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Pathogens2022,11,1403.https://doi.org/10.3390/pathogens11121403www.mdpi.com/journal/pathogens
Article
Ticks,Fleas,andHarbouredPathogensfromDogs
andCatsinCyprus
AnastasiaDiakou
1,
*,DimitraSofroniou
2
,BarbaraPaoletti
3
,AndronikiTamvakis
4
,StanislavKolencik
5
,
DimitrisDimzas
1
,SimoneMorelli
3
,MarikaGrillini
6
andDonatoTraversa
3
1
LaboratoryofParasitologyandParasiticDiseases,SchoolofVeterinaryMedicine,FacultyofHealth
Sciences,AristotleUniversityofThessaloniki,54124Thessaloniki,Greece
2
IndependentResearcher,Love4PetsOmoniasAve.26,25088Lemesos,Cyprus
3
FacultyofVeterinaryMedicine,TeachingVeterinaryHospital,UniversityofTeramo,64100Teramo,Italy
4
LaboratoryofEcologyandSystemDynamics,DepartmentofMarineSciences,UniversityoftheAegean,
81100Mytilene,Greece
5
DepartmentofBiology,UniversityofNevadaReno,Reno,NV89557,USA
6
DepartmentofAnimalMedicine,ProductionandHealth,UniversityofPadua,35020Legnaro,Italy
*Correspondence:diakou@vet.auth.gr
Abstract:Ticksandfleasareblood‐suckingectoparasitesthatcauseirritationandanaemiatotheir
hostsandactasvectorsofpathogens(vector‐bornepathogens,VBPs)ofrelevanceforanimalandhu‐
manhealth.Inthepresentstudy,tickandfleaspeciesindogsandcatsfromCypruswererecorded
andVBPsweredetectedinthecollectedspecimens.Ectoparasiteswerecollectedfrom220animals(161
dogsand59cats),andaquestionnaireincludingdemographic,clinical,andotherinformationwas
filledoutforeachanimal.TheectoparasitesweremorphologicallyidentifiedandthedetectionofVBPs
wasperformedbyPCR‐coupledsequencing.Rhipicephalussanguineussensulatowasfoundon108
dogsand13cats,andIxodesgibbosuson2dogs.Ctenocephalidesfeliswasthepredominantfleaspecies
(on62dogsand45cats),whileonedogandonecatwereinfestedbyCtenocephalidescanisandEchid‐
nophagagallinacea,respectively.TheVBPsintickswereAnaplasmaplatys,Rickettsiamassiliae,Rickettsia
conorii,Rickettsiafelis,HepatozoonfelisandHepatozooncanis,whileRickettsiafelis,Rickettsiasp.,Bartonella
koehlerae,Bartonellaclarridgeiae,andBartonellahenselaewererecordedinfleas.Statisticalanalysis(chi‐
squaretestandmultipleunivariategeneralizedlinearmodel)showedthatanimalsupto6monthsof
agewerelesslikelytobeinfestedwithticksthanolderanimals,butmorelikelytobeinfestedwith
fleas.Ticksweremoreprevalentinshelteredthaninownedanimals,whiletheoddsratiooffleapres‐
encewashigherinownedanimalsthanthoselivinginshelters.Thepresentstudyisthefirstinvesti‐
gationontheoccurrenceofticksandfleasindogsandcatsfromCyprus,showingthepresenceof
differentVBPsintheseimportantectoparasites.Theresultspointouttheimportanceofsystematic
ectoparasitecontrolindogsandcats.
Keywords:ectoparasites;epidemiology;petanimals;vector‐bornepathogens
1.Introduction
Ticksandfleasareblood‐suckingarthropods,infestingseveralvertebrates,among
themdogsandcats.Theyhavebeenextensivelystudiedbecauseoftheirdirectclinical
impactonanimals,thepathogenstheytransmit,andtheirrelevanceinhumanhealth[1,2].
Theseectoparasitescancausediscomfortandmayseverelyimpactthehealthandwell‐
beingofdogsandcats.Tickscausenuisance,anaemia,irritation,cutaneouslesionswith
inflammationandeosinophilicaggregation,secondaryinfectionsoccasionallyleadingto
abscessesorevenpyaemia,andtoxicosis(tickparalysis).Fleascausesevereirritation,
pruritusandself‐woundformation,bloodlossandanaemia,andflea‐associatedallergic
dermatitis[3–5].Ticksandfleasmayalsotransmitvariousvector‐bornepathogens(VBPs)
Citation:Diakou,A.;Sofroniou,D.;
Paoletti,B.;Tamvakis,A.;
Kolencik,S.;Dimzas,D.;Morelli,S.;
Grillini,M.;Traversa,D.Ticks,Fleas,
andHarbouredPathogensfrom
DogsandCatsinCyprus.Pathogens
2022,11,1403.https://doi.org/
10.3390/pathogens11121403
AcademicEditor:
LawrenceS.Young
Received:5November2022
Accepted:21November2022
Published:23November2022
Publisher’sNote:MDPIstaysneu‐
tralwithregardtojurisdictional
claimsinpublishedmapsandinstitu‐
tionalaffiliations.
Copyright:©2022bytheauthors.Li‐
censeeMDPI,Basel,Switzerland.
Thisarticleisanopenaccessarticle
distributedunderthetermsandcon‐
ditionsoftheCreativeCommonsAt‐
tribution(CCBY)license(https://cre‐
ativecommons.org/licenses/by/4.0/).
Pathogens2022,11,14032of13
totheirhosts,manyofwhicharezoonotic.Pathogenstransmittedbytickstodogsand
catsincludemostlyprotozoa(e.g.Babesiaspp.,Hepatozoonspp.,Cytauxzoonspp.)andbac‐
teria(Rickettsiaspp.,Ehrlichiaspp.,Anaplasmaspp.,Coxiellaspp.,Borreliaspp.).Fleasare
vectorsofBartonellaspp.,Rickettsiafelis,andYersiniapestis,andarealsoanintermediate
hostofthecestodesDipylidiumcaninumandHymenolepisdiminuta,andthenematode
Acanthocheilonemareconditum[3,6–8].
Specificdrivers,e.g.,climatechangeandglobalwarming,destructionofwildhabi‐
tatsforagricultureintensification,landscapemodification,poorecosystemprotection,
andincreaseinpettravelhaveasignificantimpactontheepidemiologyandtheincreas‐
ingoccurrenceofectoparasites[6].Consequently,theaffiliatedVBPsandassociateddis‐
easesareexpectedtoexpand,emerge,orre‐emergeinmanyareas[9].Knowledgeofthe
currentepidemiologyofticks,fleas,andtransmittedpathogensisstillscantinmanyareas
ofEuropeandtheirdistributionandoccurrenceareconstantlychangingovertime[10].
InCyprus,someinvestigationsonticksandtick‐bornepathogenshavebeencon‐
ductedinthepast[11–16],whiledataonfleasandflea‐bornepathogensarelimitedto
onlyrats,foxes,andhares[14,17,18].Therefore,theaimofthepresentstudywas(i)to
investigatetheinfestationbyticksandfleasindogsandcatsfromCyprus;(ii)todetect
thepresenceofVBPsintheseectoparasites;and(iii)toassociatefindingswithdifferent
possibleriskfactors,inordertoupdateandenrichknowledgeabouttheepidemiologyof
theseimportantectoparasites.
