Vector Borne Disease
Lab Contact: ncstatevectorborne@ncsu.edu
Hours of Operation: 9am – 5pm Eastern Standard Time Monday through Friday
Update regarding BAPGM testing at the VBDDL
Beginning October 1st, 2024, our laboratory will be offering Bartonella BAPGM Enrichment Culture testing for veterinary patients. We are excited to offer this testing as a way to improve sensitivity and detection of Bartonella pathogens for our veterinary clients. Testing can be submitted on aseptically collected EDTA whole blood or body fluid samples (CSF, effusion,etc.) and will require a minimum sample volume of 2mLs. Bartonella testing will be performed by qPCR on the initial sample, and again after being placed in enrichment culture for 7, 14, and 21 days. Preliminary results will be reported as they become available, but the final turnaround time for this testing is 4-5 weeks. Please see our Laboratory Test Catalog and Laboratory Submission Form or reach out to us via email for further information.
We are happy to implement improved laboratory testing options to meet your needs and look forward to providing continued vector borne disease testing for you and your patients.
Have Fleas?
Please help our FleaNet:Flea-borne Disease Surveillance program by sending us any dead fleas that were attached to the animal whose blood samples you are submitting to the VBDDL.
Our Mission
The focus of the VBDDL at NCSU-CVM is research to benefit animal health. It is our intention to provide quality answers to diagnostic questions. The assays, antigens and controls used are developed and validated as a component of our research. We reserve the right to modify methods or reagents as needed to achieve the best analysis possible without reliance on any proprietary methods or reagents.
It is our intention to give each case with which we become involved the highest quality and attention possible. We will handle the sample with care and appropriate speed to obtain the most informative and accurate result. We intend to collect and utilize descriptive information imparted with that sample (zip code, age, breed, sex, history) in ways that reveal the useful and pertinent context for the diseases we study without using information in any way that might insult or harm the animal, owner, or veterinarian concerned.
All samples submitted to the VBDDL of sufficient volume are stored for potential future testing for a minimum of 2 years. Following completion of requested testing, ownership of the sample is transferred to the VBDDL and we reserve the right to use archived samples for research purposes, always respecting privacy rights of the contributing animal, owner and veterinarian.
Test Catalog & Submission Form
Frequently Asked Questions
How do I get preliminary results for my patient?
Our lab system accessions testing by test type. You will receive a separate report for each test (SNAP4DX, Serology, PCR, etc.). These reports will say “FINAL” at the bottom of each one. Results are sent out automatically via email by our laboratory system as they are finalized. Once the final results are put in, you will receive a full final report.
Our lab system is only able to have one email address listed per clinic. We strongly recommend that this email address is a shared hospital address rather than a particular doctor or staff member. We also recommend adding ncstatediagnosticlaboratories@ncsu.edu to your email contacts. This way emails are not automatically filtered into the SPAM or JUNK folders.
If you have taken these steps and are still not seeing your results come through, please reach out to us via email at ncstatevectorborne@ncsu.edu and let us know so that we can forward the information to our IT team and troubleshoot the issue.
How do I ship samples to your laboratory?
Samples can be shipped overnight via UPS or FedEX to:
NCSU/CVM, VBDDL, RM 462A
1060 William Moore Drive Raleigh, NC 27607
Phone #: 919-513-8279
We do not recommend shipping samples with a delivery date longer than two days from ship date. Samples cannot be shipped via priority mail or through the US Postal Service since there is a significant delay in package delivery to our location. Samples should be shipped with an icepack to keep samples cool. Samples must be properly labeled with the patient’s name and sample type and must have matching submission paperwork enclosed with the sample. If sending samples from multiple patients, it is advised that a packing list also be included with the shipment (indicating the patient names and specimen types of all samples in package). Submitted samples must always satisfy federal shipping regulations in the event of breakage/leakage, (i.e. wrap in absorbent towels or bubble wrap and place in sealed plastic bag within a Styrofoam or cardboard box). It is helpful to seal the tops of tubes with parafilm when packaging the sample to help decrease the chance of leakage during shipment.
Unfortunately, our laboratory does not have any special shipping promotions or pre-paid shipping labels available. If shipping samples to us from another country, please contact us via email so that we can further assist you in ensuring that you have importation permits from our lab.
