TY - JOUR
T1 - Human infection with a novel tick-borne Anaplasma species in China
T2 - A surveillance study
AU - Li, Hao
AU - Zheng, Yuan Chun
AU - Ma, Lan
AU - Jia, Na
AU - Jiang, Bao Gui
AU - Jiang, Rui Ruo
AU - Huo, Qiu Bo
AU - Wang, Ya Wei
AU - Liu, Hong Bo
AU - Chu, Yan Li
AU - Song, Yu Dong
AU - Yao, Nan Nan
AU - Sun, Tie
AU - Zeng, Fan Yi
AU - Dumler, J. Stephen
AU - Jiang, Jia Fu
AU - Cao, Wu Chun
N1 - Funding Information:
The study was supported by Natural Science Foundation of China ( 81290344, 81130086, and 81172729 ), China Mega-project for Infectious Diseases ( 2013ZX10004-202 ), National Key Technology Support Program ( 2014BAI13B02 ), and Special Fund for Quarantine Scientific Research in the Public Interest ( 201310076 ). JSD was supported in part by grant R01 AI044102 from the US National Institutes of Allergy and Infectious Diseases . We thank the doctors and nurses in the Department of Tick-borne Infectious Disease in Mudanjiang Forestry Central Hospital for their kind help with sample collection, and all the participants for their cooperation.
Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background: Anaplasma phagocytophilum and Anaplasma ovis cause human infections. We investigated the potential for human pathogenicity of a newly discovered Anaplasma species infecting goats in China. Methods: We collected blood samples from patients with a history of tick bite in the preceding 2 months at Mudanjiang Forestry Central Hospital of Heilongjiang Province from May 1, to June 10, 2014, to detect the novel Anaplasma species by PCR. We inoculated positive samples into cell cultures. We characterised the isolated pathogen by morphological and phylogenetic analyses. We tested serum antibodies by indirect immunofluorescence assay. Findings: 28 (6%) of 477 patients assessed were infected with the novel Anaplasma species according to PCR and sequencing. We isolated the pathogen in vitro from three patients. Phylogenetic analyses of rrs, gltA, groEL, msp2, and msp4 showed that the pathogen was distinct from all known Anaplasma species. We provisionally nominate it ". Anaplasma capra". 22 (92%) of 24 patients with data available had seroconversion or a four-fold increase in antibody titres. All 28 patients developed non-specific febrile manifestations, including fever in 23 (82%), headache in 14 (50%), malaise in 13 (46%), dizziness in nine (32%), myalgia in four (14%), and chills in four (14%). Additionally, ten (36%) of 28 patients had rash or eschar, eight (29%) had lymphadenopathy, eight (29%) had gastrointestinal symptoms, and three (11%) had stiff neck. Five patients were admitted to hospital because of severe disease. Six (35%) of 17 patients with data available had high hepatic aminotransferase concentrations. Interpretation: The emergence of ". A capra" as a cause of human disease suggests that individuals living in or travelling to endemic regions in northern China should take precautions to reduce their risk of exposure to this novel tick-borne pathogen. Funding: Natural Science Foundation of China and the US National Institutes of Health.
AB - Background: Anaplasma phagocytophilum and Anaplasma ovis cause human infections. We investigated the potential for human pathogenicity of a newly discovered Anaplasma species infecting goats in China. Methods: We collected blood samples from patients with a history of tick bite in the preceding 2 months at Mudanjiang Forestry Central Hospital of Heilongjiang Province from May 1, to June 10, 2014, to detect the novel Anaplasma species by PCR. We inoculated positive samples into cell cultures. We characterised the isolated pathogen by morphological and phylogenetic analyses. We tested serum antibodies by indirect immunofluorescence assay. Findings: 28 (6%) of 477 patients assessed were infected with the novel Anaplasma species according to PCR and sequencing. We isolated the pathogen in vitro from three patients. Phylogenetic analyses of rrs, gltA, groEL, msp2, and msp4 showed that the pathogen was distinct from all known Anaplasma species. We provisionally nominate it ". Anaplasma capra". 22 (92%) of 24 patients with data available had seroconversion or a four-fold increase in antibody titres. All 28 patients developed non-specific febrile manifestations, including fever in 23 (82%), headache in 14 (50%), malaise in 13 (46%), dizziness in nine (32%), myalgia in four (14%), and chills in four (14%). Additionally, ten (36%) of 28 patients had rash or eschar, eight (29%) had lymphadenopathy, eight (29%) had gastrointestinal symptoms, and three (11%) had stiff neck. Five patients were admitted to hospital because of severe disease. Six (35%) of 17 patients with data available had high hepatic aminotransferase concentrations. Interpretation: The emergence of ". A capra" as a cause of human disease suggests that individuals living in or travelling to endemic regions in northern China should take precautions to reduce their risk of exposure to this novel tick-borne pathogen. Funding: Natural Science Foundation of China and the US National Institutes of Health.
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U2 - 10.1016/S1473-3099(15)70051-4
DO - 10.1016/S1473-3099(15)70051-4
M3 - Article
C2 - 25833289
AN - SCOPUS:84929515581
SN - 1473-3099
VL - 15
SP - 663
EP - 670
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 6
ER -