Human Parvovirus 4 Viremia in Young Children, Ghana

nucleotide substitutions in position 198 (T→C) and in position 136 (A→G) of the 249-bp fragment. The remaining sample showed 100% identity with B. henselae strains Brazil-1 and 4500249 (GenBank accession nos. HQ012580 and GQ225709). Four of the 56 successfully sequenced samples (7.14%; all samples from nymphs) showed the sequence pattern of B. grahamii. One sample revealed 100% identity with B. grahamii (GenBank accession no. EU014266); the remaining 3 samples showed an identity of 98% with the B. grahamii strain Hokkaido-1 (GenBank accession no. AB426652) and 99% (T→C in position 93) with a sequence described as B. grahamii–like (GenBank accession no. AY435122). Sequences obtained in this study (deposited in GenBank under accession nos. JQ770304 and JK758018) support the genetic variability of Bartonella spp., as demonstrated by others (5,7,8). It remains unclear whether ticks are involved in transmission of pathogenic Bartonella spp. to humans under natural conditions. However, the total prevalence rate of 4.76% (100/2,100) questing I. ricinus ticks infected with B. henselae and B. grahamii highlights the need for public awareness and draws attention to the possibility of an infection with zoonotic Bartonella spp. after a tick bite (3,4). B. henselae, the predominantly identifi ed species, has been associated with cat scratch disease, peliosis hepatis, and bacillary angiomatosis in humans. Eskow et al. (3) also connected chronic symptoms of Lyme disease to co-infections with Borrelia burgdorferi and B. henselae. B. grahamii has been associated with neuroretinitis and ocular artery thrombosis in humans (9,10). The potential risk for zoonotic Bartonella spp. infection in urban recreation areas should not be underestimated. Elisabeth Janecek, Andreas Mietze, Ralph Goethe, Thomas Schnieder,1 and Christina Strube Author affi liation: University of Veterinary Medicine Hannover, Hanover, Germany