Clinical Presentation and Outcomes of Children With Human Granulocytic Anaplasmosis

Schotthoefer, Anna M.; Hall, Matthew C.; Vittala, Satya; Bajwa, Raza; Frost, Holly M.

doi:10.1093/jpids/pix029

Cited by 16 publications

(11 citation statements)

References 17 publications

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“…The basic epidemiologic characteristics of anaplasmosis cases in NYS are consistent with previous reports at the national level and are comparable with those of other tickborne diseases transmitted by I. scapularis ticks in NYS (7,10,25,26). Anaplasmosis, similar to Lyme disease and babesiosis, disproportionately affects White men, possibly because of residential and behavioral factors that increase the risk for tick bites in this group (27,28). The age distribution of patients shows a unimodal peak in the range of 60-69 years, similar to babesiosis but unlike Lyme disease, which shows bimodal peaks in the 5-9 and 50-54 year ranges (27,28).…”

Section: Discussionsupporting

confidence: 87%

“…Anaplasmosis, similar to Lyme disease and babesiosis, disproportionately affects White men, possibly because of residential and behavioral factors that increase the risk for tick bites in this group (27,28). The age distribution of patients shows a unimodal peak in the range of 60-69 years, similar to babesiosis but unlike Lyme disease, which shows bimodal peaks in the 5-9 and 50-54 year ranges (27,28). This finding might be related to the increased susceptibility for severe anaplasmosis infections with age, and the greater likelihood of subclinical infections in young patients (7,29).…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018

Russell¹,

Prusinski²,

Sommer³

et al. 2021

Emerg. Infect. Dis.

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A naplasmosis is an emergent tickborne disease caused by the obligate intracellular bacterium Anaplasma phagocytophilum (1). Initially termed human granulocytic ehrlichiosis, human infection with A. phagocytophilum was fi rst described in 1994 in patients from Minnesota and Wisconsin, USA (1,2). Now referred to as human granulocytic anaplasmosis or simply anaplasmosis, this infection is characterized by a nonspecifi c infl uenza-like illness marked by fever, fatigue, muscle aches, and headache (3). Although severe complications and death occur in rare instances, most patients recover fully after treatment with appropriate antimicrobial drugs (4).Human infection with A. phagocytophilum has now been documented in patients in North America, Europe, and Asia, and a notable incidence has occurred in the United States (5). Anaplasmosis became a nationally notifi able disease in the United States during 1999, and nationwide case counts have since increased >16-fold, from 348 cases during 2000 to 5,762 cases during 2017 (6). Most of these infections occur in the northeastern and upper midwestern states, where well-established populations of Ixodes scapularis (blacklegged or deer ticks) transmit A. phagocytophilum in addition to the infectious agents of Lyme disease, babesiosis, and Powassan virus disease (7-9).New York State (NYS), which is situated within the northeastern United States, to which tickborne diseases are endemic, has reported the second highest number of anaplasmosis cases of any state, closely behind Minnesota (10-12). Surveillance of anaplasmosis cases by the NYS Department of Health (NYSDOH) indicates that since the fi rst NYS case was reported in 1994, the burden of anaplasmosis has increased substantially, accounting for a larger proportion of NYS tickborne disease cases every year (≈4% during 2010 vs. ≈11% during 2018) (13). Since 2015, anaplasmosis has consistently surpassed babesiosis as the second most common tickborne disease in NYS, after Lyme disease (13). In addition to surveillance of tickborne disease cases, the NYSDOH also conducts routine vector surveillance to monitor the dynamics of tick populations and the prevalence of tickborne pathogens, including A. phagocytophilum, to estimate

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018

Russell¹,

Prusinski²,

Sommer³

et al. 2021

Emerg. Infect. Dis.

