Coinfection patterns and associations of tick-borne pathogens in natural foci of severe fever with thrombocytopenia syndrome: A One Health approach
4 affiliations
- 1Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- 2School of Public Health, Fudan University, Shanghai, China
- 3Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- 4Taizhou City Center for Disease Control and Prevention, Zhejiang Province, China
Abstract
Background: Tick-borne pathogens (TBPs) circulate in complex ecological systems involving vectors, animal hosts, and humans. Coinfections have been shown to influence clinical outcomes and may complicate pathogen associations, yet current research remains limited.
Methods: We adopted a One Health approach in Taizhou City, a severe fever with thrombocytopenia syndrome (SFTS) endemic area, by collecting 485 community residents, 90 confirmed SFTS patients, 1081 ticks, and 471 small mammals. Five TBPs, including Anaplasma spp., Bartonella spp., Coxiella spp., Ehrlichia spp., and spotted fever group rickettsiae (SFGR), were detected using indirect immunofluorescence assay or polymerase chain reaction. We subsequently analyzed pathogen prevalence and coinfection patterns, assessed pathogen-pathogen associations, and evaluated cross-host correlations at the township level.
Results: All five TBPs were detected across ticks, small mammals, and humans, with prevalence varying substantially. Human IgG showed diverse co-seropositivity, while coinfections in ticks and small mammals were limited. Significant pathogen-pathogen associations were observed: Anaplasma spp./Ehrlichia spp. and Ehrlichia spp./SFGR in humans, and Anaplasma spp./Coxiella spp. in small mammals. Cross-host correlations included positive associations of SFGR in ticks with community residents, Bartonella spp. in small mammals with community residents, and significant links of Anaplasma spp./Ehrlichia spp. and Anaplasma spp./SFGR between ticks and community residents.
Conclusions: Multiple TBPs co-circulate in this SFTS epidemic area, following distinct exposure routes involving ticks and small mammals. Anaplasma spp., Ehrlichia spp., and SFGR are tick-borne, while Bartonella spp. is more associated with small mammals. IgG co-seropositivity in humans likely reflects repeated or long-term exposures rather than a single tick bite. These findings suggest that effective prevention should consider human activity patterns and the role of small mammals in sustaining pathogen circulation, while a One Health approach integrating humans, animals, and vectors can guide the development of more targeted control strategies.
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BibTeX
@article{zhang2026coinfection,
title = {{Coinfection patterns and associations of tick-borne pathogens in natural foci of severe fever with thrombocytopenia syndrome: A One Health approach}},
author = {Zhiyi Zhang and Bingzhi Chen and Yishuang Zhao and Xiang Zheng and Qing Gao and Hongbiao Liang and Haijiang Lin and Na He},
journal = {One Health},
year = {2026},
month = sep,
doi = {10.1016/j.onehlt.2026.101543},
url = {https://doi.org/10.1016/j.onehlt.2026.101543},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Coinfection patterns and associations of tick-borne pathogens in natural foci of severe fever with thrombocytopenia syndrome: A One Health approach
AU - Zhiyi Zhang
AU - Bingzhi Chen
AU - Yishuang Zhao
AU - Xiang Zheng
AU - Qing Gao
AU - Hongbiao Liang
AU - Haijiang Lin
AU - Na He
PY - 2026
DA - 2026/09/17
JO - One Health
DO - 10.1016/j.onehlt.2026.101543
UR - https://doi.org/10.1016/j.onehlt.2026.101543
AB - Background: Tick-borne pathogens (TBPs) circulate in complex ecological systems involving vectors, animal hosts, and humans. Coinfections have been shown to influence clinical outcomes and may complicate pathogen associations, yet current research remains limited. Methods: We adopted a One Health approach in Taizhou City, a severe fever with thrombocytopenia syndrome (SFTS) endemic area, by collecting 485 community residents, 90 confirmed SFTS patients, 1081 ticks, and 471 small mammals. Five TBPs, including Anaplasma spp., Bartonella spp., Coxiella spp., Ehrlichia spp., and spotted fever group rickettsiae (SFGR), were detected using indirect immunofluorescence assay or polymerase chain reaction. We subsequently analyzed pathogen prevalence and coinfection patterns, assessed pathogen-pathogen associations, and evaluated cross-host correlations at the township level. Results: All five TBPs were detected across ticks, small mammals, and humans, with prevalence varying substantially. Human IgG showed diverse co-seropositivity, while coinfections in ticks and small mammals were limited. Significant pathogen-pathogen associations were observed: Anaplasma spp./Ehrlichia spp. and Ehrlichia spp./SFGR in humans, and Anaplasma spp./Coxiella spp. in small mammals. Cross-host correlations included positive associations of SFGR in ticks with community residents, Bartonella spp. in small mammals with community residents, and significant links of Anaplasma spp./Ehrlichia spp. and Anaplasma spp./SFGR between ticks and community residents. Conclusions: Multiple TBPs co-circulate in this SFTS epidemic area, following distinct exposure routes involving ticks and small mammals. Anaplasma spp., Ehrlichia spp., and SFGR are tick-borne, while Bartonella spp. is more associated with small mammals. IgG co-seropositivity in humans likely reflects repeated or long-term exposures rather than a single tick bite. These findings suggest that effective prevention should consider human activity patterns and the role of small mammals in sustaining pathogen circulation, while a One Health approach integrating humans, animals, and vectors can guide the development of more targeted control strategies.
SN - 2352-7714
ER -