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<art>
   <ui>1751-0147-42-331</ui>
   <ji>1751-0147</ji>
   <fm>
      <dochead>Original article</dochead>
      <bibl>
         <title>
            <p>Serological Investigation of Granulocytic <it>Ehrlichia </it>Infection in Sheep in Norway</p>
         </title>
         <aug>
            <au id="A1" ca="yes">
               <snm>Stuen</snm>
               <fnm>S</fnm>
               <insr iid="I1"/>
            </au>
            <au id="A2">
               <snm>Bergstr&#246;m</snm>
               <fnm>K</fnm>
               <insr iid="I2"/>
            </au>
         </aug>
         <insg>
            <ins id="I1">
               <p>Norwegian School of Veterinary Science, Department of Sheep and Goat Research, Sandnes, Norway</p>
            </ins>
            <ins id="I2">
               <p>National Veterinary Institute, Department of Bacteriology, Uppsala, Sweden</p>
            </ins>
         </insg>
         <source>Acta Veterinaria Scandinavica</source>
         <issn>1751-0147</issn>
         <pubdate>2001</pubdate>
         <volume>42</volume>
         <issue>3</issue>
         <fpage>331</fpage>
         <lpage>338</lpage>
         <url>http://www.actavetscand.com/content/42/3/331</url>
         <xrefbib>
            <pubidlist>
               <pubid idtype="pmpid">11887393</pubid>
               <pubid idtype="doi">10.1186/1751-0147-42-331</pubid>
            </pubidlist>
         </xrefbib>
      </bibl>
      <history>
         <rec>
            <date>
               <day>27</day>
               <month>11</month>
               <year>1999</year>
            </date>
         </rec>
         <acc>
            <date>
               <day>14</day>
               <month>3</month>
               <year>2001</year>
            </date>
         </acc>
         <pub>
            <date>
               <day>30</day>
               <month>9</month>
               <year>2001</year>
            </date>
         </pub>
      </history>
      <kwdg>
         <kwd>Ehrlichia phagocytophila</kwd>
         <kwd>antibodies</kwd>
         <kwd>lambs</kwd>
         <kwd>seroprevalence.</kwd>
      </kwdg>
      <abs>
         <sec>
            <st>
               <p/>
            </st>
            <p>Serum samples of 749 sheep from 75 sheep flocks in Norway, i.e. 361 lambs (6 to 7 months old) and 388 adults (>1.5 year), were analysed for antibodies to <it>Ehrlichia equi</it>. Ten animals from each flock were examined. Seropositive animals were found along the coast of southern Norway from Vestfold to S&#248;r-Tr&#248;ndelag (as far north as 63&#176;38'N). Seropositive sheep were not found in southeast, east or northern Norway. Thirty-two flocks were seropositive, although tick-borne fever had only been diagnosed earlier in half of these. In 78% of the seropositive flocks, more than 80% of the sheep were seropositive. A total of 35.7 % and 36.3 % of lambs and adults were found seropositive, respectively. However, the overall seroprevalence among animals that had been grazing on <it>Ixodes </it>pastures were 0.80 for the lambs and 0.84 for the adults. Mean antibody titres (&#177; SD) (log<sub>10</sub>) in seropositive lambs and adults were 2.59 (&#177; 0.449) and 2.70 (&#177; 0.481), respectively. No significant differences in either seroprevalence or mean antibody titre between sheep of different ages were obtained in this study. Based on antibodies 94% of sheep flocks on <it>Ixodes </it>pastures were infected with a granulocytic <it>Ehrlichia </it>infection. The association between seropositive flocks and <it>Ixodes </it>infested pasture shows a very high degree of agreement (p &lt; 0.00001). The present study indicates that granulocytic <it>Ehrlichia </it>infection in sheep is underdiagnosed in Norway.</p>
         </sec>
      </abs>
   </fm>
   <bdy>
      <sec>
         <st>
            <p>Introduction</p>
         </st>
         <p>The most common tick-borne disease in domestic animals in Norway is tick-borne fever (TBF), caused by <it>Ehrlichia phagocytophila</it>, and transmitted by the tick <it>Ixodes ricinus </it><abbrgrp><abbr bid="B35">35</abbr><abbr bid="B27">27</abbr></abbrgrp>. TBF may cause abortion in ewes and temporary infertility in rams <abbrgrp><abbr bid="B34">34</abbr></abbrgrp>, but the main consequence of an <it>E. phagocytophila </it>infection in sheep is the ensuing immunosuppresion that leads to secondary infections, such as <it>Staphylococcus aureus </it>pyaemia and <it>Pasteurella hemolytica (trehalosi) </it>septicaemia <abbrgrp><abbr bid="B5">5</abbr><abbr bid="B26">26</abbr></abbrgrp>. In the UK, it has been estimated that more than 300 000 lambs develop tick pyaemia annually <abbrgrp><abbr bid="B5">5</abbr></abbrgrp>.</p>
         <p>TBF has for decades been considered as an important disease in lambs in certain areas along the coast of southern Norway <abbrgrp><abbr bid="B28">28</abbr></abbrgrp>. The purpose of the present study was to investigate the distribution of <it>E. phagocytophila </it>infection in sheep in different areas of Norway, especially in areas with a distribution of <it>I. ricinus</it>.</p>
      </sec>
      <sec>
         <st>
            <p>Materials and methods</p>
         </st>
         <p>Flocks from each county in Norway were included in this study, such that flocks in <it>Ixodes </it>areas along the coast and areas with a high number of winterfed sheep were preferred. However, representative flocks in each area were chosen and sampled by the local veterinarians.</p>
         <p>Serum samples from sheep flocks were obtained in October/November. Samples from 10 sheep were randomly collected in each herd, around half of the samples were from lambs (6 to 7-months-old). A questionaire was filled out by the veterinarian during the visit of each flock, including questions about ectoparasitic treatment, <it>Ixodes </it>infested pastures, earlier treatment against TBF, and occurrence of tick-associated infections. Four sheep flocks were chosen from each of the 18 counties in Norway, except from the county of S&#248;r-Tr&#248;ndelag, where 8 flocks were selected. The reason for this was that the northernmost observation of tick-borne fever so far has been in the county of S&#248;r-Tr&#248;ndelag <abbrgrp><abbr bid="B27">27</abbr></abbrgrp>.</p>
         <p>An indirect immunofluorescence antibody assay (IFA) was used to determine the antibody titre to <it>Ehrlichia equi </it><abbrgrp><abbr bid="B1">1</abbr></abbrgrp>. Two-fold dilutions of sera were added to slides precoated with <it>E. equi </it>antigen (Protatek International and Organon Teknika). Bound antibodies were visualized by fluorescein-isothiocyanate (FITC)-conjugated rabbit-anti-sheep immunoglobulin (Cappel, Organon Teknika). Sera were screened for antibodies at dilution 1:40. If positive, the serum was further diluted and retested. A titre of 1.6 (log<sub>10 </sub>reciprocal of 1:40) or more was regarded as positive.</p>
         <p>The statistical analysis was done according to <abbrgrp><abbr bid="B14">14</abbr></abbrgrp>. The overall seroprevalence and mean antibody titre were estimated and stratified by ectoparasitic treatment and age. Statistical calculations were done by using Statistix<sup>&#174;</sup>, version 4.0 (Analytical software). Statistical analyses on seroprevalence were performed using a chi-square test and the antibody titres were compared using a Students <it>t</it>-test for independent samples. Significance was set at p &lt; 0.05.</p>
      </sec>
      <sec>
         <st>
            <p>Results</p>
         </st>
         <p>Of a total of 749 sheep from 75 flocks, 71 flocks in 1996 and 4 flocks in 1997, 270 sheep (36%) were found positive for antibodies to granulocytic <it>Ehrlichia </it>infection. Seropositive flocks were found in the coastal areas from Vestfold to S&#248;r-Tr&#248;ndelag. The northernmost seropositive flocks were found south of Trondheimsfjorden on the island of Hitra (63&#176;38'N). The geographical distribution of the flocks is shown in Fig. <figr fid="F1">1</figr>. Thirty-two flocks were found positive, but only 16 of these had a history of previous TBF infection (Table <tblr tid="T1">1</tblr>). Symptoms of disease were not observed in any sampled animal.</p>