2.MaterialsandMethods
2.1.AnimalsandEctoparasiteCollection
Thesurveywasconductedon220animals(161dogsand59cats),livinginfivedis‐
trictsofCyprus,i.e.,Ammochostos,Larnaca,Lemesos,Lefkosia,andPaphos(Figure1),
andpresentedtoaprivateveterinaryclinicinLimassolforroutineclinicalexaminations
(e.g.,vaccination,castration,investigationofclinicalcondition,injury).Ectoparasiteswere
detectedbyfurandskininspectionandbycombingwithastainless‐steelfleacomb.The
ectoparasiteswerecollectedbyentomologicalforceps,storedinEppendorftubescontain‐
ing70ethanol,andtaggedwithanindividualcode.Foreachanimalincludedinthesur‐
vey,aquestionnairewasfilledout,withinformationaboutage,sex,countrydistrict,life‐
style,lastectoparasiticideadministration,thereasonforthevisit,andclinicalandlabora‐
toryfindings.
Figure1.ThemapofCyprusandthedistrictsfromwhichthesampledanimalsoriginated.
Pathogens2022,11,14033of13
2.2.IdentificationofEctoparasites
ThecollectedectoparasitesweretransferredtotheLaboratoryofParasitologyandPar‐
asiticDiseases,SchoolofVeterinaryMedicineoftheAristotleUniversityofThessaloniki.
Theectoparasiteswereexaminedunderastereomicroscope(8×–64×)andalightmicroscope
(100×,400×)foridentificationbasedontheirmorphologicalcharacteristics[19–21].
2.3.DetectionofVBPs
Afteridentification,ectoparasitespecimensweretransferredtotheLaboratoryof
ParasitologyoftheFacultyofVeterinaryMedicine,UniversityofTeramo,forthedetec‐
tionofVPBsbymolecularmethods.
Ticksandfleaswereexaminedinpooledsamplesperanimal,intogroupsofoneto
fiveindividuals.Overall,122pooledticksamplesand111pooledfleasampleswereex‐
amined,excludinghighlyengorgedtickspecimenstoavoidexcessnucleicacidsofverte‐
bratehostorigin.TheectoparasitepoolswerehomogenizedbeforeDNAextraction.
Briefly,thespecimensweretakenfromthe70ethanolsolution,air‐dried,andmechani‐
callycrushedina1.5mlsafe‐locktubewithsterilepestles.Thehomogenateswereincu‐
batedwithproteinaseKsolutionovernightat56°Candtotalnucleicacidswereextracted
fromthesehomogenatesinaccordancewiththemanufacturer’sinstructions(ExgeneTis‐
sueSV,GeneAll,SouthKorea).Inticks,Anaplasmaspp./Ehrlichiaspp.,Babesiaspp.,Bar‐
tonellaspp.,Rickettsiaspp.,andHepatozoonspp.,andinfleas,Bartonellaspp.andRickettsia
spp.,weredetectedbypolymerasechainreaction(PCR).Afragmentofthe18SrRNAgene
ofAnaplasma/Hepatozoonspp.andBabesiaspp.,apartialsequenceofthe16S–23SrRNA
intergenicspeciesregion(ITS)ofBartonellaspp.,andafragmentoftherickettsialouter
membraneproteinA(ompA)genewereamplifiedusingprimersandprotocolsdescribed
previously[22–25].TheprimersusedfortheamplificationofthetargetedDNAareshown
inTable1.AllamplificationsincludedapositivecontrolcontaininggenomictargetDNA
andanegativecontrolwithoutDNA.PCRproductswerevisualizedunderUVillumina‐
tionafterelectrophoresismigrationona1.8%agarosegel.PCRproductsweresequenced
inonedirection,usingthesameprimersasthoseusedforDNAamplification.Sequences
werecomparedforsimilaritytosequencesinGenBank,usingtheBLASTprogramhosted
byNCBI,NationalInstitutesofHealth,USA(http://www.ncbi.nlm.nih.gov,accessedon1
August2022).
Table1.PrimersusedforthedetectionofVBPsinectoparasitesofdogsandcatsfromCyprusand
correspondingreferences(Ref).
PrimerPathogenTargetgeneNucleotideSequences(5’‐3’)Product
Size(bp)Ref
Rrl9O.70pRickettsia190kDaanti‐
gen
ATGGCGAATATTTCTCCAAAA~532[22]
Rrl9O.602nAGTGCAGCATTCGCTCCCCCT
325sBartonella16S‐23SrRNA
ITS
CTTCAGATGATGATCCCAAGCCTTYTGGCG~600[23]
1100asGAACCGACGACCCCCTGCTTGCAAAGCA
PiroABabesia18SrRNAAATACCCAATCCTGACACAGGG400[24]
PiroBTTAAATACGAATGCCCCCAAC
EHR16SDAnaplasma/Ehr‐
lichia18SrRNAGGTACCYACAGAAGAAGTCC345[24]
EHR16SRTAGCACTCATCGTTTACAGC
TabarFHepatozoon18SrRNACCAGCAGCCGCGGTAATTC373[25]
TabarRCTTTCGCAGTAGTTYGTCTTTAACAAATCT
2.4.StatisticalAnalysis
Theoccurrenceoffleasandticksondogsandcatswasevaluatedinrelationtofactors
expressingdemographicdetails(gender,age),status(ownedorsheltered),andprevious
Pathogens2022,11,14034of13
treatments(timepassedsincethelastdosing).Moreover,theexistenceofVBPsintheec‐
toparasiteswasassociatedwithadditionalfactors:geographicregion,thestatusofthe
animal(ownedorsheltered),andclinicalexaminationorlaboratoryfindingsassociated
withdisease(e.g.,anorexia,weightloss,eyelesions,neurologicalsigns,positivein‐clinic
diagnostictestforinfectiousdiseases).Thechi‐squaretestofindependencewasusedto
assesstheeffectoftheabovefactorsontheoccurrenceofectoparasitesandtheexistence
ofVBPs,respectively.Thesignificantfactorsdefinedbythechi‐squaretestwerethenen‐
teredintoamultipleunivariategeneralizedlinearmodel(GLM)fordeterminingtheir
combinedeffectontheoccurrenceofectoparasites[26].Theoddsratioswiththeircorre‐
spondingconfidenceintervals(C.I.)wereusedtocomparetheproportionoftheoccur‐
renceofeachectoparasiteamongthefactorgroups.Theinformationcollectedthroughthe
questionnaires,abouttheveterinaryproductusedonsomeoftheanimals,wasnotin‐
cludedinthestatisticalanalysisowingtomissingorunreliabledata.Thestatisticalanal‐
ysiswasimplementedusingtheRpackageversion[27]andtheRcmdrpackage[28].
3.Results
3.1.StudyAnimals
ThedemographicsandotherdetailsoftheexaminedanimalsareshowninTable2.
Table2.Recordeddataforthedogsandcats(n=220)withectoparasitesexaminedinCyprus.
FactorDogs(n=161)Cats(n=59)
StatusOwner/Shelter134/2751/8
Region
Lefkosia323
Lemesos9142
Larnaca286
Paphos84
Amochostos24
SexMale/Female81/8023/36
Age
<6months2317
6–≤12months1314
>1–≤7years9325
>7years323
Lasttreatmentfor
ectoparasites
≤1month172
1–≤3months176
>3–≤6months113
>6–≤12months220
>12months9448
Reasonforvisitor
findingsDisease/Other88/7334/25
3.2.Ectoparasites
Fromatotalof161dogswithectoparasites,98and51hadticksorfleasonly,respec‐
tively,while12hadmixedtickandfleainfestation.Accordingly,intotal,110(68.3%)dogs
wereinfestedwithticksand63(39.1%)hadfleas,includingbothsingleandmixedinfec‐
tions.Fromatotalofthe59catsinfestedwithectoparasites,9hadonlyticks;45hadonly
fleas;3hadticksandfleas;1hadfleasandlice;and1hadamixedinfestationwithticks,
fleas,andlice.Intotal,13(22%)catswereinfestedwithticks,50(84.7%)withfleas,and2
(3.4%)withlice,includingbothsingleandmixedinfections(Tables3and4).
