Archive for the ‘Anaplasmosis’ Category

Tick Data – 76% Infected With One Organism, 20% Have Three or More Pathogens

https://www.tickcheck.com/statistics?

Each tick submitted for testing contributes to the research being conducted at TickCheck. By keeping records of all the results generated, we have been able to gain valuable insights into disease prevalence and co-infection rates. The comprehensive testing panel has been especially helpful in contributing to this research by ensuring all diseases and coinfections are accounted for when examining a tick.

Our current research shows:
  • 76% of ticks tested have at least one disease causing organism
  • 49% are co-infected with two or more organisms
  • 20% carry three or more
  • 9% of the ticks tested carry four or more

Infection Visualization by Tick Species

All Ticks Tested
76% Positive for Infection
Negative (24%)
_____________________________
  • 93% Positive for Infection
  • Negative (7%)
  • 63% Positive for Infection
  • Negative (37%)
  • 48% Positive for Infection
  • Negative (52%)

Coinfection Visualization

  • 2+ coinfection 49%
  • No coinfection 51%

Pathogenic Prevalence

The information below shows the positive/negative prevalence ratio of selected pathogens we test for. These pathogens were observed in ticks from the United States and Canada. Data set includes tests performed since TickCheck’s founding in 2014 and is updated in real time. (

Go to link at beginning to filter by state.  I’ve added the 3 listed for Wisconsin next to the entire sample size.  Please note the small sample sizes of WI ticks. 

Borrelia burgdorferi (deer tick) associated with Lyme disease

Sample size of 3,280 ticks.           70 Wisconsin ticks
  • 30% postive                                           33% positive
  • 70% negative                                         67% negative

Borrelia burgdorferi (western blacklegged tick) associated with Lyme disease

Sample size of 279 ticks.
  • 4% positive
  • 96% negative

Borrelia burgdorferi (lone star tick) associated with Lyme disease

Sample size of 899 ticks.
  • 8% positive
  • 92% negative

Borrelia burgdorferi (American dog tick) associated with Lyme disease

Sample size of 901 ticks.
  • 2% positive
  • 98% negative

Anaplasma phagocytophilum associated with anaplasmosis

Sample size of 2,146 ticks.           36 Wisconsin ticks
  • 8% positive                                           11% positive in Wisconsin
  • 92% negative                                        89% negative in Wisconsin

Babesia microti associated with babesiosis

Sample size of 1,894 ticks.           32 Wisconsin ticks
  • 4% positive                                            6% positive
  • 96% negative                                        94% negative

Bartonella spp. associated with bartonellosis

Sample size of 1,060 ticks.
  • 47% positive
  • 53% negative

Ehrlichia chaffeensis associated with ehrlichiosis

Sample size of 857 ticks.
  • 2% positive
  • 98% negative

Rickettsia spp. associated with Rocky Mountain spotted fever

Sample size of 944 ticks.
  • 23% postive
  • 77% negative

Francisella tularensis associated with tularemia

Sample size of 1,028 ticks.
  • 1% positive
  • 99% negative

Borrelia miyamotoi associated with B. miyamotoi

Sample size of 1,091 ticks.
  • 6% postive
  • 94% negative

Borrelia lonestari associated with STARI

Sample size of 831 ticks.
  • 19% postitive
  • 81% negative

Babesia spp. associated with babesiosis

Sample size of 564 ticks.
  • 5% positive
  • 95% negative

Mycoplasma spp. associated with Mycoplasma spp.

Sample size of 948 ticks.
  • 8% positive
  • 92% negative

Borrelia spp. associated with Borrelia spp.

Sample size of 612 ticks.
  • 17% postive
  • 83% negative

Powassan virus Lineage II associated with Deer tick virus

Sample size of 102 ticks.
  • 24% positive
  • 76% negative

Borrelia mayonii associated with Lyme disease

Sample size of 376 ticks.
  • 100% negative

Ehrlichia ewingii associated with ehrlichiosis

Sample size of 283 ticks.
  • 100% negative

Rickettsia amblyommii associated with Rocky Mountain spotted fever

Sample size of 177 ticks.
  • 46% positive
  • 54% negative

__________________

For more about Tickcheckhttps://www.tickcheck.com/about

You can request free tick identification by sending in a quality picture of your tick. Using real-time PCR (Polymerase Chain Reaction), Tickcheck can determine the presence of certain pathogens with an accuracy level of over 99.9%.  All information about how to send in your tick, costs of various tests, time for results, etc. is found here:  https://www.tickcheck.com/info/faq

Jonathan Weber is the founder and CEO of TickCheck and became acutely aware of the dangers of tick-borne diseases after his father caught Lyme during a family trip on the Appalachian Trail.