         <p>Clinical symptoms indicating a TBF infection, such as arthritis, polyarthritis and sudden death, were observed in only 6 flocks (8%); 4 of these had been prophylatically treated with insecticides. Twenty flocks were given prophylactic treatment against ticks with insecticides/repellents (mainly synthetical pyrethroids); lambs and adults were treated in 15 flocks, while only lambs were treated in 5 flocks.</p>
         <fig id="F1">
            <title>
               <p>Figure 1</p>
            </title>
            <caption>
               <p>Geographical distribution of sheep flocks examined for antibodies to <it>Ehrlichia equi </it>in Norway</p>
            </caption>
            <text>
               <p>Geographical distribution of sheep flocks examined for antibodies to <it>Ehrlichia equi </it>in Norway. A titre less than 1:40 was considered negative. &#9679;- seropositive flock, &#9675;- seronegative flock.</p>
            </text>
            <graphic file="1751-0147-42-331-1"/>
         </fig>
         <tbl id="T1">
            <title>
               <p>Table 1</p>
            </title>
            <caption>
               <p>Serological investigation of sheep sera for antibodies to <it>Ehrlichia equi </it>from different counties of Norway.</p>
            </caption>
            <tblbdy cols="5">
               <r>
                  <c ca="left">
                     <p>County</p>
                  </c>
                  <c ca="center">
                     <p>Number of positive flocks/total number of flocks</p>
                  </c>
                  <c ca="center">
                     <p>Number of flocks on tick pasture</p>
                  </c>
                  <c ca="center">
                     <p>Number of flocks treated against ticks</p>
                  </c>
                  <c ca="center">
                     <p>Number of flocks with a history of tick-borne fever (during the year of sampling)</p>
                  </c>
               </r>
               <r>
                  <c cspan="5">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Akershus #</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Aust-Agder</p>
                  </c>
                  <c ca="right">
                     <p>4/4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>3</p>
                  </c>
                  <c ca="right">
                     <p>2(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Buskerud #</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Finnmark #</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Hedmark #</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Hordaland</p>
                  </c>
                  <c ca="right">
                     <p>4/4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>3</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>M&#248;re og Romsdal</p>
                  </c>
                  <c ca="right">
                     <p>4/4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>1</p>
                  </c>
                  <c ca="right">
                     <p>4(2)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Nordland</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Nord-Tr&#248;ndelag</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Oppland #</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Rogaland</p>
                  </c>
                  <c ca="right">
                     <p>3*/4</p>
                  </c>
                  <c ca="right">
                     <p>3</p>
                  </c>
                  <c ca="right">
                     <p>2</p>
                  </c>
                  <c ca="right">
                     <p>2(1)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Sogn og Fjordane</p>
                  </c>
                  <c ca="right">
                     <p>4/4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>2</p>
                  </c>
                  <c ca="right">
                     <p>4(1)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>S&#248;r-Tr&#248;ndelag</p>
                  </c>
                  <c ca="right">
                     <p>3/8</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>2</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Telemark</p>
                  </c>
                  <c ca="right">
                     <p>4/4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>2</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Troms #</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Vest-Agder</p>
                  </c>
                  <c ca="right">
                     <p>4/4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>4(2)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Vestfold</p>
                  </c>
                  <c ca="right">
                     <p>2*/3</p>
                  </c>
                  <c ca="right">
                     <p>3</p>
                  </c>
                  <c ca="right">
                     <p>1</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>&#216;stfold</p>
                  </c>
                  <c ca="right">
                     <p>0/4</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Total</p>
                  </c>
                  <c ca="right">
                     <p>32/75</p>
                  </c>
                  <c ca="right">
                     <p>34</p>
                  </c>
                  <c ca="right">
                     <p>20</p>
                  </c>
                  <c ca="right">
                     <p>16(6)</p>
                  </c>
               </r>
            </tblbdy>
            <tblfn>
               <p># No known occurrence of <it>I. ricinus</it></p>
               <p>* Only one seropositive lamb in one flock</p>
            </tblfn>
         </tbl>
         <p>In 78% of the seropositive flocks, more than 80% of the sheep were seropositive and in 91% of the flocks, more than half of the animals were seropositive (Table <tblr tid="T2">2</tblr>).</p>
         <tbl id="T2">
            <title>
               <p>Table 2</p>
            </title>
            <caption>
               <p>Distribution of <it>E. equi </it>antibodies in seropositive sheep flocks in Norway. Ten animals were investigated in each flock.</p>
            </caption>
            <tblbdy cols="3">
               <r>
                  <c ca="center">
                     <p>Percentage of seropositive animals</p>
                  </c>
                  <c cspan="2" ca="center">
                     <p>Seropositive flocks</p>
                  </c>
               </r>
               <r>
                  <c>
                     <p/>
                  </c>
                  <c cspan="2">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c>
                     <p/>
                  </c>
                  <c ca="center">
                     <p>Numbers</p>
                  </c>
                  <c ca="center">
                     <p>(%)</p>
                  </c>
               </r>
               <r>
                  <c ca="center">
                     <p>100</p>
                  </c>
                  <c ca="right">
                     <p>18</p>
                  </c>
                  <c ca="right">
                     <p>(56)</p>
                  </c>
               </r>
               <r>
                  <c ca="center">
                     <p>80&#8211;99</p>
                  </c>
                  <c ca="right">
                     <p>7</p>
                  </c>
                  <c ca="right">
                     <p>(22)</p>
                  </c>
               </r>
               <r>
                  <c ca="center">
                     <p>50&#8211;79</p>
                  </c>
                  <c ca="right">
                     <p>4</p>
                  </c>
                  <c ca="right">
                     <p>(13)</p>
                  </c>
               </r>
               <r>
                  <c ca="center">
                     <p>31&#8211;49</p>
                  </c>
                  <c ca="right">
                     <p>1</p>
                  </c>
                  <c ca="right">
                     <p>(3)</p>
                  </c>
               </r>
               <r>
                  <c ca="center">
                     <p>&lt;30</p>
                  </c>
                  <c ca="right">
                     <p>2*</p>
                  </c>
