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Tick paralysis: atypical presentation, unusual location.

We present 2 unrelated cases of tick paralysis presenting within a 2-month period in the greater Philadelphia region, a geographic area in which this disease is highly unusual. Our first patient demonstrated early onset of prominent bulbar palsies, an atypical presentation. Our second patient, residing in a nearby but distinct community, presented with ascending paralysis 2 months after the first. The atypical presentation of our first patient and the further occurrence within a few months of a second patient, both from the Northeastern United States where this diagnosis is rarely made, suggest the need to maintain a high index of suspicion for this disease in patients presenting with acute onset of cranial nerve dysfunction or muscle weakness. Through simple diagnostic and therapeutic measures (ie, careful physical examination to locate and remove the offending tick), misdiagnosis and unnecessary morbidity can be avoided.

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Spatial and temporal variations in the commencement of seasonal activity in the Karoo paralysis tick, Ixodes rubicundis.

Successful prophylaxis of paralysis, induced in small stock by feeding female Ixodes rubicundus, is dependent on the accurate determination of the commencement of seasonal activity by the tick. The commencement of this activity was recorded for 11 consecutive years on a farm in the south-western Free State, South Africa, and for shorter periods on other farms, some of these in regions with markedly colder climates. The colder the mean minimum atmospheric temperatures during the 2 months preceding the start to tick activity, the earlier it commenced. This could differ by 4 weeks from year to year on the same farm. In a region with a low effective temperature activity commenced between 3-8 weeks earlier than in a region with a higher effective temperature.

Animals↗

Tick paralysis in a grey fox.

One hundred seventeen Dermacentor variabilis were removed from the head and back of a grey fox (Urocyon cinereoargenteus) showing paresis and diminished motor reflexes of the hind limbs. Rapid and total recovery led to a diagnosis of tick paralysis.

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Control of Karoo paralysis ticks through vegetation management.

Karoo paralysis, caused by feeding Ixodes rubicundus females, is a major disease of small stock in South Africa. Control methods currently practised are almost exclusively chemical based. To limit overdependance on chemicals, vegetation management was investigated as a possible method for control, to be incorporated in an integrated tick management system. Laboratory and field experiments were conducted to determine, firstly, the extent of vertical migration and survival of ticks on long and short copper rods which simulated grasses as questing substrates; secondly, the infestation burdens of sheep exposed to similar tick challenges in pens with long and short grass; and thirdly, the effect of trimming the lower crown line of wild olive trees, simulating the browsing effect of goats, on tick density in the immediate environment of the trees. When ticks were exposed to optimal ( > 45 cm) and sub-optimal ( < 10 cm) length rods on which to quest, the extent of vertical migration over extended periods of time (up to 87 days) was significantly higher (P < 0.001) for the ticks exposed to long rods. Also, almost 3 times as many ticks exposed to long rods survived compared to those exposed to short rods. Sheep exposed to long grass were infested by twice as many ticks compared to those exposed to short grass. Tick density at modified wild olive trees (Olea europaea africana) (0.027 ticks/m2) differed significantly (P < 0.05) from that at control trees (0.088 ticks/m2). It is recommended that coarse grazers such as cattle and horses should be used to graze down long grasses before sheep are introduced into camps known to be infested with I. rubicundus. Similarly, domestic goats can, through their browsing effect on shrubs and trees, modify the vegetation and as such play an important role in an integrated tick management system.

Animals↗

Creatine phosphokinase elevation in a case of tick paralysis.

The results of studies on a case of tick paralysis in a female child are described. The patient was paralysed by a single female specimen of Dermacentor andersoni Stiles attached to the left temporal area of the scalp. Paralysis of the lower limbs, incoordinate respiration and weakness of the arms were evident.The findings on physical examination and the results of diagnostic laboratory procedures are reported and the possible significance of the results is discussed. The only abnormal laboratory finding was an elevated level of plasma creatine phosphokinase (CPK) activity occurring during the paralytic phase and persisting for 10 days.

Action Potentials↗

An outbreak of suspected tick paralysis in one-humped camels (Camelus dromedarius) in the Sudan.

An outbreak of suspected tick paralysis occurred in one-humped camels in Southern Darfur, the Sudan, between latitudes 11-12 degrees N and longitudes 24-25 degrees E, when the camels were herded in tick infested areas. It involved 251 camels of different ages, in ten herds causing 34.3% mortality. The symptoms were incoordination of movements, unsteady gait and recumbency followed by death or recovery. Hyalomma adults and/or Rhipicephalus nymphs and adults were incriminated to be the cause of the disease. Transient paralysis in a guinea pig was produced after experimental feeding of ticks. Removal of the camels from the tick infested areas and treatment against the ectoparasites with Lindane at the concentration of 0.23% contributed to controlling the disease.

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Site and mechanism of tick paralysis.

A neurophysiological investigation indicates that the paralysis produced in the dog by the wood tick, Dermacentor andersoni Stiles, is due to failure in the liberation of acetylcholine at the neuromuscular junction because of a conduction block in the somatic motor fibers produced by the tick "toxin".

Acetylcholine↗

Tick paralysis.

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Humans↗

Tick paralysis.

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Animals↗

The effect of feeding immature Karoo paralysis ticks Ixodes rubicundus (Acari: Ixodidae) on the metabolic rate of the rock elephant shrew.

The effect of feeding immature Karoo paralysis ticks (Ixodes rubicundus) on the resting metabolic rate (RMR) of their principal natural host, the rock elephant shrew (Elephantulus myurus), was investigated under laboratory conditions. The elephant shrews were artificially infested with numbers of ticks simulating natural burdens. The RMR of the elephant shrews was quantified by measuring the oxygen consumption in an open through-flow system. The RMR of hosts infested only with larvae did not differ from that of the control group. Those infested with nymphs, or nymphs and larvae, had significantly lower RMR's compared to the control animals. There were no signs of paralysis in any of the infested hosts.

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Sites of attachment of Karoo paralysis ticks (Ixodes rubicundus) on three cattle breeds.

The sites of attachment of female Karoo paralysis ticks (Ixodes rubicundus) were determined on Friesian, Bonsmara and Nguni cattle in the south-western Orange Free State. The largest proportion of the ticks (> 30%) attached to the forelegs and shoulders of the cattle. Contrary to the findings on small stock, no significant differences in the preferred sites of attachment were evident between the breeds of cattle.

Animals↗

Tick paralysis.

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Animals↗

Vector competence of the Australian paralysis tick, Ixodes holocyclus, for the Lyme disease spirochete Borrelia burgdorferi.

Clinical and serologic evidence of Lyme disease in Australia, including the typical rash, erythema migrans, has been reported. The vector tick transmitting Borrelia burgdorferi in Australia, however, has not been determined. The Australian paralysis tick, Ixodes holocyclus, is a logical candidate vector of the Lyme disease spirochete in Australia; therefore, we tested the ability of I. holocyclus to acquire and maintain a North American isolate of B. burgdorferi. Larval I. holocyclus ingested spirochetes, but none of 84 derived nymphs were infected. These experiments should be repeated with Australian strains of spirochetes.

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