[The Less Frequent Tick-borne Infections in Central Europe]

The Less Frequent Tick-borne Infections in Central Europe Abstract. The incidence of tick-borne infections is increasing, the endemic areas of tick vectors are expanding, novel tick-borne pathogens have been identified, and known pathogens are emerging in new geographic areas. This review focuses on the less frequent tick-borne pathogens in Central Europe, including Anaplasma, Babesia, Borrelia miyamotoi, Candidatus Neoehrlichia mikurensis, Ehrlichia, Francisella tularensis, Rickettsia, relapsing fever spirochetes, and tick-borne viruses. Travel-associated infections are also considered emphasizing a clinical and geographic approach. In addition to the most frequent Ixodes sp. also other tick species transmitting human pathogens are endemic in Europe. Clinicians should maintain suspicion for tick-borne diseases in patients presenting with fever of unexplained cause, with acute rash or with febrile neurological signs and symptoms. Because clinical manifestations of tick-borne infections are nonspecific - except for Erythema migrans - it is important to consider tick-borne illnesses even without a reported tick exposure or a suggesting travel history. Less than 50% of infected patients are aware of a tick-bite. Patients' history must include profession, leisure time activities, travel, and immune status. Tick-borne diseases may have a severe and life-threatening course in immunocompromised and splenectomized persons.