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“…Indeed, recent serosurveys of HGA in Ontario, Canada found no significant differences in the mean ages of seropositive and seronegative patients who were tested [ 59 ], suggesting that infection in younger individuals may be under-detected at greater rates than older individuals, which may have resulted in our observation of an older mean age of laboratory-positive cases for non-Lyme tick-borne diseases in the MCHS. A retrospective study of HGA pediatric cases in the MCHS also found evidence that infections in children are clinically less severe than in adults [ 60 ], suggesting that they may be less likely to be tested for the disease than adults. These differences in detection based on age have important consequences for the data collected through surveillance and may impact the trends and observations of these diseases.…”

Section: Discussionmentioning

confidence: 99%

Spatio-Temporal Dynamics of Tick-Borne Diseases in North-Central Wisconsin from 2000–2016

Rau

Muñoz-Zanzi

Schotthoefer

et al. 2020

IJERPH

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Lyme disease is a well-recognized public health problem in the USA, however, other tick-borne diseases also have major public health impacts. Yet, limited research has evaluated changes in the spatial and temporal patterns of non-Lyme tick-borne diseases within endemic regions. Using laboratory data from a large healthcare system in north-central Wisconsin from 2000–2016, we applied a Kulldorf’s scan statistic to analyze spatial, temporal and seasonal clusters of laboratory-positive cases of human granulocytic anaplasmosis (HGA), babesiosis, and ehrlichiosis at the county level. Older males were identified as the subpopulation at greatest risk for non-Lyme tick-borne diseases and we observed a statistically significant spatial and temporal clustering of cases (p < 0.05). HGA risk shifted from west to east over time (2000–2016) with a relative risk (RR) ranging from 3.30 to 11.85, whereas babesiosis risk shifted from south to north and west over time (2004–2016) with an RR ranging from 4.33 to 4.81. Our study highlights the occurrence of non-Lyme tick-borne diseases, and identifies at-risk subpopulations and shifting spatial and temporal heterogeneities in disease risk. Our findings can be used by healthcare providers and public health practitioners to increase public awareness and improve case detection.

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“…Ticks are special blood-sucking parasitic arthropods that can transmit a variety of pathogens, including viruses, bacteria, protozoa, and nematodes. Examples of these pathogens include tick-borne encephalitis virus (Selinger et al, 2017), Borrelia burgdorferi (causing Lyme disease) (Marchant et al, 2017), Rickettsia (causing tick-borne rickettsiosis) (Kartashov et al, 2017), Anaplasma phagocytophilum (causing human granulocytic anaplasmosis) (Schotthoefer et al, 2018), Babesia (Abdullah et al, 2018), and filarial nematodes (Zhang et al, 2011), which cause various diseases in humans and animals (Estrada-Peña et al, 2012). But at present, research on ticks is obviously lagging behind.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Analysis of the Global Protein Changes That Occur During Salivary Gland Degeneration in Female Ixodid Ticks Haemaphysalis longicornis

et al. 2019

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Ticks are notorious blood-sucking arthropods that can spread a variety of pathogens and cause great harm to the health of humans, wildlife and domestic animals. The salivary glands of female ticks degenerate rapidly when the ticks reach critical weight or become engorged, which can be caused by hormones and by the synergistic effects of multiple proteins. To explore the complex molecular mechanisms of salivary gland degeneration in ticks, this study applies iTRAQ quantitative proteomic technology for the first time to study changes in protein expression in the salivary glands of female Haemaphysalis longicornis during the process of degeneration and to search for proteins that play an important role in salivary gland degeneration. It was found that the expression of some proteins associated with energy production was continuously down-regulated during salivary gland degeneration, while some proteins associated with DNA or protein degradation were consistently up-regulated. Furthermore, the expression of some proteins related to cell apoptosis or autophagy was also changed. These proteins were knocked down by RNAi to observe the phenotypic and physiological changes in female ticks. The results showed that the time required for engorgement and the mortality rates of the female ticks increased after RNAi of F0F1-type ATP synthase, NADH-ubiquinone oxidoreductase, cytochrome C, or apoptosis-inducing factor (AIF). The corresponding engorged weights, oviposition amounts, and egg hatching rates of the female ticks decreased after RNAi. Interference of the expression of AIF in engorged ticks by RNAi showed that the degeneration of salivary glands of female ticks was slowed down.

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Clinical Presentation and Outcomes of Children With Human Granulocytic Anaplasmosis

Abstract: Evidence suggests that the frequency of HGA in children is increasing. Although most children had mild disease, doxycycline remains the treatment of choice, because outcome data for children without treatment remains limited.

Cited by 16 publications

References 17 publications

Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018

Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018

Spatio-Temporal Dynamics of Tick-Borne Diseases in North-Central Wisconsin from 2000–2016

Comprehensive Analysis of the Global Protein Changes That Occur During Salivary Gland Degeneration in Female Ixodid Ticks Haemaphysalis longicornis

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