| Paralysis produced by ticks bites.
/
Paralisis producida por picadura de garrapatas.
DATA-MEDICOS
DERMAGIC/EXPRESS 19-(201)
24 Noviembre 2.017 24 November 2.017
EDITORIAL ENGLISH
=================
Hello friends of the network today DERMAGIC EXPRESS brings you
another interesting and hot topic, once again about the TICKS
and the diseases that are capable of transmitting to the human
being, it is the TICK PARALYSIS (TP), produced by the
bite of some TICKS, which transmit a
NEUROTOXIN which produces
PARALYSIS in some parts of your body, even causing
death in 10 to 12% of cases.
The TICK PARALYSIS, is now considered a
ENVENOMING NEUROTOXIC which is similar to polio,
affects both children and adults (majority children) especially
in regions considered
HYPERENDEMIC as the
West of the United States and the regions of
Eastern Australia.
Historically, the Australians Hamilton Hume and William Hove
described the first bites of TICKS TO HUMANS in 1.824, but
it was Bancroft in 1.884 the first to report two cases
(2) of toxicosis by TICKS TO HUMANS describing 2
cases with weakness and blurred vision.
The first death was reported by Cleland in 1,912.
Since that time the disease has been reported almost everywhere
in the world.
This disease is considered a rare condition, but very well
studied by our scientists, and begins with the transmission
of a
NEUROTOXIN that is in the salivary glands of the
FEMALE ticks that when feed with blood enter to the bloodstream
causing the symptoms which are characterized by A
ASCENDING FLACCID PARALYSIS of the muscles that
begins 2 to 7 days after the bite, in the lower limbs, and then
goes up to the trunk, arms, head and death can occur due to
respiratory failure. Other symptoms include numbness,
decreased tendon reflexes, ophthalmoplegia, and bulbar palsy.
THE TICK PARALYSIS (TP) can be misdiagnosed, and
confuse medical science with entities such as: ACUTE ATAXIA,
TRANSVERSE MYELITIS, EPIDURAL ABSCESS, BOTULISM AND
GULLAIN BARRE SYNDROME (GBS), the latter being the
one that lends itself most to confusion.
The causative agents of this condition are fully identified:
In the United States of America, the vector is the
TICK DERMACENTOR ANDERSONI, which also transmits
the
DISEASE THE ROCKY MOUNTAINS SPOTTED FEVER. Another
causative agent of this disease is the
TICK DERMACENTOR VARIABILIS, considered the
second most frequent vector in the transmission of THE ROCKY
MOUNTAINS SPOTTED FEVER.
But this does not stop here; Approximately
69 species of TICKS from all over the world are able to
induce PARALYSIS BY BITTING. In other countries, such as the
southeast of
AUSTRALIA, this disease (TP) is also endemic
and the causative agents are other TICKS, among which the
TICK of the
IXODES genus, IXODES HOLOCYCLUS, and
IXODES CORNUATUS, also
DERMACENTOR ANDESONI and
VARIABILIS
stand out.
In South Africa the most important vector is the
TICK IXODES RUBICUNDUS,
in ETHIOPIA, the
TICKS RHIPICEPHALUS EVERTSI EVERTIS and
ARGAS WALKERAE and
TICK ARGAS RADIATUS in the
Neartic region of North America.
The disease considered as a
global extension "SUPPOSEDLY" has not been described in
the HEMISPHERE SUR, but in the year 1.994, two (2) cases
were described in
ARGENTINA in the province of Jujuy. A case (1) was
also described on the Pacific coast of
MEXICO, produced by the TICK
AMBLYOMA MACULATUM. It has also been reported in
THE BRITISH COLUMBIA, the third most populated province of
CANADA, 57 cases between 1.993 and 2.016 being the
most common vector the TICK DERMACENTOR ANDERSONI, the cases
were found in both humans and animals.
TICKS PARALYSIS has also been described in animals such as:
cats, dogs, cattle horses, sheep, and birds, being
the
TICK IXODES HOLOCYCLUS the most involved. In fact,
today this disease in Australia is considered a veterinary
problem because of the large number of infected animals, and the
main host of this is the mammal
LONG-NOSED-BANDICOOT.
Unlike other diseases such as LYME, POWASSAN and HEARTLAND
DISEASE, where the TICK involved TRANSMITS a bacterium (LYME)
or virus (POWASSAN and HEARTLAND) that infects the organism,
in the case of TICK PARALYSIS (TP) it is a
NEUROTOXIN that only remains in the organism
WHILE THE TICK IS ADHERED TO THE SKIN FEEDING WITH BLOOD,
when taking it off the symptoms gradually disappear recovering
the patient, even though the
LETHALITY is of 10 -12%. So that...
I describe another disease TRANSMITTED BY TICKS, and I leave you
the same reflection of my other reviews, the best way to
AVOID THEM, is not only to fight
for human rights to receive adequate treatment
LIKE THE CASE OF LYME DISEASE, which have been
Violated in many countries, especially in the US, we also have
to fight against
VECTORS and
HOSTS.
Greetings to all
Dr. José Lapenta
EDITORIAL ESPAÑOL
=================
Hola amigos de la red hoy DERMAGIC EXPRESS te trae otro tema
bien interesante y caliente, una vez más sobre las
GARRAPATAS y las enfermedades que son capaces de
transmitir al humano, se trata de la PARALISIS POR
GARRAPATAS, producida por la picadura de unas
GARRAPATAS, las cuales transmiten una
NEUROTOXINA la cual produce
PARALISIS en ciertas partes de tu organismo
incluso pudiendo causar la
muerte en un 10 a 12%
de los casos.
La PARALISIS POR MORDEDURA DE GARRAPATAS, es considerada
hoy día un
ENVENENAMIENTO NEUROTOXICO la cual es similar
al polio, afecta tanto niños como adultos (mayormente a
niños) especialmente en regiones consideradas
HIPERENDEMICAS como el
Oeste de los Estados Unidos y las regiones del
Este de Australia.
Históricamente los Australianos Hamilton Hume y William
Hove describieron las primeras mordeduras de GARRAPATAS
A HUMANOS en 1.824,
pero fue Bancroft en 1.884 el primero en reportar dos
casos (2) de toxicosis por GARRAPATAS A HUMANOS
describiendo 2 casos con debilidad y visión Borrosa.
