of the disease. As many as 15 percent of patients may never develop a rash.
Tick-borne diseases, which afflict humans and other animals, are caused by infectious agents transmitted by tick bites. Tick-borne illnesses are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa. Because individual ticks can harbor more than one disease-causing agent, patients can be infected with more than one pathogen at the same time, compounding the difficulty in diagnosis and treatment. As of 2016, 16 tick-borne diseases of humans are known (four discovered since 2013).
As the incidence of tick-borne illnesses increases and the geographic areas in which they are found expand, health workers increasingly must be able to distinguish the diverse, and often overlapping, clinical presentations of these diseases.
African tick bite fever is often asymptomatic or mild in clinical presentation and complications are rare. The onset of illness is typically 5–7 days after the tick bite, although in some cases it may take up to 10 days for symptoms to occur. Symptoms can persist for several days to up to three weeks. Common presenting symptoms include:
- Fever
- Headache
- Muscle aches
- Inoculation eschar, which is dead, often black, tissue around a bite site (see photo above)
- Eschars may or may not be present. "Amblyomma" ticks actively attack cattle or humans and can bite more than once. In African tick bite fever, unlike what is typically seen with other Rickettsial spotted fevers when only one eschar is identified, multiple eschars may be seen and are considered pathognomonic.
- Swollen lymph nodes near the site of the bite
- Maculopapular and/or vesicular rash
Rocky Mountain spotted fever (RMSF), also known as blue disease, is the most lethal and most frequently reported rickettsial illness in the United States. It has been diagnosed throughout the Americas. Some synonyms for Rocky Mountain spotted fever in other countries include “tick typhus,” “Tobia fever” (Colombia), “São Paulo fever” or “"febre maculosa"” (Brazil), and “"fiebre manchada"” (Mexico). It is distinct from the viral tick-borne infection, Colorado tick fever. The disease is caused by "Rickettsia rickettsii", a species of bacterium that is spread to humans by "Dermacentor" ticks. Initial signs and symptoms of the disease include sudden onset of fever, headache, and muscle pain, followed by development of rash. The disease can be difficult to diagnose in the early stages, and without prompt and appropriate treatment it can be fatal.
The name “Rocky Mountain spotted fever” is something of a misnomer. The disease was first identified in the Rocky Mountain region, but beginning in the 1930s, medical researchers realized that it occurred in many other areas of the United States. It is now recognized that the disease is broadly distributed throughout the contiguous United States and occurs as far north as Canada and as far south as Central America and parts of South America. Between 1981 and 1996, the disease was reported from every state of the United States except for Hawaii, Vermont, Maine, and Alaska.
Rocky Mountain spotted fever remains a serious and potentially life-threatening infectious disease. Despite the availability of effective treatment and advances in medical care, approximately three to five percent of patients who become ill with Rocky Mountain spotted fever die from the infection. However, effective antibiotic therapy has dramatically reduced the number of deaths caused by Rocky Mountain spotted fever. Before the discovery of tetracycline and chloramphenicol during the latter 1940s, as many as 30% of those infected with "R. rickettsii" died.
Cytauxzoon felis is a protozoal organism transmitted to domestic cats by tick bites, and whose natural reservoir host is the bobcat. "C. felis" has been found in other wild felid species such as Florida bobcat, eastern bobcat, Texas cougar, and a white tiger in captivity. "C. felis" infection is limited to the family felidae which means that "C. felis" poses no zoonotic (transmission to humans) risk or agricultural (transmission to farm animals) risk. Until recently it was believed that after infection with "C. felis", pet cats almost always died. As awareness of "C. felis" has increased it has been found that treatment is not always futile. More cats have been shown to survive the infection than was previously thought. New treatments offer as much as 60% survival rate.
Ehrlichiosis (; also known as canine rickettsiosis, canine hemorrhagic fever, canine typhus, tracker dog disease, and tropical canine pancytopenia is a tick-borne disease of dogs usually caused by the organism "Ehrlichia canis". "Ehrlichia canis" is the pathogen of animals. Humans can become infected by "E. canis" and other species after tick exposure. German Shepherd Dogs are thought to be susceptible to a particularly severe form of the disease, other breeds generally have milder clinical signs. Cats can also be infected.
Most infected cats have been healthy before a very sudden onset of severe disease. The course of clinical disease is often swift with clinical signs of lethargy and inappetence within 5 to 20 days after the tick bite. Cats develop a high fever, but the temperature may become low before death. Other clinical findings can be: dehydration, icterus (jaundice), enlarged liver and spleen, lymphadenopathy, pale mucus membranes, respiratory distress, tachycardia or bradycardia, and tick infestation (although ticks are not often found on infected cats since cats typically groom ticks off their fur). Signs of disease seen on blood work include hemolytic anemia, thrombocytopenia, increased or decreased white blood cell numbers, icterus, and elevated liver enzymes. Death usually follows the onset of clinical signs within a few days. However, more recent studies show not all cats develop clinical signs after infection, and some cats survive the infection.
