BACKGROUND: Feline-associated hemotropic Mycoplasma (hemoplasmas) are believed to be transmitted by two primary mechanisms: (1) direct transmission via fighting and (2) vector-borne transmission by the cat flea (Ctenocephalides felis). While the efficiency of transmission by C. felis appears low, most manuscripts focus on the prevalence of hemoplasmas in wild-caught fleas and report either a very low (< 3%) or a high (> 26%) prevalence. Therefore, we aimed to assess the influence of sample processing and PCR methods on C. felis hemoplasma infection prevalence.
METHODS: A systemic review of PubMed articles identified 13 manuscripts (1,531 fleas/flea pools) that met the inclusion criteria (performed PCR for >1 hemoplasma on C. felis collected from cats). Risk of bias was assessed utilizing the ROBINS-E tool. Meta-analysis performed in R of these manuscripts found that not washing samples and a common set of 16S rRNA primers first published in Jensen et al. 2001 were associated with increased hemoplasma prevalence. To evaluate the influence of washing on newly collected fleas, we assessed the hemoplasma status of 20 pools of 5 C. felis each, half of which were washed and half not washed.
RESULTS: Flea washing did not influence the detection of hemoplasma but instead amplified Spiroplasma. To assess non-specific amplification with the Jensen et al. 2001 primers, 67 C. felis samples (34% previously reported hemoplasma infected) were subject to PCR and sequencing. By this method, hemoplasma was detected in only 3% of samples. In the remaining \"hemoplasma infected\" fleas, PCR amplified Spiroplasma or other bacteria.
CONCLUSIONS: Therefore, we concluded that hemoplasma infection in C. felis is rare, and future flea prevalence studies should sequence all positive amplicons to validate PCR specificity. Further investigation of alternative methods of feline-associated hemoplasma transmission and the ability of C. felis to maintain hemoplasma infection is necessary.

We studied the relationship between fleas\' metabolic rate and their ecological traits, using data on standard metabolic rate (SMR), mean abundance, host specificity, and geographic range size in males and females of seven desert flea species. SMR was measured via mass-specific CO2 emission, whereas host specificity was measured as (a) the mean number of host species used by a flea per region in regions where this flea was recorded; (b) the total number of host species a flea exploited across its geographic range; and (c) the phylogenetic diversity of the flea\'s hosts. To control for confounding effects of phylogeny when analysing data on multiple species, we applied the Phylogenetic Generalised Least Squares (PGLS) model. We found that the only ecological trait significantly correlating with flea SMR was the phylogenetic diversity of hosts utilized by a flea across its geographic range. The strength of the association between SMR and host phylogenetic diversity was higher in male than in female fleas. We explain the relationship between flea SMR and their host specificity by the necessity of host-opportunistic species to compensate for the high energetic cost of neutralizing multiple defences from multiple hosts by increased SMR.

Coccidioidomycosis (CM) is a fungal infection endemic to the southwestern United States with a wide range of clinical presentations depending on the infected organ systems. Most infections are asymptomatic. Coccidioidomycosis causes a primary pulmonary infection and when symptoms occur, they most often resemble community-acquired pneumonia. One percent of cases disseminate, typically via hematogenous or lymphatic spread. It is in these cases that more severe symptoms may present and potentially overlap with those characteristics of other systemic illnesses. This is a case of CM disseminated to lymph nodes in a 24-year-old man with concomitant metastatic embryonal carcinoma. It is difficult to identify the primary etiology for many components of this patient\'s presentation, including diffuse lymphadenopathy and multiple pulmonary nodules. Furthermore, the relationship between these 2 concurrent disease processes is not entirely clear. Factors that may contribute include the well-known phenomenon of locus minoris resistentiae (LMR) or potentially a shared immune failure between infectious organisms and malignant cells.