___________________

**Comment**

This information supports current research showing many patients are infected with numerous pathogens causing more severe illness & requiring far more than the CDC’s mono therapy of doxycycline:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

It also supports previous work showing coinfections within ticks:  https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/

What I want to know is WHY nothing’s being done about this?  Why are people STILL given 21 days of doxycycline when that particular med will not work on numerous pathogens?
Lastly, a word about statistics – this tick data should be used with caution & never to turn sick patients away due to a statistic. If you are the sorry sucker who gets bit by that ONE tick carrying a “statistically insignificant” pathogen, you still got bit and have to deal with it.  
Shame on doctors for turning sick people away due to statistics and maps.
There’s no such thing as an “insignificant” tick bite!

But, Patients are STILL being turned away:  https://madisonarealymesupportgroup.com/2019/04/22/its-just-crazy-why-is-lyme-disease-treatment-so-difficult-to-find-in-mississippi/

https://madisonarealymesupportgroup.com/2019/03/19/jacksonville-family-shares-daughters-9-month-diagnosis-of-rare-disease-which-isnt-rare-lyme/

https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/

https://madisonarealymesupportgroup.com/2017/10/24/no-lyme-in-oklahoma-yeah-right/

https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/  “They had the classic symptoms, they had the bulls eye rash, they had the joint pain, they had fevers and had flu like symptoms, yet we were denied treatment for at least two of them and I don’t understand how this is legal,” said Bowerman.

According to Dr. Naveen Patil, Director of the Infectious Disease Program, ADH,

“We don’t have Lyme Disease in Arkansas, we have the ticks that transmit Lyme Disease but we don’t have any recorded cases of Lyme Disease.” 

Bowerman also received a letter from the clinic stating doctors would no longer treat her children because she consistently questioned their medical advice and recommendations.

This is getting to be way beyond ludicrous.

 

Co-infections in Persons With Early Lyme Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433014/#__ffn_sectitle

. 2019 Apr; 25(4): 748–752.
PMCID: PMC6433014
PMID: 30882316

Co-infections in Persons with Early Lyme Disease, New York, USA

Abstract

In certain regions of New York state, USA, Ixodes scapularis ticks can potentially transmit 4 pathogens in addition to Borrelia burgdorferi: Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi, and the deer tick virus subtype of Powassan virus. In a prospective study, we systematically evaluated 52 adult patients with erythema migrans, the most common clinical manifestation of B. burgdorferi infection (Lyme disease), who had not received treatment for Lyme disease. We used serologic testing to evaluate these patients for evidence of co-infection with any of the 4 other tickborne pathogens. Evidence of co-infection was found for B. microti only; 4–6 patients were co-infected with Babesia microti. Nearly 90% of the patients evaluated had no evidence of co-infection. Our finding of B. microti co-infection documents the increasing clinical relevance of this emerging infection.