                  <c ca="right">
                     <p>(6)</p>
                  </c>
               </r>
            </tblbdy>
            <tblfn>
               <p>* Only one seropositive lamb in each flock</p>
            </tblfn>
         </tbl>
         <p>The antibody titres in 361 lambs and 388 adults (>1.5 years) were recorded. A total of 129 of the lambs (35.7%) and 141 of the adults (36.3%) were found seropositive (Table <tblr tid="T3">3</tblr>). However, among animals that had been grazing on tick infested pasture, 79.6% and 83.9% of lambs and adults were found seropositive, respectively. Significant difference in seroprevalence between animals of different ages was not found (Table <tblr tid="T4">4</tblr>).</p>
         <tbl id="T3">
            <title>
               <p>Table 3</p>
            </title>
            <caption>
               <p>Reciprocal antibody titres against <it>E. equi </it>in 361 lambs and 388 adult sheep (>1.5 years) in Norway.</p>
            </caption>
            <tblbdy cols="5">
               <r>
                  <c ca="left">
                     <p>Titre values</p>
                  </c>
                  <c ca="center">
                     <p>Number of lambs</p>
                  </c>
                  <c ca="center">
                     <p>Number of adults</p>
                  </c>
                  <c ca="center">
                     <p>Total</p>
                  </c>
                  <c ca="center">
                     <p>(%)</p>
                  </c>
               </r>
               <r>
                  <c cspan="5">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>&lt;40</p>
                  </c>
                  <c ca="right">
                     <p>232</p>
                  </c>
                  <c ca="right">
                     <p>247</p>
                  </c>
                  <c ca="right">
                     <p>479</p>
                  </c>
                  <c ca="right">
                     <p>(64)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>40</p>
                  </c>
                  <c ca="right">
                     <p>5</p>
                  </c>
                  <c ca="right">
                     <p>5</p>
                  </c>
                  <c ca="right">
                     <p>10</p>
                  </c>
                  <c ca="right">
                     <p>(1)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>80</p>
                  </c>
                  <c ca="right">
                     <p>11</p>
                  </c>
                  <c ca="right">
                     <p>10</p>
                  </c>
                  <c ca="right">
                     <p>21</p>
                  </c>
                  <c ca="right">
                     <p>(3)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>160</p>
                  </c>
                  <c ca="right">
                     <p>18</p>
                  </c>
                  <c ca="right">
                     <p>21</p>
                  </c>
                  <c ca="right">
                     <p>39</p>
                  </c>
                  <c ca="right">
                     <p>(5)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>320</p>
                  </c>
                  <c ca="right">
                     <p>36</p>
                  </c>
                  <c ca="right">
                     <p>36</p>
                  </c>
                  <c ca="right">
                     <p>72</p>
                  </c>
                  <c ca="right">
                     <p>(10)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>640</p>
                  </c>
                  <c ca="right">
                     <p>37</p>
                  </c>
                  <c ca="right">
                     <p>33</p>
                  </c>
                  <c ca="right">
                     <p>70</p>
                  </c>
                  <c ca="right">
                     <p>(9)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>1280</p>
                  </c>
                  <c ca="right">
                     <p>12</p>
                  </c>
                  <c ca="right">
                     <p>23</p>
                  </c>
                  <c ca="right">
                     <p>35</p>
                  </c>
                  <c ca="right">
                     <p>(5)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>2560</p>
                  </c>
                  <c ca="right">
                     <p>8</p>
                  </c>
                  <c ca="right">
                     <p>7</p>
                  </c>
                  <c ca="right">
                     <p>15</p>
                  </c>
                  <c ca="right">
                     <p>(2)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>5120</p>
                  </c>
                  <c ca="right">
                     <p>2</p>
                  </c>
                  <c ca="right">
                     <p>5</p>
                  </c>
                  <c ca="right">
                     <p>7</p>
                  </c>
                  <c ca="right">
                     <p>(1)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>10240</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>(0)</p>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>20480</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>1#</p>
                  </c>
                  <c ca="right">
                     <p>1</p>
                  </c>
                  <c ca="right">
                     <p>(0)</p>
                  </c>
               </r>
               <r>
                  <c cspan="5">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c ca="right">
                     <p>Total</p>
                  </c>
                  <c ca="right">
                     <p>361</p>
                  </c>
                  <c ca="right">
                     <p>388</p>
                  </c>
                  <c ca="right">
                     <p>749</p>
                  </c>
                  <c ca="right">
                     <p>(100)</p>
                  </c>
               </r>
            </tblbdy>
            <tblfn>
               <p># The highest titre recorded was in a 3.5-year-old sheep.</p>
            </tblfn>
         </tbl>
         <tbl id="T4">
            <title>
               <p>Table 4</p>
            </title>
            <caption>
               <p>Seroprevalence and mean antibody titres (log<sub>10 </sub>&#177; SD) to granulocytic <it>Ehrlichia </it>in sheep of different ages that had been grazing on <it>Ixodes </it>pastures.</p>
            </caption>
            <tblbdy cols="4">
               <r>
                  <c ca="left">
                     <p>Age</p>
                  </c>
                  <c ca="center">
                     <p>Seroprevalence</p>
                  </c>
                  <c ca="center">
                     <p>Mean titre values*</p>
                  </c>
                  <c ca="center">
                     <p>Number</p>
                  </c>
               </r>
               <r>
                  <c cspan="4">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>&lt;1 year</p>
                  </c>
                  <c ca="center">
                     <p>0.80</p>
                  </c>
                  <c ca="center">
                     <p>2.59 &#177; 0.449</p>
                  </c>
                  <c ca="center">
                     <p>129</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>1.5 years</p>
                  </c>
                  <c ca="center">
                     <p>0.82</p>
                  </c>
                  <c ca="center">
                     <p>2.59 &#177; 0.418</p>
                  </c>
                  <c ca="center">
                     <p>37</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>2.5 years</p>
                  </c>
                  <c ca="center">
                     <p>0.85</p>
                  </c>
                  <c ca="center">
                     <p>2.68 &#177; 0.387</p>
                  </c>
                  <c ca="center">
                     <p>22</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>>3 years</p>
                  </c>
                  <c ca="center">