La primera muerte fu reportada por Cleland en 1,912.
Desde esa época la enfermedad ha sido reportada en casi todo
el mundo.
Esta enfermedad es considerada una rara condición, pero muy
bien estudiada por nuestros científicos, y comienza por
la transmisión de una
NEUROTOXINA que está en las glándulas salivales de
las garrapatas HEMBRAS que al alimentarse de sangre
pasan al torrente sanguíneo ocasionando los síntomas los
cuales están caracterizados por
UNA PARALISIS FLACIDA de los músculos
ASCENDENTE que comienza 2 a 7 días después de
la picadura, en los miembros inferiores, y luego sube al
troco, brazos, cabeza y puede ocurrir la muerte por fallo
respiratorio. Otros síntomas incluyen, obnubilación,
disminución de los reflejos tendinosos, oftalmoplegia y
parálisis bulbar.
LA PARALISIS POR GARRAPATAS (TP) puede ser
diagnosticada erróneamente, y confundir a la ciencia médica
con entidades como: ATAXIA AGUDA, MIELITIS TRANSVERSA,
ABSCESO EPIDURAL, BOTULISMO Y
SINDROME DE GULLAIN BARRE (GBS), siendo este
ultimo el que se presta más a confusión.
Los agentes causales de esta condición están totalmente
identificados: En los Estados Unidos de Norteamérica el
vector es la
GARRAPATA DERMACENTOR ANDERSONI, la cual
también es transmisora de
LA ENFERMEDAD FIEBRE MOTEADA DE LAS MONTAÑAS ROCOSAS.
Otro agente causal de esta enfermedad es la
GARRAPATA DERMACENTOR VARIABILIS, considerado el
segundo vector más frecuente en la transmisión DE LA
FIEBRE MOTEADA DE LAS MONTAÑAS ROCOSAS.
Pero esto no queda aquí, Aproximadamente
69 especies de garrapatas de todo el mundo son
capaces de inducir LA PARALISIS POR MORDEDURA DE GARRAPATA.
En otros países como el sureste de
AUSTRALIA, esta enfermedad (TP) también es
endémica y los agentes causales son otras GARAPATAS
entre las que destacan principalmente la
GARAPATA
del genero IXODES,
IXODES HOLOCYCLUS, e
IXODES CORNUATUS, también
DERMACENTOR ANDESONI y
VARIABILIS.
En
SUDAFRICA el vector más importante es
LA GARRAPATA IXODES RUBICUNDUS, en
ETIOPIA, las
GARRAPATAS RHIPICEPHALUS EVERTSI EVERTIS y
ARGAS WALKERAE y la
GARRAPATA ARGAS RADIATUS en la
región Neartica de América del Norte.
La enfermedad considerada de
extensión mundial "SUPUESTAMENTE" no ha
sido descrita en el HEMISFERIO SUR, pero en él año 1.994
fueron descritos dos (2) caso en
ARGENTINA en la provincia de Jujuy. También
fue descrito un caso (1) en la costa del pacifico
MEXICANA producido por la
GARRAPATA AMBLYOMA MACULATUM. También ha sido
reportada en LA COLUMBIA BRITANICA, tercera provincia
más poblada de
CANADA, 57 casos entre 1.993 Y 2.016 siendo el
vector mas común la GARRAPATA
DERMACENTOR ANDERSONI, los caso fueron
hallados tanto en humanos como animales.
La PARALISIS POR GARRAPATAS también ha sido descrita en
animales como:
gatos perros, ganado caballos, ovejas, y pájaros,
siendo la GARRAPATA
IXODES HOLOCYCLUS la mas involucrada. De hecho
hoy día esta enfermedad en Australia es considerada un
problema veterinario por la gran cantidad de animales
infectados, y el huesped principal de esta garrapata en
AUSTRALIA es el mamifero marsupial
"BANDICOOT DE NARIZ LARGA"
A diferencia de otras enfermedades como LA ENFERMEDAD DE
LYME, POWASSAN y HEARTLAND donde LA GARRAPATA involucrada
TRANSMITE una bacteria (LYME) o virus (POWASSAN y
HEARTLAND) que infecta el organismo, en el caso de la
PARALISIS POR GARRAPATA (TP) es una
NEUROTOXINA
que solo permanece en el organismo MIENTRAS LA
GARRAPATA ESTA
ADHERIDA A LA PIEL ALIMENTANDOSE CON SANGRE,
al despegarla los síntomas paulatinamente desaparecen
recuperándose el paciente, aun así la
LETALIDAD es del 10 -12%. De modo que...
Te describo hoy otra enfermedad TRANSMITIDAD POR GARRAPATAS,
y te dejo la misma reflexión de mis otras revisiones, la
mejor manera de EVITARLAS NO ES SOLO luchar por los
derechos humanos a recibir tratamiento adecuado
COMO EL CASO DE
LA ENFERMEDAD DE LYME, los cuales han sido
violentados en muchos países, especialmente en US, también
hay que luchar contra los
VECTORES y
HUESPEDES.
Saludos a Todos
Dr. José Lapenta.
=============================================================================
BIBLIOGRAPHICAL REFERENCES /
REFERENCIAS BIBLIOGRAFICAS
=============================================================================
1.) A Retrospective Cohort Study of Tick Paralysis in British
Columbia.
2.) A Comparative Meta-Analysis of Tick Paralysis in the United
States and Australia.
3.) A 60-year meta-analysis of tick paralysis in the United States:
a predictable, preventable, and often misdiagnosed poisoning.
4.) Tick paralysis.
5.) Tick paralysis cases in Argentina.
6.) Neurotoxin-induced paralysis: a case of tick paralysis in a 2-year-old
child.
7.) Tick paralysis presenting in an urban environment.
8.) Tick paralysis: 33 human cases in Washington State, 1946-1996.
9.) Cluster of tick paralysis cases--Colorado, 2006.
10.) The association between landscape and climate and reported tick
paralysis cases in dogs and cats in Australia.
