Lifestyle,habitat and farmers' risk of exposure to tick bites in an endemic area of tick‐borne diseases in Hungary

Controlling tick bites on farmers is important to the management of tick‐borne diseases and occupational health risks in agriculture. Based on an extensive household survey conducted between June and August 2015 with 219 farmers from western Hungary where tick‐borne diseases are endemic, we analysed the pattern of farmers' self‐reported contacts with ticks and investigated the potential interactions between farmers, landscape and the risk of exposure to tick bites. We developed a lifestyle typology based on farmers' socioeconomic profiles, farming objectives and time use patterns, and a habitat typology describing different configurations of tick habitats and agricultural areas in place of farming. We found no relationship between tick exposure risk and self‐prevention. The lifestyle typology could be used to classify the risk of tick bites and the adoption of prevention measures into different levels, the difference between which could further be modified by the habitat typology. Our results suggest that (i) farmers who are frequently engaged in outdoor recreations and (ii) part‐time and inexperienced farmers who have lower rate of preventive actions are likely to experience greater exposure to tick bites either in less cultivated, semi‐natural habitats or in agricultural landscape with highly diverse land uses. Future disease prevention practices should take into consideration the interaction of lifestyle and habitat and the need to associate different farmer groups with different landscape configurations.     

Seasonality and anatomical location of human tick bites in the United Kingdom

Tick bites on humans can occur in a variety of habitats and may result in the transmission of tick‐borne pathogens, such as the causative agent of Lyme borreliosis (LB), Borrelia burgdorferi sensu lato. As the risk of transmission of this pathogen to the host increases with the duration of tick feeding, the recognition and removal of ticks as soon as possible following attachment is important for reducing the risk of infection. Performing a thorough body examination for ticks following potential exposure is recommended by tick awareness campaigns. Knowledge of where on the body feeding ticks are frequently found, and at which times of year peak tick exposure occurs, provides important information for public health messaging and may aid those bitten by ticks to engage more effectively with tick‐checking behaviour. This paper summarizes human tick bites in the United Kingdom (UK) during 2013–2018 reported to Public Health England's passive Tick Surveillance Scheme and further examines the anatomical location and seasonality of bites from the most commonly encountered tick and LB vector Ixodes ricinus. A total of 1,328 tick records from humans were received of which 93% were I. ricinus. Humans were most commonly bitten by I. ricinus nymphs (70% bites). Tick bites were recorded on all parts of the body, but there were significant differences in their anatomical location on adults and children. Most tick bites on adults occurred on the legs (50%), whereas on children tick bites were mostly on the head and neck (43%). Bites from I. ricinus were recorded throughout the year but were most numerous during May to August. This study adds to the body of research on the seasonality and anatomical location of human tick bites in temperate Europe and highlights the importance of data collected through passive surveillance in addition to research and epidemiological studies.     

Challenges to human rabies elimination highlighted following a rabies outbreak in bovines and a human in Punjab,India

In August 2015, a rabies outbreak occurred in bovines in a Punjab village, India; subsequently, a farmer in the same village died of rabies in October 2015. We surveyed farmers to describe the outbreak, the demographics and rabies prophylaxis administered to householders on case farms, and farmers’ knowledge of rabies prevention and treatment. We used multiple correspondence analysis to guide investigation of associations between demographics, farm status and rabies knowledge, attitudes and practices. The number of affected bovines was unusually high; 15 cattle and buffalo died on 13 smallholder farms (attack rate 4%). Post‐exposure vaccinations were administered to 24 people (median 2 doses). Affected farms had significantly larger households and were more likely to keep their livestock outside (therefore, accessible by stray dogs), suggesting that the impact of the outbreak was disproportionally borne by households of lower socio‐economic status. Primary sources of rabies information were friends and neighbours, not health authorities or media. Women who had not received formal education were less likely to have heard of rabies. Although case farm participants were more likely to have heard about rabies from a veterinarian, their knowledge and practices to prevent rabies did not reflect the level expected considering their contact with a health professional; they were more likely to believe that traditional remedies prevent rabies and less likely to tell their children to avoid playing with stray dogs than participants from other farms. This study highlights knowledge dissemination disparities that, if typical of rural locations, could obstruct attempts to eliminate canine‐mediated human rabies in India. Therefore, understanding the pervasiveness and influence of traditional medical beliefs on treatment‐seeking behaviour, communication structures within villages and the impact of local practices such as carcass disposal on dog populations will be essential to ensure that rabies control strategies are effective in rural India.     