                     <p>0.84</p>
                  </c>
                  <c ca="center">
                     <p>2.79 &#177; 0.527</p>
                  </c>
                  <c ca="center">
                     <p>82</p>
                  </c>
               </r>
            </tblbdy>
            <tblfn>
               <p>* Only positive sera included</p>
            </tblfn>
         </tbl>
         <p>Mean antibody titre (log<sub>10 </sub>&#177; SD) in seropositive lambs and adults were 2.59 &#177; 0.449 and 2.70 &#177; 0.481, respectively. However, no significant differences in mean antibody titres between different age groups of seropositive animals were observed (Table <tblr tid="T4">4</tblr>).</p>
         <p>In addition, no significant differences in either seroprevalence or mean antibody titre values were found between flocks treated or not treated with insecticides/repellents (data not shown). The present investigation indicates that 94% of sheep flocks on <it>Ixodes </it>pastures were infected with a granulocytic <it>Ehrlichia </it>infection. The association between seropositive flocks and <it>Ixodes </it>infested pasture shows a very high degree of agreement (p &lt; 0.00001) (Table <tblr tid="T5">5</tblr>).</p>
         <tbl id="T5">
            <title>
               <p>Table 5</p>
            </title>
            <caption>
               <p>Comparison of <it>E. equi </it>serology and tick pasture in relation to the number of seropositive sheep flocks in Norway.</p>
            </caption>
            <tblbdy cols="4">
               <r>
                  <c ca="left">
                     <p>Pasture</p>
                  </c>
                  <c ca="center">
                     <p>Seropositive flocks</p>
                  </c>
                  <c ca="center">
                     <p>Seronegative flocks</p>
                  </c>
                  <c ca="center">
                     <p>Total</p>
                  </c>
               </r>
               <r>
                  <c cspan="4">
                     <hr/>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p><it>Ixodes</it>-infested</p>
                  </c>
                  <c ca="right">
                     <p>32</p>
                  </c>
                  <c ca="right">
                     <p>2 *</p>
                  </c>
                  <c ca="right">
                     <p>34</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p><it>Ixodes</it>-free</p>
                  </c>
                  <c ca="right">
                     <p>0</p>
                  </c>
                  <c ca="right">
                     <p>41</p>
                  </c>
                  <c ca="right">
                     <p>41</p>
                  </c>
               </r>
               <r>
                  <c ca="left">
                     <p>Total</p>
                  </c>
                  <c ca="right">
                     <p>32</p>
                  </c>
                  <c ca="right">
                     <p>43</p>
                  </c>
                  <c ca="right">
                     <p>75</p>
                  </c>
               </r>
            </tblbdy>
            <tblfn>
               <p>Yates corrected &#967;<sup>2 </sup>= 63.51 (p &lt; 0.00001)</p>
               <p>* Both flocks were grazing on pasture with an unknown distribution of <it>I. ricinus; </it>one flock had been prophylactically treated with synthetic pyrethroids</p>
            </tblfn>
         </tbl>
      </sec>
      <sec>
         <st>
            <p>Discussion</p>
         </st>
         <p>Strong serological cross-reactions between <it>E. equi, E. phagocytophila </it>and the agent causing human granulocytic ehrlichiosis (HGE) have been reported <abbrgrp><abbr bid="B8">8</abbr><abbr bid="B19">19</abbr><abbr bid="B23">23</abbr></abbrgrp>. It is therefore possible to use any of the 3 closely related <it>Ehrlichia </it>antigens to get acceptable results in serosurveys. The titre to a heterologous strain of <it>Ehrlichia </it>is normally less than against the homologous strain, but the IgG titres may also differ noticeably depending on the source of the antigen <abbrgrp><abbr bid="B4">4</abbr><abbr bid="B33">33</abbr></abbrgrp>. The sensitivity of the present test could perhaps have been increased by use of a more proper antigen, but unfortunately <it>E. phagocytophila </it>was not available for use as antigen in this study.</p>
         <p>All blood samples were collected in October/November. Earlier investigations indicate that the antibody titres can be detected for at least 6 months in sheep after the primary infection <abbrgrp><abbr bid="B22">22</abbr></abbrgrp>, also when <it>E. equi </it>was used as antigen in the serological test <abbrgrp><abbr bid="B28">28</abbr></abbrgrp>. In humans, serological titres may last for at least 30 months after an acute HGE infection <abbrgrp><abbr bid="B3">3</abbr></abbrgrp>. In horses, serological investigations indicate that a positive antibody titre to <it>E. equi </it>could persist for more than 12 months in naturally infected horses <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>. The persistence of <it>Ehrlichia </it>antibodies therefore indicates that animals infected during the grazing season would be found seropositive the following autumn and winter.</p>
         <p>The present study shows that granulocytic <it>Ehrlichia </it>infected sheep are found on the coast of southern Norway from Vestfold to S&#248;r-Tr&#248;ndelag (as far north as 63&#176;38'N). No antibodies to granulocytic <it>Ehrlichia </it>were found on the southeast, east or northern parts of Norway. The distribution of seropositive animals in this study is in accordance with the distribution of <it>I. ricinus </it>in Norway, although scattered populations of <it>I. ricinus </it>have been found as far north as Br&#248;nn&#248;ysund (65&#176;30'N) <abbrgrp><abbr bid="B16">16</abbr></abbrgrp>.</p>
         <p>The present results are also in accordance with earlier reports on the distribution of clinical cases of TBF in domestic animals <abbrgrp><abbr bid="B27">27</abbr></abbrgrp>. In addition, in June 1997, cattle was found infected with <it>E. phagocytophila </it>for the first time in Stadsbygd (north of Trondheimsfjorden-63&#176;32'N), in an area where <it>Babesia divergens </it>in cattle is common (<it>Schei</it>, personal communication). The present study indicates that the area around Trondheimsfjorden is so far the northernmost limit of <it>Ehrlichia </it>infections in domestic animals in Norway.</p>
         <p>In comparison, babesiosis in cattle in Norway has been observed as far north as in Nordland county (65&#176;47'N) <abbrgrp><abbr bid="B27">27</abbr></abbrgrp>. This difference in northern distribution between babesiosis in cattle and ehrlichiosis in sheep, may be due to differences in the maintenance of the respective infections in hosts or vectors. Sheep, wild deer and small rodents have been proposed as reservoir hosts for granulocytic <it>Ehrlichia </it>infection in Europe <abbrgrp><abbr bid="B20">20</abbr><abbr bid="B6">6</abbr></abbrgrp>, while <it>B. divergens </it>is regarded to be rather host specific <abbrgrp><abbr bid="B10">10</abbr></abbrgrp>. Both <it>B. divergens </it>and <it>E. phagocytophila </it>may cause persistent infection in cattle and sheep, respectively <abbrgrp><abbr bid="B13">13</abbr><abbr bid="B9">9</abbr><abbr bid="B28">28</abbr></abbrgrp>, so both infections could be brought from endemic areas by both ticks or hosts. Both microorganisms are transmitted by <it>I. ricinus</it>, the only tick in Norway known to transmit infections to animals <abbrgrp><abbr bid="B17">17</abbr></abbrgrp>. <it>E. phagocytophila </it>is transmitted transstadially in <it>I. ricinus</it>, and ovarial transmission has not yet been observed <abbrgrp><abbr bid="B15">15</abbr><abbr bid="B21">21</abbr></abbrgrp>. In contrast, <it>B. divergens </it>infection could persist in <it>I. ricinus </it>for at least 2 generations even in the abscence of cattle <abbrgrp><abbr bid="B7">7</abbr><abbr bid="B10">10</abbr></abbrgrp>. These observations might indicate a greater chance for maintenance of a <it>B. divergens </it>infection than a granulocytic <it>Ehrlichia </it>infection in <it>I. ricinus </it>populations in areas where competent hosts are sparsely scattered, as along the coast of northern Norway.</p>