__________________

**Comment**

Sigh…..where to even begin

rashes-larger-blog-2

  • They used serologic testing. Research has proven this form of testing is abysmal: https://madisonarealymesupportgroup.com/2018/10/12/direct-diagnostic-tests-for-lyme-the-closest-thing-to-an-apology-you-are-ever-going-to-get/  Key quote: “These serologic tests cannot distinguish active infection, past infection, or reinfection.”In plain English, these tests don’t show squat. While this study in the link was for Lyme testing, I assure you, serologic testing for coinfections is just as abysmal. All of these coinfections are stealthy and persistent. They purposely don’t hang out in the blood & they’ve developed strategies to avoid the immune system as well as treatment.
  • The fact they only found 1 coinfection isn’t a shocker. Some of the sickest patients NEVER test positive because of dysfunctional immune systems. I’m not sure when they are ever going to think of using a provoking agent to stir the pathogens up, kill them, and then get the dead pieces and parts into the blood where this abysmal testing for antibodies can be picked up, but I’m not going to hold my breath. This study seriously makes me want to bang my head against the wall. They’ve learned nothing and continue to do the same exact things.
  • The only thing they got right was the, increasing clinical relevance of this emerging infection,” but I’ve got news for them: this is just the tip of the iceberg.
  • They need to get Dr. Breitshwerdt in on these studies and allow him to test the patients for Bartonella using the tests he’s developed.  They also need to use provoking agents and then test, or use direct testing, and to drop the EM rash criteria like a bad habit.

 

 

 

 

 

Eye Problems in Tick-borne Diseases Other Than Lyme

http://danielcameronmd.com/eye-problems-tick-borne-diseases-lyme/

EYE PROBLEMS IN TICK-BORNE DISEASES OTHER THAN LYME

“Why should an ophthalmologist have a good understanding of Lyme diagnosis and treatment?” asks Sathiamoorthi [1], from the Mayo Clinic, in an article published in the Current Opinion in Ophthalmology. “Vision-threatening ophthalmic manifestations are relatively common in Lyme disease (LD) and Rocky Mountain spotted fever.”

by Daniel J. Cameron, MD MPH

“Knowledge of systemic and ophthalmic manifestations combined with an understanding of the epidemiology of disease vectors is crucial for the diagnosis of tick-borne diseases,” she explains.

While manifestations may be present with LD and Rocky Mountain spotted fever, ocular involvement is rare in other tick-borne diseases such as babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever, Sathiamoorthi points out.

However, the true prevalence of ocular involvement due to tick-borne illnesses is unknown. Limitations with testing can make it difficult to identify patients. “It is crucial to know who is appropriate to test in order to avoid false positive results.” If an individual has been symptomatic for only a short period of time, they “may not have detectable serum IgM antibodies to the causative organism because it takes time for this immune response to develop.”

It can also be difficult to determine the cause of the ocular complaints if there is evidence of more than one tick-borne illness.

“One case report [2] describes a patient with optic neuritis and orbital myositis who had serologic evidence of HME [Human Monocytic Ehrlichioisis], Borrelia burgdorferi, and Babesia,” cites Sathiamoorthi.

There are more than one species of ticks associated with ocular findings, as well. According to Sathiamoorthi, those include Ornithodoros genus, Dermacentor variabilis Ambylomma americanum, Ixodes scapularis, and Dermacentor andersonii.

Sathiamoorthi advises doctors to “carefully generate a reasonable differential based on clues in the medical and social history regarding exposures and risks.”

“Patients who are most likely to have ophthalmic Lyme disease,” explains Sathiamoorthi, “are those with ocular manifestations commonly associated with Lyme disease (i.e. Bells palsy, cranial nerve palsies and keratitis); tick exposure in Lyme endemic regions; other signs/symptoms of late Lyme disease (i.e. inflammatory arthritis, carditis, acrodermatitis chronica atrophicans rash, encephalopathy and meningitis); and negative syphilis testing.”

Read more on eye problems in tick-borne diseases in “A growing list of eye problems in Lyme disease.”

References:

1. Sathiamoorthi S, Smith WM. The eye and tick-borne disease in the United States. Curr Opin Ophthalmol. 2016;27(6):530-537.
2. Pendse S, Bilyk JR, Lee MS. The ticking time bomb. Surv Ophthalmol. 2006;51(3):274-279.

 

African Tick Found on Untraveled U.K. Horse

https://www.ncbi.nlm.nih.gov/pubmed/30876825

2019 Apr;10(3):704-708. doi: 10.1016/j.ttbdis.2019.03.003. Epub 2019 Mar 9.

Hyalomma rufipes on an untraveled horse: Is this the first evidence of Hyalomma nymphs successfully moulting in the United Kingdom?

