Vivian Kjelland - Academia.edu (original) (raw)

Papers by Vivian Kjelland

Ticks and Tick-borne Diseases, Jun 1, 2015

Ticks are important vectors of human pathogens. The knowledge of disease causing agents harboured... more Ticks are important vectors of human pathogens. The knowledge of disease causing agents harboured by ticks in Norway is limited. The focus of this study was (a) to detect the bacteria of medical importance in ticks collected from the vegetation at locations in the southern part of the country and (b) to evaluate a novel commercially available multiplex PCR based method by comparing results with conventional established real-time PCR protocols. Borrelia burgdorferi sensu lato was confirmed to be the most prevalent pathogen detected (31%) among one hundred individually analysed adult ticks. Borrelia miyamotoi, a spirochete associated with relapsing fever, was detected in one sample. Anaplasma phagocytophilum was found in 4% of the ticks, followed by Rickettsia helvetica which was detected in one sample. Similar pathogen prevalence was also detected in 500 ticks analysed in pools. This is the first report of the spotted fever group Rickettsia in Norway. Francisella tularensis, Bartonella species or Coxiella burnetti was not detected. However, due to the low number of ticks analysed, the possible presence of these pathogens in the region cannot be ruled out. All isolates were screened by at least two different molecular methods for each bacterial target; one commercially available multiplex PCR based tick-borne bacteria flow chip system (Master Diagnostica) and corresponding real-time PCR protocols. The comparison of methods verified that most findings were detected by both methods (71 Borrelia, 15 Anaplasma and 2 Rickettsia), whereas two additional Borrelia and Anaplasma infected samples were detected by the real-time protocols.

PLOS ONE, Apr 9, 2020

Birds are important hosts for the first life stages of the Ixodes ricinus tick and they can trans... more Birds are important hosts for the first life stages of the Ixodes ricinus tick and they can transport their parasites over long distances. The aim of this study was to investigate the prevalence of Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Neoehrlichia mikurensis and Rickettsia helvetica in ticks collected from migratory birds in Norway. A total of 815 Ixodes ricinus ticks from 216 birds trapped at Lista Bird Observatory in southern Norway during spring and autumn migration in 2008 were analysed by real-time PCR. B. burgdorferi s. l. was the most prevalent pathogen, detected in 6.1% of the ticks. The prevalence of N. mikurensis, A. phagocytophilum and R. helvetica was 1.2%, 0.9% and 0.4% respectively. In addition, one sample (0.1%) was positive for B. miyamotoi. In total, 8.2% of the ticks were infected with at least one pathogen. Co-infection with B. burgdorferi s. l. and N. mikurensis or A. phagocytophilum was found in 6.0% of the infected ticks. Our results show that all the known major tick-borne bacterial pathogens in Norway are subject to transport by migratory birds, potentially allowing spread to new areas. Our study showed a surprisingly high number of samples with PCR inhibition (57%). These samples had been extracted using standard methodology (phenol-chloroform extraction). This illustrates the need for inhibition controls to determine true prevalence rates.

Ticks and Tick-borne Diseases, Apr 1, 2013

The capability of imidacloprid 10% + flumethrin 4.5% (Seresto®) collars to prevent transmission o... more The capability of imidacloprid 10% + flumethrin 4.5% (Seresto®) collars to prevent transmission of Borrelia burgdorferi sensu lato (Bbsl) and Anaplasma phagocytophilum (Ap) by naturally infected ticks was evaluated in two studies with 44 dogs. In each study, one group served as non-treated control, whereas the other groups were treated with the Seresto® collar. All dogs were exposed to naturally Bbsland Ap-infected hard ticks (Ixodes ricinus, Ixodes scapularis). In study 1, tick infestation was performed on study day (SD) 63 (2 months post-treatment [p.t.]); in study 2, it was performed on SD 32 (one month p.t.) respectively SD 219 (seven months p.t.). In situ tick counts were performed 2 days after infestation. Tick counts and removals followed 6 (study 1) or 5 days (study 2) later. Blood sampling was performed for the detection of specific Bbsl and Ap antibodies and, in study 1, for the documentation of Ap DNA by PCR. Skin biopsies were examined for Bbsl by PCR and culture (only study 1). The efficacy against Ixodes spp. was 100% at all time points. In study 1, two of six non-treated dogs became infected with Bbsl, and four of six tested positive for Ap; none of the treated dogs tested positive for Bbsl or Ap. In study 2, ten of ten non-treated dogs became infected with Bbsl and Ap; none of the treated dogs tested positive for Bbsl or Ap; 100% acaricidal efficacy was shown in both studies. Transmission of Bbsl and Ap was successfully blocked for up to 7 months.