         <p>In the present study, 32 out of 34 flocks that grazed on tick infested pastures were infected with granulocytic <it>Ehrlichia</it>. The association between seropositive flocks and <it>Ixodes </it>infested pastures indicates a high degree of agreement. In 78% of the seropositive flocks, more than 80% of the sheep were seropositive. These results indicate a widespread <it>Ehrlichia </it>infection in areas where <it>I. ricinus </it>populations are present. Observations done in UK indicate a nearly 100% probability that a susceptible sheep will acquire granulocytic <it>Ehrlichia </it>infection on tick infested pasture <abbrgrp><abbr bid="B20">20</abbr></abbrgrp>. Earlier investigations indicate that the prevalence of granulocytic <it>Ehrlichia </it>infection in populations of <it>I. ricinus </it>varies between different countries <abbrgrp><abbr bid="B6">6</abbr></abbrgrp>. However, no information on the prevalence of <it>Ehrlichia </it>infection in <it>I. ricinus </it>populations in Norway is available.</p>
         <p>No significant differences in antibody titres between different age groups of sheep were observed in this study. The titre values are in accordance with <it>E. equi </it>titres, found in experimentally <it>E. phagocytophila </it>infected lambs, 2 months after the initial infection <abbrgrp><abbr bid="B28">28</abbr></abbrgrp>.</p>
         <p>No effect of acaricide treatment was observed on the prevalence of infection or the titre values in <it>Ehrlichia </it>infected sheep. Most lambs/sheep were treated only once with acaricides on tick pastures. Earlier observations indicate that synthetical pyrethroids only give 2 to 3 weeks of full protection against ticks <abbrgrp><abbr bid="B18">18</abbr><abbr bid="B12">12</abbr></abbrgrp>. In addition, lambs grazing on tick pastures may seroconvert to <it>E. phagocytophila </it>after 3 weeks of tick exposure, although synthetical pyrethroids have been applied <abbrgrp><abbr bid="B11">11</abbr></abbrgrp>.</p>
         <p>Only half of the seropositive flocks had a known history of TBF, indicating that granulocytic <it>Ehrlichia </it>infection is underdiagnosed in sheep flocks on tick infested pastures in Norway. This statement is supported by the fact that only 20 of 32 seropositive flocks (62.5%) had been treated prophylatically against TBF. Disease problems associated with tick infested pasture were only recorded in 6 flocks during the year of sampling; 4 of these had been treated with synthetical pyrethroids. These results indicate that some strains of granulocytic <it>Ehrlichia </it>may have low virulence in sheep, as observed earlier by <abbrgrp><abbr bid="B9">9</abbr><abbr bid="B32">32</abbr><abbr bid="B25">25</abbr><abbr bid="B28">28</abbr></abbrgrp>. <abbrgrp><abbr bid="B9">9</abbr></abbrgrp> and <abbrgrp><abbr bid="B32">32</abbr></abbrgrp> also observed that isolates of <it>E. phagocytophila </it>from cattle and sheep in different geographic areas of infection may vary considerably with regard to their ability to cross-protect. Antigenic diversity has also been observed in isolates of the HGE agent <abbrgrp><abbr bid="B2">2</abbr></abbrgrp>.</p>
         <p>Mild or subclinical <it>E. phagocytophila </it>infection may also be due to breed variations in susceptibility to a TBF infection, as has earlier been reported in sheep <abbrgrp><abbr bid="B24">24</abbr></abbrgrp>. However, to the authors knowledge, no such breed differences have been observed in Norwegian sheep breeds. Few recorded disease problems may also indicate a recent introduction of TBF in the flock, since most primary infections of TBF in the field are not observed due to unobtrusive clinical signs <abbrgrp><abbr bid="B24">24</abbr></abbrgrp>. The main disease problems associated with TBF are seen in lambs, and in sheep purchased from tick-free areas and put onto tick infested pastures.</p>
         <p>In conclusion, the present results indicate that granulocytic <it>Ehrlichia </it>infection is abundant on tick infested pastures in Norway. The total sheep population in Norway during summer time is around 2.4 million, and the average flock size is approximately 100 sheep <abbrgrp><abbr bid="B31">31</abbr></abbrgrp>. In 1996, more than 5100 flocks were treated prophylatically against TBF with tick repellents/insecticides (Norwegian Animal Disease Report 1996). However, in the present investigation only around 60% of the seropositive flocks had been prophylatically treated against tick infestation; all animals were treated in 75% of these flocks. These results indicate that more than 850 000 sheep in Norway are grazing on <it>I. ricinus </it>infested pastures and may be exposed to infection with <it>E. phagocytophila</it>. It is therefore probable that TBF infection in sheep may have a wider distribution in Norway than earlier believed.</p>
      </sec>
   </bdy>
   <bm>
      <ack>
         <sec>
            <st>
               <p>Acknowledgements</p>
            </st>
            <p>The authors wish to thank all local veterinarians participating in this study by collecting blood samples, and Pfizer AS and the Norwegian Research Council for economic support of the study. We also want to thank Ulla-Britt Wikstr&#248;m for excellent technical assistance.</p>
         </sec>
      </ack>
      <refgrp>
         <bibl id="B1">
            <title>
               <p>A serological and clinical follow-up in horses with confirmed equine granulocytic ehrlichiosis</p>
            </title>
            <aug>
               <au>
                  <snm>Artursson</snm>
                  <fnm>K</fnm>
               </au>
               <au>
                  <snm>Gunnarsson</snm>
                  <fnm>A</fnm>
               </au>
               <au>
                  <snm>Wikstr&#246;m</snm>
                  <fnm>U-B</fnm>
               </au>
               <au>
                  <snm>Olsson Engvall</snm>
                  <fnm>E</fnm>
               </au>
            </aug>
            <source>Equine Vet J</source>
            <pubdate>1999</pubdate>
            <volume>31</volume>
            <fpage>473</fpage>
            <lpage>477</lpage>
            <xrefbib>
               <pubid idtype="pmpid">10596927</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B2">
            <title>
               <p>Antigenic diversity of granulocytic <it>Ehrlichia </it>isolates from humans in Wisconsin and New York and a horse in California</p>
            </title>
            <aug>
               <au>
                  <snm>Asanovich</snm>
                  <fnm>KM</fnm>
               </au>
               <au>
                  <snm>Bakken</snm>
                  <fnm>JS</fnm>
               </au>
               <au>
                  <snm>Madigan</snm>
                  <fnm>JE</fnm>
               </au>
               <au>
                  <snm>Aguero-Rosenfeld</snm>
                  <fnm>M</fnm>
               </au>
               <au>
                  <snm>Wormser</snm>
                  <fnm>GP</fnm>
               </au>
               <au>
                  <snm>Dumler</snm>
                  <fnm>JS</fnm>
               </au>
            </aug>
            <source>J infect Dis</source>
            <pubdate>1997</pubdate>
            <volume>176</volume>
            <fpage>1029</fpage>
            <lpage>1034</lpage>
            <xrefbib>
               <pubid idtype="pmpid">9333162</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B3">
            <title>
               <p>Duration of IFA serologic response in human infected with the agent of human granulocytic ehrlichiosis (HGE). Abstract of the IDSA 35th Annual meeting</p>
            </title>
            <aug>
               <au>
                  <snm>Bakken</snm>
                  <fnm>JS</fnm>
               </au>
               <au>
                  <snm>Krueth</snm>
                  <fnm>J</fnm>
               </au>
               <au>
                  <snm>Tilden</snm>
                  <fnm>RL</fnm>
               </au>
               <au>
                  <snm>Asanovich</snm>
                  <fnm>MN</fnm>
               </au>
               <au>
                  <snm>Asanovich</snm>
                  <fnm>K</fnm>
               </au>
               <au>
                  <snm>Walls</snm>
                  <fnm>J</fnm>
               </au>
               <au>
