1. Zoonotic Anaplasmosis: Another Reason We Hate Ticks Belinda L. Flores and Dr. R.L. Stanko Texas A&M University-Kingsville

2. Key Terms Acaricide Granulocyte Morulae Reservoir Host Vector Zoonotic Disease

3. What is Anaplasmosis?(CFSPH, 2005) A disease caused by bacteria of the genus Anaplasma Zoonotic species is Anaplasmaphagocytophilum This includes organisms previously thought to be separate species, including: Ehrlichiaequi Ehrlichiaphagocytophila “the agent of human granulocytic ehrlichiosis”

4. Anaplasmaphagocytophilum A. phagocytophilummorula( cell grouping) Neutrophil (white blood cell) Red blood cell Wright-Giemsa blood smear/stain 1000X magnification Human blood cells stained with Wright-Giemsa at 1000x magnification. Normal red blood cells and a neutrophil carrying a A. phogocytophilummorula. Auburn University College of Veterinary Medicine. http://www.vetmed.auburn.edu/anaplasmosis_canine/feline

5. Areas Affected(Rikihisa, 2010) Asia Europe United States of America

6. Species Affected (Ogden et al., 1998) and (CFSPH, 2005) Bison Cats Cattle Deer Dogs Elk Goats Horses Humans Llamas Primates Rodents Sheep

7. Reservoir Hosts(CFSPH, 2005) and (Dulmer et al., 2005) Deer Elk Rodents * Peromyscusleucopus, thewhite-footed mouse. (US) A white-footed mouse, Peromyscusleucopus. Natural Unseen Hazards Blog-05/05/2009 by: Jerry Genesio http://naturalunseenhazards.wordpress.com/tag/babesiosis/

8. Vector: Ticks(CFSPH, 2005) and (Dulmer et al., 2005) In the United States Ixodesscapularis Ixodespacificus In Europe Ixodesrincus Possibly in Asia Ixodespersulcatus Size and appearance of adult female and male, nymph and larva of lxodesscapularis. (by TainaLitwak, CMI, CDC) Female Ixodesrincusfound in Finland. Photo by JarmoHolopainen http://www.pbase.com/image/16565682

9. Regional Distribution of I. scapularisin the U.S. CDC 2011.

10. Regional Distribution of I. pacificus in the U.S.CDC 2011.

11. Tick HabitatLDA 2009 Wooded areas Under plant cover in yards Tall grasses and brush Border regions where yards/fields/woods meet In areas where small mammals live, such as wood piles

12. Tick AttackCDC 2011 Ticks rest on the tips of plants and shrubs and climb onto potential hosts that come in contact with them. Some ticks assume a position know as “questing” while waiting for a host. QuestingI. scapularis CDC. James Gathanay, William Nicholson

14. Anorexia

15. Decreased milk production

16. Respiratory dryness

17. Abortions

18. Reduced reproductive efficiency due to reduced semen qualityCattle: a livestock species susceptible to infection by A. phagocytophilum infection. http://agriculturalservices.org/cattle/anaplasmosis.htm

21. Decreased appetite

22. Ataxia

23. Depression

24. IcterusVideo of a horse with Anaplasmosis. Horse is catheterized for intravenous antibiotic treatment. Note the movement of the horse. http://www.youtube.com/watch?v=aOxyDewtxK0&NR=1

26. Weight loss

27. Listlessness

28. Coughing

29. Increased respiratory rate

30. Increased pulse rate

31. Abortion

32. Reduced semen qualitySheep: a livestock species susceptible to infection by A. phagocytophilum infection. http://www.vetsweb.com/news/characterization-of-anaplasma-phagocytophilum-and-a-ovis-infection-1074.html

34. Depression

35. Reluctance to movePhotograph of a tick infested deer in Millburn Township, NJ Millburn Township Deer Management Task Force. http://twp.millburn.nj.us/View-document/65-Deer-Task-Force