11.) Delineation of an endemic tick paralysis zone in southeastern
Australia.
12.) A list of the 70 species of Australian ticks; diagnostic guides
to and species accounts of Ixodes holocyclus (paralysis tick),
Ixodes cornuatus (southern paralysis tick) and Rhipicephalus
australis (Australian cattle tick); and consideration of the place
of Australia in the evolution of ticks with comments on four
controversial ideas.
13.) Tick paralysis caused by Amblyomma maculatum on the Mexican
Pacific Coast.
14.) Tick Paralysis — Washington, 1995
15.) Rare Cause of Facial Palsy: Case Report of Tick Paralysis by
Ixodes Holocyclus Imported by a
Patient Travelling into Singapore from Australia.
16.) A Comparative Meta-Analysis of Tick Paralysis in the United
States and Australia.
17.) Tick paralysis in Australia caused by Ixodes holocyclus Neumann
=================================================================
=================================================================
1.) A Retrospective Cohort Study of Tick Paralysis in British
Columbia.
=================================================================
Vector Borne Zoonotic Dis. 2017 Oct 30. doi: 10.1089/vbz.2017.2168.
[Epub ahead of print]
Morshed M1,2, Li L1,2, Lee MK1, Fernando K1, Lo T1, Wong Q1.
Author information
1
1 Zoonotic Diseases and Emerging Pathogens Section, BC Centre of
Disease Control Public Health Laboratory , Vancouver, Canada .
2
2 Department of Pathology and Laboratory Medicine, University of
British Columbia , Vancouver, Canada .
Abstract
BACKGROUND:
Tick paralysis is a frequently overlooked severe disease
characterized by bilateral ascending flaccid paralysis caused by a
neurotoxin produced by feeding ticks. We aimed to characterize
suspected tick paralysis cases documented at the BC Centre for
Disease Control (BCCDC) in British Columbia (BC) from 1993 to 2016
and reviewed prevention, diagnosis, and treatment considerations.
METHODS:
Demographic, geographic, and clinical data from test requisition
forms for ticks submitted to the BCCDC Public Health Laboratory (PHL)
from patients across BC between 1993 and 2016 for suspected human
and animal tick paralysis were reviewed. Descriptive statistics were
generated to characterize tick paralysis cases in BC, including tick
species implicated, seasonality of disease, and regional differences.
RESULTS:
From 1993 to 2016, there were 56 cases of suspected tick paralysis
with at least one tick specimen submitted for testing at the BCCDC
PHL. Humans and animals were involved in 43% and 57% of cases,
respectively. The majority of cases involved a Dermacentor andersoni
tick (48 cases or 86%) and occurred between the months of April and
June (49 cases or 88%). Among known locations of tick acquisition,
the Interior region of BC was disproportionately affected, with 25
cases (69%) of tick bites occurring in that area.
CONCLUSIONS:
Tick paralysis is a rare condition in BC. The region of highest risk
is the Interior, particularly during the spring and summer months.
Increasing awareness of tick paralysis among healthcare workers and
the general public is paramount to preventing morbidity and
mortality from this rare disease.
===========================================================================
2.) A Comparative Meta-Analysis of Tick Paralysis in the United
States and Australia.
==========================================================================
Clin Toxicol (Phila). 2015 Nov;53(9):874-83. doi:
10.3109/15563650.2015.1085999. Epub 2015 Sep 11.
Diaz JH1.
Author information
1
a Louisiana State University Health Sciences Center, School of
Public Health , 2020 Gravier Street, New Orleans, Louisiana 70112
United States.
Abstract
CONTEXT:
Tick paralysis is a neurotoxic envenoming that mimics polio and
primarily afflicts children, especially in hyperendemic regions of
the Western United States of America (US) and Eastern Australia.
OBJECTIVE:
To compare the epidemiology, clinical and electrodiagnostic
manifestations, and outcomes of tick paralysis in the US versus
Australia.
METHODS:
A comparative meta-analysis of the scientific literature was
conducted using Internet search engines to identify confirmed cases
of tick paralysis in the US and Australia. Continuous variables
including age, time to tick removal, and duration of paralysis were
analyzed for statistically significant differences by unpaired
t-tests; and categorical variables including gender, regional
distribution, tick vector, tick attachment site, and misdiagnosis
were compared for statistically significant differences by chi-square
or Fisher exact tests.
RESULTS:
Tick paralysis following ixodid tick bites occurred seasonally and
sporadically in individuals and in more clusters of children than in
adults of both sexes in urban and rural locations in North America
and Australia. The case fatality rate for tick paralysis was low,
and the proportion of misdiagnoses of tick paralysis as Guillain-Barré
syndrome (GBS) was greater in the US than in Australia. Although
electrodiagnostic manifestations were similar, the neurotoxidromes
differed significantly with prolonged weakness and even residual
neuromuscular paralysis following tick removal in Australian cases
compared with US cases.
DISCUSSION:
Tick paralysis was a potentially lethal envenoming that occurred in
children and adults in a seasonally and regionally predictable
fashion. Tick paralysis was increasingly misdiagnosed as GBS during
more recent reporting periods in the US. Such misdiagnoses often
directed unnecessary therapies including central venous
plasmapheresis with intravenous immunoglobulin G that delayed
correct diagnosis and tick removal.
CONCLUSION:
Tick paralysis should be added to and quickly excluded from the
differential diagnoses of acute ataxia with ascending flaccid
paralysis, especially in children living in tick paralysis-endemic
regions worldwide.
===========================================================================
3.) A 60-year meta-analysis of tick paralysis in the United States:
a predictable, preventable, and often misdiagnosed poisoning.
==========================================================================
J Med Toxicol. 2010 Mar;6(1):15-21. doi: 10.1007/s13181-010-0028-3.
Diaz JH1.
