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Tick-Bite; FeverFATBNCT03932448

Fever After Tick Bite Study

An observational study of Tick-Bite; Fever and Tick Fever, run by Göteborg University at 1 site in Sweden.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The proposed study is a collaboration between Microbiology, SU/Sahlgrenska and the Infectious Diseases clinic at SU/Östra as well as several Infectious Diseases clinics throughout Sweden aiming at improving microbiological diagnostic assays regarding the early identification of tick-borne microorganisms (including as… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Tick-Bite; Fever, Tick Fever, Tick-Borne Diseases
What is being tested?
The proposed study is not interventional.
How many people
0 participants
Where
1 siteSweden
Study dates
15 May 2019to 4 Apr 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Men and women ≥18 years old with documented or a medical history of fever (≥38°C) within 2 weeks after a tick bite.

Who may be able to join

  • Written informed consent
  • Male and female patients ≥18 years of age
  • Medical history of tick bite within past 2 weeks
  • Documented or medical history of fever (≥38°C) within past 2 weeks

Who cannot join

  • Inability or unwillingness to provide informed consent or abide by the requirements of the study
  • Presence of urinary tract symptoms
  • Presence of non-tick related, infectious agent causing fever, e.g. a respiratory virus
  • Presence of other medical, non-infectious cause of fever

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Dept. of Infectious Diseases

    Gothenburg

Other trials in Sweden

About this study

Official title: Fever After Tick Bite (FATB) Study; Determining the Etiology of Tick-Borne Human Infections in Northern Europe

The proposed study is a collaboration between Microbiology, SU/Sahlgrenska and the Infectious Diseases clinic at SU/Östra as well as several Infectious Diseases clinics throughout Sweden aiming at improving microbiological diagnostic assays regarding the early identification of tick-borne microorganisms (including as of yet unidentified pathogens) capable of causing human disease using modern diagnostic tools.

At the initial study visit (day 0) plasma, serum, urine, saliva, and PBMCs (and tick, if available) will be collected from patients developing fever within two weeks after a tick bite. Additional follow-up samples will be obtained after 9 and 30 days as well as after 6 months. The initial samples will be analyzed using (a) directed multiplex PCR analysis for Tick-Borne Encephalitis (TBE), Borrelia, Anaplasma, Neoerlichia, Rickettsia, Coxiella, Tularemia, and Babesiosis in plasma, whole blood and urine, (b) conventional IgM and IgG serology for TBE, (c) "Next Generation Sequencing" (NGS) for the detection of bacterial 16s rRNA as well as unknown viruses, (d) potential biomarkers, and (e) host genetic factors. Among patients where initial sampling indicates the presence of a potential pathogen or in patients developing neurological symptoms, a lumbar puncture will be performed and CSF will be further analyzed. Samples will also be evaluated regarding potential microbiological factors predisposing for severity of infection.

The primary objective of the study is to improve diagnostic tools in the initial early phase of infections caused by tick-borne pathogens, especially TBE prior to the affliction of the central nervous system, and to attempt to identify which factors impact the course of infection as it is believed that approximately 75% of infected individuals resolve their infection in this first phase whereas others develop meningoencephalitis with significant subsequent neurological sequelae. Secondary objectives of the study include investigating for the presence of and treating other tick-borne pathogens, setting the stage for coming clinical trials evaluating novel anti-viral therapies for TBE.

Being tested
The proposed study is not interventional.
Medical subject headings
Tick Bites, Fever, Anaplasmosis, Tick-Borne Diseases, Encephalitis, Tick-Borne

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • The proposed study is not interventional.Other

    The proposed study is not interventional. However, if a treatable microorganism is detected, e.g. Borrelia or Anaplasma, suitable therapy, e.g. doxycycline, will be in initiated if appropriate.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Etiology of fever (≥38°C) developing within 2 weeks after a tick bite.