Scandinavian Journal of Infectious Diseases, Apr 29, 2010

From April to October 2007, host-seeking Ixodes ricinus ticks were collected from 4 locations in ... more From April to October 2007, host-seeking Ixodes ricinus ticks were collected from 4 locations in southern Norway: Farsund, Mandal, Søgne and Tromøy. Two hundred and ten larvae, 1130 nymphs and 449 adults were investigated for infection with Borrelia burgdorferi sensu lato (s.l.) by real-time polymerase chain reaction (PCR) amplification of the 16S rRNA gene. The total percentage of B. burgdorferi s.l. in nymphal and adult ticks was determined to be 31.3% in Farsund, 25.2% in Mandal, 22.3% in Søgne and 22.1% in Tromøy. Larvae were pooled in groups of 10 before analysis, and Borrelia infection was detected in 1 of the 21 larvae pools. B. burgdorferi s.l. were genotyped by melting curve analysis after real-time PCR amplification of the hbb gene, or by direct sequencing of the PCR amplicon generated from the rrs (16S)-rrl (23S) intergenetic spacer. The most prevalent B. burgdorferi genospecies identified were B. afzelii (61.6%), followed by B. garinii (23.4%) and B. burgdorferi sensu stricto (10.6%). B. valaisiana (4.5%) was identified in Norwegian ticks for the first time. Mixed infections were observed in 0.3% of the infected ticks. A higher prevalence of B. burgdorferi s.l. was found in the present study than what has been reported in previous Nordic studies.

Annals of the Rheumatic Diseases, Jun 1, 2013

Background: Although bone and joint manifestations are common in children with cystic fibrosis (C... more Background: Although bone and joint manifestations are common in children with cystic fibrosis (CF), they have received little attention in adults. CF-related arthropathy (CFA) is a relatively infrequent complication previously reported to be present in 2-8.5% of the CF population. It usually affects the large joints with recurrent episodes of swelling and stiffness. It may become more persistent with a polyarticular distribution. Less commonly and affecting older patients (2-7%) is hypertrophic osteoarthropathy which is a syndrome characterized by abnormal proliferation of the skin and osseous tissue at the distal parts of the extremities, occurring in association with radiographically confirmed periosteal new bone formation. Objectives: In this study we aimed to assess the frequency and describe the clinical presentation of musculoskeletal complications in adults with CF. Methods: At the time of this study, 143 adult CF patients (range 16-63, 80 males, 63 females, average age 28.5) were under the care of the London Chest Hospital CF Unit. Their medical records, laboratory and radiological results were analysed retrospectively. Results: 19 of 143 CF patients (13.3%) suffered from musculoskeletal problems, of which 10 had CFA (7%). Other diseases included spondyloarthritis, chondromalatia patellae, vitamin D deficiency, back pain and rotator cuff tendinopathy. There were no cases of hypertrophic osteoarthropathy or transient synovitis. Among the CFA patients, 6 were female and 4 were male. The average age at diagnosis was 25 years in the female group (range 23-30) and 38 years in the male group (range 36-43). All patients suffered from polyarthralgia. 5 patients had moderate and 5 had severe underlying CF disease. On screening only one patient tested positive for ANA, all were negative for both RF and anti-CCP antibody. 5 patients had US scan of their affected joints; one had evidence of active synovitis and erosions. There was no radiological evidence of erosive joint disease in any of the patients. All patients received nonsteroidal-antiinflammatory drugs (NSAIDs) as their primary treatment. Due to inadequate clinical response 5 received disease modifying anti-rheumatic drugs (DMARDs) as well (sulphasalazine, hydroxychloroquine or methotrexate). Conclusions: Similar to previous reports, the incidence of CFA in our cohort was 7%. Interestingly, the age of onset was lower for female patients compared to males. Though there was hardly any synovitis clinically, there was evidence of synovial thickening and erosions on US and Doppler. Although NSAIDs usually control symptoms, half of our patients needed DMARDs as well. Early diagnosis and appropriate management is especially important for CF patients, as joint pain, swelling, and limitation of movement may become disabling and interfere with mobility, exercise and chest clearance, all essential components of CF daily treatment schedule.

