Tick-borne diseases at the crossroads of the Middle East and central Europe
Pavle Banović, Dejan Jakimovski, Ivana Bogdan, Verica Simin, Dragana Mijatović, Mile Bosilkovski, Sofija Mateska , Adrian A. Díaz-Sánchez, Angelique Foucault-Simonin, Zbigniew Zając, Jaonna Kulisz, Sara Moutailler and Alejandro Cabezas-Cruz
New study by Banović et al. has highlighted the complex epidemiology of tick-borne diseases (TBDs) in Serbia and North Macedonia, two countries with diverse ecosystems that support various tick species capable of transmitting TBDs. Conducted in 2022, this observational study focused on human-biting ticks and the prevalence of tick-borne pathogens (TBPs) among individuals from Novi Sad, Serbia, and Skopje, North Macedonia.
The study involved 62 participants, with 45 from Novi Sad and 17 from Skopje, who had experienced tick bites within the previous 48 hours. Researchers conducted clinical evaluations and tested patient samples and ticks for TBPs using a High-Throughput pathogen detection system based on microfluidic real-time PCR. Additionally, the study assessed the genetic diversity of the identified pathogens.
The study found that Ixodes ricinus was the most prevalent tick species, with varying infestation rates across different body parts. Notably, tick species and feeding times differed between Novi Sad and Skopje. In Novi Sad, ticks exhibited a higher prevalence of Rickettsia spp., including Rickettsia aeschlimannii and Rickettsia monacensis, as well as Anaplasma phagocytophilum and Borrelia afzelii. In Skopje, Rickettsia spp. dominated the detected TBPs.
Subclinical bacteremia occurred in 8.06% of cases, predominantly involving Anaplasma spp. Clinical manifestations were primarily local hypersensitivity reactions observed in six patients. Phylogenetic analysis confirmed the identities of R. aeschlimannii and R. monacensis, highlighting genetic differences in the gltA gene sequences.
The study revealed significant regional variations in tick-borne disease epidemiology. Serbian patients were exposed to a broader spectrum of TBPs compared to their Macedonian counterparts. The high prevalence of Rickettsia spp. in Skopje contrasts with trends in other European countries, underscoring the need for tailored public health strategies.
In addition, this study provides valuable insights into the prevalence and diversity of TBPs in tick-infested individuals from Serbia and North Macedonia. The findings underscore the importance of continued research to better understand the epidemiology of TBDs in the Balkan region, ultimately contributing to improved public health interventions and disease management strategies.