Recent progress in molecular biology of Crimean-Congo hemorrhagic fever

Crimean–Congo hemorrhagic fever (CCHF) is a severe hemorrhagic fever in humans with a case fatality rate of up to 50%. A causative agent of CCHF is CCHF virus, which is a tick-borne virus in the family Bunyaviridae, genus Nairovirus. The virus is transmitted to humans through infected tick bites, squashed ticks or from direct contact with viremic animals or humans. Outbreaks of CCHF have been documented in Africa, the Middle East, Eastern Europe and Western Asia where the vector and/or reservoir ticks of Hyalomma spp. are distributed. Recent advances in molecular and biochemical analyses of CCHF virus revealed that the virus encodes larger proteins compared to other genus of Bunyavirus and the processing of viral proteins are complicated. Recent studies also showed that the CCHF viruses are relatively divergent in its genome sequence and the viruses are grouped in seven different clades. In general, these phylogenetic analyses based on sequences of S-RNA and L-RNA segment of CCHF viruses indicate that the seven clades correlate with their geographical location. The phylogenetic topology based on M-RNA segment sequences of CCHF viruses is different from those based on S-RNA and L-RNA segments. These analyses indicate that M-RNA segment reassortment events occur more frequently than those in S- and L-RNA segments.     

Tick bite and Lyme disease‐related emergency department encounters in New Hampshire, 2010–2014

Lyme disease (LD) is a common tick‐borne disease in New Hampshire (NH). While LD is a reportable condition and cases are counted for public health surveillance, many more people receive care for tick bites or diagnoses of LD than are reflected in surveillance data. NH's emergency department (ED) data system was queried for tick bite and LD‐related encounters. Chief complaint text was queried for words related to LD or tick bites. International Classification of Diseases 9th Revision (ICD‐9) codes were queried for the LD diagnosis code (088.81). Emergency department patient data were matched to reportable disease data to determine the proportion of ED patients reported to the health department as a suspected LD case. Data were analysed to calculate frequencies for key demographic and reporting characteristics. From 2010 to 2014, 13,615 tick bite or LD‐related ED encounters were identified in NH, with most due to tick bites (76%). Of 3,256 patients with a LD‐related ED encounter, 738 (23%) were reported to the health department as a suspected LD case. The geographic distribution of ED patients was similar to reported LD cases; however, the regions of the state that experienced higher rates of ED encounters were different than the regions that observed higher rates of reported LD cases. Seasonal distribution of ED encounters peaked earlier than reported LD cases with a second peak in the fall. While age and sex distribution was similar among ED patients and reported LD cases, the rates for children 5 years and younger and adults 65 years and older were greater for ED encounters. Patients frequently visit the ED to seek care for tick bites and suspected LD. Results of ED data analyses can be used to target education, in particular for ED providers and the public through timely distribution of evidence‐based educational materials and training programmes.     

Cause,Setting and Ownership Analysis of Dog Bites in Bay County,Florida from 2009 to 2010

Emergency room and hospital discharge data have been used to describe the risk factors and public health impact of dog bites. These data sets are based on financial charges for severe bites and underestimates dog bite burdens within communities. This study expands both the source of information and risk factor data collected to provide demographic analysis of dog bite injury risk factors reported in Bay County, Florida in 2009–2010. Extended data for dog bites reported by various sources from January 1, 2009 to December 31, 2010 were collected by Florida Department of Health in Bay County. Data collected included bite victim's age and gender, primary reported cause of bite, setting, dog's restraint status and relationship between the victim and the dog. A total of 799 bites were reported. Most bites (55%) were reported first by healthcare practitioners, particularly bites involving children <6 years. Bites involving unfamiliar dogs and dogs off the owner's property were more likely to be reported by other sources. Boys aged 6–14 years accounted for 2.24 times more bites than same‐aged females (P < 0.001) and had the highest incidence with 424 bites per 100 000 persons per year. Persons 6 years or older were 3.6 times more likely to be bitten by an unfamiliar dog. Inappropriate behaviour management was the most common cause of bites (26%), followed by protective behaviour (24%). Bites of unknown cause were 2.5 times more likely in children <6 years. Separating dog fights was the most common cause of bites for persons 15 years or older (24%); females were significantly more likely to be bit than males (P = 0.01). Bites by unrestrained dogs off the owner's property (32% of all bites) most commonly involved males. Estimates based solely on healthcare discharge data significantly underestimate dog bite burden within a community. Characterizing these risks by age group or gender provides an opportunity to implement targeted interventions to prevent dog bites.     