Our laboratory is closed during the weekend. Any blood samples collected on Friday or Saturday can be held in the refrigerator and shipped on Monday. Samples may be stored in the refrigerator for up to two weeks (this is especially useful if trying to save on shipping costs by batching multiple samples in a single shipment). Our laboratory is closed on most federal holidays. North Carolina State University also has a mandatory closing for energy conservation during the winter holiday. Please check our website for details on our hours of operation.
How do I create an account?
Please send an email to our laboratory at ncstatevectorborne@ncsu.edu to request our External Client Account form. We would prefer to set up accounts in our laboratory system prior to receiving samples for patient testing.
Accounts can only be created for veterinary clients and cannot be created for owners as the results must be interpreted by a licensed veterinarian.
How do I pay my bill and/or inquire about invoices?
Invoices are sent out monthly and any billing correspondence will be sent to the clinic mailing address found on the submission form. Please do not send payment for testing with submission paperwork. Any billing questions can be directed to our Diagnostic Lab Accountant, Denise Crowell, at 919-513-6305 or dccrowel@ncsu.edu
What is the typical turn-around time for results?
We take special care in making sure that our testing is thorough and results are reported accurately. Our testing takes about 10 business days to complete from the date that the sample is received in our lab. Our turn-around time can also vary in cases where results need to be confirmed or repeated. Please contact us by email at ncstatevectorborne@ncsu.edu with any preliminary result inquiries.
What samples are required for testing?
We recommend sending EDTA-anticoagulated whole blood (lavender top tube) and serum (serum separating tube), red top tube, or tiger top tube) with each test submission. There is no cost associated with holding samples for potential additional add-on tests. We request that you send at least 2mL of each sample type, but tests can be run with as little as 0.5mL volume. The 0.5mL volume does not allow for samples to be banked for troubleshooting and/or repeated testing. Our serology IFA tests and the SNAP®4DX®Plus are run with serum and PCR tests are run with DNA extracted from EDTA whole blood. We recommend that both serum and EDTA whole blood be submitted regardless of which testing is requested. It is useful to have pre-treatment samples banked back for acute and convalescent pairing of serology tests and for testing of pre-antibiotic samples by PCR. Samples are banked back for at least two years and additional testing can be requested at any time.
What other sample types can be submitted?
Any sample type can be submitted for PCR testing. An additional charge of $75 must be added to cover the costs of the special handling required to extract DNA from fresh/frozen tissue or from formalin-fixed paraffin embedded samples. Fresh (frozen or refrigerated) tissues are the preferred sample type for non-blood submissions. Fresh tissue samples can be stored in an EDTA or no additive tube with sterile saline to prevent the tissue from drying out. Tissue samples stored in formalin solution are not recommended as prolonged exposure to formalin causes DNA crosslinking which can result in false negative PCR results. Vascular tissue samples such as spleen or liver are standard tissue types for PCR testing, but any type of tissue can be tested. We usually recommend testing tissues that are showing signs of pathology. Tissues can be pooled together and tested as a single sample or can be tested separately (please indicate on request form how you would like samples tested if sending multiple tissue types). Formalin-fixed or parafin embedded samples can be submitted by sending the whole tissue block or by sending pre-prepared scrolls (please send at least 10 scrolls if not sending a whole block).
Bone marrow aspirates are also commonly submitted samples for PCR testing and generally do not require a $75 tissue extraction fee. Please make sure to send sample in a lavender top tube and clearly indicate on the submission form and the sample tube that the sample is from bone marrow so it is not confused with EDTA whole blood.
Lymph node aspirates can be useful samples for diagnosing vector-borne pathogens by PCR. Testing lymph node tissue is can increase the sensitivity when submitting samples for Leishmania PCR testing. You may also add lymph node aspirates to a small volume of EDTA whole blood ( ≤ 0.5mL) to enrich the blood sample (there is no tissue processing fee for this sample). Other aspirate samples can be submitted on slides. Please make sure to send at least 3-4 slides and make sure they are appropriately labeled with the sample type/source. Slides are usually pooled together for testing to ensure that there is enough sample for DNA extraction.
When sending alternative sample types, it is recommended that the standard EDTA whole blood and serum samples be submitted as well for holding or additional testing.
