立克次体和军团菌中的蜱传人畜共患病引起的感染通常表现为未分化的发烧,在临床上不容易与其他急性高热疾病的原因区分开。这部分归因于自恢复期血清以来实验室确认的困难,特异性诊断试剂,所需的专业知识可能不容易获得。因此,一些蜱传的人畜共患病被低估,导致不必要的发病率,死亡率和巨大的经济损失。在伊朗,很大一部分人类传染病是蜱传的,轶事证据表明,蜱传人畜共患病在该国很普遍,但报道不足。因此,有必要进行流行病学审查,以帮助有效控制和预防伊朗的tick传播的zonooses病。这篇综述的目的是对无形体病进行深入全面的概述,埃里希体病,伊朗的斑点热组立克次体病和考氏病。
使用系统审查和荟萃分析(PRISMA)指南的首选报告项目,使用多个搜索词搜索了伊朗立克替西ales和军团菌群中有关蜱传人畜共患病的所有相关出版物.搜索仅限于来自流行数据库存储库的真实资源,其中包括PubMed,WebofScience,谷歌学者,科学直接,SpringerLink和SCOPUS。搜索项目包括同行评审的期刊,1996年至2017年出版的书籍和书籍章节。
共采购了1205份科学出版物和报告,其中63人符合搜索标准,并接受了审查。在审查的63篇文章中,36例(57.1%)报告了考氏病,15(23.8%)无形体病,在一项涉及四个国家的大规模研究中,埃里希菌病有11例(17.5%),斑点热组立克次体有1例(1.6%),其中,伊朗。通过分子证实了立克次体和军团菌中蜱传病原体的存在,对从绵羊获得的样品进行的血清学和显微镜技术,牛,山羊,骆驼,家禽,动物产品(牛奶和鸡蛋),狗,全国不同地区的蜱甚至人类受试者;指向全国范围的分布。
根据审查,柯氏杆菌病,无形体病,埃里希体病,和SFG立克次体可以被归类为伊朗新兴的蜱传播的人畜共患疾病,因为它们的病原体的存在(C.Burnetii,A.吞噬细胞,A.边际,A.牛,A.Ovis,A.中央,E.canis,E.艾文吉,E.Chaffeensis和R.conorii)在各种家畜中共同报告,动物产品,来自伊朗22个省的节肢动物和人类。
鉴于其中一些人畜共患病的无症状性质,在这个国家的许多地方,无声传播给人类的可能性很高,这应该被视为公共卫生问题。目前,有关立克次体和军团菌中的病原体对人类的传播强度以及对伊朗的公共卫生影响的信息很少。
Tick-borne zoonoses in the Order
Rickettsiales and Legionellales cause infections that often manifest as undifferentiated fevers that are not easy to distinguish from other causes of acute febrile illnesses clinically. This is partly attributed to difficulty in laboratory confirmation since convalescent sera, specific diagnostic reagents, and the required expertise may not be readily available. As a result, a number of tick-borne zoonoses are underappreciated resulting in unnecessary morbidity, mortality and huge economic loses. In Iran, a significant proportion of human infectious diseases are tick-borne, with anecdotal evidence suggesting that tick-borne zoonoses are widespread but underreported in the country. Epidemiological
review is therefore necessary to aid in the effective control and prevention of tick-borne zonooses in Iran. The aim of this
review is to provide an in-depth and comprehensive overview of anaplasmosis, ehrlichiosis, spotted fever group rickettsioses and coxiellosis in Iran.
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all relevant publications on tick-borne zoonoses in the Order Rickettsiales and Legionellales in Iran were searched using a number of search terms. The search was confined to authentic resources from repositories of popular data bases among them PubMed, Web of Science, Google Scholar, Science Direct, SpringerLink and SCOPUS. The search items included peer reviewed journals, books and book chapters published between 1996 and 2017.
A total of 1 205 scientific publications and reports were sourced, of which 63 met the search criteria and were reviewed. Of the 63 articles reviewed, 36 (57.1%) reported on coxiellosis, 15 (23.8%) on anaplasmosis, 11 (17.5%) on ehrlichiosis and 1(1.6%) on spotted fever group rickettsiae in a large scale study involving four countries, among them Iran. The existence of tick-borne pathogens in the Order
Rickettsiales and Legionellales was confirmed by molecular, serological and microscopic techniques conducted on samples obtained from sheep, cattle, goats, camels, poultry, animal products (milk and eggs), dogs, ticks and even human subjects in different parts of the country; pointing to a countrywide distribution.
Based on the
review, coxiellosis, anaplasmosis, ehrlichiosis, and SFG rickettsiae can be categorized as emerging tick-borne zoonotic diseases in Iran given the presence of their causiative agents (C. burnetii, A. phagocytophilum, A. marginale, A. bovis, A. ovis, A. central, E. canis, E. ewingii, E. chaffeensis and R. conorii) collectively reported in a variety of domestic animals, animal products, arthropods and human beings drawn from 22 provinces in Iran.
Given the asymptomatic nature of some of these zoonoses, there is a high likelihood of silent transmission to humans in many parts of the country, which should be considered a public health concern. Presently, information on the transmission intensity of tick-borne zoonoses caused by pathogens in the Order Rickettsiales and Legionellales to humans and its public health impact in Iran is scanty.