Crimean–Congo haemorrhagic fever virus: Past,present and future insights for animal modelling and medical countermeasures

Crimean–Congo haemorrhagic fever (CCHF) is a widespread tick‐borne viral zoonosis with a case‐fatality rate ranging from 9% to 50% in humans. Although a licensed vaccine to prevent infection by the CCHF virus (CCHFV) exists, its ability to induce neutralizing antibodies is limited and its efficacy against CCHFV remains undetermined. In addition, controlling CCHF infections by eradication of the tick reservoir has been ineffective, both economically and logistically, and the treatment options for CCHF remain limited. In this review, we first critically discuss the existing animal models to evaluate therapeutics for CCHF. We then review the therapeutic options for CCHF that have been investigated in human cases, followed by investigational drugs that have been evaluated in pre‐clinical studies. We highlight the importance of understanding human prognostic factors in developing an animal model for CCHF that recapitulates hallmarks of human disease and its implication for selecting therapeutic candidates.     

Dermatologic aspects of tick bites and tick-transmitted diseases

Dermatologic manifestations of tick bites and tickborne disease are not commonly encountered. However, recognition of the signs and histopathologic conditions of tick bites can be important to the diagnosis and management of small animal diseases. Understanding the local nodular inflammatory reaction to a tick bite can allay the owner's fear that a newly recognized nodule may be a malignant growth. Additionally, recognition of tick bites and pathognomonic dermatologic changes may provide important evidence in making a diagnosis of tick-transmitted diseases.     

Parasites of sheep and goats and their prevalence in Bokova, a rural area of Buea Sub Division, Cameroon

Small ruminant production in the South West Province of Cameroon is practised mostly by subsistence farmers in the rural areas on natural grass pastures which grow once the primary forest has been cleared. Investigations revealed certain endo- and ectoparasites that were abundant and caused problems on the pastures to both animals and farmers. Haemonchus contortus was the most prevalent species with a prevalence of 94.23%. The highest mean monthly intensity was obtained in August and there was a significant difference (P<0.05) from the other months. Strongyle infections were prevalent in 93.18% of the animals examined. In the flock there was a prevalence of 96.25% in sheep as opposed to 86% in goats. The prevalence in the subsistence system was 95.4%. Mean monthly egg counts and prevalence of flukes was highest in December, 187.84 (29.73%). The overall prevalence of flukes was 73.88% with an overall mean intensity of 22 flukes per animal. The most abundant tick species was Haemaphysilis leachi. Genital distribution of ticks was significantly higher (P<0.05) in females than males. In the males they were more concentrated around the scrotum.     

Canine babesiosis caused by Babesia canis vogeli in rural areas of the State of Minas Gerais, Brazil and factors associated with its seroprevalence

This epidemiological survey on canine babesiosis was carried out in three distinct rural regions (Lavras, Belo Horizonte and Nanuque) of the State of Minas Gerais, Brazil. Ticks and blood samples were collected during a dry season (Lavras, n = 92; Belo Horizonte, n = 50; Nanuque, n = 102) and the subsequent rainy season (Lavras, n = 71; Belo Horizonte, n = 28; Nanuque, n = 66) from dogs living on farms. Plasma samples were analyzed by the indirect fluorescent antibody test for detection of anti-Babesia canis vogeli antibodies. DNA was extracted from blood of serologically positive dogs and molecular characterization of Babesia species was performed. Rhipicephalus sanguineus, Amblyomma cajennense and Boophilus microplus were the tick species identified in all regions. In Lavras, in addition to those tick species, A. tigrinum and A. ovale were also identified. The most prevalent tick species was A. cajennense (35.3%), followed by R. sanguineus (19%) and B. microplus (4.0%). Dogs living in Nanuque region were more heavily infested with ticks than dogs living in Belo Horizonte and Lavras regions. The overall frequency of anti-B. c. vogeli antibodies in the canine population in rural areas of Minas Gerais was 28.7%, with prevalence rates of 49.0% in Nanuque, 34.0% in Belo Horizonte and 3.3% in Lavras. The age of the animals and tick infestation were associated with seroprevalence of B. c. vogeli. The sequence analysis showed that B. c. vogeli was the only Babesia species present in all three regions. This study showed different rates of prevalence and incidence of canine babesiosis among the three rural regions sampled in Minas Gerais State. The results point to the importance of canine babesiosis in rural areas and to the need for further studies related to its transmission and maintenance in nature.     