Can icteric, hemolyzed, or lipemic serum samples be submitted?
All types of serum can be submitted for testing. Icterus, hemolysis, and /or lipemia should not interfere with IFA test results.
Can non-canine/feline species be tested?
Any species of animal can be tested by PCR methodology. IFA serology testing, however, can only be performed on canine or feline samples since our assays depend on reagents that are host species specific (see IFA interpretation below). Our first level of PCR testing is performed at a genus level and is usually broad enough to detect vector borne disease pathogens that may infect a wide variety of host species. If a novel/unusual pathogen is detected, the result is verified by additional testing and DNA sequencing. Please reach out to us via phone or email if there are any questions about specific pathogens that you would like to identify in a patient. We are unable to perform diagnostic testing on human samples. If in need of human testing, please contact Galaxy Diagnostics or other diagnostic laboratories approved to test human samples.
Can samples be tested after beginning treatment?
Appropriate antimicrobial administration should have minimal to no effect on acute and convalescent serology testing but may decrease the number of circulating organisms to levels below detection by PCR testing. Sample collection prior to antimicrobial treatments is ideal; however, PCR testing may still be useful even after antimicrobial therapy is started. Studies have shown that PCR tests do not immediately become negative after the initiation of antimicrobials. Furthermore, many antibiotics (that are not anti-rickettsial agents) are unlikely to affect vector-borne pathogens. Immunosuppressive therapy is not a contraindication for PCR or serology testing, Use of immunosuppressive therapy may increase the pathogen load in some patients, and its effect on antibody development in vector borne pathogen infections is unclear. Prior immunosuppressive therapy should not deter further vector-borne disease testing.
How should I interpret a positive IFA test?
Immunofluorescent antibody test (IFAT) detects and quantifies antibodies that cross react to whole-cell vector-borne pathogens. IFAT can be performed on animal serum, provided the fluorescent-labeled secondary antibody conjugate is specific for that animal’s antibodies (i.e. dog serum must be tested with canine-specific conjugate and cat serum must be tested with feline-specific conjugate). The VBDDL only performs IFATs on canine and feline serum samples. The VBDDL performs 2-fold serial dilutions (1:2, 1:4, 1:8, 1:16, etc.) of submitted serum samples. Individual diagnostic laboratories may perform different serial dilutions of the serum, and thus may establish different endpoint titers to indicate positive or negative results. Because of this, it is recommended to use the same diagnostic laboratory when comparing IFAT results. The VBDDL considers an end point titer of ≥1:64, positive for exposure.
IFAT is a serological diagnostic modality that can be used to identify exposure to or infection with vector-borne pathogens. Antibodies made in response to pathogens can take several weeks post-exposure to become detectable, thus serology is not appropriate for the diagnosis of most acute diseases. Comparison of antibody titers in serum collected from acute and convalescent time points can indicate an active infection. When comparing acute and convalescent antibody titers, a 4-fold increase (i.e. 2 dilutions if 2-fold serial dilutions were performed on the serum) in the convalescent titer indicates an active infection. Detection of antibodies at a single point in time may represent a past exposure or an active infection.
It is important to remember IFAT depends on a technician for microscopy and visual interpretation of IFAT antigen slides; thus, end-point titer decisions may vary by 1-2 dilutions, depending on visual interpretation difference between different technicians. This is a limitation of IFAT serology.
General Guidelines for Serology Interpretation
- Detects antibodies, not the pathogen so for many vector-borne disease, you may only be identifying a previous exposure or a cross-reaction with a similar organism.
- Not optimal for detecting acute infections (~2 weeks to mount and antibody response).
- A 4 fold or greater increase in titers measured ~2-4 weeks apart (acute and convalescent samples) indicate a recent active infection (optimal to test samples in parallel) example: 1:64 → 1:256 = 4 fold increase.
- In general, serology is not useful for discrimination of species or subspecies for most vector-borne pathogens.
- Duration of antibodies present after a vector-borne pathogen has been cleared varies.
How should I interpret a negative IFA test?