Author information
1
LSU School of Public Health, New Orleans, LA, USA. [email protected]
Abstract
Tick paralysis (TP) is a neurotoxic poisoning primarily afflicting
young girls in endemic regions. Recent case series of TP have
described increasing misdiagnoses of TP as the Guillain-Barré
syndrome (GBS). A meta-analysis of the scientific literature was
conducted using Internet search engines to assess the evolving
epidemiology of TP. Fifty well-documented cases of TP were analyzed
over the period 1946-2006. Cases were stratified by demographics,
clinical manifestations, and outcomes. Misdiagnoses were subjected
to Yates-corrected chi-square analyses to detect statistically
significant differences in proportions of misdiagnoses between
earlier and later reporting periods. TP occurred seasonally and
sporadically in individuals and in clusters of children and adults
of both sexes in urban and rural locations. The case fatality rate (CFR)
for TP was 6.0% over 60 years. The proportion of misdiagnoses of TP
as GBS was significantly greater (chi(2) = 7.850, P = 0.005) in more
recently collected series of TP cases, 1992-2006, than the
proportion of misdiagnoses in earlier series, 1946-1996. TP was a
potentially lethal poisoning that occurred in children and adults in
a seasonally and regionally predictable fashion. TP was increasingly
misdiagnosed as GBS during more recent reporting periods. Such
misdiagnoses often directed unnecessary therapies such as central
venous plasmapheresis with intravenous immunoglobulin G, delayed
correct diagnosis, and tick removal, and could have increased CFRs.
TP should be added to and quickly excluded from the differential
diagnoses of acute ataxia and ascending flaccid paralysis,
especially in children living in TP-endemic regions of the USA.
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4.) Tick paralysis.
=========================================================================
Infect Dis Clin North Am. 2008 Sep;22(3):397-413, vii. doi: 10.1016/j.idc.2008.03.005.
Edlow JA1, McGillicuddy DC.
Author information
1
Beth Israel Deaconess Medical Center, West Clinical Center 2, One
Deaconess Road, West Campus - CC 2, Boston, MA 02215, USA. [email protected]
Abstract
The one tick-borne disease that rarely comes under the auspices of
the infectious disease specialist is not caused by an infectious
agent, but is tick paralysis. This condition is caused by tick bite
and typically presents as a flaccid ascending paralysis. This
article discusses this entity partly because of completeness, but
also because tick paralysis, or tick toxicosis as it is sometimes
called, is worth the infectious disease consultant's consideration.
The differential diagnosis includes entities that are infectious or
caused by toxins of infectious agents, such as epidural abscess,
some causes of transverse myelitis, and botulism. Lastly, in an era
of antibiotic toxicity, multidrug-resistant bacteria, antigen-switching
viruses, and complex antibiotic regimens, the cure for tick
paralysis-removing the tick-is as simple as it is gratifying.
==========================================================================
5.) Tick paralysis cases in Argentina.
==========================================================================
Rev Soc Bras Med Trop. 2012 Jul-Aug;45(4):533-4.
Remondegui C1.
Author information
1
Servicio de Infectologia y Medicina Tropical, Hospital San Roque,
Ministerio de Salud de la Provincia de Jujuy, Jujuy, Argentina.
[email protected]
Abstract
Tick paralysis (TP) occurs worldwide and is caused by a neurotoxin
secreted by engorged female ticks that affects the peripheral and
central nervous system. The clinical manifestations range from mild
or nonspecific symptoms to manifestations similar to Guillain-Barré
syndrome, bulbar involvement, and death in 10% of the patients. The
diagnosis of TP is clinical. To our knowledge, there are no formal
reports of TP in humans in South America, although clusters of TP
among hunting dogs in Argentina have been identified recently. In
this paper, clinical features of two cases of TP occurring during
1994 in Jujuy Province, Argentina, are described.
==========================================================================
6.) Neurotoxin-induced paralysis: a case of tick paralysis in a 2-year-old
child.
==========================================================================
Pediatr Neurol. 2014 Jun;50(6):605-7. doi: 10.1016/j.pediatrneurol.2014.01.041.
Epub 2014 Jan 24.
Taraschenko OD1, Powers KM2.
Author information
1
Department of Neurology, Albany Medical College, Albany, New York.
Electronic address: [email protected].
2
Department of Neurology, Albany Medical College, Albany, New York.
Abstract
BACKGROUND:
Tick paralysis is an arthropod-transmitted disease causing
potentially lethal progressive ascending weakness. The presenting
symptoms of tick paralysis overlap those of acute inflammatory
diseases of the peripheral nervous system and spinal cord; thus, the
condition is often misdiagnosed, leading to unnecessary treatments
and prolonged hospitalization.
PATIENT:
A 2-year-old girl residing in northern New York and having no
history of travel to areas endemic to ticks presented with rapidly
progressing ascending paralysis, hyporeflexia, and intact sensory
examination. Investigation included blood and serum toxicology
screens, cerebrospinal fluid analysis, and brain imaging. With all
tests negative, the child's condition was initially mistaken for
botulism; however, an engorged tick was later found attached to the
head skin. Following tick removal, the patient's weakness promptly
improved with no additional interventions.
CONCLUSION:
Our patient illustrates the importance of thorough skin examination
in all cases of acute progressive weakness and the necessity to
include tick paralysis in the differential diagnosis of paralysis,
even in nonendemic areas.
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7.) Tick paralysis presenting in an urban environment.
==========================================================================
Pediatr Neurol. 2004 Feb;30(2):122-4.
Gordon BM1, Giza CC.
Author information
1
Department of Pediatrics, David Geffen School of Medicine, UCLA, Los
Angeles, California 90095, USA.
Abstract
We report the case of a 17-month-old female with tick paralysis
presenting to an urban Los Angeles emergency department. The tick
was later identified as the North American wood tick, Dermacentor
andersoni, and was likely obtained while the family was vacationing
on a dude ranch in Montana. We discuss the epidemiology of tick
paralysis, a differential diagnosis for health care providers, and
methods of detection and removal. Given the increasing popularity of
outdoor activities and ease of travel, tick paralysis should be
considered in cases of acute or subacute weakness, even in an urban
setting.
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8.) Tick paralysis: 33 human cases in Washington State, 1946-1996.
==========================================================================
Clin Infect Dis. 1999 Dec;29(6):1435-9.
Dworkin MS1, Shoemaker PC, Anderson DE.
Author information
1
Division of HIV/AIDS Prevention, National Center for HIV, STD, and
TB Prevention, Centers for Disease Control and Prevention, Atlanta,
GA 30333, USA. [email protected].
