Human infection with a novel tick-borne Anaplasma species in China: A surveillance study

Hao Li, Yuan Chun Zheng, Lan Ma, Na Jia, Bao Gui Jiang, Rui Ruo Jiang, Qiu Bo Huo, Ya Wei Wang, Hong Bo Liu, Yan Li Chu, Yu Dong Song, Nan Nan Yao, Tie Sun, Fan Yi Zeng, J. Stephen Dumler, Jia Fu Jiang, Wu Chun Cao

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)663-670
Number of pages8
JournalThe Lancet Infectious Diseases
Volume15
Issue number6
DOIs
StatePublished - Jun 1 2015

ASJC Scopus subject areas

  • Infectious Diseases

Fingerprint Dive into the research topics of 'Human infection with a novel tick-borne Anaplasma species in China: A surveillance study'. Together they form a unique fingerprint.

  • Cite this

    Li, H., Zheng, Y. C., Ma, L., Jia, N., Jiang, B. G., Jiang, R. R., Huo, Q. B., Wang, Y. W., Liu, H. B., Chu, Y. L., Song, Y. D., Yao, N. N., Sun, T., Zeng, F. Y., Dumler, J. S., Jiang, J. F., & Cao, W. C. (2015). Human infection with a novel tick-borne Anaplasma species in China: A surveillance study. The Lancet Infectious Diseases, 15(6), 663-670. https://doi.org/10.1016/S1473-3099(15)70051-4