title: Detection and prevalence of Anaplasma phagocytophilum and Rickettsia helvetica in Ixodes ricinus ticks in seven study areas in Sweden.
abstract: BACKGROUND
  Tick-borne Anaplasma phagocytophilum and Rickettsia spp. are considered to be emerging human pathogens, but only limited data are available on their occurrence in Sweden. Two real-time PCR assays followed by nested PCR and sequence analysis were carried out to investigate the prevalence of A. phagocytophilum and spotted fever rickettsiae in ticks from seven areas in Sweden.
  
  
  RESULTS
  In 139 pooled samples, representing a total of 1245 Ixodes ricinus ticks (204 larvae, 963 nymphs, 38 males, 40 females), the overall positive mean infection prevalence was 1.3-15.0% for A. phagocytophilum and 1.5-17.3% for R. helvetica. A. phagocytophilum was only detected in nymphs (1.7-19.4%), whereas R. helvetica was detected in all three tick stages. Support for vertical and transstadial transmission was only obtained for R. helvetica. Both agents showed similar infection rates across study areas, although infection rates were greater in coastal areas.
  
  
  CONCLUSIONS
  The results show that both pathogens occurred in all seven locations, indicating that they are prevalent in Sweden and should be considered etiological agents in patients recently bitten by ticks.
authors.affiliation: Department of Medical Sciences, Clinical Bacteriology, Uppsala University, Uppsala, Sweden. kenneth.nilsson@medsci.uu.se.
authors.forename: Kristofer
authors.initials: K
authors.lastname: Severinsson
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Jaenson
authors.forename: John
authors.initials: J
authors.lastname: Pettersson
authors.forename: Kerstin
authors.initials: K
authors.lastname: Falk
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nilsson