Pathogens2022,11,14035of13
Table3.Number(n)ofanimals(dogsorcats)inCyprus,infestedwithdifferenttypesofectopara‐
sites,withthecorrespondingconfidenceinterval(C.I.)oftheoccurrencepercentage.
AnimalSpecies
(SampleSize)
Ticks
n(%C.I.)
Fleas
n(%C.I.)
TicksandFleas
n(%C.I.)
FleasandLice
n(%C.I.)
Ticks,Fleas,andLice
n(%C.I.)
Dogs(n=161)98(60.8±7.7)51(31.7±6.7)12(7.5±3.1)00
Cats(n=59)9(15.3±7.0)45(76.3±12.2)3(5.1±3.3)1(1.7±1.4)1(1.7±1.4)
Twodifferenttickspecieswereidentified:Rhipicephalussanguineussensulato(s.l.)on
108dogsand13cats,andIxodesgibbosuson2dogs.Themostabundantfleaspecieswas
Ctenocephalidesfelis,foundon62dogsand45cats,whileCtenocephalidescanisandEchid‐
nophagagallinaceawerefoundononedogandonecat,respectively.Themixedinfestations
included10dogsand4catswithR.sanguineuss.l.andC.felis;twodogswithI.gibbosus
andC.felis;onecatwithR.sanguineuss.l.,C.felis,andthelouseFelicolasubrostratus;and
onecatinfestedwithE.gallinaceaandF.subrostratus(Table4).
Table4.SpeciesidentificationofticksandfleasandmixedinfectionsindogsandcatsfromCyprus.
AnimalSpecies
(SampleSize)
Rhipicephalussan‐
guineuss.l.
Ixodesgib‐
bosusCtenocephalidesfelisCtenocephalidesca‐
nis
Echidnophagagal‐
linacea
Dogs(n=161)108122621,210
Cats(n=59)133,40453,4015
1TendogswithmixedinfestationbyR.sanguineusandC.felis;22dogswithmixedinfestationbyI.
gibbosusandC.felis;34catswithmixedinfestationbyR.sanguineusandC.felis;4acatwithamixed
infestationbyR.sanguineus,C.felis,andFelicolasubrostratus;5acatwithamixedinfestationbyE.
gallinaceaandthelouseF.subrostratus.
3.3.DetectionofVBPs
Intotal,233ectoparasitesamples(122tickand111fleasamples)wereexaminedfor
thedetectionofVBPs.Inthecaseofmultipleticksorfleaspecimensperanimal,apooled
sample(perectoparasitetypeandperanimal)wasprepared.VBPs’detectionbyPCRwas
notpossibleforonetickandtwofleasamplesowingtoaninsufficientornotsuitableDNA
sample.Overall,32(14.5%)animalswereinfestedwithectoparasitesthatharbouredone
ormoreVBPs,whereas35(15%)ectoparasitepoolsampleswerepositiveforVBPs,be‐
cause,inthreecases(twodogsandonecat)withamixedinfestationbyR.sanguineuss.l.
andC.felis,VBPswerefoundinbothticksandfleas.
TheDNAofsixdifferentpathogenswasdetectedinticks,i.e.,Anaplasmaplatys,Rick‐
ettsiamassiliae,Rickettsiaconorii,Rickettsiafelis,Hepatozoonfelis,andHepatozooncanis,while
noBabesiaspp.wasfoundintheexaminedspecimens.TheDNAoffivedifferentVBPs
wasdetectedinfleas,i.e.,Rickettsiafelis,Rickettsiasp.,Bartonellakoehlerae,Bartonellaclar‐
ridgeiae,andBartonellahenselae.Detailsaboutthespeciesandnumberofanimalsinthe
ectoparasitesofwhichtheseVBPsweredetectedareshowninTable5.
Table5.Vector‐bornepathogens(VBPs)detectedin122tickand111fleapooledsamples(perec‐
toparasitetypeandperanimal)collectedfromdogsandcatsinCyprus.
Animal
Species
VBPsinTicksVBPsinFleas
A
.pR.mR.
c
R.
f
H.cH.
f
R.
f
R.sp.B.kB.
c
B.h
Dogs(n)3101‐ 313412‐
Cats(n) 2‐ 1‐ 15‐ ‐ 1
Total312113284121
n=numberofanimalsintheectoparasitesofwhichthepathogenwasfound,A.p.=Anaplasma
platys;R.m=Rickettsiamassiliae;R.c=Rickettsiaconorii;R.f=Rickettsiafelis;H.f=Hepatozoonfelis;
H.c=Hepatozooncanis;R.sp.=Rickettsiasp.;B.k=Bartonellakoehlerae;B.c=Bartonellaclarridgeiae;B.
h=Bartonellahenselae.
Pathogens2022,11,14036of13
SequencingofPCRproductsandBLASTanalysisrevealedsimilaritiesoftheherein
detectedVBPswithDNAsequencespublishedinGenBank,asshowninTable6.
Table6.Vector‐bornepathogens(VBPs)detectedinticksandfleasfromdogsandcatsinCyprus,
andtheirsimilaritywithGenBankentries.
VBP(nofSequencesAnalyzed)GenBankAccessionNumberSimilarity
Anaplasmaplatys(n=3)JX392984.199%
Rickettsiamassiliae(n=12)MW026209.197–99%
Rickettsiafelis(n=9)KP318094.196–99%
Hepatozoonfelis(n=2)KY649442.1100%
Hepatozooncanis(n=3)MK645969.197–100%
Rickettsiaconorii(n=1)AE006914.197%
Rickettsiasp.(n=4)MF134884.196–99%
Bartonellakoehlerae(n=1)MT095046.198%
Bartonellaclarridgeiae(n=2)EU589237.196%
Bartonellahenselae(n=1)KT314216.1100%
3.4.StatisticalAnalysis
Chi‐squaretestofindependenceshowedthatneitherticknorfleapresencewasre‐
latedtothetimepassedsincethelastectoparasitictreatment(χ2=3.68,df=4,p>0.05for
ticksandχ2=3.54,df=4,p>0.05forfleas)ortheanimal’ssex(χ2=0.60,df=1,p>0.05for
ticksandχ2=0.02,df=1,p>0.05forfleas).Ontheotherhand,theoccurrenceofectopar‐
asiteswasassociatedwiththeageofthehost(χ2=27.19,df=3,p<0.001forticksandχ2=
20.90,df=3,p<0.001forfleas)andtheir“ownedorsheltered”status(χ2=14.99,df=1,p
<0.001forticksandχ2=16.34,df=1,p<0.001forfleas)(Table7).
Table7.Chi‐squaretestofindependenceshowingassociationsbetweentheoccurrenceofectopar‐
asitesandvariousfactorsrecordedforeachanimal.
TicksFleas
VariablePositiveNegativep‐valuePositiveNegativep‐value
Lasttreatment 0.451 0.471
≤1month14(73.7%)5(26.3%) 6(31.6%)13(68.4%)
>1–3months12(52.2%)11(47.8%) 13(56.5%)10(43.5%)
>3–6months6(42.9%)8(57.1%) 8(57.1%)6(42.9%)
>6–12months13(59.1%)9(40.9%) 11(50.0%)11(50.0%)
>12months78(54.9%)64(45.1%) 75(52.8%)67(47.2%)
Sex 0.438 0.875
Male61(58.7%)43(41.3%) 54(51.9%)50(48.1%)
Female62(53.4%)54(46.6%) 59(50.9%)57(49.1%)
Agecategory 0.000* 0.000*
<6months13(32.5%)27(67.5%) 30(75.0%)10(25.0%)
6–12months7(25.9%)20(74.1%) 20(74.1%)7(25.9%)
>1–7years81(68.6%)37(31.4%) 49(41.5%)69(58.5%)
>7years22(62.9%)13(37.1%) 14(40.0%)21(60.0%)
Status 0.000* 0.000*
Owned93(50.3%)92(49.7%) 106(57.3%)79(42.7%)
Sheltered30(85.7%)5(14.3%) 7(20.0%)28(80.0%)
*Statisticallysignificantfactor,p<0.001.
