[Possible types of tick-borne diseases and the predictive role of history data in their diagnosis (parasitological aspects of the problem)].Med Parazitol (Mosk). 2004 Oct-DecMP
The paper discusses the proven and probable role of different tick-borne pathogens and their combinations in the occurrence of zoonotic diseases. The variants of coexistence of various combinations of 7 proved disease agents (3 species of Borrelia, 2 species of Ehrlichia, Babesia, and TBE virus) with different, if might to be, disease agents, such as rickettsiae of two groups, which do not belong to the Borrelia burgdorferi sensu lato group spirochetes, are analyzed. The difference of their development and the time of transmission after of the vector Ixodes persulcatus Schulze attachment are considered. Based on the their own hypothesis that one tick specimen is able to be the vector of only three human pathogenic agents simultaneously, the authors examined the possible number of combinations of pathogens, which might be obtained by a patient after 1 tick attachment. Proper history data are recommended as a tool for making a correct diagnosis, wherein the time of attachment has to be a main factor. For example, it should be taken into account that TBE virus might be transmitted only some minutes after attachment by not only a female tick, but also a male one. Mixed infection of virus plus Borrelia might develop only following some hours of attachment (most probably after 18-24 hours). The very similar situation has to be considered to lead to virus-Borrelia-Ehrlichia (or Rickettsia) coinfection. Any combination with Babesia involvement may appear not earlier than 24-36 hours after mixed infected tick attachment (or even later). It is necessary to consider a possible role of apathogenic microorganisms which are present in the most of vector specimens in nature and which might be injected with infected tick saliva may play a possible role in the manifestation of disease and in the prediction of their possible influence.