36. Signs-Cats(Billeter et al., 2007) Fever Thrombocytopenia Hyperglobulinemia Lethargy Anorexia Weight loss Vomiting Polyarthritis Lameness Ocular discharge Cats: a companion animal species susceptible to infection by A. phagocytophilum infection. Photo Credit: nikki from Fotolia.com http://www.ehow.com/how_7654927_remove-soft-tick-cat.html

38. Diarrhea

39. Coughing

40. Labored breathing

41. Meningitis

42. Haemolyticanaemiaand thrombocytopenia Common Depression Fever Lethargy Malaise Anorexia General muscle pain (reluctance to move) Joint pain Lameness from polyarthritis

43. Signs-Dogs(Bexfield et al., 2005) Dog infected with A. phagocytophilum. Manifestation of a scleral hemorrhage was observed as a result of hemolytic anemia and thrombocytopenia. (Bexfield et al., 2005) Video of a veterinarian discussing various aspects of tick-borne disease in companion animals, including zoonotic disease transmission. http://www.youtube.com/watch?v=3G_1xk-JQs&feature=related

45. Fever

46. Malaise

47. Chills

48. Muscle aches

49. Nausea

50. Vomiting

51. Diarrhea

52. Abdominal pain

53. Anorexia

54. Photophobia

55. Conjunctivitis

56. Joint pain

57. Coughing

58. Confusion

59. RashLife cycle and a diagram of possible routes of A. phagocytophilum infection of humans. http://pathmicro.med.sc.edu/mayer/ricketsia.htm

61. Respiratory distress

62. Secondary infections

63. Hemorrhages

64. Cardiomyopathy

65. Multiple organ failure

66. Meningoencephalitis

67. Seizures and ComaVideo of Young Woman diagnosed with Lyme Disease and A. phagocytophilum co-infection. http://www.youtube.com/watch?v=vTHARhGwiEY Video of a doctor discussing human granulocytic anaplasmosis (HGE), A. phagocytophiluminfection. http://www.youtube.com/watch?v=rxhTvU8-FvY&feature=related

69. The detection of antibodies in response to A. phagocytophilum infection through the use of enzyme-linked immunosorbent assay (ELISA).

70. The use of a Polymerase Chain Reaction (PCR) assay to detect A. phagocytophilum DNA. The detection of A. phagocytophilumin blood leukocytes when stained and viewed under a microscope. In-clinic SNAP® 4Dx® blood test for dogs and horses. In-clinic Snap 4Dx blood test for dogs. http://www.idexx.com/view/xhtml/en_us/corporate/news/press-releases/20070119pr.jsf

71. Prevention(CFSH, 2005) and (CDC, 2010). Exposure to ticks should be minimized and prevented whenever possible. Use pesticides to reduce ticks near buildings Check companion animals for ticks regularly Humans can use DEET insect repellants and permethrin products to treat clothing and gear Livestock and pets may be treated with acaricides Avoid tick habitat when possible An example of a commercially available DEET insect repellant. milanomedical.com An example of a commercially available acaricide for use in livestock and companion animals. http://www.ultravetis.com/?page_id=51

72. Treatment(UWM, 2000) and (LOPH-IDES, 2009) A. phagocytophiluminfection is treated with tetracycline antibiotics. For use in livestock, oxytetracycline is recommended. In humans, the antibiotic of choice is doxycycline. Due to negative side-effects of tetracyclines in pregnant women, the antibiotic rifampin can be used as an alternative treatment. An example of commercially available oxytetracycline antibiotic which will be administered intravenously. http://www.bestvetstore.com/search/oxytetracycline+veterinary/

73. Why do we care about Anaplasmosis? Zoonotic disease puts livestock handlers and owners of companion animals at risk of infection Infection of wildlife species is less easily identified and these infected individuals can spread A. phagocytophilumcarrying ticks into areas where they can infect livestock, pets, and humans Negative economic impact due to reduction of reproductive efficiency in livestock