    Number of participants with detectable Tick-Borne Encephalitis Virus (TBEV), Borrelia, Anaplasma, Neoerlichia, Rickettsia, Coxiella burnetii, Tularemia, and/or Babesia infections.

    Measured: Up to two weeks after the tick bite.

  2. Proportion of subjects developing neurological symptoms after a tick bite.

    The proportion of subjects developing neurological symptoms in each of the following etiological categories: Tick-Borne Encephalitis Virus (TBEV), Borrelia, Anaplasma, Neoerlichia, Rickettsia, Coxiella burnetii, Tularemia, and/or Babesia.

    Measured: Up to six months after the tick bite.

  3. Proportion of subjects developing other serious, non-neurological symptoms or disease after a tick bite.

    The proportion of subjects developing other serious, non-neurological symptoms or disease in each of the following etiological categories: Tick-Borne Encephalitis Virus (TBEV), Borrelia, Anaplasma, Neoerlichia, Rickettsia, Coxiella burnetii, Tularemia, and/or Babesia.

    Measured: Up to six months after the tick bite.

Secondary outcomes (24)
  1. Impact of body mass index (BMI) of subjects on the risk of development of neurological symptoms.

    Evaluation of body mass index (weight and height will be combined to report BMI in kg/m2) of subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  2. Impact of waist circumference of subjects on the risk of development of neurological symptoms.

    Evaluation of waist circumference (measured in cm) of subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  3. Impact of gender of subjects on the risk of development of neurological symptoms.

    Evaluation of gender (male vs. female) of subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  4. Impact of age of subjects on the risk of development of neurological symptoms.

    Evaluation of age (measured in years) of subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  5. Impact of body mass index of subjects developing other serious, non-neurological symptoms or disease.

    Evaluation of body mass index (weight and height will be combined to report BMI in kg/m2) of subjects developing vs. not developing other serious, non-neurological symptoms or disease.

    Measured: Up to six months after the tick bite.

  6. Impact of waist circumference of subjects developing other serious, non-neurological symptoms or disease.

    Evaluation of waist circumference (measured in cm) of subjects developing vs. not developing other serious, non-neurological symptoms or disease.

    Measured: Up to six months after the tick bite.

  7. Impact of gender of subjects developing other serious, non-neurological symptoms or disease.

    Evaluation of gender (male vs. female) of subjects developing vs. not developing other serious, non-neurological symptoms or disease.

    Measured: Up to six months after the tick bite.

  8. Impact of age of subjects developing other serious, non-neurological symptoms or disease.

    Evaluation of age (measured in years) of subjects developing vs. not developing other serious, non-neurological symptoms or disease.

    Measured: Up to six months after the tick bite.

  9. Prospective evaluation of the utility of Next Generation Sequencing (NGS) for the detection of unknown viruses and of bacterial 16s rRNA vs. directed Multiplex PCR

    Number of participants with Tick-Borne Encephalitis Virus (TBEV), Borrelia, Anaplasma, Neoerlichia, Rickettsia, Coxiella burnetii, Tularemia, and/or Babesia infections as detected using Next Generation Sequencing (NGS) in comparison to Multiplex Polymerase Chain Reaction (Multiplex PCR).

    Measured: Up to 30 days after the tick bite.

  10. Prospective evaluation of the specificity and sensitivity of TBEV-RNA and TBE IgM serology in the early phase of infection, i.e. up to 30 days after the tick bite.

    Comparison of the number of subjects correctly identified as being infected with TBEV by means of analysis of TBEV-RNA vs. TBE IgM serology in the early phase of infection, i.e. up to 30 days after the tick bite.

    Measured: Up to 30 days after the tick bite.

  11. Prospective evaluation of the specificity and sensitivity of TBEV-RNA in urine vs. plasma/whole blood in the early phase of TBE infection, i.e. up to 30 days after the tick bite.