IFAT is a serological diagnostic modality that detects antibodies against vector-borne pathogens. A negative IFAT result (< 1:64) indicates antibodies were not detected against a specific pathogen. End-point titers of 1:16 and 1:32 are not considered positive due to high degree of non-specific reactivity that can occur when antibodies are highly concentrated. A negative IFAT could indicate the animal was not exposed to a particular vector-borne pathogen or antibodies have not yet been generated in response to infection. Antibodies made in response to pathogens can take several weeks post-exposure to become detectable. False negative results can generate negative titers. If you suspect a false results, please contact the VBDDL and we can perform repeat testing in many instances.
What if I have discordant SNAP®4DX®Plus and IFA results?
IFAT positive and SNAP®4DX®plus negative
- Titers may be below limit of SNAP4DXplus detection
- New species or strain of pathogen that cross reacts w/ whole cells in IFAT but not peptide in SNAP4DX
- IFA detects earlier Ab response (IgM)
- IFAT false (+) or SNAP®4DX®plus false (-)
IFAT negative and SNAP®4DX®plus positive
- Additional pathogens tested for on SNAP®4DX®plus but not IFAT (e.g. ewingii)
- Dog previously SNAP®4DX®plus (+) (dogs can remain SNAP+ for years)
- IFA false (-)/ SNAP®4DX®plus (+)
How should I interpret SNAP®4DX®Plus results in non-canine patients?
SNAP®4DX®plus test kit is designed to detect antibodies seroreactive to tick-borne diseases and uses a conjugate that is not species-specific (e.g. can bind to antibodies from other animals other than dogs); however, it is licensed only for use in dogs. Several studies report using feline and equine sera with SNAP®4DX®plus to detect seroreactivity to Anaplasma spp, Ehrlichia spp, and Borrelia burgdorferi peptides. Clinicians who choose to use serologic tests not licensed for use in a particular animals, should do so with the understanding that the sera may not consistently react with small peptides validated for canine seroreactivity, potentially generating inaccurate results.
How should I interpret a positive PCR test?
A positive PCR test indicates the presence of pathogen DNA in the clinical sample, which supports a recent or current infection. All positive PCRs are confirmed with either DNA sequence analysis and/or a second species-specific PCR. Occasionally we may report results as equivocal if we obtain a weak positive screening result and are unable to repeat or confirm the original positive PCR. In these cases, you will be provided with a free PCR test to use immediately or at a later date for retesting.
How should I interpret a negative PCR test?
PCR is a highly sensitive method for the detection of pathogen DNA; however, false-negative results may occur if pathogen is not in the specimen submitted for testing or if the pathogen load is below the limit of detection. The stage of infection can impact pathogen load. For example, vector-borne pathogen load is typically higher when sampled during the acute phase of an infection. Clinicians should not consider a negative diagnostic PCR result as conclusive evidence for the absence of an infection, but rather that the pathogen DNA was not detected in a particular sample at a particular point in time. Combining molecular and serologic modalities can improve the likelihood of obtaining a diagnosis.
How do I request a consult with a VBDDL clinician?
Our clinicians are available to consult on cases with veterinarians. To request a consult, please send us an email at ncstatevectorborne@ncsu.edu to request our online consult form. Our clinicians are not available to consult directly with owners regarding their pets.
What do I need to do if shipping wildlife/exotic samples?
For all international shippers shipping blood/serum samples from exotic animals (not cats or dogs) please check the CITES appendices (www.Cites.org/eng/app/appendices.php) for a list of species requiring export permits or special certificates.
Additional information about required permits (by country) can be found by reaching out to the contacts on the National CITES authorities list.(https://www.cites.org/cms/index.php/component/cp/)
An import permit is required for most all international shipments. This can be obtained by emailing us at ncstatevectorborne@ncsu.edu. Please make sure to include the species, specimen type, and a copy of your Export Permit or CITES Permit (if available) in the body of your email.
*It is important to note that sending DNA samples instead of blood, serum, or tissue specimens are the preferred for some countries and can be easier to ship
What happens to my patient’s samples after testing is completed?
All samples are stored for at least 2 years. Samples can be removed from long-term storage in the event that additional testing is needed during this time period. Add-on testing availability is dependent upon the sample volume requirements for each test and the amount of sample available in long-term storage. As a veterinary research laboratory we also reserve the right to use archived samples for research purposes, always respecting privacy rights of the contributing animal, owner and veterinarian.