Abstract
Tick paralysis is a preventable cause of illness and death that,
when diagnosed promptly, requires simple, low-cost intervention (tick
removal). We reviewed information on cases of tick paralysis that
were reported to the Washington State Department of Health (Seattle)
during 1946-1996. Thirty-three cases of tick paralysis were
identified, including 2 in children who died. Most of the patients
were female (76%), and most cases (82%) occurred in children aged <8
years. Nearly all cases with information on site of probable
exposure indicated exposure east of the Cascade Mountains. Onset of
illness occurred from March 14 to June 22. Of the 28 patients for
whom information regarding hospitalization was available, 54% were
hospitalized. Dermacentor andersoni was consistently identified when
information on the tick species was reported. This large series of
cases of tick paralysis demonstrates the predictable epidemiology of
this disease. Improving health care provider awareness of tick
paralysis could help limit morbidity and mortality due to this
disease.
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9.) Cluster of tick paralysis cases--Colorado, 2006.
==========================================================================
MMWR Morb Mortal Wkly Rep. 2006 Sep 1;55(34):933-5.
Centers for Disease Control and Prevention (CDC).
Abstract
Tick paralysis is a rare disease characterized by acute, ascending,
flaccid paralysis that is often confused with other acute neurologic
disorders or diseases (e.g., Guillain-Barré syndrome or botulism).
Tick paralysis is thought to be caused by a toxin in tick saliva;
the paralysis usually resolves within 24 hours after tick removal.
During May 26-31, 2006, the Colorado Department of Public Health and
Environment received reports of four recent cases of tick paralysis.
The four patients lived (or had visited someone) within 20 miles of
each other in the mountains of north central Colorado. This report
summarizes the four cases and emphasizes the need to increase
awareness of tick paralysis among health-care providers and persons
in tick-infested areas.
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10.) The association between landscape and climate and reported tick
paralysis cases in dogs and cats in Australia.
==========================================================================
Vet Parasitol. 2014 Aug 29;204(3-4):339-45. doi: 10.1016/j.vetpar.2014.05.018.
Epub 2014 May 17.
Brazier I1, Kelman M2, Ward MP3.
Author information
1
The University of Sydney, Faculty of Veterinary Science, Camden
2570, NSW, Australia.
2
Virbac Australia, Milperra 1891, NSW, Australia.
3
The University of Sydney, Faculty of Veterinary Science, Camden
2570, NSW, Australia. Electronic address: [email protected].
Abstract
The aim of this study was to describe the association between
landscape and climate factors and the occurrence of tick paralysis
cases in dogs and cats reported by veterinarians in Australia. Data
were collated based on postcode of residence of the animal and the
corresponding landscape (landcover and elevation) and climate (precipitation,
temperature) information was derived. During the study period (October
2010-December 2012), a total of 5560 cases (4235 [76%] canine and
1325 [24%] feline cases) were reported from 341 postcodes, mostly
along the eastern seaboard of Australia and from the states of New
South Wales and Queensland. Significantly more cases were reported
from postcodes which contained areas of broadleaved, evergreen tree
coverage (P=0.0019); broadleaved, deciduous open tree coverage
(P=0.0416); and water bodies (P=0.0394). Significantly fewer tick
paralysis cases were reported from postcodes which contained areas
of sparse herbaceous or sparse shrub coverage (P=0.0297) and areas
that were cultivated and managed (P=0.0005). No significant
(P=0.6998) correlation between number of tick paralysis cases
reported per postcode and elevation was found. Strong positive
correlations were found between number of cases reported per
postcode and the annual minimum (rSP=0.9552, P<0.0001) and maximum (rSP=0.9075;
P=0.0001) precipitation. Correlations between reported tick
paralysis cases and temperature variables were much weaker than for
precipitation, rSP<0.23. For maximum temperature, the strongest
correlation between cases was found in winter (rSP=0.1877; P=0.0005)
and for minimum temperature in autumn (rSP=0.2289: P<0.0001). Study
findings suggest that tick paralysis cases are more likely to occur
and be reported in certain eco-climatic zones, such as those with
higher rainfall and containing tree cover and areas of water.
Veterinarians and pet owners in these zones should be particularly
alert for tick paralysis cases to maximize the benefits of early
treatment, and to be vigilant to use chemical prophylaxis to reduce
the risk of tick parasitism.
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11.) Delineation of an endemic tick paralysis zone in southeastern
Australia.
==========================================================================
Vet Parasitol. 2017 Nov 30;247:42-48. doi: 10.1016/j.vetpar.2017.09.005.
Epub 2017 Sep 6.
Whitfield Z1, Kelman M2, Ward MP3.
Author information
1
Sydney School of Veterinary Science, The University of Sydney,
Camden NSW, Australia.
2
Kelman Scientific, Peregian Beach QLD, Australia.
3
Sydney School of Veterinary Science, The University of Sydney,
Camden NSW, Australia. Electronic address: [email protected].
Abstract
Tick paralysis has a major impact on pet dog and cat populations in
southeastern Australia. It results from envenomation by Ixodes
holocyclus and Ixodes cornuatus ticks, the role of Ixodes cornuatus
in the epidemiology of this disease in Australia being unclear. The
aim of this study was to describe the geographical distribution of
tick paralysis cases in southeastern Australia using data from a
national disease surveillance system and to compare characteristics
of "endemic" cases with those reported outside this endemic zone ("sporadic"
cases). Data were collated and a proportional symbol map of all
cases by postcode was created. A 15-case isopleth was developed
based on descriptive spatial statistics (directional ellipses) and
then kernel smoothing to distinguish endemic from sporadic cases.