Scurvy is a disease caused by vitamin C deficiency, historically associated with long sea voyages, periods of famine and war. Currently, it is often misdiagnosed and underreported, as physicians tend to consider it a disease of the past. We present the case of a 79-year-old female who was admitted to the Emergency Department complaining of pruritus. The patient lived alone and in poor hygiene conditions. Diet was scarce. One week before admission she was in contact with flea-ridden stray dogs. Sometime later she noted several fleas and multiple pruritic small papules, crusts, and excoriations on her torso, limbs, palms, soles, and scalp. Physical examination showed the patient to be pale, emaciated, and poorly groomed. Laboratory analysis showed microcytic anemia. Flea bites were treated with oral antihistamines and prednisolone. Follow-up one month later showed weight gain and partial resolution of skin lesions. However, multiple small ecchymosis on both lower and upper limbs, and occasional perifollicular petechias on her lower extremities, were noted. Additional workup showed undetectable serum vitamin C levels. A diagnosis of scurvy was made. The patient was treated with 1000 mg per day of oral vitamin C for one month leading to complete recovery. We present this case to remind that early recognition of vitamin C deficiency and appropriate supplementation are essential in patients with scurvy. Physicians should be aware of classic signs, symptoms, and social factors associated with this forgotten disease.

We studied patterns of ectoparasite species turnover and pairwise ectoparasite-host interactions across space and time in fleas and mites harboured by small mammals using a novel metric, zeta diversity (similarity between multiple communities). We asked whether the zeta diversity of parasites and their interactions with hosts follow a similar spatial or temporal trend. We found substantial differences in some (zeta decline and retention rate) but not in other (zeta decay) spatial patterns of zeta diversity between species and interactions, whereas the differences between the patterns of the temporal species versus interaction zeta diversity occurred to a much lesser extent. In particular, the parametric form of zeta decline suggested that the distribution of ectoparasite species across localities is driven mainly by niche-based processes, whereas the spatial distribution of flea-host and mite-host interactions is predominantly stochastic. We also found much stronger variation in the number of shared species and interactions over space than over time. Parasite community composition, in terms of species, appeared to be much more temporally stable than that in terms of parasite-host interactions. The parametric form of temporal zeta decline indicated that both parasite communities and parasite-host networks are assembled over time via niche-based processes.

Fleas are ectoparasites of various animals, including Homo sapiens Linnaeus, 1758 (Primates: Hominidae). Among the species relevant to the human health field, either due to their dermatopathological potential or because of their role as vectors of microorganisms responsible for infectious diseases, such as plague or murine typhus, are the human flea, oriental rat flea, closely related cat and dog fleas, and chigoe flea. However, other species can accidentally infest humans. We have herein reported two unusual cases of humans infested and bitten by Archaeopsylla erinacei, the hedgehog flea. This species has been identified using stereomicroscopy, on the base of key characteristics. Furthermore, a brief literature review has revealed that hedgehog fleas could carry human-infectious agents, such as Rickettsia felis Bouyer et al. 2001 (Rickettsiales: Rickettsiaceae) or Bartonella henselae Regnery et al.1992 (Rhizobiales: Bartonellaceae). Using molecular biology, we thus tested nine A. erinacei specimens taken from these patients, for several bacteria species commonly associated with hematophagous arthropods, implicated in human pathology. However, all our samples were proven negative. The role of A. erinacei in human epidemiology has never been evaluated to date. This report sought to remind us that these fleas can be accidental parasites in humans. In addition, recent findings pertaining to bacteria of medical interest that are present in these insects should be brought to the fore, given that the question of their role as vectors in human infections remains unanswered and deserves further investigation.