74. Acknowledgements T.B. Hairgrove, D.V.M. and P.D. Teel, Ph.D. Funding provided by National Center for Foreign Animal and Zoonotic Disease Defense

75. References ALDF. 2010. Other Tick-Borne Diseases. American Lyme Disease Foundation, Inc. Available: http://www.aldf.com/ Anaplasmosis.shtml. Accessed: March 9, 2011. Alleman, A.R. and H.L. Wamsley. 2008. An update on anaplasmosis in dogs. Available: http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=506867&sk=&date=&&pageID=1. Accessed: May 3, 2011. Bexfield, N.E., E.J. Villiers, and M.E. Herrtage. 2005. Immune-mediated haemolyticanaemia and thrombocytopenia associated with Anaplasma phagocytophilum in a dog. Journal of Small Animal Practice. 46:543-548. Billeter, S.A., J.A. Spencer, B. Griffin, C.C. Dykstra, B.L. Blagburn. 2007. Prevalence of Anaplasmaphagocytophilum in domestic felines in the United States.Veterinary Parasitology. 147:194-198. CDC. 2011. Ticks. Center for Disease Control and Prevention. Available: http://www.cdc.gov/ticks/. Accessed: April 28, 2011. CFSPH. 2005. Ehrlichiosis. Center for Food Security and Public Health. Available: http://www.cfsph.iastate.edu/Factsheets/pdfs/ehrlichiosis.pdf. Accessed: February 8, 2011. Dulmer, J.S., K. Choi, J.C. Garcia-Garcia, N.S. Barat, D.G. Scorpio, J.W. Garyu, D.J. Grab, and J.S. Bakken. Human Granulocytic Anaplasmosis and Anaplasma phagocytophilum. Emerging infectious Diseases. 11:1828-1834. IDEXX Laboratories. 2007. New Canine SNAP® 4Dx® Diagnostic Test Available. IDEXX Laboratories. Available: http://www.idexx.com/view/xhtml/en_us/corporate/news/ press-releases/20070119pr.jsf. Accessed: May 2, 2011.

76. References LDA. 2009. Tick Habitat. Lyme Disease Association. Available: http://www.lymediseaseassociation.org/index.php?option=com_content&view=article&id=269&Itemid=183. Accessed: September 13, 2011. LOPH-IDES. 2009. Ehrlichiosis/Anaplasmosis. Louisiana Office of Public Health-Infectious Disease Epidemiology Section. Available: http://www.dhh.louisiana. gov/offices/miscdocs/docs-249/Manual/EhrlichiosisManual.pdf. Accessed: March 9, 2011. Maurin, M., J.S. Bakken and J.S. Dulmer. 2003. Antibiotic susceptibilitir4es o Anaplasma (Ehrlichia) phagocytophilum strains from various geographic areas in the United States. Antimicrobial Agentsand Chemotherapy. 47: 413-415. Ogden, N.H., Z. Woldehiwet and C.A. Hart. 1998. Granulocytic ehrlichiosis: an emerging or rediscovered tick-borne disease? Journal of Medical Microbiology. 47: 475-482. Rikihisa, Yasuko. 2010. Anaplasmaphagocytophilum and Ehrlichiachaffeensis: subversive manipulators of host cells. Microbiology. 8: 328-339. Tate, C.M., D.G. Mead, M.P. Luttrell, E.W. Hawerth, V.G. Dugan. U.G. Munderloh and W.R. Davidson. 2005. Experimental infection of white tail deer with Anaplasmaphagocytophilum etiologic agent of Human Granulocytic Anaplasmosis. Journal of Clinical Microbiology. 43:3595-3601. UWM. 2000. Anaplasmaphagocytophila(Ehrlichiaequi)in horses. University of Wisconsin-Madison. Available: http://www.vetmed.wisc.edu/pbs/zoonoses/ Ehrlichia/ehrlequihorses.html. Accessed: May 2, 2011.