                  <snm>Dumler</snm>
                  <fnm>JS</fnm>
               </au>
            </aug>
            <source>Reviews of infectious diseases</source>
            <pubdate>1997</pubdate>
            <volume>25</volume>
            <note>abst 73</note>
         </bibl>
         <bibl id="B4">
            <title>
               <p>Serological evidence of <it>Ehrlichia </it>infection in Swedish Lyme borreliosis patients</p>
            </title>
            <aug>
               <au>
                  <snm>Bjoersdorff</snm>
                  <fnm>A</fnm>
               </au>
               <au>
                  <snm>Brouqui</snm>
                  <fnm>P</fnm>
               </au>
               <au>
                  <snm>Eliasson</snm>
                  <fnm>I</fnm>
               </au>
               <au>
                  <snm>Massung</snm>
                  <fnm>RF</fnm>
               </au>
               <au>
                  <snm>Wittesj&#246;</snm>
                  <fnm>B</fnm>
               </au>
               <au>
                  <snm>Berglund</snm>
                  <fnm>J</fnm>
               </au>
            </aug>
            <source>Scand J infect Dis</source>
            <pubdate>1999</pubdate>
            <volume>31</volume>
            <fpage>51</fpage>
            <lpage>55</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="doi">10.1080/00365549950161880</pubid>
                  <pubid idtype="pmpid">10381218</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B5">
            <title>
               <p>Some aspects of tick-borne diseases of British sheep</p>
            </title>
            <aug>
               <au>
                  <snm>Brodie</snm>
                  <fnm>TA</fnm>
               </au>
               <au>
                  <snm>Holmes</snm>
                  <fnm>PH</fnm>
               </au>
               <au>
                  <snm>Urquhart</snm>
                  <fnm>GM</fnm>
               </au>
            </aug>
            <source>Vet Rec</source>
            <pubdate>1986</pubdate>
            <volume>118</volume>
            <fpage>415</fpage>
            <lpage>18</lpage>
            <xrefbib>
               <pubid idtype="pmpid">3754669</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B6">
            <title>
               <p>Ehrlichiosis in Europe</p>
            </title>
            <aug>
               <au>
                  <snm>Brouqui</snm>
                  <fnm>P</fnm>
               </au>
            </aug>
            <source>Rickettsiae and rickettsial diseases at the turn of the third millenium, Elsevier, Paris</source>
            <editor>Raoult D, Brouqui P</editor>
            <pubdate>1999</pubdate>
            <fpage>220</fpage>
            <lpage>232</lpage>
         </bibl>
         <bibl id="B7">
            <title>
               <p>Experimental transmission of <it>Babesia divergens </it>to cattle by the tick <it>Ixodes ricinus</it></p>
            </title>
            <aug>
               <au>
                  <snm>Donnelly</snm>
                  <fnm>J</fnm>
               </au>
               <au>
                  <snm>Pierce</snm>
                  <fnm>MA</fnm>
               </au>
            </aug>
            <source>Int J Parasitol</source>
            <pubdate>1975</pubdate>
            <volume>5</volume>
            <fpage>363</fpage>
            <lpage>367</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="doi">10.1016/0020-7519(75)90085-5</pubid>
                  <pubid idtype="pmpid" link="fulltext">1126789</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B8">
            <title>
               <p>Serologic cross-reactions among <it>Ehrlichia equi, Ehrlichia phagocytophila</it>, and human granulocytic ehrlichia</p>
            </title>
            <aug>
               <au>
                  <snm>Dumler</snm>
                  <fnm>JS</fnm>
               </au>
               <au>
                  <snm>Asanovich</snm>
                  <fnm>KM</fnm>
               </au>
               <au>
                  <snm>Bakken</snm>
                  <fnm>JS</fnm>
               </au>
               <au>
                  <snm>Richter</snm>
                  <fnm>P</fnm>
               </au>
               <au>
                  <snm>Kimsey</snm>
                  <fnm>R</fnm>
               </au>
               <au>
                  <snm>Madigan</snm>
                  <fnm>JE</fnm>
               </au>
            </aug>
            <source>J clin Microbiol</source>
            <pubdate>1995</pubdate>
            <fpage>1098</fpage>
            <lpage>1103</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="pmcid">228112</pubid>
                  <pubid idtype="pmpid" link="fulltext">7542262</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B9">
            <title>
               <p>Studies on the infectious agent of tick-borne fever in sheep</p>
            </title>
            <aug>
               <au>
                  <snm>Foggie</snm>
                  <fnm>A</fnm>
               </au>
            </aug>
            <source>J Path Bact</source>
            <pubdate>1951</pubdate>
            <volume>63</volume>
            <fpage>1</fpage>
            <lpage>15</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="doi">10.1002/path.1700630103</pubid>
                  <pubid idtype="pmpid">14832686</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B10">
            <title>
               <p>Bovine babesiosis in Ireland</p>
            </title>
            <aug>
               <au>
                  <snm>Gray</snm>
                  <fnm>JS</fnm>
               </au>
               <au>
                  <snm>Murphy</snm>
                  <fnm>TM</fnm>
               </au>
            </aug>
            <source>Irish vet News</source>
            <pubdate>1985</pubdate>
            <fpage>9</fpage>
            <lpage>14</lpage>
         </bibl>
         <bibl id="B11">
            <title>
               <p>Controlling tick infestations and diseases in sheep by pour-on formulations of synthetic pyrethroids</p>
            </title>
            <aug>
               <au>
                  <snm>Hardeng</snm>
                  <fnm>F</fnm>
               </au>
               <au>
                  <snm>Baalsrud</snm>
                  <fnm>KJ</fnm>
               </au>
               <au>
                  <snm>&#216;vernes</snm>
                  <fnm>G</fnm>
               </au>
            </aug>
            <source>A field study Vet Res Comm</source>
            <pubdate>1992</pubdate>
            <volume>16</volume>
            <fpage>429</fpage>
            <lpage>436</lpage>
            <xrefbib>
               <pubid idtype="doi">10.1007/BF01839020</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B12">
            <title>
               <p>Cypermethrin pour-on for the control of ticks (<it>Ixodes ricinus</it>) on sheep</p>
            </title>
            <aug>
               <au>
                  <snm>Henderson</snm>
                  <fnm>D</fnm>
               </au>
               <au>
                  <snm>Stevens</snm>
                  <fnm>DP</fnm>
               </au>
            </aug>
            <source>Vet Rec</source>
            <pubdate>1987</pubdate>
            <volume>121</volume>
            <fpage>317</fpage>
            <lpage>19</lpage>
            <xrefbib>
               <pubid idtype="pmpid">3424583</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B13">
            <title>
               <p>Acquired resistance to <it>Babesia divergens </it>in experimental calves</p>
            </title>
            <aug>
               <au>
                  <snm>Joyner</snm>
                  <fnm>LP</fnm>
               </au>
               <au>
                  <snm>Davies</snm>
                  <fnm>SFM</fnm>
               </au>
            </aug>
            <source>J Protozol</source>
            <pubdate>1967</pubdate>
            <volume>14</volume>
            <fpage>260</fpage>
            <lpage>262</lpage>
         </bibl>
         <bibl id="B14">
            <title>
               <p>Veterinary epidemiology. Principles and methods</p>
            </title>
            <aug>
               <au>
                  <snm>Martin</snm>
                  <fnm>SW</fnm>
               </au>
               <au>