UNASSIGNED: Rodent species reported from Iran are subject of several studies, but the fauna called ectoparasite, infesting the rodents, along with their epidemic effects, are poorly known. In this study, ectoparasitic insect fauna of rodents found across the Iran were studied, to generate an annotated checklist of fleas and lice species.
UNASSIGNED: Several field expeditions focused on different habitats of northeastern Iran were conducted between January 2017 and May 2018. Rodent trapping was carried out using custom-made mesh live traps and \"Faragir\" live traps baited mainly with scorched sunflower and gourd seeds. The trapped rodents were examined for ectoparasites on their body, and then released at their trapping point. The rodents and ectoparasite species were identified based on available keys.
UNASSIGNED: A total of 217 rodents belonging to 16 species of the families Calomyscidae, Cricetidae, Dipodidae, Mu- ridae and Sciuridae were captured. Five species of each fleas and lice were collected from the body of the trapped rodents. Three flea species, Ctenophthalmus pseudagyrtes, Nosopsyllus iranus and Xenopsylla buxtoni; and two louse species, Polyplax gerbilli and P. spinulosa, were recorded for the first time.
UNASSIGNED: The study generated an annotated checklist of 79 species of fleas and 8 species of lice harboured by different species of rodents distributed in Iran which would be helpful in different taxonomic studies such as parasite-host coevolution, and also sanitation and health monitoring programs.

It has been proposed that the transmission of canine visceral leishmaniasis might involve the participation of mechanical vectors, including ticks of the family Ixodidae, in particular the brown dog tick Rhipicephalus sanguineus, and the cat flea Ctenocephalides felis felis. Here, the association between the infestation by R. sanguineus and C. felis felis and the occurrence of anti-Leishmania antibodies was evaluated in an observational case-control study of dogs living in a Brazilian endemic area for canine visceral leishmaniasis. Blood samples were taken once every three months for one year from 96 initially seronegative domestic dogs, and submitted to indirect immunofluorescence antibody assay. All dogs were evaluated for the presence of ticks and fleas, and the results were expressed qualitatively as infested or non-infested, irrespective of the intensity of infestation. At the end of follow-up, twenty dogs had turned seropositive, while 68 remained seronegative and 8 were excluded because of incomplete data. All the dogs were asymptomatic. The odds of infection was significantly greater (OR=3.54, CI95%=1.10-12.53) for dogs infested by C. felis felis compared to their non-infested counterparts. In contrast, the odds of infection showed no significance difference between non-infested and R. sanguineus-infested groups of dogs (OR=0.31, CI95%=0.03-1.52). This study provides further evidence for the potential role of C. felis felis in mechanically transmitting Leishmania among the canine population.

Cat flea bite in humans results in extremely pruritic skin lesions. It has been reported to occur among those living in domiciliary accommodation. However, nosocomial infestation with cat flea has not been reported. We hereby report a case of nosocomial infestation of cat flea in a hospital facility. Identification of the parasite, its appropriate eradication, and adequate medical management of the patients resulted in a satisfactory outcome.

The association between the prevalence of infestation by Rhipicephalus sanguineus and Ctenocephalides felis felis and the presence of anti-Leishmania antibodies has been evaluated in dogs located in a city of Brazil endemic for canine visceral leishmaniasis. Blood samples from 5556 domestic dogs domiciliated in the urban area of Belo Horizonte (Minas Gerais state) were submitted to enzyme linked immunosorbent (ELISA) and indirect immunofluorescent antibody (IFAT) assays, and 432 (7.8%) animals tested positive. Seropositive (n=200) and seronegative (n=200) dogs were randomly selected and examined for the presence of ticks and fleas, the results of which were expressed qualitatively as infested or non-infested, irrespective of the intensity of infestation. The prevalence of infestation by R. sanguineus was significantly greater (ρ=0.04) among seropositive dogs (38.5%) compared with their seronegative counterparts (29.0%). Similarly, the prevalence of infestation by C. felis felis was significantly greater (ρ<0.01) within the seropositive group (36.5%) than within the seronegative group (15.0%). Moreover, the probability of seropositivity for Leishmania was 53% higher in tick-infested dogs and 300% higher in flea-infested dogs in comparison with non-infested animals. Our data provide evidence of the vectorial capacity of these ectoparasites in transmitting Leishmania to the canine population, although further studies are needed to confirm or reject this hypothesis.