TheinvestigationoftheassociationbetweenVBPs’occurrenceandvariousfactors
showedthatVBPs’detectionwasnotassociatedwithclinicalsignsorfindingsofdisease
Pathogens2022,11,14037of13
(χ2=2.42,df=1,p>0.05),theanimals’“ownedorsheltered”status(χ2=1.06,df=1,p>
0.05),ortheregionofliving(χ2=3.62,df=4,p>0.05)(Table8).
Table8.Contingencytableswithchi‐squaretestresultsbetweenVBPs’existenceandotherfactors.
VBPsp‐Value
VariablePositiveNegative
Signs/findings 0.120
Disease21(17.8%)97(82.2%)
Other10(10.3%)87(89.7%)
Status 0.304
Owned24(13.3%)156(86.7%)
Sheltered7(20.0%)28(80.0%)
Region 0.460
Ammochostos2(40.0%)3(60.0%)
Larnaca3(9.4%)29(90.6%)
Lemesos18(13.7%)113(86.3%)
Lefkosia6(17.1%)29(82.9%)
Paphos2(16.7%)10(83.3%)
Theagecategoryandthe“ownedorsheltered”statuswerefurtheranalysedfortheir
combinedeffectontheoccurrenceofticksorfleasusingmultipleGLM(Table9).The
analysisshowedthatanimalsupto6monthsandthosebetween6and12monthshadthe
samelikelihoodtobeinfestedbyticksorfleas(multipleGLMp‐values>0.05).However,
younganimalshadahigherlikelihoodofbeinginfestedwithfleas,whereasolderanimals
hadahigherlikelihoodofbeinginfestedwithticks.Indeed,animalsupto6monthswere
0.26and0.27timeslesslikelytobeinfestedwithticksthananimals1to7yearsorolder,
respectively.Animalsupto6monthswere3.59and4.88timesmorelikelytobeinfested
withfleasthananimalsfrom1to7yearsandthoseolderthan7years,respectively(mul‐
tipleGLMp‐value<0.01).Thestatus(ownedorsheltered)oftheanimalwasalsofound
toberelatedtothepresenceofectoparasites(multipleGLMp‐value<0.01).Tickswere
fivetimes(i.e.theinverseof0.2oddsratioshowninTable9)morelikelytobefoundon
shelteredanimalsthanownedanimals,whiletheoddsratiooffleapresencewas4.84
timeshigherinownedanimalsthaninthoselivinginshelters.
Table9.Assessmentofriskfactorsofectoparasites’occurrenceincludingtheresultsofthemulti‐
plegeneralizedlinearmodel(GLM).
TicksFleas
VariableOddsRatio95%CIGLM
p‐valueOddsRatio95%CIGLM
p‐Value
Agecategory
<6mvs.6–12m 1.40(0.47,4.43)0.5571.05(0.32,3.30)0.928
vs.1–7years0.26(0.11,0.55)0.001*3.59(1.61,8.54)0.002*
vs.>7years0.27(0.10,0.67)0.007*4.88(1.83,13.82)0.001*
Status
Ownedvs.Sheltered0.20(0.06,0.52)0.002*4.84(2.04,12.91)0.001*
*MultipleGLMp‐value<0.01,identifyingariskfactor.
4.Discussion
Cyprus,anislandcountryintheEasternMediterraneanSea,isacosmopolitanhub
andacentreoftourism,market,education,andotheractivities,whichreceivesagreat
numberofvisitorsthroughouttheyear.Ontheotherhand,Cyprushasalargenumberof
Pathogens2022,11,14038of13
dogsandcats,livingasownedpets,free‐roaming,orstrays.Asignificantnumberofani‐
malsheltersinthecountryareactivelyfacilitatingadoptionofstrayanimals,which,in
manycases,travelabroad,totheirnewhome,indifferentareasoftheworld.Inthiscon‐
text,investigatingandmonitoringpathogensthatmaybetransmittedlocallyorinremote
countriesviaticksandfleasisofgreatepidemiologicalimportance.
Thesubtropical–MediterraneanclimateofCypruswithmildwintersandwarmto
hotsummersisfavourabletoticksandfleas,becausetheirdevelopment,especiallythe
rateoftransitionfromonedevelopmentstagetothenext,whichinmostcasestakesplace
intheenvironment,istemperature‐dependent[29,30].Thepresentresultsareinlinewith
thefactthattickparasitismismorecommonindogsthanincats,whiletheoppositeis
trueforfleainfestations,probablybecauseofthedifferentbehaviourofdogsandcatsand
thedifferentbiologyoftheseectoparasites[1,31].
Theectoparasitespeciesidentifiedhereinhaveaworldwidedistributionandareprev‐
alentinSouthernEurope[32].Thepredominanttickspecies,R.sanguineuss.l.[33],also
madeupthemajority(89–92%)ofthetickscollectedfromdogsinearliersurveysinCyprus,
showinglimitedaffiliationtootherhostspecies(mouflons,foxes,hares,goats,sheep,and
bovines)[13,15].Itisathree‐hosttick,afactthatfacilitatesthetransmissionofVBPsfrom
animaltoanimalandisthevectorofmanyVBPs[4,34].Accordingly,6differentVBPswere
detectedin22outof120R.sanguineuss.l.samplesexaminedinthepresentstudy.
TheprevalenceofA.platys,theagentofcaninecyclicthrombocytopenia(CCT),varies
between0.4%and87.5%indifferentareasoftheworld[35].InCyprus,thisbacteriumhas
beendetectedonlyonceinadog[16].Anaplasmaplatysisarecognizedzoonoticagent[35],
andenrichinginformationonitsoccurrenceinareaswheredataarelackingisimportant.
ThepresentresultsconfirmthatthisVBPiscirculatingamongticksanddogsinCyprus.
EventhoughseropositivedogstoR.conoriiarehighlyprevalentinsouthernEurope
[9,36–39],usually,onlyasmallnumberoftheexaminedticksscorepositivelyinPCR[40–
42],whichisconsistentwiththepresentresults.Theinfectionindogsisusuallysubclini‐
cal,butinhumans,R.conoriiistheagentofMediterraneanspottedfever[43],thuscreation
ofepidemiologicalinformationisessential.Interestingly,R.massiliaewasthemostpreva‐
lentVBPinthepresentstudy.ItisconsideredanemergingpathogeninAfrica,Europe,
andtheUSA,incriminatedforseveralhumancaseswithclinicalsignssimilartoMediter‐
raneanspottedfever[44].Onthebasisofthepresentfindings,R.massiliaeisapossible
emergingpublichealththreatinCyprusandtheawarenesstowardsthisbacteriumshould
beincreased.
BothH.canisandH.feliswerefoundinticks,albeitatalowprevalence.InCyprus,H.
canishasbeenpreviouslyreportedindogs[45],whileH.felishasbeendetectedwithahigh
prevalence(37.9%)incats[46].Similarly,H.felisoccurswithahighprevalenceincatsin
otherEuropeanenzooticareas,reaching25.5%inGreece[47].Hepatozoonspeciescirculating
inEurope,i.e.,H.canisindogsandH.canis,H.felis,andHepatozoonsilvestrisincats,have
diversepathogenicpotentials.Althoughinfectionsareoftensubclinical,animalsmayde‐
velopseverediseasedependingonthespeciesorhaplotypeinvolved[47–50].