Antibiotic use and resistance in animal farming: a quantitative and qualitative study on knowledge and practices among farmers in Khartoum, Sudan

Antibiotic resistance is a major emerging global public health threat. Farmers in the Khartoum state are believed to misuse antibiotics in animal farming leading to daily exposure to resistant bacteria and antibiotic residues. Hence, farmers are at potential risk exposure to bacteria, zoonotic infection and toxicity. We hypothesized that farmers' misuse of antibiotics could be due to their ignorance of the importance of optimal use of antibiotics, the potential health hazards and the economical waste associated with antibiotic misuse practices. In the present study, we investigated knowledge and practices among farmers regarding antibiotic use and resistance. For this purpose, a cross-sectional study was conducted in Khartoum state where data were collected from 81 farmers using structured interviews. Data were analysed both quantitatively and qualitatively. Fifty-two per cent of farmers were uneducated or had studied for < 6 years. The majority reported antibiotic use for treatment and prevention while only 5% stated use for growth promotion. Antibiotic group treatment for both sick and healthy animals was commonly practiced among most farmers. The most commonly used group of antibiotics was the quinolones, which was reported by one-third. Only 30% of the farmers had heard of antibiotic resistance and provided their definition. Almost half were not aware of the commonly transferred zoonotic infections between humans and animals. The farmers consume 1-2 meals/day from their own farm products. A significant association between low education, poor knowledge of farmers on antibiotic use, antibiotic resistance and zoonotic infections was found. This association may play a vital role in the present practiced misuse of antibiotics. Our findings on farmers' practices could be used as baseline information in defining the gaps related to antibiotic use and resistance in animal farming in Sudan. It can thus serve as a foundation for future interventions.     

Amblyomma triste Koch, 1844 (Acari: Ixodidae): hosts and seasonality of the vector of Rickettsia parkeri in Uruguay

Amblyomma triste Koch, 1844, the tick species most frequently involved in human bites in Uruguay, has been implicated as a vector of human rickettsiosis. Seasonal abundance of adult A. triste was examined by standard flagging at three sites where human tick bites and cases of the disease have been reported. Adult tick activity occurred from August to February (end of winter to mid summer in the southern hemisphere) with a peak in spring. Activity declined in step with decreasing temperatures and photoperiod during winter. This period of activity coincides with seasonal outbreaks of human rickettsiosis in the region. In a small mammal survey, the Sigmodontinae rodents Scapteromys tumidus (Waterhouse, 1837) and Oxymycterus nasutus (Waterhouse, 1837) and the small marsupial Monodelphis dimidiata (Wagner, 1847) were the main hosts for immature A. triste. Immature ticks were observed on hosts in November, well within the period of peak adult abundance. In stored collections, immature ticks were most often collected from January to March. These data suggest that one generation might be completed in 1 year. The main animal host for adult A. triste at our study sites was the domestic dog. Humans were afflicted by the tick in rural and suburban settlements where other host animals are scarce or extinct and where dogs are common.     

