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Diseased animals experienced fever, anorexia, agalactia, and depression. Anemia, ectoparasite infestation, and, occasionally, hemoglobinuria were observed. To determine the roles of vector-borne pathogens and to characterize the disease, blood samples were collected from all 286 animals: 50% of the cows were anemic. Upon microscopic examination of red blood cells,<jats:italic>Anaplasma marginale<\/jats:italic>inclusion bodies were found in 47% of the cows. The infection was confirmed serologically and by molecular methods. Interestingly, we also found evidence of infections with<jats:italic>Anaplasma phagocytophilum<\/jats:italic>, large<jats:italic>Babesia<\/jats:italic>and<jats:italic>Theileria<\/jats:italic>spp., and<jats:italic>Mycoplasma wenyonii<\/jats:italic>. The last two species had not previously been described in Switzerland. Anemia was significantly associated with the presence of the infectious agents detected, with the exception of<jats:italic>A. phagocytophilum<\/jats:italic>. Remarkably, concurrent infections with up to five infectious vector-borne agents were detected in 90% of the ill animals tested by PCR. We concluded that<jats:italic>A. marginale<\/jats:italic>was the major cause of the hemolytic anemia, while coinfections with other agents exacerbated the disease. This was the first severe disease outbreak associated with concurrent infections with vector-borne pathogens in alpine Switzerland; it was presumably curtailed by culling of the entire herd. It remains to be seen whether similar disease outbreaks will have to be anticipated in northern Europe in the future.<\/jats:p>","DOI":"10.1128\/jcm.42.8.3775-3780.2004","type":"journal-article","created":{"date-parts":[[2004,8,5]],"date-time":"2004-08-05T18:08:04Z","timestamp":1091729284000},"page":"3775-3780","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":124,"title":["Concurrent Infections with Vector-Borne Pathogens Associated with Fatal Hemolytic Anemia in a Cattle Herd in Switzerland"],"prefix":"10.1128","volume":"42","author":[{"given":"Regina","family":"Hofmann-Lehmann","sequence":"first","affiliation":[{"name":"Clinical Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina L.","family":"Meli","sequence":"additional","affiliation":[{"name":"Clinical Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute M.","family":"Dreher","sequence":"additional","affiliation":[{"name":"Clinical Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eniko\u0308","family":"Go\u0308nczi","sequence":"additional","affiliation":[{"name":"Clinical Laboratory"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Deplazes","sequence":"additional","affiliation":[{"name":"Institute of Parasitology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ueli","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Farm Animals"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Engels","sequence":"additional","affiliation":[{"name":"Institute of Virology, Vetsuisse Faculty, University of Zurich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u0308rg","family":"Schu\u0308pbach","sequence":"additional","affiliation":[{"name":"Swiss National Center for Retroviruses, Zurich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaspar","family":"Jo\u0308rger","sequence":"additional","affiliation":[{"name":"Veterinary Services, Canton of Grisons, Chur"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf","family":"Thoma","sequence":"additional","affiliation":[{"name":"Veterinary Services, Canton of Grisons, Chur"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Griot","sequence":"additional","affiliation":[{"name":"Institute of Virology and Immunoprophylaxis, Mittelha\u0308usern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina D. 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