Abstract

During September 2018, a tick was submitted to Public Health England’s Tick Surveillance Scheme for identification. The tick was sent from a veterinarian who removed it from a horse in Dorset, England, with no history of overseas travel. The tick was identified as a male Hyalomma rufipes using morphological and molecular methods and then tested for a range of tick-borne pathogens including;

  • Alkhurma virus
  • Anaplasma
  • Babesia
  • Bhanja virus
  • Crimean-Congo Haemorrhagic fever virus
  • Rickettsia
  • Theileria

The tick tested positive for Rickettsia aeschlimannii, a spotted fever group rickettsia linked to a number of human cases in Africa and Europe.

This is the first time H. rufipes has been reported in the United Kingdom (UK), and the lack of travel by the horse (or any in-contact horses) suggests that this could also be the first evidence of successful moulting of a Hyalomma nymph in the UK. It is postulated that the tick was imported into the UK on a migratory bird as an engorged nymph which was able to complete its moult to the adult stage and find a host.

This highlights that passive tick surveillance remains an important method for the detection of unusual species that may present a threat to public health in the UK. Horses are important hosts of Hyalomma sp. adults in their native range, therefore, further surveillance studies should be conducted to check horses for ticks in the months following spring bird migration; when imported nymphs may have had time to drop off their avian host and moult to adults. The potential human and animal health risks of such events occurring more regularly are discussed.

_________________________

A ProMED-mail post

A tick capable of carrying a host of killer illnesses has been found in the UK for the very 1st time, health officials have revealed.

The _Hyalomma rufipes_ tick – a small blood-sucking arachnid – is usually confined to Africa, Asia and parts of southern Europe. But Public Health England [PHE] has now revealed one of the ticks, 10 times larger than others, was discovered in Dorset last year [2018]. The creature itself wasn’t found to be carrying the deadly Crimean-Congo Haemorrhagic fever virus (CCHF).

The disturbing find, which could ‘present a threat to public health in the UK’, has been documented in the journal Ticks and Tick-borne Diseases.

A vet at The Barn Equine Surgery in Wimborne removed the tick from a horse last September [2018]. They then sent it to PHE’s tick surveillance team. Writing in the journal, the PHE team said: ‘This is the first time _Hyalomma rufipes_ has been reported in the United Kingdom. ‘The lack of travel by the horse – or any in-contact horses – suggests that this could also be the 1st evidence of successful moulting of a _Hyalomma_ nymph in the UK.’

The team of researchers who found the tick was led by Kayleigh Hansford, of PHE’s medical entomology and zoonoses ecology group.

Writing in the journal, they said it is suspected the tick hitched a ride on a migratory bird before landing in the UK. Neither the infested horse, nor other horses in the stable had travelled anywhere and no further ticks were detected on any of the horses. It is thought the tick travelled on a swallow because they are known to nest in the stables of horses and migrate from Africa to the UK for summer.

The UK climate, known to be getting warmer, is thought to be a major limiting factor for the survival of _Hyalomma rufipes_. However, the unusually warm weather experienced during the summer of 2018 may have been a factor for helping it moult – become an adult.

Currently, the ticks are found in Greece, Northern China, Russia, Turkey, Iraq, Syria, Pakistan, Egypt, Yemen and Oman.

The World Health Organization last year [2018] named CCHF as one of 10 pathogens that pose the most ‘urgent’ threat to humanity.

Figures show the virus – most often spread through tick bites – kills around 40% of humans that it strikes. The horrific illness is said to manifest ‘abruptly’, with initial symptoms including fever, backache, headache, dizziness and sore eyes.

[Byline: Stephen Matthews]


Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Not mentioned in detail in the above report, the PHE team, using morphological and molecular methods, then tested for a range of tick-borne pathogens including: Alkhurma virus, Anaplasma, Babesia, Bhanja virus, Crimean-Congo Haemorrhagic fever virus, Rickettsia and Theileria. The tick tested positive for _Rickettsia aeschlimannii_, a spotted fever group rickettsia linked to a number of human cases in Africa and Europe.

The critical question is if this is a single tick transported into Dorset, or represents one tick of a local breeding population. Transportation of a single tick by a migrating bird is a reasonable possibility. Immature (nymph) _Hyalomma_ usually feed on birds, rodents, and hares. Nymphs are often transported from one place to another by migrating birds. For example, a migrating bird carrying a CCH virus-infected _Hyalomma marginatum_ nymph can introduce the virus into new localities and infect humans and domestic livestock (Larry S.Roberts, 2009). Continued surveillance in the area where the single tick was found, as well as generally in the UK over the spring and summer months, would be prudent.