Tothebestoftheauthors’knowledge,thisisthefirstrecordofI.gibbosusondogsin
Cyprus.ItisoneofthemostcommonIxodesspeciesontheisland[15,31]anditwaspre‐
viouslyreportedonmouflons[51].Ixodesgibbosusisadaptedtowarmanddryclimates,
replacingIxodesricinusintheeasternMediterranean,whichislessresistanttosuchcon‐
ditions[31].FurtherinvestigationsintotheprevalenceandvectorialcapacityofI.gibbosus,
asthedominantIxodesspeciesinthearea,wouldbeofmerit.
Ctenocephalidesfelisisthevectorofimportantpathogens,includingB.henselaede‐
tectedhereinandpreviouslyreportedinratsandcatsofCyprus[6,46,52].Ontheother
hand,tothebestoftheauthors’knowledge,thepresentreportofB.koehleraeandB.clar‐
ridgeiaeisthefirstinthecountry.Bartonellaspp.areagentsofdiseaseinbothanimalsand
humans;forexample,B.henselaeistheagentofcat‐scratchdisease[53],thusconstantsur‐
veillanceofthepresenceoftheseVBPsindogs,cats,andectoparasitesispivotal.
Pathogens2022,11,14039of13
Rickettsiafelisistheagentofhumanflea‐bornespottedfeverandanemergingVBP
[6].InCyprus,ithasbeendetectedpreviouslyinC.felisfromrats[17].Thecatfleaisthe
primaryvectorofR.felis,butitisprobablyalsotransmittedbyotherfleaspecies,ticks,
andotherblood‐suckingarthropods[6,54]anditwasalsodetectedinR.sanguineuss.l.in
thepresentstudy.
Ctenocephalidescanis,thedogflea,islesscommonindogsthanC.felis[6].Accord‐
ingly,thisfleaspecieswasfoundonlyononedoginthepresentstudy.Nevertheless,in
someareas,C.canisisreportedtobemoreprevalentthanC.felis[55].Thedogfleamay
alsotransmitpathogensincludingR.felisandB.henselae;however,becauseofitslimited
abundancecomparedwiththecatflea,itsvectorialroleisconsideredinferior[56].
ThefleaE.gallinacea,alsoknownasthe“sticktightflea”,wasfoundononecat.This
speciesiscommononfowl,butitalsoinfestsmammals,mostfrequentlycats,probably
owingtobirdhunting[57].Itisafleaspeciesofbothveterinaryandmedicalimportance,
transmittingfowlviruses,Y.pestis,R.typhi,andD.caninum[58],whichrendersitanim‐
portanttargetforstudyandcontrol,despiteitslowfrequency.
AnincidentalfindingintheexaminationforticksandfleaswasthecatlouseF.subro‐
stratusontwocats.Catlousehasaworldwidedistributionandinfestationisoftenanin‐
dicationofapoorgeneralhealthconditionandlackofcare[59].Evenifoutofthescope
ofthepresentarticle,thisfindingisimportantasthecatlousehasbeenidentifiedasa
potentialintermediatehostofaDipylidiumspecies,geneticallydistantfromD.caninum,
infectinghyenas,dogs,andcats[60].
TheuseofompAgeneappearstobespecificanddiscriminatingforthespottedfever
groupRickettsiae,butsomeauthorsrecommendthatmultiplegenetargetsshouldbeused
togainanaccurateidentification[61].Thiscouldbethereasonthat,forafewisolates,iden‐
tificationonlytothegenuslevelwasfeasible(Table5).TheremainderofVBPsidentifiedin
thepresentstudyshowedavaryinglevelofsimilaritywithGeneBankdeposits,isolated
fromdifferenthostsandareasoftheworld(Table6).Itisworthnotingthatthedetectionof
Rickettsiaspp.DNA,mainlyinR.sanguineus,providesevidencethatthistickmaybeamong
themainvectorsofRickettsiaspp.inCyprus,accordingtopreviousstudies[40,62].
Thefindingthatyounganimals(<6months)weresignificantlylesslikelytobein‐
festedwithticks,butmorelikelytobeinfestedwithfleas,maybeattributedtothefact
thatyounganimalswillspendmostoftheirtimeinarestrictedenvironmentneartheir
home,incloseproximitytotheirmotherandsiblings,aconditionthatfavourshost‐to‐
hostfleatransmission[1].Thiscontrastswitholderanimalsthatspendmoretimeroaming
awiderareaoutdoors.Assuch,olderanimalsaremorelikelytocomeintocontactwith
ticks,explainingthefindingthatolderanimalsweresignificantlymorelikelytoharbour
ticksthanyounganimals.
Theactivitywithinawiderorrestrictedenvironmentmayalsobethereasonticks
weremoreprevalentonshelteredanimals,especiallyconsideringthatsomeofthemwere
introducedrecentlyandwerepreviouslyroaminginawiderareaoftheirregion.Accord‐
ingly,theoccurrenceoffleaswasmorefrequentinownedanimals,livinginaconfined/re‐
strictedenvironment(indoorsformostcats,indoorsor/andinthegardenfordogs),which
canoftenmaintainfleainfestation,comparedwiththoselivinginshelters.
Interestingly,theinfestationwasnotstatisticallyassociatedwiththetimethathad
passedsincethelastectoparasiticapplication.Thus,animalswitharecentectoparasite
treatmentwereatthesameriskofinfestationastherestoftheanimals.Althoughdrug
resistancedevelopmentinectoparasitesisaknownproblem[29,63],thelackofspecific
investigationintotheproductsusedandtheapplicationpracticesdoesnotallowfurther
evaluationofthisfinding.
5.Conclusions
Ticksandfleasareamajorconcernforpetowners,veterinarians,andmedicaldoctors
becauseoftheirclinicalimpactondogsandcatsandtheVBPstheytransmit.Theresults
ofthepresentstudyprovidenewknowledgeabouttheoccurrenceofticksandfleasin
Pathogens2022,11,140310of13
dogsandcatsfromCyprus,andthepathogensthattheseectoparasitesmaytransmit,cov‐
eringarelevantgapinknowledge.Companionanimalstravellingforadoption(com‐
monlyshelteredanimals)orwiththeirownersforvacationsmayfacilitatethespreading
ofVPBs[45].Thisriskislurking,particularlyinanimalmovementsfromandtoMediter‐
raneanareas,includingCyprus,asthispartofEuropeisconsideredamajorepidemiolog‐
icalhubforVBPs[47].Systematicectoparasitecontrolispivotalandaplethoraofveteri‐
naryproductsareavailableforthispurpose.Furthermore,theresearchintonewanimal
andenvironment‐friendlytoolsforcontrolisongoing,andeffectivebiologicalorbotani‐
cal‐basedcompoundsandvaccinesmayalsobeavailableinthefuture[64,65].
AuthorContributions:Conceptualization,A.D.andD.S.;methodology,A.D.,D.S.,B.P.,A.T.,S.K.,
D.D.,S.M.,andM.G.;datacuration,A.D.,D.S.,D.D.,S.K,andA.T.;writing—originaldraftprepa‐
ration,A.D.,B.P.,andA.T.;writing—reviewandediting,A.D.,S.M.,S.K,andD.T.;supervision,
A.D.andD.T.Allauthorshavereadandagreedtothepublishedversionofthemanuscript.
Funding:Thisresearchreceivednoexternalfunding.
InstitutionalReviewBoardStatement:Ethicalreviewandapprovalwerewaivedforthisstudyas
alloftheanimalsinvolvedwereclinicallyexaminedintheframeoftheirroutineveterinarycheck‐
upandnomedicalinvasiveprocedureswereperformed.
InformedConsentStatement:Informedconsentwasobtainedfromalloftheanimals’ownersfor
theuseofectoparasitesinresearch.
DataAvailabilityStatement:Notapplicable.