Multivariate relationships between epidemiologic risk factors and zoonotic infections among military personnel in the country of Georgia: A non‐linear canonical correlation analysis

Zoonotic diseases are endemic in the country of Georgia. Using the non‐linear canonical correlation (NCC) method, the aim of this study was to examine the relationship between thirteen epidemiological risk factors and seropositivity to five zoonotic infections (anthrax, Q fever, tularemia, leptospirosis, and Crimean‐Congo hemorrhagic fever [CCHF]) among Georgian military recruits during 2014–2016. According to this multivariate statistical technique, which is suitable for the analysis of two or more sets of qualitative variables simultaneously, two canonical variables were identified. These variables accounted for 68% of the variation between the two sets of categorical variables (“risk factors” and “zoonotic infections”). For the first canonical variable, there was a relationship among CCHF (canonical loading, which is interpreted in the same way as the Pearson's correlation coefficient, [cl] = 0.715), tick bites (cl = 0.418) and slaughter of animals (cl = 0.351). As for the second canonical variable, Q fever (cl = ?0.604) and leptospirosis (cl = ?0.486) were related to rodents inside and outside home (cl = ?0.346) and sweeping in or around home (cl = ?0.317). The NCC method allows researchers to obtain additional insights into the complex relationship between epidemiological risk factors and multiple zoonotic infections.     

Knowledge and Practices of Pig Farmers Regarding Japanese Encephalitis in Kathmandu,Nepal

Japanese encephalitis (JE) is the single largest cause of viral encephalitis in the world and has been endemic in Nepal since the early 1980s. Since then, it has spread from its origins in lowland plains to the Kathmandu Valley as well as in hill and mountain districts. Pigs are amplifying hosts for the virus. The Nepal government has been encouraging the development of pig farming as a means of poverty alleviation. Whereas other countries have reduced JE through vaccination programmes and improvements in pig husbandry, these options are not economically possible in Nepal. The objective of this study was to examine the occupational risk of pig farmers in Nepal and to determine their level of knowledge and practice of JE prevention techniques. We surveyed 100 randomly selected pig farmers in the Kathmandu District and found that pig farmers were exposed to many JE risk factors including poverty and close proximity to pigs, rice paddy fields and water birds, which are the definitive hosts for the virus. Forty‐two percent of the farmers had heard of JE, 20% associated it with mosquito bites and 7% named pigs as risk factors. Few protective measures were taken. None of the farmers were vaccinated against JE nor were any pigs, despite an ongoing human vaccination campaign. This farming community had little ownership of land and limited education. JE education programmes must consider gender differences in access to public health information as there were an equal number of male and female farmers. We provide findings that can inform future JE education programmes for this vulnerable population.     

Knowledge,Attitudes and Practices Regarding Risk to Human Infection due to Mycobacterium bovis among Cattle Farming Communities in Western Uganda

A cross‐sectional study involving multistage cluster sampling was undertaken in Kashari county, Mbarara district, western Uganda, in which quantitative and qualitative approaches were utilized to determine the knowledge, attitudes and practices regarding risk of human infection with zoonotic tuberculosis due to Mycobacterium bovis among cattle farmers. Of 496 respondents, 50% were farm owners and 50% herdsmen. Males were 70.9% of all the study participants. Among these, 37.5% had good knowledge, 41.4% had positive attitudes and 75.2% good practices regarding zoonotic tuberculosis. In the multivariable model, good knowledge was associated with having ever received health education, spending more than 5 years keeping cattle, having heard of cattle condemned at the abattoir due to tuberculosis and marital status. Positive attitudes were associated with having ever received health education, having heard of cattle condemned at the abattoir due to tuberculosis and being a farm owner versus being a herdsman. Good practices were associated with health education and good knowledge of the disease. Overall, knowledge and attitudes towards zoonotic tuberculosis due to M. bovis in humans was found to be low. While the majority of the respondents reported good practices, there were some still consuming raw milk and its products, which may predispose them to infection and indicates the need for greater outreach for zoonotic tuberculosis education.     

An <Emphasis Type="Italic">in-vivo</Emphasis> study of the efficacy and safety of ethno-veterinary remedies used to control cattle ticks by rural farmers in the Eastern Cape Province of South Africa

Ticks feed on blood, are vectors of tick-borne diseases and cause considerable skin damage to livestock. They are commonly controlled using commercial acaricides, which are expensive to the rural farmers, causing them to resort to alternative tick control methods. The objective of this study was to assess the acaricidal properties and safety of some materials (Ptaeroxylon obliquum, Aloe ferox, Lantana camara, Tagetes minuta, Used engine oil and Jeyes fluid, used by rural farmers to control cattle ticks in the Eastern Cape Province, South Africa. A total of 52 cattle were divided into 13 experimental groups with 4 cattle in each. Jeyes fluid at 76.8% concentration and Used engine oil had an efficacy that was almost similar to that of the positive control Ektoban® (Cymiazol 17.5 and cypermethrin 2.5%). Extracts of L. camara at 40% concentration had an efficacy of 57% while A. ferox, P. obliquum and T. minuta were not effective. The test materials had no irritation effect on rats. The study revealed that the materials rural farmers use as acaricides vary in their efficacy in controlling ticks.     