 

Human Tick-Borne Diseases in Australia

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360175/

Published online 2019 Jan 28. doi: 10.3389/fcimb.2019.00003
PMCID: PMC6360175
PMID: 30746341

Human Tick-Borne Diseases in Australia

Abstract

There are 17 human-biting ticks known in Australia. The bites of Ixodes holocyclus, Ornithodoros capensis, and Ornithodoros gurneyi can cause paralysis, inflammation, and severe local and systemic reactions in humans, respectively. Six ticks, including Amblyomma triguttatum, Bothriocroton hydrosauri, Haemaphysalis novaeguineae, Ixodes cornuatus, Ixodes holocyclus, and Ixodes tasmani may transmit Coxiella burnetii, Rickettsia australis, Rickettsia honei, or Rickettsia honei subsp. marmionii. These bacterial pathogens cause Q fever, Queensland tick typhus (QTT), Flinders Island spotted fever (FISF), and Australian spotted fever (ASF). It is also believed that babesiosis can be transmitted by ticks to humans in Australia.

In addition, Argas robertsi, Haemaphysalis bancrofti, Haemaphysalis longicornis, Ixodes hirsti, Rhipicephalus australis, and Rhipicephalus sanguineus ticks may play active roles in transmission of other pathogens that already exist or could potentially be introduced into Australia. These pathogens include Anaplasma spp., Bartonella spp., Burkholderia spp., Francisella spp., Dera Ghazi Khan virus (DGKV), tick-borne encephalitis virus (TBEV), Lake Clarendon virus (LCV), Saumarez Reef virus (SREV), Upolu virus (UPOV), or Vinegar Hill virus (VINHV).

It is important to regularly update clinicians’ knowledge about tick-borne infections because these bacteria and arboviruses are pathogens of humans that may cause fatal illness. An increase in the incidence of tick-borne infections of human may be observed in the future due to changes in demography, climate change, and increase in travel and shipments and even migratory patterns of birds or other animals. Moreover, the geographical conditions of Australia are favorable for many exotic ticks, which may become endemic to Australia given an opportunity. There are some human pathogens, such as Rickettsia conorii and Rickettsia rickettsii that are not currently present in Australia, but can be transmitted by some human-biting ticks found in Australia, such as Rhipicephalus sanguineus, if they enter and establish in this country.

Despite these threats, our knowledge of Australian ticks and tick-borne diseases is in its infancy.

**Comment**

I appreciate the way the researchers wrote about the possibility of infection even though there are not recorded cases yet.  This open-mindedness is imperative if we are to move forward. Gone are the days where tick-borne illness is presented as if the information were akin to the 10 commandments.

Tick-borne illness has become a true pandemic and is found virtually everywhere.

While Lyme is not mentioned (please note further down that autopsy results showed Lyme all over a man from Sydney) the following infections are on record:

  • Q fever
  • Queensland tick typhus (QTT)
  • Flinders Island spotted fever (FISF)
  • Australian spotted fever (ASF)
  • Babesiosis
  • Anaplasma spp.
  • Bartonella spp.
  • Burkholderia spp.
  • Francisella spp. (Tularemia)
  • Dera Ghazi Khan virus (DGKV)
  • tick-borne encephalitis virus (TBEV)
  • Lake Clarendon virus (LCV)
  • Saumarez Reef virus (SREV)
  • Upolu virus (UPOV)
  • Vinegar Hill virus (VINHV)

I would say that is quite enough to make our Aussie friends quite sick.