Acknowledgements:Theauthorswouldliketoexpresstheiracknowledgementstotheveterinari‐
ansthatcontributedtotheectoparasites’collection,PanagiotisKokkinos,LefterisChalvadakis,Ma‐
riaVafiadou,MariosLiogris,NektariaIoannou,Arsenoglou,FiliposLigdas,ChristinaStrati,Orestis
Dizoglidis,andMarilenaJosephides.
ConflictsofInterest:Theauthorsdeclarenoconflictofinterest.
References
1. Morelli,S.;Diakou,A.;DiCesare,A.;Colombo,M.;Traversa,D.CanineandFelineParasitology:Analogies,Differences,and
RelevanceforHumanHealth.Clin.Microbiol.Rev.2021,34,e0026620.https://doi.org/10.1128/CMR.00266‐20.
2. Mubemba,B.;Mburu,M.M.;Changula,K.;Muleya,W.;Moonga,L.C.;Chambaro,H.M.;Kajihara,M.;Qiu,Y.;Orba,Y.;
Hayashida,K.;etal.Currentknowledgeofvector‐bornezoonoticpathogensinZambia:Aclarioncalltoscaling‐up“One
Health”researchinthewakeofemergingandre‐emerginginfectiousdiseases.PLoSNegl.Trop.Dis.2022,16,e0010193.
https://doi.org/10.1371/journal.pntd.0010193.
3. Shaw,S.E.;Day,M.J.;Birtles,R.J.;Breitschwerdt,E.B.Tick‐borneinfectiousdiseasesofdogs.TrendsParasitol2001,17,74–80.
https://doi.org/10.1016/S1471‐4922(00)01856‐0.
4. Wall,R.;Shearer,D.VeterinaryEctoparasites:Biology,PathologyandControl,2nded.;BlackwellScienceLtd:Oxford,UK,2001.
https://doi.org/10.1002/9780470690505.
5. Traversa,D.Fleasinfestingpetsintheeraofemergingextra‐intestinalnematodes.Parasit.Vectors2013,6,59.
https://doi.org/10.1186/1756‐3305‐6‐59.
6. Bitam,I.;Dittmar,K.;Parola,P.;Whiting,M.F.;Raoult,D.Fleasandflea‐bornediseases.Int.J.Inf.Dis.2010,14,e667–e676.
https://doi.org/10.1016/j.ijid.2009.11.011.
7. Shaw,S.E.Flea‐TransmittedInfectionsofCatsandDogs.InProceedingsofthe33rdWorldSmallAnimalVeterinaryCongress,
Dublin,Ireland,20–24August2008.
8. Nichols,M.C.;Ettestad,P.J.;Vinhatton,E.S.;Melman,S.D.;Onischuk,L.;Pierce,E.A.;Aragon,A.S.Yersiniapestisinfectionin
dogs:62cases(2003–2011).J.Am.Vet.Med.Assoc.2014,244,1176–1180.https://doi.org/10.2460/javma.244.10.1176.
9. Colombo,M.;Morelli,S.;Simonato,G.;DiCesare,A.;Veronesi,F.;FrangipanediRegalbono,A.;Grassi,L.;Russi,I.;Tiscar,
P.G.;Morganti,G.;etal.ExposuretoMajorVector‐BorneDiseasesinDogsSubjectedtoDifferentPreventativeRegimensin
EndemicAreasofItaly.Pathogens2021,10,507.https://doi.org/10.3390/pathogens10050507.
10. Beugnet,F.;Marié,J.L.Emergingarthropod‐bornediseasesofcompanionanimalsinEurope.Vet.Parasitol.2009,163,298–305.
https://doi.org/10.1016/j.vetpar.2009.03.028.
11. Psaroulaki,A.;Loukaidis,F.;Hadjichristodoulou,C.;Tselentis,Y.DetectionandidentificationoftheaetiologicalagentofMed‐
iterraneanspottedfever(MSF)intwogeneraofticksinCyprus.Trans.R.Soc.Trop.Med.Hyg.1999,93,597–598.
https://doi.org/10.1016/s0035‐9203(99)90061‐5.
Pathogens2022,11,140311of13
12. Ioannou,I.;Sandalakis,V.;Kassinis,N.;Chochlakis,D.;Papadopoulos,B.;Loukaides,F.;Tselentis,Y.;Psaroulaki,A.Tick‐borne
bacteriainmouflonsandtheirectoparasitesinCyprus.J.Wild.Dis.2011,47,300–306.https://doi.org/10.7589/0090‐3558‐47.2.300.
13. Chochlakis,D.;Ioannou,I.;Sandalakis,V.;Dimitriou,T.;Kassinism,N.;Papadopoulos,B.;Tselentis,Y.;Psaroulaki,A.Spotted
fevergroupRickettsiaeinticksinCyprus.Microb.Ecol.2012,63,314–323.https://doi.org/10.1007/s00248‐011‐9926‐4.
14. Psaroulaki,A.;Chochlakis,D.;Angelakis,E.;Ioannou,I.;Tselentis,Y.Coxiellaburnetiiinwildlifeandticksinanendemicarea.
Trans.R.Soc.Trop.Med.Hyg.2014,108,625–631.https://doi.org/10.1093/trstmh/tru134.
15. Tsatsaris,A.;Chochlakis,D.;Papadopoulos,B.;Petsa,A.;Georgalis,L.;Angelakis,E.;Ioannou,I.;Tselentis,Y.;Psaroulaki,A.
Speciescomposition,distribution,ecologicalpreferenceandhostassociationofticksinCyprus.Exp.Appl.Acarol.2016,70,523–
542.https://doi.org/10.1007/s10493‐016‐0091‐9.
16. Attipa,C.;Hicks,C.A.E.;Barker,E.N.;Christodoulou,V.;Neofytou,K.;Mylonakis,M.E.;Siarkou,V.I.;Vingopoulou,E.I.;Sout‐
ter,F.;Chochlakis,D.;etal.Caninetick‐bornepathogensinCyprusandauniquecaninecaseofmultipleco‐infections.Ticks
TickBorneDis.2017,8,341–346.https://doi.org/10.1016/j.ttbdis.2016.12.006.
17. Psaroulaki,A.;Antoniou,M.;Papaeustathiou,A.;Toumazos,P.;Loukaides,F.;Tselentis,Y.FirstdetectionofRickettsiafelisin
CtenocephalidesfelisfleasparasitizingratsinCyprus.Am.J.Trop.Med.Hyg.2006,74,120–122.
18. Christou,C.;Psaroulaki,A.;Antoniou,M.;Toumazos,P.;Ioannou,I.;Mazeris,A.;Chochlakis,D.;Tselentis,Y.Rickettsiatyphi
andRickettsiafelisinXenopsyllacheopisandLeptopsyllasegnisparasitizingratsinCyprus.Am.J.Trop.Med.Hyg.2010,83,1301–
1304.https://doi.org/10.4269/ajtmh.2010.10‐0118.
19. Lewis,R.E.TheFleas(Siphonaptera)ofEgypt.AnIllustratedandAnnotatedKey.J.Parasitol.1967,53,863.
https://doi.org/10.2307/3276790.
20. Linardi,P.M.;Santos,J.L.Ctenocephalidesfelisfelisvs.Ctenocephalidescanis(Siphonaptera:Pulicidae):Someissuesincorrectly
identifythesespecies.Rev.Bras.Parasitol.Vet.2012,21,345–354.https://doi.org/10.1590/s1984‐29612012000400002.
21. Estrada‐Peña,A.;Bouattour,A.;Camicas,J.L.;Walker,A.R.TicksofDomesticAnimalsintheMediterraneanRegion–AGuideto
IdentificationofSpecies,1sted;UniversityofZaragoza:Zaragoza,Spain,2004.
