title: Ticks infesting humans in Italy and associated pathogens.
abstract: BACKGROUND
  Ticks may transmit a large variety of pathogens, which cause illnesses in animals and humans, commonly referred to as to tick-borne diseases (TBDs). The incidence of human TBDs in Italy is underestimated because of poor surveillance and the scant amount of studies available.
  
  
  METHODS
  Samples (n = 561) were collected from humans in four main geographical areas of Italy (i.e., northwestern, northeastern, southern Italy, and Sicily), which represent a variety of environments. After being morphologically identified, ticks were molecularly tested with selected protocols for the presence of pathogens of the genera Rickettsia, Babesia, Theileria, Candidatus Neoehrlichia mikurensis, Borrelia and Anaplasma.
  
  
  RESULTS
  Ticks belonged to 16 species of the genera Argas, Dermacentor, Haemaphysalis, Hyalomma, Ixodes and Rhipicephalus, with Ixodes ricinus (59.5%) being the species most frequently retrieved, followed by Rhipicephalus sanguineus sensu lato (21.4%). Nymphs were the life stage most frequently retrieved (41%), followed by adult females (34.6%). The overall positivity to any pathogen detected was 18%. Detected microorganisms were Rickettsia spp. (17.0%), Anaplasma phagocytophilum (0.8%), Borrelia afzelii (0.5%), Borrelia valaisiana (0.3%), C. N. mikurensis (0.5%) and Babesia venatorum (0.6%).
  
  
  CONCLUSIONS
  Results indicate that people living in the Italian peninsula are at risk of being bitten by different tick species, which may transmit a plethora of TBD causing pathogens and that co-infections may also occur.
authors.affiliation: Department of Veterinary Medicine, University of Bari, 70010 Valenzano, Bari, Italy. domenico.otranto@uniba.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Otranto
authors.forename: Filipe
authors.initials: F
authors.lastname: Dantas-Torres
authors.forename: Alessio
authors.initials: A
authors.lastname: Giannelli
authors.forename: Maria Stefania
authors.initials: MS
authors.lastname: Latrofa
authors.forename: Antonio
authors.initials: A
authors.lastname: Cascio
authors.forename: Stefania
authors.initials: S
authors.lastname: Cazzin
authors.forename: Silvia
authors.initials: S
authors.lastname: Ravagnan
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montarsi
authors.forename: Sergio Aurelio
authors.initials: SA
authors.lastname: Zanzani
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Manfredi
authors.forename: Gioia
authors.initials: G
authors.lastname: Capelli
mesh_terms: D000818:Animals; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D013984:Tick Infestations / Q000453:epidemiology* / Q000469:parasitology*; D013987:Ticks / Q000145:classification* / Q000382:microbiology*