Infectious diseases, Nov 10, 2017

Tests for direct detection of Borrelia burgdorferi sensu lato (Bb) in Lyme neuroborreliosis (LNB)... more Tests for direct detection of Borrelia burgdorferi sensu lato (Bb) in Lyme neuroborreliosis (LNB) are needed. Detection of Bb DNA using PCR is promising, but clinical utility is hampered by low diagnostic sensitivity. We aimed to examine whether diagnostic sensitivity can be improved by the use of larger cerebrospinal fluid (CSF) volumes and faster handling of samples. Patients who underwent CSF examination for LNB were included. We collected two millilitres of CSF for PCR analysis, extracted DNA from the pellets within 24 h and analysed the eluate by two real-time PCR protocols (16S rRNA and OspA). Patients who fulfilled diagnostic criteria for LNB were classified as LNB cases and the rest as controls. Bb DNA in CSF was detected by PCR in seven of 28 adults with LNB. Two were Bb antibody negative. No Bb DNA was detected in CSF from 137 controls. Diagnostic sensitivity was 25% and specificity 100%. There was a non-significant trend towards larger CSF sample volume, faster handling of the sample, shorter duration of symptoms, and higher CSF cell count in the PCR-positive cases. We did not find that optimized handling of CSF increased diagnostic sensitivity of PCR in adults with LNB. However, our case series is small and we hypothesize that the importance of these factors will be clarified in further studies with larger case series and altered study design. PCR for diagnosis of LNB may be useful in cases without Bb antibodies due to short duration of symptoms.

Acta Veterinaria Scandinavica, Nov 6, 2010

Background: Borrelia burgdorferi sensu lato (s.l.) are the causative agent for Lyme borreliosis (... more Background: Borrelia burgdorferi sensu lato (s.l.) are the causative agent for Lyme borreliosis (LB), the most common tick-borne disease in the northern hemisphere. Birds are considered important in the global dispersal of ticks and tick-borne pathogens through their migration. The present study is the first description of B. burgdorferi prevalence and genotypes in Ixodes ricinus ticks feeding on birds during spring and autumn migration in Norway. Methods: 6538 migratory birds were captured and examined for ticks at Lista Bird Observatory during the spring and the autumn migration in 2008. 822 immature I. ricinus ticks were collected from 215 infested birds. Ticks were investigated for infection with B. burgdorferi s.l. by real-time PCR amplification of the 16S rRNA gene, and B. burgdorferi s.l. were thereafter genotyped by melting curve analysis after real-time PCR amplification of the hbb gene, or by direct sequencing of the PCR amplicon generated from the rrs (16S)-rrl (23S) intergenetic spacer. Results: B. burgdorferi s.l. were detected in 4.4% of the ticks. The most prevalent B. burgdorferi genospecies identified were B. garinii (77.8%), followed by B.valaisiana (11.1%), B. afzelii (8.3%) and B. burgdorferi sensu stricto (2.8%). Conclusion: Infection rate in ticks and genospecies composition were similar in spring and autumn migration, however, the prevalence of ticks on birds was higher during spring migration. The study supports the notion that birds are important in the dispersal of ticks, and that they may be partly responsible for the heterogeneous distribution of B. burgdorferi s.l. in Europe.

Ticks and Tick-borne Diseases, Aug 1, 2017

The most common tick-borne human disease in Norway is Lyme borreliosis. Ticks in Norway also harb... more The most common tick-borne human disease in Norway is Lyme borreliosis. Ticks in Norway also harbour less known disease-causing agents such as Candidatus Neoehrlichia mikurensis, Borrelia miyamotoi and Rickettsia helvetica. However, human infections caused by these pathogens have never been described in Norway. The main aims of the study were to evaluate the contribution of several tick-borne bacterial agents, other than Borrelia burgdorferi sensu lato, to zoonotic diseases in Norway and to determine their clinical pictures. Blood samples from 70 symptomatic tick-bitten adults from the Agder counties in southern Norway were screened for seven tick-borne pathogens by using a commercial multiplex PCR-based method and by singleplex real-time PCR protocols. Most patients (65/70) presented with a rash clinically diagnosed as erythema migrans (EM). The most frequently detected pathogen DNA was from Ca. N. mikurensis and was found in the blood of 10% (7/70) of the patients. The Ca. N. mikurensis-infected patients presented with an EM-like rash as the only symptom. B. burgdorferi s.l. DNA was present in the blood of 4% (3/70) of the study participants. None had detectable Anaplasma phagocytophilum, B. miyamotoi, Rickettsia typhus group or spotted fever group, Francisella tularensis, Coxiella burnetii or Bartonella spp. DNA in the blood. The commercially available multiplex PCR bacteria flow chip system failed to identify half of the infected patients detected by corresponding real-time PCR protocols. The recovery of Ca. N. mikurensis DNA was higher in the pellet/plasma fraction of blood than from whole blood. To conclude, Ca. N. mikurensis appeared to be the etiological agent in patients with EM in a surprisingly large fraction of tick-bitten persons in the southern part of Norway.