22. Regnery,R.L.;Spruill,C.L.;Plikaytis,B.D.Genotypicidentificationofrickettsiaeandestimationofintraspeciessequencediver‐
genceforportionsoftworickettsialgenes.J.Bacteriol.1991,173,1576–1589.https://doi.org/10.1128/jb.173.5.1576‐1589.1991.
23. Diniz,P.;Maggi,R.;Schwartz,D.;Cadenas,M.;Bradley,J.;Hegarty,B.;Breitschwerdt,E.Caninebartonellosis:Serologicaland
molecularprevalenceinBrazilandevidenceofco‐infectionwithBartonellahenselaeandBartonellavinsoniisubsp.berkhoffii.Vet.
Res.2007,38,697–710.
24. Harrus,S.;Perlman‐Avrahami,A.;Mumcuoglu,K.;Morick,D.;Eyal,O.;Baneth,G.MoleculardetectionofEhrlichiacanis,Ana‐
plasmabovis,Anaplasmaplatys,CandidatusMidichloriamitochondriiandBabesiacanisvogeliinticksfromIsrael.Clin.Microbiol.
Infect.2011,17,459–463.
25. Díaz‐Regañón,D.;Villaescusa,A.;Ayllón,T.;Rodríguez‐Franco,F.;Baneth,G.;Calleja‐Bueno,L.;García‐Sancho,M.;Agulla,
B.;Sainz,A.MoleculardetectionofHepatozoonspp.andCytauxzoonsp.indomesticandstraycatsfromMadrid,Spain.Parasit.
Vectors2017,10,112.
26. Faraway,J.J.ExtendingtheLinearModelwithR:GeneralizedLinear,MixedEffectsandNonparametricRegressionModels;Chapman
andHall/CRC:BocaRaton,FL,USA,2016.https://doi.org/10.1201/9781315382722.
27. RCoreTeam.R:ALanguageandEnvironmentforStatisticalComputing;RFoundationforStatisticalComputing:Vienna,Austria
2020;Availableonline:https://www.R‐project.org/(accessedon5May2022).
28. Fox,J.UsingtheRCommander:APoint‐and‐ClickInterfaceforR.BocaRatonFL;ChapmanandHall/CRCPress:BocaRaton,FL,
USA,2017.https://doi.org/10.1201/9781315380537.
29. Rust,M.K.TheBiologyandEcologyofCatFleasandAdvancementsinTheirPestManagement:AReview.Insects2017,8,118.
https://doi.org/10.3390/insects8040118.
30. El‐Sayed,A.;Kamel,M.Climaticchangesandtheirroleinemergenceandre‐emergenceofdiseases.Environ.Sci.Pollut.Res.Int.
2020,27,22336–22352.https://doi.org/10.1007/s11356‐020‐08896‐w.
31. Estrada‐Peña,A.;Mihalca,A.D.;Petney,T.N.TicksofEuropeandNorthAfrica:AGuidetoSpeciesIdentification;Springer:Cham,
Switzerland,2017.
32. Dantas‐Torres,F.;Chomel,B.B.;Otranto,D.Ticksandtick‐bornediseases:AOneHealthperspective.TrendsParasitol.2012,28,
437–446.https://doi.org/10.1016/j.pt.2012.07.003.
33. Nava,S.;Estrada‐Peña,A.;Petney,T.;Beati,L.;Labruna,M.B.;Szabó,M.P.;Venzal,J.M.;Mastropaolo,M.;Mangold,A.J.;Gug‐
lielmone,A.A.ThetaxonomicstatusofRhipicephalussanguineus(Latreille,1806).VetParasitol.2015,208,2–8.
https://doi.org/10.1016/j.vetpar.2014.12.021.
34. Dantas‐Torres,F.Thebrowndogtick,Rhipicephalussanguineus(Latreille,1806)(Acari:Ixodidae):Fromtaxonomytocontrol.Vet
Parasitol.2008,152,173–185.https://doi.org/10.1016/j.vetpar.2007.12.030.
35. Atif,F.A.;Mehnaz,S.;Qamar,M.F.;Roheen,T.;Sajid,M.S.;Ehtisham‐ul‐Haque,S.;Kashif,M.;BenSaid,M.Epidemiology,
Diagnosis,andControlofCanineInfectiousCyclicThrombocytopeniaandGranulocyticAnaplasmosis:EmergingDiseasesof
VeterinaryandPublicHealthSignificance.Vet.Sci.2021,8,312.https://doi.org/10.3390/vetsci8120312.
36. Alexandre,N.;Santos,A.S.;Bacellar,F.;Boinas,F.J.;Núncio,M.S.;deSousa,R.DetectionofRickettsiaconoriistrainsinPortu‐
guesedogs(Canisfamiliaris).TicksTickBorneDis.2011,2,119–122.https://doi.org/10.1016/j.ttbdis.2011.03.001.
Pathogens2022,11,140312of13
37. Espejo,E.;Andrés,M.;Pérez,J.;Prat,J.;Guerrero,C.;Muñoz,M.T.;Alegre,M.D.;Lite,J.;Bella,F.Prevalenceofantibodiesto
RickettsiaconoriiinhumanbeingsanddogsfromCatalonia:A20‐yearperspective.Epidemiol.Inf.2016,144,1889–1894.
https://doi.org/10.1017/S0950268816000261.
38. Diakou,A.;DiCesare,A.;Morelli,S.;Colombo,M.;Halos,L.;Simonato,G.;Tamvakis,A.;Beugnet,F.;Paoletti,B.;Traversa,D.
Endoparasitesandvector‐bornepathogensindogsfromGreekislands:Pathogendistributionandzoonoticimplications.PLoS
Negl.Trop.Dis.2019,13,e0007003.https://doi.org/10.1371/journal.pntd.0007003.
39. Laušević,D.;Ilić,T.;Nenadović,K.;Bacić,D.;Obrenović,S.SeroprevalencesofRickettsiaconorii,EhrlichiacanisandCoxiella
burnetiiinDogsfromMontenegro.ActaParasitol.2019,64,769–778.https://doi.org/10.2478/s11686‐019‐00098‐w.
40. Psaroulaki,A.;Spyridaki,I.;Ioannidis,A.;Babalis,T.;Gikas,A.;Tselentis,Y.FirstisolationandidentificationofRickettsiaconorii
fromtickscollectedintheregionofFokidainCentralGreece.J.Clin.Microbiol.2003,41,3317–3319.
https://doi.org/10.1128/JCM.41.7.3317‐3319.2003.
41. Fernández‐Soto,P.;Pérez‐Sánchez,R.;Alamo‐Sanz,R.;Encinas‐Grandes,A.Spottedfevergrouprickettsiaeinticksfeedingon
humansinnorthwesternSpain:IsRickettsiaconoriivanishing?Ann.N.Y.Acad.Sci.2006,1078,331–333.
https://doi.org/10.1196/annals.1374.063.
42. Ionita,M.;Silaghi,C.;Mitrea,I.L.;Edouard,S.;Parola,P.;Pfister,K.MoleculardetectionofRickettsiaconoriiandotherzoonotic
spottedfevergrouprickettsiaeinticks,Romania.TicksTickBorneDis.2016,7,150–153.
https://doi.org/10.1016/j.ttbdis.2015.10.006.
43. Spernovasilis,N.;Markaki,I.;Papadakis,M.;Mazonakis,N.;Ierodiakonou,D.MediterraneanSpottedFever:Current
KnowledgeandRecentAdvances.Trop.Med.Inf.Dis.2021,6,172.https://doi.org/10.3390/tropicalmed6040172.
