{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:57:05Z","timestamp":1789804625903,"version":"4.0.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vector-Borne and Zoonotic Diseases"],"published-print":{"date-parts":[[2024,11]]},"abstract":"\n Background:<\/jats:title>\n \n Tick-borne relapsing fever (TBRF) caused by\n Borrelia persica<\/jats:italic>\n is an endemic disease in Israel and highly prevalent in military personnel. Prevention among the Israel Defense Force soldiers is based on increased awareness mainly in hyperendemic areas and selective postexposure prophylaxis with doxycycline. In this study, we report the presence of a suspected outbreak of TBRF in four soldiers who spent 30 h inside a deserted bunker.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n Clinical data on TBRF suspected cases were retrieved from clinical records, soft ticks were collected using carbon dioxide (CO\n 2<\/jats:sub>\n ) traps and their DNA was extracted and analysed by PCR and nucleotide sequencing. Environmental conditions such as relative humidity, air temperature, wind speed, and type of soil, as well as presence or absence of animal traces inside the bunkers were documented.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n TBRF-like clinical symptoms in the patients included: tick bite scars, fever (37.5\u201339.2\u00b0C), rash, tachycardia, hypotension, myalgia, cough, headache, cervical lymphadenopathy and nausea. Microscopic search for\n B. persica<\/jats:italic>\n in blood smears was performed in three patients and was negative. Out of the 255\n Ornithodoros tholozani<\/jats:italic>\n ticks collected from the bunker, 198 were analyzed and 2 (1%) were infected with\n B. persica<\/jats:italic>\n . To determine if tick infestation in military bunkers is a common phenomenon, we surveyed nine additional military bunkers located in four different geographical areas for the presence of soft ticks. Only one additional bunker was infested with two\n O. tholozani<\/jats:italic>\n ticks, both negative for\n B. persica<\/jats:italic>\n . Presence of earth that probably helped sustain a relatively big tick population was observed on the floor in the highly infested bunker. Environmental treatment with lambda-cyhalothrin at 9.7% was performed and showed efficacy with no ticks recovered in the infested bunker 124 days after intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n This study shows that military bunkers may harbor soft ticks infected with\n B. persica<\/jats:italic>\n and entrance into bunkers should be considered as a risk for acquiring this infection like entrance into natural caves and archeological ruins.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/vbz.2024.0041","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T05:14:35Z","timestamp":1719810875000},"page":"738-744","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Tick-Borne Relapsing Fever Infection from a Bunker, a Case Report on a \u201cOne Health\u201d Approach"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2928-8522","authenticated-orcid":false,"given":"Gabriela","family":"Kleinerman","sequence":"first","affiliation":[{"name":"Medical Corps, Israel Defense Forces, Qriat Ono, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mor","family":"Rittblat","sequence":"additional","affiliation":[{"name":"Department of Military Medicine and \u201cTzameret,\u201d Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7549-1305","authenticated-orcid":false,"given":"Gad","family":"Baneth","sequence":"additional","affiliation":[{"name":"Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagi","family":"Gavriel","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces, Qriat Ono, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaarit","family":"Nahum-Biala","sequence":"additional","affiliation":[{"name":"Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Grinstein","sequence":"additional","affiliation":[{"name":"Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nufar","family":"Dagan","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces, Qriat Ono, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavie","family":"Chaim","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces, Qriat Ono, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.02767.x"},{"key":"e_1_3_6_3_1","first-page":"109","article-title":"Ecological studies on the cave tick Ornithodoros tholozani and its distribution in Israel","volume":"8","author":"Avivi A","year":"1973","unstructured":"Avivi A, , Warburg M, , Galun R. Ecological studies on the cave tick Ornithodoros tholozani and its distribution in Israel. Israel J Entomol, 1973; 8:109\u2013129.","journal-title":"Israel J Entomol"},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/MMBR.50.4.381-400.1986"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-009-0846-x"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2013.04.001"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cll.2015.07.001"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/516276"},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2008.03.006"},{"key":"e_1_3_6_10_1","volume-title":"Argasid ticks (Argasidae). Fauna SSSR: Paukoobraznye, Tom IV Vypusk 3","author":"Filippova NA","year":"1966","unstructured":"Filippova NA. 1966. Argasid ticks (Argasidae). Fauna SSSR: Paukoobraznye, Tom IV Vypusk 3. Book on Demand, India. 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Oxford University Press, Oxford, 2013; pp. 39\u201360."},{"key":"e_1_3_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa053884"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0065-308x(08)60563-1"},{"key":"e_1_3_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10493-010-9346-z"},{"key":"e_1_3_6_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.03117-20"},{"key":"e_1_3_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2006.03.030"},{"key":"e_1_3_6_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2013.1347"},{"issue":"10","key":"e_1_3_6_19_1","first-page":"2039","article-title":"Tick-borne relapsing fever","volume":"72","author":"Roscoe C","year":"2005","unstructured":"Roscoe C, , Epperly TED. Tick-borne relapsing fever. 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