During the study period (January 2010-December 2015) 12,421 cases
were reported, and 10,839 of these reported by clinics located in
434 postcodes were included in the study. Endemic cases were
predominantly reported from postcodes in coastal southeastern
Australia, from southern Queensland to eastern Victoria. Of those
cases meeting selection criteria, within the endemic zone 10,767
cases were reported from 351 (88%) postcodes and outside this zone
72 cases were reported from 48 (12%) postcodes. Of these latter 48
postcodes, 18 were in Victoria (26 cases), 16 in New South Wales (28
cases), 7 in Tasmania (9 cases), 5 in South Australia (7 cases) and
2 in Queensland (2 cases). Seasonal distribution in reporting was
found: 62% of endemic and 52% of sporadic cases were reported in
spring. The number of both endemic and sporadic cases reported
peaked in October and November, but importantly a secondary peak in
reporting of sporadic cases in April was found. In non-endemic areas,
summer was the lowest risk season whilst in endemic areas, autumn
was the lowest risk season. Two clusters of sporadic cases were
identified, one in South Australia (P=0.022) during the period 22
May to 2 June 2012 and another in New South Wales (P=0.059) during
the period 9 October to 29 November 2012. Endemic and sporadic cases
did not differ with respect to neuter status (P=0.188), sex
(P=0.205), case outcome (P=0.367) or method of diagnosis (P=0.413).
However, sporadic cases were 4.2-times more likely to be dogs than
cats (P<0.001). The endemic tick paralysis zone described is
consistent with previous anecdotal reports. Sporadic cases reported
outside this zone might be due to a history of pet travel to endemic
areas, small foci of I. holocyclus outside of the endemic zone, or
in the case of southern areas, tick paralysis caused by I. cornuatus.
==========================================================================
12.) A list of the 70 species of Australian ticks; diagnostic guides
to and species accounts of Ixodes holocyclus (paralysis tick),
Ixodes cornuatus (southern paralysis tick) and Rhipicephalus
australis (Australian cattle tick); and consideration of the place
of Australia in the evolution of ticks with comments on four
controversial ideas.
==========================================================================
Barker SC1, Walker AR2, Campelo D3.
Author information
1
Department of Parasitology, School of Chemistry and Molecular
Biosciences, The University of Queensland, Brisbane, Qld 4072,
Australia. Electronic address: [email protected].
2
Royal (Dick) School of Veterinary Studies, University of Edinburgh,
EH25 9RG Scotland, United Kingdom.
3
Department of Parasitology, School of Chemistry and Molecular
Biosciences, The University of Queensland, Brisbane, Qld 4072,
Australia.
Abstract
Seventy species of ticks are known from Australia: 14 soft ticks (family
Argasidae) and 56 hard ticks (family Ixodidae). Sixteen of the 70
ticks in Australia may feed on humans and domestic animals (Barker
and Walker 2014). The other 54 species of ticks in Australia feed
only on wild mammals, reptiles and birds. At least 12 of the species
of ticks in Australian also occur in Papua New Guinea. We use an
image-matching system much like the image-matching systems of field
guides to birds and flowers to identify Ixodes holocyclus (paralysis
tick), Ixodes cornuatus (southern paralysis tick) and Rhipicephalus
(Boophilus) australis (Australian cattle tick). Our species accounts
have reviews of the literature on I. holocyclus (paralysis tick)
from the first paper on the biology of an Australian tick by
Bancroft (1884), on paralysis of dogs by I. holocyclus, to papers
published recently, and of I. cornuatus (southern paralysis tick)
and Rhipicephalus (Boophilus) australis (Australian cattle tick). We
comment on four controversial questions in the evolutionary biology
of ticks: (i) were labyrinthodont amphibians in Australia in the
Devonian the first hosts of soft, hard and nuttalliellid ticks?; (ii)
are the nuttalliellid ticks the sister-group to the hard ticks or
the soft ticks?; (iii) is Nuttalliella namaqua the missing link
between the soft and hard ticks?; and (iv) the evidence for a
lineage of large bodied parasitiform mites (ticks plus the
holothyrid mites plus the opiliocarid mites).
=============================================================================
13.) Tick paralysis caused by Amblyomma maculatum on the Mexican
Pacific Coast.
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Vector Borne Zoonotic Dis. 2011 Jul;11(7):945-6. doi: 10.1089/vbz.2010.0154.
Epub 2011 Mar 11.
Espinoza-Gomez F1, Newton-Sanchez O, Flores-Cazares G, De la
Cruz-Ruiz M, Melnikov V, Austria-Tejeda J, Rojas-Larios F.
Author information
1
Communicable Disease Group, Faculty of Medicine, University of
Colima, Colima, Mexico.
Abstract
Tick paralysis is a rare entity in which it is necessary to identify
the cause and remove the arthropod to have a rapid remission of
symptoms. In the absence of an early diagnosis, the outcome can be
fatal, as toxins are released from the tick's saliva as it feeds. To
the best of the authors' knowledge, this is the first clinical
report of the disease in Mexico and Latin America. A 22-year-old man
from a rural area, who was in contact with cattle, developed
ascending flaccid paralysis secondary to Amblyomma maculatum tick
toxin. He presented flaccid paraplegia and arreflexia that
progressed until causing dyspnea. The clinical symptoms subsided 48
h after the ticks spontaneously detached. The ticks were discovered
by nursing personnel while the patient was being transferred to a
regional hospital with the diagnosis of Guillain-Barré syndrome. The
patient was asymptomatic on discharge from hospital and showed no
further motor deterioration at a 1-month follow-up.
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14.) Tick Paralysis — Washington, 1995
============================================================================
Tick Paralysis — Continued Tick paralysis (tick toxicosis)—one of
the eight most common tickborne diseases in
the United States (1 )—is an acute, ascending, flaccid motor
paralysis that can be confused
with Guillain-Barré syndrome, botulism, and myasthenia gravis. This
report
summarizes the results of the investigation of a case of tick
paralysis in Washington.
On April 10, 1995, a 2-year-old girl who resided in Asotin County,
Washington, was
taken to the emergency department of a regional hospital because of
a 2-day history
of unsteady gait, difficulty standing, and reluctance to walk. Other
than a recent history
of cough, she had been healthy and had not been injured. On physical
examination,
she was afebrile, alert, and active but could stand only briefly
before requiring
assistance. Cranial nerve function was intact. However, she
exhibited marked extremity
and mild truncal ataxia, and deep tendon reflexes were absent. She
was admitted
with a tentative diagnosis of either Guillain-Barré syndrome or
postinfectious
polyradiculopathy.