44. Socolovschi,C.;Parola,P.;Raoult,D.Tick‐borneSpottedFeverRickettsioses.InHunterʹsTropicalMedicineandEmergingInfec‐
tiousDisease,9thed.Magill,A.J.,Hill,D.R,Solomon,T.,RyanE.T.,Eds.;Elsevier:London,UK,2013;pp.546–552.
https://doi.org/10.1016/b978‐1‐4160‐4390‐4.00064‐3.
45. Attipa,C.;Maguire,D.;Solano‐Gallego,L.;Szladovits,B.;Barker,E.N.;Farr,A.;Baneth,G.;Tasker,S.Hepatozooncanisinthree
importeddogs:AnewtickbornediseasereachingtheUnitedKingdom.Vet.Rec.2018,183,716.
https://doi.org/10.1136/vr.105087.
46. Attipa,C.;Papasouliotis,K.;Solano‐Gallego,L.;Baneth,G.;Nachum‐Biala,Y.;Sarvani,E.;Knowles,T.G.;Mengi,S.;Morris,D.;
Helps,C.;etal.Prevalencestudyandriskfactoranalysisofselectedbacterial,protozoalandviral,includingvector‐borne,
pathogensincatsfromCyprus.Parasit.Vectors2017,10,130.https://doi.org/10.1186/s13071‐017‐2063‐2.
47. Morelli,S.;Diakou,A.;Traversa,D.;DiGennaro,E.;Simonato,G.;Colombo,M.;Dimzas,D.;Grillini,M.;FrangipanediRegal‐
bono,A.;Beugnet,F.;etal.FirstrecordofHepatozoonspp.indomesticcatsinGreece.TicksTickBorneDis.2021,12,101580.
https://doi.org/10.1016/j.ttbdis.2020.101580.
48. Baneth,G.Perspectivesoncanineandfelinehepatozoonosis.Vet.Parasitol.2011,181,3–11.https://doi.org/10.1016/j.vet‐
par.2011.04.015.
49. Kegler,K.;Nufer,U.;Alic,A.;Posthaus,H.;Olias,P.;Basso,W.FatalinfectionwithemergingapicomplexanparasiteHepatozoon
silvestrisinadomesticcat.Parasit.Vectors2018,11,428.https://doi.org/10.1186/s13071‐018‐2992‐4.
50. Basso,W.;Görner,D.;Globokar,M.;Keidel,A.;Pantchev,N.FirstautochthonouscaseofclinicalHepatozoonfelisinfectionina
domesticcatinCentralEurope.Parasitol.Ιnt.2019,72,101945.https://doi.org/10.1016/j.parint.2019.101945.
51. Ioannou,I.;Chochlakis,D.;Kasinis,N.;Anayiotos,P.;Lyssandrou,A.;Papadopoulos,B.;Tselentis,Y.;Psaroulaki,A.Carriage
ofRickettsiaspp.,CoxiellaburnetiiandAnaplasmaspp.byendemicandmigratorywildbirdsandtheirectoparasitesinCyprus.
Clin.Microbiol.Infect.2009,15,158–160.https://doi.org/10.1111/j.1469‐0691.2008.02207.x.
52. Psaroulaki,A.;Antoniou,M.;Toumazos,P.;Mazeris,A.;Ioannou,I.;Chochlakis,D.;Christophi,N.;Loukaides,P.;Patsias,A.;
Moschandrea,I.;etal.RatsasindicatorsofthepresenceanddispersalofsixzoonoticmicrobialagentsinCyprus,anisland
ecosystem:Aseroepidemiologicalstudy.Trans.R.Soc.Trop.Med.Hyg.2010,104,733–739.
https://doi.org/10.1016/j.trstmh.2010.08.005.
53. Chomel,B.B.;Kasten,R.W.Bartonellosis,anincreasinglyrecognizedzoonosis.J.Appl.Microbiol.2010,109,743–750.
https://doi.org/10.1111/j.1365‐2672.2010.04679.x.
54. Danchenko,M.;Benada,O.;Škultéty,Ľ.;Sekeyová,Z.CultureIsolateofRickettsiafelisfromaTick.Int.J.Environ.Res.Public
Health2022,19,4321.https://doi.org/10.3390/ijerph19074321.
55. Shukullari,E.;Rapti,D.;Visser,M.;Pfister,K.;Rehbein,S.Parasitesandvector‐bornediseasesinclient‐owneddogsinAlbania:
Infestationwitharthropodectoparasites.Parasitol.Res.2017,116,396–407.https://doi.org/10.1007/s00436‐016‐5302‐0.
56. Brown,L.D.;Macaluso,K.R.Rickettsiafelis,anEmergingFlea‐BorneRickettsiosis.Curr.Trop.Med.Rep.2016,3,27–39.
https://doi.org/10.1007/s40475‐016‐0070‐6.
57. Kumsa,B.;Abiy,Y.;Abunna,F.EctoparasitesinfestingdogsandcatsinBishoftu,centralOromia,Ethiopia.Vet.Parasitol.RSR
2019,15,100263.https://doi.org/10.1016/j.vprsr.2019.100263.
58. Kapoor,R.;Elston,D.M.Whatʹseatingyou?Thesticktightflea(Echidnophagagallinacea).Cutis2012,89,157–158.
59. Knaus,M.;Rapti,D.;Shukullari,E.;Kusi,I.;Postoli,R.;Xhaxhiu,D.;Silaghi,C.;Hamel,D.;Visser,M.;Winter,R.;etal.Charac‐
terisationofecto‐ andendoparasitesindomesticcatsfromTirana,Albania.Parasitol.Res.2014,113,3361–3371.
https://doi.org/10.1007/s00436‐014‐3999‐1.
Pathogens2022,11,140313of13
60. Low,V.L.;Prakash,B.K.;Tan,T.K.;Sofian‐Azirun,M.;Anwar,F.H.K.;Vinnie‐Siow,W.Y.;AbuBakar,S.Pathogensinectopara‐
sitesfromfree‐ranginganimals:InfectionwithRickettsiaasembonensisinticks,andapotentiallynewspeciesofDipylidiumin
fleasandlice.Vet.Parasitol.2017,245,102‐105.https://doi.org/10.1016/j.vetpar.2017.08.015.
61. Robinson,M.T.;Satjanadumrong,J.;Hughes,T.;Stenos,J.;Blacksell,S.D.DiagnosisofspottedfevergroupRickettsiainfections:
TheAsianperspective.Epidemiol.Infect.2019,147,e286.https://doi.org/10.1017/S0950268819001390.
62. Khrouf,F.;MʹGhirbi,Y.;Znazen,A.;Jemaa,M.B.;Hammami,A.;Bouattour,A.DetectionofRickettsiainRhipicephalussanguineus
TicksandCtenocephalidesfelisFleasfromSoutheasternTunisiabyReverseLineBlotAssay.J.Clin.Microbiol.2014,52,268–274.
https://doi.org/10.1128/JCM.01925‐13.
63. Obaid,M.K.;Islam,N.;Alouffi,A.;Khan,A.Z.;daSilvaVaz,I.Jr;Tanaka,T.;Ali,A.AcaricidesResistanceinTicks:Selection,
Diagnosis,Mechanisms,andMitigation.Front.Cell.Infect.Microbiol.2022,12,941831.https://doi.org/10.3389/fcimb.2022.941831.
64. RustMK.RecentAdvancementsintheControlofCatFleas.Insects2020,11,668.https://doi.org/10.3390/insects11100668.
65. Ribeiro,H.S.;Pereira,D.F.S.;Melo‐Junior,O.;Mariano,R.M.D.S.;Leite,J.C.;Silva,A.V.D.;Oliveira,D.S.;Gonçalves,A.A.M.;
Lair,D.F.;Soares,I.D.S.;etal.Vaccineapproachesappliedtocontrollingdogticks.TicksTickBorneDis.2021,12,101631.
https://doi.org/10.1016/j.ttbdis.2020.101631.