Scientific Data

An amendment to this paper has been published and can be accessed via a link at the top of the pa... more An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Estimated individual pathogen prevalence in Ixodes ricinus nymphs from southern Scandinavia

Pass/Fail test results of pathogen screening from analyzed pools of 10 nymphs from 50 sites in so... more Pass/Fail test results of pathogen screening from analyzed pools of 10 nymphs from 50 sites in southern Scandinavia

Ixodes ricinus instar abundance from 159 sites in 2016 and 30 sites in 2017 in southern Scandinavia

satellite imagery, and human population density maps DTU Orbit (23/04/2019) Modelling risk of tic... more satellite imagery, and human population density maps DTU Orbit (23/04/2019) Modelling risk of tick exposure in southern Scandinavia using machine learning techniques, satellite imagery, and human population density maps Vector-borne diseases such as Lyme disease and tick-borne encephalitis have become more common in recent decades and present a real health problem in many parts of Europe. Risk assessment, control, and prevention of these diseases require a better understanding of vector abundance as well as risk factors determining human exposure to ticks. There is a great need for analyses and models that can predict how vectors and their associated diseases are distributed and how this relates to high risk areas for human exposure.As a part of the ScandTick Innovation project, we surveyed ticks at approximately 30 sites (forests and meadows) in each of Denmark, southern Norway and south-eastern Sweden. At each site we measured presence/absence of ticks, and used the data obtained ...

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Annals of the Rheumatic Diseases, 2013

BMC Infectious Diseases, 2014

Background: Despite Southern Norway is an endemic area for Lyme borreliosis there is a lack of da... more Background: Despite Southern Norway is an endemic area for Lyme borreliosis there is a lack of data on Lyme arthritis (LA). In the literature controversies exist if acute LA can develop into chronic arthritis. Our objective was to identify and characterize patients with LA in Southern Norway and explore disease course after antibiotic treatment. Methods: Patients aged 20 years or older with arthritis and a positive serology for Borrelia burgdorferi infection (IgG and/or IgM) suspected of having LA were consecutively recruited either from general practitioners or from hospital departments. Results: From January 2007 to December 2010 a total of 27 patients were assessed. Mean (range) age was 56 years (41-80) and mean symptom duration prior to inclusion was 11.2 weeks (1 day-2 years). Definite LA was diagnosed in 16 patients, probable LA in 5 patients and 6 patients were concluded to have other arthritis disorders. Among the 21 LA patients 20 had mono-arthritis (knee 18, ankle 2) and 1 had polyarthritis. All LA patients responded favourable to antibiotic treatment and none of the patients developed chronic arthritis after long term follow up, not even in LA patients who had intraarticular glucocorticosteroid (GC) injection prior to antibiotic treatment. Conclusions: Our data shows that LA in Southern Norway is a benign disease which successfully can be treated with antibiotics even in patients treated with GC prior to antibiotics.

Russian Journal of Infection and Immunity, 2019

Scientific Reports

Tick-borne pathogens cause diseases in animals and humans, and tick-borne disease incidence is in... more Tick-borne pathogens cause diseases in animals and humans, and tick-borne disease incidence is increasing in many parts of the world. There is a need to assess the distribution of tick-borne pathogens and identify potential risk areas. We collected 29,440 tick nymphs from 50 sites in Scandinavia from August to September, 2016. We tested ticks in a real-time PCR chip, screening for 19 vector-associated pathogens. We analysed spatial patterns, mapped the prevalence of each pathogen and used machine learning algorithms and environmental variables to develop predictive prevalence models. All 50 sites had a pool prevalence of at least 33% for one or more pathogens, the most prevalent beingBorrelia afzelii, B. garinii,Rickettsia helvetica,Anaplasma phagocytophilum,andNeoehrlichia mikurensis. There were large differences in pathogen prevalence between sites, but we identified only limited geographical clustering. The prevalence models performed poorly, with only models forR. helveticaandN....

PLOS ONE

Rickettsia helvetica is a tick-borne pathogen that may cause severe human disease. Knowledge of i... more Rickettsia helvetica is a tick-borne pathogen that may cause severe human disease. Knowledge of its distribution in Norway, where Ixodes ricinus reaches its northern limit, is very sparse. It was detected only recently in Norway, but it is prevalent and widely distributed in I. ricinus ticks in the neighboring countries Sweden and Denmark. In this study 2396 questing adult, nymphal and larval I. ricinus ticks were collected from two counties in Norway and analyzed for the presence of R. helvetica using a specific real-time PCR targeting the citrate synthase gene gltA. A further 495 nymphal I. ricinus from a third county was analyzed for Rickettsia spp. using a different method that is not speciesspecific. The overall prevalence was 1.6 %. Local variations were observed, but prevalence was < 5 % at all locations.