How do I cancel testing?
All test cancellations must be submitted in writing via email to ncstatevectorborne@ncsu.edu within 2 business days of the sample being received in our laboratory. Testing that has already been completed or begun is unable to be canceled, and we will confirm with you via email what testing (if any) will be invoiced.
Why is the veterinarian incorrect on our results report?
Our new lab system requires a Veterinarian for every submission. If the veterinarian is left blank on the form, or if the full first and last name of the veterinarian is not provided, we will select a default veterinarian from the list to use instead. Please make sure that the first and last name are provided for every submission to avoid this issue.
Why are not all of the testing I ordered listed on the preliminary report?
Our new lab system creates an accession for each sample type. This means that when preliminary results are entered, it will only send out the preliminary results for that sample type. Please feel free to reach out to us via email if you would like to double check the order and make sure that all testing was entered correctly.
Where do I send a tick that I found to have it tested?
We recommend going to www.tickcheck.com for testing and identifying ticks after removal.
Which University holiday and closings will affect the VBDDL?
The VBDDL follows the NC State University guidelines on holiday and other closures. You can find a list of holiday closures at https://hr.ncsu.edu/common-tasks/university-holidays-and-closings/. We will also update our website, automatic email reply, and voicemail message to reflect any closures. These messages will provide information on when the lab will reopen and return to normal operations.
Research
Imagine an innovative, new discovery could span species and provide hope and healing not only to humans, but also cats, dogs, horses, and other mammals.
This dream is close to being realized through the combined research partnership of Infectious Disease Specialist Dr. Edward Breitschwert and Oncology Genetics Specialist Dr. Matthew Breen. Research is underway at N.C. State, but they need your help. If you (or your client) would like to make a tax-deductible donation (tax deductible) in support of our vector borne disease research, outbreak investigations and pro bono consultations provided by the NC State College of Veterinary Medicine faculty, click the button below.
Diagnostic services provided under by the Vector Borne Disease Diagnostic Laboratory are completely self-supported by revenue or donations to the Lab. All income derived from diagnostic testing is used to recover costs for reagents, equipment, supplies and for the salaries of the receptionist and technicians who process the specimens submitted for testing.
Over the years, we have supported a spectrum of outreach and educational opportunities using the revenues generated as a result of our diagnostic service offerings. As examples, students at all academic levels and from many national and international locations, have had the experience of working in a diagnostic laboratory or have participated in a focused research project related to vector borne infectious diseases of companion animals or wildlife species. We are proud of the fact that many of our undergraduate and graduate students have subsequently pursued careers in research or medicine (both human and veterinary medicine).
Your donation could lead patients and their families to a much awaited diagnosis and to receive the gift of health.
Ongoing Research Studies
Interactions with veterinarians throughout the world have led to Lab investigations of complicated cases involving single sick animal or disease outbreaks involving entire kennels. The Lab has frequently participated in these case-based or kennel outbreak studies without taking remuneration into consideration. Unfortunately, there is not a CDC or USDA equivalent for companion animal diseases; therefore there is no infrastructure or established source of funds to address unusual illnesses in pets.