Within several hours of hospitalization, she had onset of drooling
and tachypnea. A
nurse incidentally detected an engorged tick on the girl’s hairline
by an ear and removed
the tick. Within 7 hours after tick removal, tachypnea subsided and
reflexes
were present but diminished. The patient recovered fully and was
discharged on
April 11. The tick species was not identified.
Reported by: E Haas, D Anderson, R Neu, Asotin County Health Dept,
Clarkston, Washington.
N Berkheiser, MD, Saint Joseph Regional Medical Center, Lewiston,
Idaho. J Grendon, DVM,
P Shoemaker, J Kobayashi, MD, P Stehr-Green, DrPH, State
Epidemiologist, Washington State
Dept of Health. Div of Field Epidemiology, Epidemiology Program
Office, CDC.
Editorial Note: Tick paralysis occurs worldwide and is caused by the
introduction of a
neurotoxin elaborated into humans during attachment of and feeding
by the female of
several tick species. In North America, tick paralysis occurs most
commonly in the
Rocky Mountain and northwestern regions of the United States and in
western Canada.
Most cases have been reported among girls aged <10 years during
April–June,
when nymphs and mature wood ticks are most prevalent (2 ). Although
tick paralysis
is a reportable disease in Washington, surveillance is passive, and
only 10 cases were
reported during 1987–1995.
In the United States, this disease is associated with Dermacentor
andersoni (Rocky
Mountain wood tick), D. variabilis (American dog tick), Amblyomma
americanum
(Lone Star tick), A. maculatum, Ixodes scapularis (black-legged tick),
and I. pacificus
April 26, 1996 / Vol. 45 / No. 16
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES / Public Health Service
325 Tick Paralysis — Washington, 1995
326 Update: Influenza Activity —
United States and Worldwide,
1995–96 Season, and Composition
of the 1996–97 Influenza Vaccine
330 Multidrug-Resistant Tuberculosis
Outbreak on an HIV Ward —
Madrid, Spain, 1991–1995
333 Adult Blood Lead Epidemiology
and Surveillance — United States,
Fourth Quarter, 1995
335 Notice to Readers
(western black-legged tick) (3,4 ). Onset of symptoms usually occurs
after a tick has
fed for several days. The pathogenesis of tick paralysis has not
been fully elucidated,
and pathologic and clinical effects vary depending on the tick
species (4 ). However,
motor neurons probably are affected by the toxin, which diminishes
release of acetylcholine
(5 ). In addition, experimental studies indicate that the toxin may
produce a
substantial decrease in maximal motor-nerve conduction velocities
while simultaneously
increasing the stimulating current potential necessary to elicit a
response (5 ).
If unrecognized, tick paralysis can progress to respiratory failure
and may be fatal
in approximately 10% of cases (6 ). Prompt removal of the feeding
tick usually is followed
by complete recovery. Ticks can be attached to the scalp or neck and
concealed
by hair and can be removed using forceps or tweezers to grasp the
tick as closely as
possible to the point of attachment (7 ). Removal requires the
application of even pressure
to avoid breaking off the body and leaving the mouth parts imbedded
in the host.
Gloves should be worn if a tick must be removed by hand; hands
should be promptly
washed with soap and hot water after removal of a tick.
The risk for tick paralysis may be greatest for children in rural
areas, especially in
the Northwest, during the spring and may be reduced by the use of
repellants on skin
and permethrin-containing acaricides on clothing. Paralysis can be
prevented by careful
examination of potentially exposed persons for ticks and prompt
removal of ticks.
Health-care providers should consider tick paralysis in persons who
reside or have
recently visited tick-endemic areas during the spring or early
summer and who present
with symmetrical paralysis.
References
1. Spach DH, Liles WC, Campbell GL, Quick RE, Anderson DE, Fritsche
TR. Tick-borne diseases
in the United States. N Engl J Med 1993;329:936–47.
2. CDC. Tick paralysis—Wisconsin. MMWR 1981;30:217–8.
3. CDC. Tick paralysis—Georgia. MMWR 1977;26:311.
4. Gothe R, Kunze K, Hoogstraal H. The mechanisms of pathogenicity
in the tick paralyses. J Med
Entomol 1979;16:357–69.
5. Kocan AA. Tick paralysis. J Am Vet Med Assoc 1988;192:1498–500.
6. Schmitt N, Bowmer EJ, Gregson JD. Tick paralysis in British
Columbia. Can Med Assoc
J 1969;100:417–21.
7. Needham GR. Evaluation of five popular methods for tick removal.
Pediatrics 1985;75:9
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15.) Rare Cause of Facial Palsy: Case Report of Tick Paralysis by
Ixodes Holocyclus Imported by a
Patient Travelling into Singapore from Australia.
=============================================================================
J Emerg Med. 2016 Nov;51(5):e109-e114. doi: 10.1016/j.jemermed.2016.02.031.
Epub 2016 Sep 9.
Pek CH1, Cheong CS2, Yap YL1, Doggett S3, Lim TC1, Ong WC1, Lim J1.
Author information
1
Division of Plastic, Reconstructive and Aesthetic Surgery,
Department of Surgery, National University Health System, Singapore.
2
Department of Otolaryngology - Head and Neck Surgery, National
University Health System, Singapore.
3
Department of Medical Entomology, Pathology West, Westmead Hospital,
Westmead, NSW, Australia.
Abstract
BACKGROUND:
Ticks are blood-sucking arachnids that feed on all classes of
vertebrates, including humans. Ixodes holocyclus, also known as the
Australian Paralysis Tick, is capable of causing a myriad of
clinical issues in humans and companion animals, including the
transmission of infectious agents, toxin-mediated paralysis,
allergic and inflammatory reactions, and mammalian meat allergies in
humans. The Australian Paralysis Tick is endemic to Australia, and
only two other exported cases have been reported in the literature.
CASE REPORT:
We report the third exported case of tick paralysis caused by I.
holocyclus, which was imported on a patient into Singapore. We also
discuss the clinical course of the patient, the salient points of
management, and the proper removal of this tick species. WHY SHOULD
AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With increasing air travel,
emergency physicians need to be aware of and to identify imported
cases of tick paralysis to institute proper management and advice to
the patient. We also describe the tick identification features and
proper method of removal of this tick species.
