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Background  Tick-borne diseases are common throughout Europe. Ticks transmit pathogens to the host while feeding and together with mosquitoes, they are major vectors of infectious agents worldwide. In recent years, there has been a marked increase in the incidence of tick-bite events and tick-borne disease in northwest Italy, but information on the prevalence of tick-borne pathogens in ticks removed from humans remains scarce. To fill this gap, we report here the prevalence of tick bites and tick-borne pathogens documented for humans in Piedmont, northwest Italy, in the 3-year period 2017–2019.    Methods  Ticks attached to humans during 2017–2019 were collected from residents of urban and rural area by physicians and veterinarians working with local veterinary agencies. All ticks ( n  = 1290) were morphologically identified to the species level. A subset of ticks removed from children (age 0–18 years) and the elderly (> 70 years), both age groups considered to be at-risk populations, was screened by biomolecular analysis to detect pathogens (e.g.  Rickettsia  spp.,  Borrelia  spp.,  Anaplasma  spp.). Pathogen identity was confirmed by Sanger sequencing.    Results  Ticks were taxonomically assigned to ten species of six genera ( Amblyomma ,  Dermacentor ,  Haemaphysalis ,  Hyalomma ,  Ixodes  and  Rhipicephalus ). Most belonged to the genus  Ixodes : 1009 ticks (78.22%) were classified as  Ixodes ricinus . A subset of 500 ticks collected from the two at-risk populations were subjected to PCR assay to determine the presence of  Rickettsia  spp.,  Borrelia  spp., and  Anaplasma  spp. The overall prevalence of infection was 22.8% ( n  = 114; 95% confidence interval [CI]: 19.19–26.73%), meaning that at least one pathogen was detected:  Rickettsia  spp. (prevalence 15%,  n  = 76; 95% CI 12.17–18.65%);  Borrelia  spp. (prevalence 6.4%,  n  = 32; 95% CI 4.42–8.92%); and  Anaplasma  spp. (prevalence 1.2%,  n  = 6; 95% CI 0.44–2.6%).    Conclusions  Our data underline the importance of surveillance in the epidemiology of tick-borne diseases and the implementation of strategies to control tick infestation and associated pathogens.

Ticks infesting humans and associated pathogens: a cross-sectional study in a 3-year period (2017–2019) in northwest Italy