Human granulocytic anaplasmosis (HGA) is a tick-borne, infectious disease caused by "Anaplasma phagocytophilum", an obligate intracellular bacterium that is typically transmitted to humans by ticks of the "Ixodes ricinus" species complex, including "Ixodes scapularis" and "Ixodes pacificus" in North America. These ticks also transmit Lyme disease and other tick borne diseases.
The bacteria infect white blood cells called neutrophils, causing changes in gene expression that prolong the life of these otherwise short-lived cells.
A robovirus is a zoonotic virus that is transmitted by a rodent vector (i.e., "ro"dent "bo"rne).
Roboviruses mainly belong to the Arenaviridae and Hantaviridae family of viruses. Like arbovirus ("ar"thropod "bo"rne) and tibovirus ("ti"ck "bo"rne) the name refers to its method of transmission, known as its vector. This is distinguished from a clade, which groups around a common ancestor. Some scientists now refer to arbovirus and robovirus together with the term ArboRobo-virus.
Complications are rare and are not life-threatening. No deaths due to African tick bite fever have been reported. Reported complications include:
- Prolonged fever > 3 weeks in duration
- Reactive arthritis
- Moderate to severe headache
Patients can present with fever, headache, myalgias, and malaise. Laboratory tests may reveal thrombocytopenia, leukopenia, and evidence of liver damage.
Signs and symptoms may include:
- fever
- severe headache
- muscle aches (myalgia)
- chills and shaking, similar to the symptoms of influenza
- nausea
- vomiting
- loss of appetite
- unintentional weight loss
- abdominal pain
- cough
- diarrhea,
- aching joints
- sensitivity to light
- weakness
- fatigue
- change in mental status (extreme confusion, memory loss, inability to comprehend environment- interaction, reading, etc.)
- temporary loss of basic motor skills
Symptoms may be minor, as evidenced by surveillance studies in high-risk areas. Gastrointestinal tract symptoms occur in less than half of patients and a skin rash is seen in less than 10% of patients. It is also characterized by a low number of platelets, a low number of white blood cells, and elevated serum transaminase levels in the majority of infected patients. Even though people of any age can get HGA, it is usually more severe in the aging or immune-compromised. Some severe complications may include respiratory failure, kidney failure, and secondary infections.
Pediculosis is an infestation of lice (blood-feeding ectoparasitic insects of the order Phthiraptera). The condition can occur in almost any species of warm-blooded animal (i.e. mammals and birds), including humans. Although "pediculosis" in humans may properly refer to lice infestation of any part of the body, the term is sometimes used loosely to refer to "pediculosis capitis", the infestation of the human head with the specific head louse.
A combination of clinical signs, symptoms, and laboratory tests can confirm the likelihood of having CTF. Some tests include complement fixation to Colorado tick virus, immunofluorescence for Colorado tick fever, and some other common laboratory findings suggestive of CTF, including leucopenia, thrombocytopenia, and mildly elevated liver enzyme levels.
Detection of viral antibodies on red blood cells is possible.
The most common symptoms include headache, muscle aches, and fatigue. A rash may occur, but is uncommon. Ehrlichiosis can also blunt the immune system by suppressing production of TNF-alpha, which may lead to opportunistic infections such as candidiasis.
Most of the signs and symptoms of ehrlichiosis can likely be ascribed to the immune dysregulation that it causes. A "toxic shock-like" syndrome is seen in some severe cases of ehrlichiosis. Some cases can present with purpura and in one such case the organisms were present in such overwhelming numbers that in 1991 Dr. Aileen Marty of the AFIP was able to demonstrate the bacteria in human tissues using standard stains, and later proved that the organisms were indeed Ehrlichia using immunoperoxidase stains.
Experiments in mouse models further supports this hypothesis, as mice lacking TNF-alpha I/II receptors are resistant to liver injury caused by ehrlichia infection.
3% of human monocytic ehrlichiosis cases result in death; however, these deaths occur "most commonly in immunosuppressed individuals who develop respiratory distress syndrome, hepatitis, or opportunistic nosocomial infections."
Colorado tick fever (CTF) (also called mountain tick fever, American tick fever, and American mountain tick fever) is a viral infection (Coltivirus) transmitted from the bite of an infected Rocky Mountain wood tick ("Dermacentor andersoni"). It should not be confused with the bacterial tick-borne infection, Rocky Mountain spotted fever.
The type species of the genus "Coltivirus", Colorado tick fever virus (CTFV) infects haemopoietic cells, particularly erythrocytes, which explains how the virus is transmitted by ticks and also accounts for the incidence of transmission by blood transfusion.