Research Publications
- Rickettsia typhi infection in a clinically-ill dog from Houston, Texas; https://www.sciencedirect.com/science/article/pii/S2405939022000971
- Detection of Vector-Borne Infections in Lions and Tigers at Two Zoos in Tennessee and Oklahoma, USA;
https://bioone.org/journals/journal-of-zoo-and-wildlife-medicine/volume-53/issue-1/2020-0199/DETECTION-OF-VECTOR-BORNE-INFECTIONS-IN-LIONS-AND-TIGERS-AT/10.1638/2020-0199.short - Visceral leishmaniasis in a New York foxhound kennel https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2002.tb01604.x
- Serosurvey of anti-Babesia antibodies in stray dogs and American pit bull terriers and American staffordshire terriers from North Carolina https://www.researchgate.net/publication/8908189_Serosurvey_of_Anti_Babesia_Antibodies_in_Stray_Dogs_and_American_Pit_Bull_Terriers_and_American_Staffordshire_Terriers_From_North_Carolina
- Efficacy of combined atovaquone and azithromycin for therapy of chronic Babesia gibsoni (Asian genotype) infections in dogs. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2004.tb02573.x
- Efficacy of Atovaquone and Azithromycin or Imidocarb Dipropionate in Cats with Acute Cytauxzoonosis https://onlinelibrary.wiley.com/doi/full/10.1111/j.1939-1676.2010.0646.x
- Re-emergence of Babesia conradae and effective treatment of infected dogs with atovaquone and azithromycin https://www.sciencedirect.com/science/article/pii/S030440171200009X
- Infection with Panola Mountain Ehrlichia sp. in a dog with atypical lymphocytes and clonal T-Cell expansion https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.12148
- Regional Seroreactivity and Vector-Borne Disease Co-Exposures in Dogs in the United States from 2004–2010: Utility of Canine Surveillance https://www.liebertpub.com/doi/full/10.1089/vbz.2014.1592
- A serological survey of tick-borne pathogens in dogs in North America and the Caribbean as assessed by Anaplasma phagocytophilum, A. platys, Ehrlichia canis, E. chaffeensis, E. ewingii, and Borrelia burgdorferi species-specific peptides https://www.tandfonline.com/doi/full/10.3402/iee.v4.24699
- Serological and molecular analysis of feline vector-borne anaplasmosis and ehrlichiosis using species-specific peptides and PCR https://link.springer.com/article/10.1186/s13071-015-0929-8
- Improved molecular detection of Babesia infections in animals using a novel quantitative real-time PCR diagnostic assay targeting mitochondrial DNA https://link.springer.com/article/10.1186/s13071-017-2064-1
- Bartonella Seroepidemiology in Dogs from North America, 2008–2014 https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.14890
- Clinical, morphological, and molecular characterization of an undetermined Babesia species in a maned wolf (Chrysocyon brachyurus) https://www.sciencedirect.com/science/article/pii/S1877959X18300463
- Babesia gibsoni cytochrome b mutations in canine blood samples submitted to a US veterinary diagnostic laboratory https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15300
- Genetic conservation of Cytauxzoon felis antigens and mRNA expression in the schizont life-stage https://www.sciencedirect.com/science/article/pii/S0304401718303443
- Clinicopathological findings in 41 dogs (2008‐2018) naturally infected with Ehrlichia ewingii https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15354
- An update on the treatment of canine monocytic ehrlichiosis (Ehrlichia canis) https://www.sciencedirect.com/science/article/pii/S1090023318306488
- Feline Vector-Borne Diseases in North America https://www.vetsmall.theclinics.com/article/S0195-5616(19)30042-7/abstract
- Prevalence of Babesia spp. and clinical characteristics of Babesia vulpes infections in North American dogs https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15560
- Ecological and Socioeconomic Factors Associated with Bartonella henselae Exposure in Dogs Tested for Vector-Borne Diseases in North Carolina https://www.liebertpub.com/doi/full/10.1089/vbz.2018.2397
- Molecular identification of vector-borne organisms in Ehrlichia seropositive Nicaraguan horses and first report of Rickettsia felis infection in the horse https://www.sciencedirect.com/science/article/pii/S0001706X1930782X
- Babesia sp. infection in a zoo-housed polar bear (Ursus maritimus) https://www.sciencedirect.com/science/article/abs/pii/S2405939019302618#:~:text=A%2028%2Dyear%2Dold%20female,the%20bear%20was%20humanely%20euthanized.
- A retrospective study of vector‐borne disease prevalence in dogs with proteinuria: Southeastern United States https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15610
- Molecular prevalence of Bartonella, Babesia, and hemotropic Mycoplasma species in dogs with hemangiosarcoma from across the United States https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227234
- Bartonella rochalimae, a newly recognized pathogen in dogs https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15793
- Comparison of Anaplasma and Ehrlichia species – specific peptide ELISAs with whole organism-based immunofluorescent assays for serologic diagnosis of anaplasmosis and ehrlichiosis in dogs
- Novel Rickettsia Species Infecting Dogs, United States
- Molecular Characteristics of Rickettsia in Ticks Collected along the Southern Border of Mongolia
- Demographics and travel history of imported and autochthonous cases of leishmaniosis in dogs in the United States and Canada, 2006 to 2019