TABLE 1.
Prevalences of coinfections of Ixodes ticks with Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti/divergens by species and geographic region as determined by PCRa
| Region | Reference | Ixodes species | No. of ticks sampled (population)b | % Infectionc with:
|
% Coinfectiond with:
|
|||
|---|---|---|---|---|---|---|---|---|
| B. burgdorferie | A. phagocytophiluma | B. microti or B. divergensf | Two pathogens | Three pathogens | ||||
| North America | ||||||||
| California | Holden et al. (86) | I. pacificus | 776 (a) | 6.7 | 7.2 | 1.0 | ||
| California | Lane et al. (109) | I. pacificus | 158 (n) | 3.8 | 3.2 | 1.3 | ||
| Maine | Holman et al. (88) | I. scapularis | 394 (a, n) | 22.3 | 2.8 | 0.8 | 1.0 | 0 |
| Massachusetts | Piesman et al. (155) | I. scapularis | 395 (n) | 27.3 | 23.0 | 10.9 | ||
| Massachusetts | Telford et al. (206) | I. scapularis | 51 (a) | 36.0 | 11.0 | 9.0 | 4.0 | 0 |
| New Jersey | Adelson et al. (1) | I. scapularis | 107 | 33.6 | 1.9 | 8.4 | 3.7 | 0 |
| New Jersey | Schulze et al. (174) | I. scapularis | 147 (a) | 50.3 | 6.1 | 2.7 | ||
| New Jersey | Varde et al. (213) | I. scapularis | 100 (a) | 43.0 | 17.0 | 5.0 | 10 | 0 |
| New York | Schauber et al. (170) | I. scapularis | 188 (a) | 66.0 | 42.6 | 28.2 | ||
| New York (1995) | Schwartz et al. (175) | I. scapularis | 100 (a) | 52.0 | 53 | 26 | ||
| 73 (n) | 26.0 | 21 | 5 | |||||
| New York (1984) | I. scapularis | 100 (a) | 45.0 | 32 | 19 | |||
| Pennsylvania | Courtney et al. (46) | I. scapularis | 454 (a) | 41.2 | 17.8 | 3.5 | ||
| Wisconsin | Pancholi et al. (147) | I. scapularis | 89 (a) | 11.2 | 7.9 | 2.2 | ||
| Europe | ||||||||
| Bulgaria | Christova et al. (41) | I. ricinus | 112 (a) | 32.1 | 33.9 | 13.4 | ||
| France | Halos et al. (77) | I. ricinus | 92 (a, n) | 3.3 | 20.6g | 2.1g | ||
| Germany | Baumgarten et al. (17) | I. ricinus | 275 (a) | 21.8 | 2.2 | 0.7 | ||
| Germany | Fingerle et al. (68) | I. ricinus | 401 (a) | 37.4 | 2.0 | 1.0 | ||
| 91 (n) | 30.8 | 0 | 0 | |||||
| Germany | Hildebrandt et al. (83) | I. ricinus | 62 (a) | 21.0 | 6.5 | 1.6 | ||
| 243 (n) | 8.6 | 1.2 | 0.4 | |||||
| Germany | Oehme et al. (141) | I. ricinus | 898 | 20.4 | 2.9 | 0.8 | ||
| Italy | Cinco et al. (44) | I. ricinus | 86 (a, n) | 19.8 | 24.4 | 8.1 | ||
| The Netherlands | Schouls et al. (173) | I. ricinus | 121 | 13.0 | 28.9 | 3.3 | ||
| Poland | Skotarczak et al. (180) | I. ricinus | 550 (a) | 12.2 | 12.5 | 1.8 | ||
| 1,160 (n) | 5.8 | 9.5 | 0.2 | |||||
| 385 (l) | 5.5 | 4.2 | 0 | |||||
| Poland | Skotarczak et al. (179) | I. ricinus | 280 (a) | 25.0 | 10.0 | 19.3 | 5.4 | 1.1 |
| 234 (n) | 11.5 | 4.3 | 11.1 | 0.8 | 0 | |||
| 19 (l) | 42.1 | 0 | 21.0 | 0 | 0 | |||
| Poland | Stánczak et al. (189) | I. ricinus | 424 (a) | 11.6 | 19.2 | 5.0 | ||
| Poland | Stánczak et al. (188) | I. ricinus | 303 (a) | 19.5 | 29.7 | 3.6 | 10.6 | 0 |
| Russia | Alekseev et al. (6) | I. persulcatus | 1,282 (a) | 29.9 | 1.0 | 0.9 | 1.2h | 0i |
| Slovakia | Derdáková et al. (54) | I. ricinus | 40 (a) | 45.0 | 20.0 | 7.5 | ||
| Switzerland | Leutenegger et al. (111) | I. ricinus | 20 (n) | 40.0 | 0 | 0 | ||
| 100 (a) | 49.0 | 2.0 | 2.0 | |||||
| China | Cao et al. (37) | I. persulcatus | 1,146 (a) | 37.3 | 4.9 | 0.5 | ||
| 199 (n) | 13.6 | 3.0 | 0.5 | |||||
PCR assays differ among studies, and results might include strain variants (e.g., A. phagocytophilum) that are potentially nonpathogenic in humans. Microscopy-based detection of infection in ticks occurs in older studies.
a, adults; n, nymphs; l, larvae.
Prevalence includes totals from coinfected ticks.
Coinfection data overlap with the single-pathogen prevalence percentages.
B. burgdorferi sensu lato genogroup; European and Asian studies include pathogenic Borrelia species, Borrelia garinii, and Borrelia afzelii.
Babesia odocoilei, not reported to cause human disease, has since been demonstrated to be prevalent among I. scapularis ticks in certain locations in the northeastern and north central United States (9, 172). I. ricinus ticks in Europe can also carry species of Babesia that are neither B. microti nor B. divergens (59). Thus, estimates of pathogen prevalence based solely on microscopy or using nonspecific assays may overestimate the risk of human babesiosis.
Particular species of Babesia not determined.
Dual coinfection with TBE virus and B. burgdorferi sensu lato was demonstrated for 15 (1.2%) of 1,280 I. persulcatus ticks.
Triple coinfection with B. microti, B. burgdorferi, and TBE virus was demonstrated for a single (0.1%) tick.