For more on TBI’s in Australia:  https://madisonarealymesupportgroup.com/2018/08/21/our-battle-ongoing-lyme-disease-in-australia/

https://madisonarealymesupportgroup.com/2016/11/03/ld-not-in-australia-here-we-go-again/

https://madisonarealymesupportgroup.com/2018/10/03/aussie-widow-of-lyme-disease-victim-to-sue-nsw-health/  A SYDNEY woman launches a class action against NSW Health after autopsy results showed her husband was riddled with Lyme in his liver, heart, kidney, and lungs. He was only 44 years old and was bitten by a tick while filming a TV show in Sydney.

 https://madisonarealymesupportgroup.com/2018/10/18/study-finds-q-fever-rickettsia-typhus-in-australian-ticks-and-people/

https://madisonarealymesupportgroup.com/2019/01/14/python-covered-with-more-than-500-ticks-rescued-in-australia/

https://madisonarealymesupportgroup.com/2018/03/23/australian-lyme-disease-research-pilot-funded/

https://madisonarealymesupportgroup.com/2017/09/19/tbis-in-australia/

 

 

1st Report of Anaplasma Found in Thai. Bartonella, Rickettsia, Leptospira, & Scrub Typhus in Humans as Well. Even More Found in Ticks

https://www.ncbi.nlm.nih.gov/pubmed/30863381

Metagenomic Approach to Characterizing Disease Epidemiology in a Disease-Endemic Environment in Northern Thailand.

Takhampunya R1, Korkusol A1, Pongpichit C2, Yodin K2, Rungrojn A1, Chanarat N1, Promsathaporn S1, Monkanna T1, Thaloengsok S1, Tippayachai B1, Kumfao N2, Richards AL3, Davidson SA1.

Abstract

In this study, we used a metagenomic approach to analyze bacterial communities from diverse populations (humans, animals, and vectors) to investigate the role of these microorganisms as causative agents of disease in human and animal populations. Wild rodents and ectoparasites were collected from 2014 to 2018 in Nan province, Thailand where scrub typhus is highly endemic. Samples from undifferentiated febrile illness (UFI) patients were obtained from a local hospital. A total of 200 UFI patient samples were obtained and 309 rodents and 420 pools of ectoparasites were collected from rodents (n = 285) and domestic animals (n = 135). The bacterial 16S rRNA gene was amplified and sequenced with the Illumina. Real-time PCR and Sanger sequencing were used to confirm the next-generation sequencing (NGS) results and to characterize pathogen species.

Several pathogens were detected by NGS in all populations studied and the most common pathogens identified included Bartonella spp., spp., Leptospira spp., and Orientia tsutsugamushi. Interestingly, Anaplasma spp. was detected in patient, rodent and tick populations, although they were not previously known to cause human disease from this region. Candidatus Neoehrlichia, Neorickettsia spp., Borrelia spp., and Ehrlichia spp. were detected in rodents and their associated ectoparasites. The same O. tsutsugamushi genotypes were shared among UFI patients, rodents, and chiggers in a single district indicating that the chiggers found on rodents were also likely responsible for transmitting to people.

Serological testing using immunofluorescence assays in UFI samples showed high prevalence (IgM/IgG) of Rickettsia and Orientia pathogens, most notably among samples collected during September-November. Additionally, a higher number of seropositive samples belonged to patients in the working age population (20-60 years old). The results presented in this study demonstrate that the increased risk of human infection or exposure to chiggers and their associated pathogen (O. tsutsugamushi) resulted in part from two important factors; working age group and seasons for rice cultivation and harvesting. Evidence of pathogen exposure was shown to occur as there was seropositivity (IgG) in UFI patients for bartonellosis as well as for anaplasmosis.

Using a metagenomic approach, this study demonstrated the circulation and transmission of several pathogens in the environment, some of which are known causative agents of illness in human populations.

 

Are You Aware of Anaplasmosis?

https://www.galaxydx.com/are-you-aware-of-anaplasmosis/

written on

Are You Aware of Analasmosis?

Immunohistochemical (IHC) staining to detect Anaplasma phagocytophilum in a tissue sample (CDC).

Anaplasmosis is a tick-borne illness that is reported across the globe in areas such as North America, Europe, and China.

Known infections in the United States have been on the rise ever since becoming a nationally notifiable disease to the CDC in 2000. Like bartonellosis and Lyme borreliosis, patients with this condition can present with mild to severe non-specific symptoms and diagnosis is often difficult.

We are introducing a new webpage this week that describes the infectious pathogens of the Anaplasma genus and the test options that Galaxy Diagnostics offers.