                  <snm>Meek</snm>
                  <fnm>AH</fnm>
               </au>
               <au>
                  <snm>Willeberg</snm>
                  <fnm>P</fnm>
               </au>
            </aug>
            <publisher>Iowa State University Press, Ames</publisher>
            <pubdate>1987</pubdate>
         </bibl>
         <bibl id="B15">
            <title>
               <p>Studies in tick-borne fever of sheep. I. Transmission by the tick <it>Ixodes ricinus </it>and the description of the disease produced</p>
            </title>
            <aug>
               <au>
                  <snm>MacLeod</snm>
                  <fnm>J</fnm>
               </au>
               <au>
                  <snm>Gordon</snm>
                  <fnm>WS</fnm>
               </au>
            </aug>
            <source>Parasitology</source>
            <pubdate>1933</pubdate>
            <volume>25</volume>
            <fpage>273</fpage>
            <lpage>283</lpage>
         </bibl>
         <bibl id="B16">
            <title>
               <p>The distribution and host relations of Norwegian ticks (Acari, Ixodides)</p>
            </title>
            <aug>
               <au>
                  <snm>Mehl</snm>
                  <fnm>R</fnm>
               </au>
            </aug>
            <source>Fauna Norv Ser B</source>
            <pubdate>1983</pubdate>
            <volume>30</volume>
            <fpage>46</fpage>
            <lpage>51</lpage>
         </bibl>
         <bibl id="B17">
            <title>
               <p>Skogfl&#229;tten <it>Ixodes ricinus</it>. (The tick <it>Ixodes </it>ricinus)</p>
            </title>
            <aug>
               <au>
                  <snm>Mehl</snm>
                  <fnm>R</fnm>
               </au>
               <au>
                  <snm>Sandven</snm>
                  <fnm>P</fnm>
               </au>
               <au>
                  <snm>Braathen</snm>
                  <fnm>LR</fnm>
               </au>
            </aug>
            <source>Tidsskr Nor L&#230;gefor</source>
            <pubdate>1987</pubdate>
            <volume>107</volume>
            <fpage>1642</fpage>
            <lpage>1644</lpage>
         </bibl>
         <bibl id="B18">
            <title>
               <p>Use of deltamethrin 'pour on' for control of the sheep tick <it>Ixodes ricinus</it></p>
            </title>
            <aug>
               <au>
                  <snm>Mitchell</snm>
                  <fnm>GBB</fnm>
               </au>
               <au>
                  <snm>Webster</snm>
                  <fnm>KA</fnm>
               </au>
               <au>
                  <snm>Wright</snm>
                  <fnm>CL</fnm>
               </au>
            </aug>
            <source>Vet Rec</source>
            <pubdate>1986</pubdate>
            <volume>119</volume>
            <fpage>156</fpage>
            <lpage>57</lpage>
            <xrefbib>
               <pubid idtype="pmpid">3776056</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B19">
            <title>
               <p>An indirect immunofluorescence assay using a cell culture-derived antigen for detection of antibodies to the agent of human granulocytic ehrlichiosis</p>
            </title>
            <aug>
               <au>
                  <snm>Nicholson</snm>
                  <fnm>WL</fnm>
               </au>
               <au>
                  <snm>Comer</snm>
                  <fnm>JA</fnm>
               </au>
               <au>
                  <snm>Sumner</snm>
                  <fnm>JW</fnm>
               </au>
               <au>
                  <snm>Gingrich-Baker</snm>
                  <fnm>C</fnm>
               </au>
               <au>
                  <snm>Coughlin</snm>
                  <fnm>RT</fnm>
               </au>
               <au>
                  <snm>Magnarelli</snm>
                  <fnm>LA</fnm>
               </au>
               <au>
                  <snm>Olson</snm>
                  <fnm>JG</fnm>
               </au>
               <au>
                  <snm>Childs</snm>
                  <fnm>JE</fnm>
               </au>
            </aug>
            <source>J clin Microbiol</source>
            <pubdate>1997</pubdate>
            <volume>35</volume>
            <fpage>1510</fpage>
            <lpage>1516</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="pmcid">229776</pubid>
                  <pubid idtype="pmpid" link="fulltext">9163471</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B20">
            <title>
               <p>Granulocytic ehrlichiosis: an emerging or rediscovered tick-borne disease?</p>
            </title>
            <aug>
               <au>
                  <snm>Ogden</snm>
                  <fnm>NH</fnm>
               </au>
               <au>
                  <snm>Woldehiwet</snm>
                  <fnm>Z</fnm>
               </au>
               <au>
                  <snm>Hart</snm>
                  <fnm>CA</fnm>
               </au>
            </aug>
            <source>J med Microbiol</source>
            <pubdate>1998</pubdate>
            <volume>47</volume>
            <fpage>475</fpage>
            <lpage>82</lpage>
            <xrefbib>
               <pubid idtype="pmpid">9879965</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B21">
            <title>
               <p>Granulocytic <it>Ehrlichia </it>infection in Ixodid ticks and mammals in woodlands and uplands of the UK</p>
            </title>
            <aug>
               <au>
                  <snm>Ogden</snm>
                  <fnm>NH</fnm>
               </au>
               <au>
                  <snm>Bown</snm>
                  <fnm>K</fnm>
               </au>
               <au>
                  <snm>Horrocks</snm>
                  <fnm>BK</fnm>
               </au>
               <au>
                  <snm>Woldehiwet</snm>
                  <fnm>Z</fnm>
               </au>
               <au>
                  <snm>Bennett</snm>
                  <fnm>M</fnm>
               </au>
            </aug>
            <source>Med vet Entomol</source>
            <pubdate>1998</pubdate>
            <volume>12</volume>
            <fpage>423</fpage>
            <lpage>429</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="doi">10.1046/j.1365-2915.1998.00133.x</pubid>
                  <pubid idtype="pmpid" link="fulltext">9824827</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B22">
            <title>
               <p>Detection of antibodies of the agent of tick-borne fever by indirect immunofluorescence</p>
            </title>
            <aug>
               <au>
                  <snm>Paxton</snm>
                  <fnm>EA</fnm>
               </au>
               <au>
                  <snm>Scott</snm>
                  <fnm>GR</fnm>
               </au>
            </aug>
            <source>Vet Microbiol</source>
            <pubdate>1989</pubdate>
            <volume>21</volume>
            <fpage>133</fpage>
            <lpage>38</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="doi">10.1016/0378-1135(89)90025-4</pubid>
                  <pubid idtype="pmpid" link="fulltext">2692278</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B23">
            <title>
               <p>Comparison of indirect immunofluorescence for <it>Ehrlichia phagocytophila </it>and <it>Ehrlichia equi </it>in horses</p>
            </title>
            <aug>
               <au>
                  <snm>Pusterla</snm>
                  <fnm>N</fnm>
               </au>
               <au>
                  <snm>Wolfensberger</snm>
                  <fnm>C</fnm>
               </au>
               <au>
                  <snm>Gerber-Bretscher</snm>
                  <fnm>R</fnm>
               </au>
               <au>
                  <snm>Lutz</snm>
                  <fnm>H</fnm>
               </au>
            </aug>
            <source>Equine Vet J</source>
            <pubdate>1997</pubdate>
            <volume>29</volume>
            <fpage>490</fpage>
            <lpage>492</lpage>
            <xrefbib>
               <pubid idtype="pmpid">9413725</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B24">
            <title>
               <p>Tick-associated infections</p>
            </title>
            <aug>
               <au>
                  <snm>Scott</snm>