Tick control methods used by resource-limited farmers and the effect of ticks on cattle in rural areas of the Eastern Cape Province,South Africa

A survey to document tick control methods used by resource-limited farmers in the control of cattle ticks in the Eastern Cape Province of South Africa was conducted by interviewing 59 cattle farmers using structured questionnaires and general conversation. Information collected was on external parasites of cattle, their effects and their control methods. Ticks were reported to be a major problem causing diseases like anaplasmosis (89.8%), babesiosis (55.9%) and ehrlichiosis (16.9%), as well as wounds that predispose to screwworm infestation, tick worry and teat damage to cows troubling farmers in their farming enterprises. The main tick control methods were; acaricides provided by government, however 94.9% of the farmers interviewed were of the opinion that the dip wash is not effective in killing the ticks. As a result, farmers complement the government dipping service with their own initiatives like spraying with conventional acaricides (22%), household disinfectants such as Jeyes fluid (18.6%), used engine oil (10.2%), chickens (5.1%), manual removal (5.1%), and pouricides (1.7%). In addition, some farmers also use plants (6.8%), mainly the leaf of Aloe ferox and the bark of Ptaeroxylon obliquum. The study revealed ticks to be a major problem in the study area.     

Seroepidemiology of Hepatitis E in Selected Population Groups in Croatia: A Prospective Pilot Study

Hepatitis E has become an emerging infection in many European countries. We analysed the prevalence of hepatitis E virus (HEV) infection in selected population groups in Croatia. Overall HEV IgG seropositivity was 5.6%, while 1.9% participants showed IgM antibodies suggestive of recent infection. No IgM‐positive sample was positive for HEV RNA. HEV IgG antibodies were most prevalent in alcohol abusers (8.9%) and war veterans (8.6%), compared with 6.1% among injecting drug users and 2.7% in healthcare professionals. No individual with high‐risk sexual behaviour tested HEV seropositive. HEV IgG positivity increased significantly with age from 1.8% to 2.3% in individuals younger than 40 years to 11.3% in individuals older than 50 years (P = 0.023). The mean age of HEV‐positive participants was significantly higher than that of HEV‐negative participants (50.9 ± 11.8 years versus 41.2 ± 11.8 years, P = 0.008). Seroprevalence rates were significantly higher in residents of suburban and rural areas compared with residents of urban areas (14.5% versus 2.5%, P = 0.003). Additionally, an increasing prevalence of HEV IgG antibodies was observed from 1.8% in participants living in families with two household members to 12.1% in those living with more than four members (P = 0.046). Gender, marital status, educational level, sexual orientation, source of drinking water, history of blood transfusions, surgical procedures, tattooing and travelling were not associated with HEV seroprevalence. Logistic regression showed that living in suburban/rural areas was the main risk factor for HEV seropositivity (OR = 6.67; 95%CI = 1.89–25.0; AOR = 7.14, 95%CI = 1.89–25.0).     

A survey of tick control methods used by resource-poor farmers in the Qwa-Qwa area of the eastern Free State Province, South Africa

A survey conducted in five villages in a resource-poor farming community in Qwa-Qwa, using the rapid rural appraisal technique and a questionnaire survey, showed that a significant proportion of the farmers (84%) use traditional or alternative methods to control ectoparasites, while 16% use commercial acaricides (chi2 = 7.1; P < or = 0.05). Alternative control methods included the use of used engine oil, household disinfectant and paraffin. Killing of ticks was the main reason for control (40%), with disease control being second (20%). Other reasons given for controlling ticks were to prevent damage to teats, to provide animals with a clean appearance and to protect hides. Some 40% of farmers were aware of the effects of ticks on their animals. There is a need for farmer education that will provide information on integrated tick management and its advantages over absolute reliance on commercial acaricides.