A review on the eco-epidemiology and clinical management of human granulocytic anaplasmosis and its agent in Europe

Parasites & Vectors

卷:12

Agustín Estrada-Peña¹  Lucía Varela-Castro¹  Muriel Vayssier-Taussat²  Ioana A. Matei³  Andrei D. Mihalca³  Aleksandar Potkonjak⁴  Herve Zeller⁵  Sally J. Cutler⁶ 

[1] Department of Animal Health, Faculty of Veterinary Medicine, University of Zaragoza;

[2] Department of Animal Health, French National Institute for Agricultural Research;

[3] Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine Cluj-Napoca;

[4] Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad;

[5] Emerging and Vector-borne Diseases Programme, European Centre for Disease Prevention and Control;

[6] School of Health, Sport & Bioscience, University of East London;

关键词: HGA;    Anaplasma phagocytophilum;    Transmission;    Prevalence;    Clinical signs;    Diagnosis;   

DOI  :  10.1186/s13071-019-3852-6

来源: DOAJ

【 摘 要 】

Abstract Anaplasma phagocytophilum is the agent of tick-borne fever, equine, canine and human granulocytic anaplasmosis. The common route of A. phagocytophilum transmission is through a tick bite, the main vector in Europe being Ixodes ricinus. Despite the apparently ubiquitous presence of the pathogen A. phagocytophilum in ticks and various wild and domestic animals from Europe, up to date published clinical cases of human granulocytic anaplasmosis (HGA) remain rare compared to the worldwide status. It is unclear if this reflects the epidemiological dynamics of the human infection in Europe or if the disease is underdiagnosed or underreported. Epidemiologic studies in Europe have suggested an increased occupational risk of infection for forestry workers, hunters, veterinarians, and farmers with a tick-bite history and living in endemic areas. Although the overall genetic diversity of A. phagocytophilum in Europe is higher than in the USA, the strains responsible for the human infections are related on both continents. However, the study of the genetic variability and assessment of the difference of pathogenicity and infectivity between strains to various hosts has been insufficiently explored to date. Most of the European HGA cases presented as a mild infection, common clinical signs being pyrexia, headache, myalgia and arthralgia. The diagnosis of HGA in the USA was recommended to be based on clinical signs and the patient’s history and later confirmed using specialized laboratory tests. However, in Europe since the majority of cases are presenting as mild infection, laboratory tests may be performed before the treatment in order to avoid antibiotic overuse. The drug of choice for HGA is doxycycline and because of potential for serious complication the treatment should be instituted on clinical suspicion alone.

【 授权许可】

Unknown