Why an Integrated Approach to Tick-Borne Pathogens (Bacterial, Viral, and Parasitic) Is Important in the Diagnosis of Clinical Cases

Abstract

Tick-borne diseases have emerged as a major global public health problem in recent decades. The increasing incidence and geographical dissemination of these diseases requires the implementation of robust surveillance systems to monitor their prevalence, distribution, and public health impact. It is therefore not unexpected that tick-borne pathogens coexist in the same vectors, but the interactions of these agents between vectors and vertebrate hosts, including humans, remain poorly understood. The impact of infection in humans extends to the diagnostic challenges that arise when the same symptomatology can be associated with any tick-borne pathogen, and therapeutic recommendations only focus on the major or best-known tick-borne diseases, ignoring other lesser-known or less prevalent infections. Both surveillance systems and the holistic diagnosis of tick-borne pathogens are necessary tools to address the emergence of vector-borne diseases. In this study, we will focus on the main tick-borne viral, bacterial, and parasitic diseases in Spain to reflect the need to establish syndromic diagnostics in samples from patients with a history of tick bites and symptomatology compatible with them. On the other hand, and highlighting this need, innovations in molecular techniques, syndromic surveillance, and surveillance programs for ticks and tick-borne pathogens with public health implications are expected to be developed.

Keywords: emerging pathogens; public health; syndromic diagnostics; tick-borne diseases; wildlife; zoonoses.

Figure 1

Individual and combined request numbers received by the National Center for Microbiology from 2014 through to 2023 for the different TBPs.

Figure 2

Timeline of the different tick-borne diseases.

Figure 3

Sankey diagram showing the overlapping symptomatology in the different tick-borne diseases.