                  <fnm>GR</fnm>
               </au>
            </aug>
            <source>Diseases of sheep</source>
            <publisher>Blackwell Scientific Publications, Oxford</publisher>
            <editor>Martin WR</editor>
            <edition>1</edition>
            <pubdate>1983</pubdate>
            <fpage>209</fpage>
            <lpage>213</lpage>
         </bibl>
         <bibl id="B25">
            <title>
               <p>Equine ehrlichiosis: A disease with similarities to tick-borne fever and bovine petechial fever</p>
            </title>
            <aug>
               <au>
                  <snm>Stannard</snm>
                  <fnm>AA</fnm>
               </au>
               <au>
                  <snm>Gribble</snm>
                  <fnm>DH</fnm>
               </au>
               <au>
                  <snm>Smith</snm>
                  <fnm>RS</fnm>
               </au>
            </aug>
            <source>Vet Rec</source>
            <pubdate>1969</pubdate>
            <volume>84</volume>
            <fpage>149</fpage>
            <lpage>150</lpage>
            <xrefbib>
               <pubid idtype="pmpid">5818868</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B26">
            <title>
               <p>Tick-borne fever (TBF) and secondary infections in sheep</p>
            </title>
            <aug>
               <au>
                  <snm>Stuen</snm>
                  <fnm>S</fnm>
               </au>
            </aug>
            <source>Rickettsiae and rickettsial diseases</source>
            <publisher>Veda, Bratislava</publisher>
            <editor>Kaz&#225;r J, Toman R</editor>
            <pubdate>1996</pubdate>
            <fpage>347</fpage>
            <lpage>349</lpage>
         </bibl>
         <bibl id="B27">
            <title>
               <p>Utbredelsen av sjodogg (tick-borne fever) i Norge. (The distribution of tick-borne fever (TBF) in Norway)</p>
            </title>
            <aug>
               <au>
                  <snm>Stuen</snm>
                  <fnm>S</fnm>
               </au>
            </aug>
            <source>Norsk Vet Tidsskr</source>
            <pubdate>1997</pubdate>
            <volume>109</volume>
            <fpage>83</fpage>
            <lpage>87</lpage>
         </bibl>
         <bibl id="B28">
            <title>
               <p>Sjodogg (tick-borne fever) &#8211; et historisk tilbakeblikk. (Sjodogg (tick-borne fever) &#8211; a historical review)</p>
            </title>
            <aug>
               <au>
                  <snm>Stuen</snm>
                  <fnm>S</fnm>
               </au>
            </aug>
            <source>Norsk Vet Tidsskr</source>
            <pubdate>1998</pubdate>
            <volume>110</volume>
            <fpage>703</fpage>
            <lpage>706</lpage>
         </bibl>
         <bibl id="B29">
            <title>
               <p>Persistence of <it>Ehrlichia phagocytophila </it>infection in lambs in relation to clinical parameters and antibody responses</p>
            </title>
            <aug>
               <au>
                  <snm>Stuen</snm>
                  <fnm>S</fnm>
               </au>
               <au>
                  <snm>Olsson Engvall</snm>
                  <fnm>E</fnm>
               </au>
               <au>
                  <snm>Artursson</snm>
                  <fnm>K</fnm>
               </au>
            </aug>
            <source>Vet Rec</source>
            <pubdate>1998</pubdate>
            <volume>143</volume>
            <fpage>553</fpage>
            <lpage>55</lpage>
            <xrefbib>
               <pubid idtype="pmpid">9854317</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B30">
            <title>
               <p>Experimental infection of lambs with an equine granulocytic <it>Ehrlichia </it>species resembling the agent that causes human granulocytic ehrlichiosis (HGE)</p>
            </title>
            <aug>
               <au>
                  <snm>Stuen</snm>
                  <fnm>S</fnm>
               </au>
               <au>
                  <snm>Artursson</snm>
                  <fnm>K</fnm>
               </au>
               <au>
                  <snm>Olsson Engvall</snm>
                  <fnm>E</fnm>
               </au>
            </aug>
            <source>Acta vet scand</source>
            <pubdate>1998</pubdate>
            <volume>39</volume>
            <fpage>491</fpage>
            <lpage>497</lpage>
            <xrefbib>
               <pubid idtype="pmpid">9926463</pubid>
            </xrefbib>
         </bibl>
         <bibl id="B31">
            <title>
               <p>Sauen som husdyr (The sheep as a domestic animal)</p>
            </title>
            <aug>
               <au>
                  <snm>Trodahl</snm>
                  <fnm>S</fnm>
               </au>
            </aug>
            <publisher>Saueboka, A/S Land-bruksforlaget, Oslo</publisher>
            <edition>2</edition>
            <pubdate>1998</pubdate>
            <fpage>11</fpage>
            <lpage>27</lpage>
         </bibl>
         <bibl id="B32">
            <title>
               <p>Experimental studies on bovine tick-borne fever (3) Immunological strain differences</p>
            </title>
            <aug>
               <au>
                  <snm>Tuomi</snm>
                  <fnm>J</fnm>
               </au>
            </aug>
            <source>Acta pathol microbiol scand</source>
            <pubdate>1967</pubdate>
            <volume>71</volume>
            <fpage>89</fpage>
            <lpage>100</lpage>
         </bibl>
         <bibl id="B33">
            <title>
               <p>Inter- and intralaboratory comparison of <it>Ehrlichia equi </it>and human granulocytic ehrlichiosis (HGE) agent strains for serodiagnosis of HGE by the immunofluorescent-antibody test</p>
            </title>
            <aug>
               <au>
                  <snm>Walls</snm>
                  <fnm>JJ</fnm>
               </au>
               <au>
                  <snm>Aguero-Rosenfeld</snm>
                  <fnm>M</fnm>
               </au>
               <au>
                  <snm>Bakken</snm>
                  <fnm>JS</fnm>
               </au>
               <au>
                  <snm>Goodman</snm>
                  <fnm>JL</fnm>
               </au>
               <au>
                  <snm>Hossain</snm>
                  <fnm>D</fnm>
               </au>
               <au>
                  <snm>Johnson</snm>
                  <fnm>RC</fnm>
               </au>
               <au>
                  <snm>Dumler</snm>
                  <fnm>JS</fnm>
               </au>
            </aug>
            <source>J clin Microbiol</source>
            <pubdate>1999</pubdate>
            <volume>37</volume>
            <fpage>2968</fpage>
            <lpage>2973</lpage>
            <xrefbib>
               <pubidlist>
                  <pubid idtype="pmcid">85424</pubid>
                  <pubid idtype="pmpid" link="fulltext">10449483</pubid>
               </pubidlist>
            </xrefbib>
         </bibl>
         <bibl id="B34">
            <title>
               <p>Tick-borne (pasture) fever</p>
            </title>
            <aug>
               <au>
                  <snm>Woldehiwet</snm>
                  <fnm>Z</fnm>
               </au>
               <au>
                  <snm>Scott</snm>
                  <fnm>GR</fnm>
               </au>
            </aug>
            <source>Rickettsial and chlamydial diseases of domestic animals</source>
            <publisher>Pergamon Press, Oxford</publisher>
            <editor>Woldehiwet Z, Ristic M</editor>
            <pubdate>1993</pubdate>
            <fpage>233</fpage>
            <lpage>254</lpage>
         </bibl>
         <bibl id="B35">
            <title>
               <p>Sjukdom hos sau p&#229; <it>Ixodes ricinus </it>infisert beite. (Diseases of sheep on <it>Ixodes ricinus infested pasture</it>)</p>
            </title>
            <aug>
               <au>
                  <snm>&#216;ver&#229;s</snm>
                  <fnm>J</fnm>
               </au>
            </aug>
            <source>Norsk Vet Tidsskr</source>
            <pubdate>1972</pubdate>
            <volume>83</volume>
            <fpage>561</fpage>
            <lpage>67</lpage>
         </bibl>
      </refgrp>
   </bm>
</art>