============================================================================
16.) A Comparative Meta-Analysis of Tick Paralysis in the United
States and Australia.
==================================================================
Clin Toxicol (Phila). 2015 Nov;53(9):874-83. doi:
10.3109/15563650.2015.1085999. Epub 2015 Sep 11.
Diaz JH1.
Author information
1
a Louisiana State University Health Sciences Center, School of
Public Health , 2020 Gravier Street, New Orleans, Louisiana 70112
United States.
Abstract
CONTEXT:
Tick paralysis is a neurotoxic envenoming that mimics polio and
primarily afflicts children, especially in hyperendemic regions of
the Western United States of America (US) and Eastern Australia.
OBJECTIVE:
To compare the epidemiology, clinical and electrodiagnostic
manifestations, and outcomes of tick paralysis in the US versus
Australia.
METHODS:
A comparative meta-analysis of the scientific literature was
conducted using Internet search engines to identify confirmed cases
of tick paralysis in the US and Australia. Continuous variables
including age, time to tick removal, and duration of paralysis were
analyzed for statistically significant differences by unpaired
t-tests; and categorical variables including gender, regional
distribution, tick vector, tick attachment site, and misdiagnosis
were compared for statistically significant differences by chi-square
or Fisher exact tests.
RESULTS:
Tick paralysis following ixodid tick bites occurred seasonally and
sporadically in individuals and in more clusters of children than in
adults of both sexes in urban and rural locations in North America
and Australia. The case fatality rate for tick paralysis was low,
and the proportion of misdiagnoses of tick paralysis as Guillain-Barré
syndrome (GBS) was greater in the US than in Australia. Although
electrodiagnostic manifestations were similar, the neurotoxidromes
differed significantly with prolonged weakness and even residual
neuromuscular paralysis following tick removal in Australian cases
compared with US cases.
DISCUSSION:
Tick paralysis was a potentially lethal envenoming that occurred in
children and adults in a seasonally and regionally predictable
fashion. Tick paralysis was increasingly misdiagnosed as GBS during
more recent reporting periods in the US. Such misdiagnoses often
directed unnecessary therapies including central venous
plasmapheresis with intravenous immunoglobulin G that delayed
correct diagnosis and tick removal.
CONCLUSION:
Tick paralysis should be added to and quickly excluded from the
differential diagnoses of acute ataxia with ascending flaccid
paralysis, especially in children living in tick paralysis-endemic
regions worldwide.
============================================================================
17.) Tick paralysis in Australia caused by Ixodes holocyclus Neumann
============================================================================
Ann Trop Med Parasitol. 2011 Mar;105(2):95-106. doi:
10.1179/136485911X12899838413628
S Hall-Mendelin,* S B Craig,†‡ R A Hall,* P O’Donoghue,* R B Atwell,§
S M Tulsiani,† and G C Graham
Author information
1
School of Chemistry and Molecular Biosciences, University of
Queensland, St Lucia, Australia. [email protected]
Abstract
Ticks are obligate haematophagous ectoparasites of various animals,
including humans, and are abundant in temperate and tropical zones
around the world. They are the most important vectors for the
pathogens causing disease in livestock and second only to mosquitoes
as vectors of pathogens causing human disease. Ticks are formidable arachnids, capable of not only transmitting the pathogens involved
in some infectious diseases but also of inducing allergies and
causing toxicoses and paralysis, with possible fatal outcomes for
the host. This review focuses on tick paralysis, the role of the
Australian paralysis tick Ixodes holocyclus, and the role of toxin
molecules from this species in causing paralysis in the host.
Many forms of tick toxicosis affect humans and other animals (Gothe
and Neitz, 1991; Mans et al., 2004). According to Gothe (1984), a
tick toxicosis is defined as a ‘generalized, experimentally
standardizable, reproducible disease syndrome induced by one or a
few potent ticks, even on first infestation of a physiological
susceptible vertebrate species without participation of an
immunopathological reaction during or following the tick feeding’.
Such toxicoses are mostly caused by ixodid or hard ticks (Stone and
Wright, 1981) and, in their most severe form, result in paralysis of
the infested host. About 69 species of ticks from around the world
are capable of inducing paralysis (Gothe and Neitz, 1991), the most
important being Ixodes holocyclus in Australia, Dermacentor
andersoni, De. variabilis and Argas (Persicargas) radiatus in North
America, Ix. rubicundus in South Africa, Rhipicephalus evertsi
evertsi and Ar. (Pers.) walkerae in Ethiopia, and Ar. (Pers.)
radiatus in the Nearctic region of North America (Stone, 1986). Some
important paralysing ticks and their distributions are summarized in
Table 1. In Australia, Ix. holocyclus can cause paralysis in humans,
dogs, cats, sheep, cattle, goats, pigs and horses but predominantly
infests dogs, cats and humans (Stone, 1986). It appears to be the
most potently toxic tick species, with a single tick capable of
killing a large dog (Stone and Wright, 1981) or sheep (Sloan, 1968).
Although the Tasmanian paralysis tick Ix. cornuatus has been
reported to cause bulbar paresis and respiratory failure in humans (Tibballs
and Cooper, 1986) and dogs (Beveridge et al., 2004), its habitat is
more restricted than that of Ix. holocyclus and very few cases of
paralysis have been associated with this tick. In Australia, tick
paralysis has mainly been seen as a problem in veterinary medicine,
affecting approximately 10,000 companion animals/year (Stone and
Aylward, 1987). Occasionally, however, the climatic conditions
become particularly favorable to tick survival, tick densities reach
very high levels, and the number of humans being bitten by Ix.
holocyclus increases. Although rarely severe, tick paralysis caused
by Ix. holocyclus can be fatal
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DATA-MEDICOS/DERMAGIC-EXPRESS No 19-(201) 24/11/2.017 DR. JOSE
LAPENTA R.
===================================================================
Produced
by Dr. Jose Lapenta R. Dermatologist 2.017
Maracay Estado Aragua Venezuela 2.017
Telf: 0416-6401045- 02432327287-02432328571
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