    Comparison of the number of subjects correctly identified as being infected with TBEV by means of analysis of TBEV-RNA in urine vs. plasma/whole blood in the early phase of TBE infection, i.e. up to 30 days after the tick bite.

    Measured: Up to 30 days after the tick bite.

  12. Prospective evaluation of the specificity and sensitivity of PCR for Borrelia DNA in plasma/serum as well as Borrelia IgM serology in the early phase of infection, i.e. up to 30 days after the tick bite.

    Comparison the number of subjects correctly identified as being infected with Borrelia by means of analysis of PCR for Borrelia DNA in plasma/serum as well as Borrelia IgM and IgG serology in the early phase of infection, i.e. up to 30 days after the tick bite.

    Measured: Up to 30 days after the tick bite.

  13. Prospective evaluation of the specificity and sensitivity of early evaluation of plasma concentrations of the neurological markers NFL in relation to the likelihood of developing neurological symptoms.

    Comparison of plasma concentrations of the neurological marker NFL will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  14. Prospective evaluation of the specificity and sensitivity of early evaluation of plasma concentrations of the neurological marker T-tau in relation to the likelihood of developing neurological symptoms.

    Comparison of plasma concentrations of the neurological marker T-tau will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  15. Prospective evaluation of the specificity and sensitivity of early evaluation of plasma concentrations of the neurological marker GFAp in relation to the likelihood of developing neurological symptoms.

    Comparison of plasma concentrations of neurological marker GFAp will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  16. Prospective evaluation of the specificity and sensitivity of early evaluation of plasma concentrations of IP-10 (aka CXCL10) in relation to the likelihood of developing neurological symptoms.

    Comparison of plasma concentrations of IP-10 (aka CXCL10) will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  17. Prospective evaluation of the specificity and sensitivity of early evaluation of 25-hydroxy vitamin D (25(OH)D) concentrations in relation to the likelihood of developing neurological symptoms.

    Comparison of plasma concentrations of 25-hydroxy vitamin D (25(OH)D) will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  18. Prospective evaluation of peripheral blood mononuclear cells (PBMCs) analyzed by FACS, in relation to the likelihood of developing neurological symptoms.

    Comparison of the proportion of CD56 negative NK, CD4+ CD38+, CD8+ CD38+, CD8+CD16+, Foxp3+, and pDC (CD303+) cells analyzed by FACS will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  19. Prospective evaluation of the impact of host genetic polymorphisms in the IFNL4 gene in relation to the likelihood of developing neurological symptoms.

    Proportion of subjects with genetic polymorphisms in the IFNL4 gene evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  20. Prospective evaluation of the impact of host genetic polymorphisms in the ITPA gene in relation to the likelihood of developing neurological symptoms.

    Proportion of subjects with genetic polymorphisms in the ITPA gene evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

  21. Prospective evaluation of the impact of prior vaccination against TBE on frequency and outcome of TBEV infection.

    Comparison of subjects with vs. without prior vaccination against TBE on frequency and outcome of TBEV infection.

    Measured: From time of prior vaccination until six months after the tick bite.

  22. Prospective evaluation of the impact of prior vaccination against Yellow Fever on frequency and outcome of TBEV infection.

    Comparison of subjects with vs. without prior vaccination against Yellow Fever on frequency and outcome of TBEV infection.

    Measured: From time of prior vaccination until six months after the tick bite.

  23. Prospective evaluation of the impact of prior vaccination against Japanese Encephalitis on frequency and outcome of TBEV infection.

    Comparison of subjects with vs. without prior vaccination against Japanese Encephalitis on frequency and outcome of TBEV infection.

    Measured: From time of prior vaccination until six months after the tick bite.

  24. Prospective evaluation of the association between presence or absence of immunosuppression in relation to the likelihood of developing neurological symptoms.

    The proportion of subjects with vs. without immunosuppression will be evaluated among subjects developing vs. not developing neurological symptoms.

    Measured: Up to six months after the tick bite.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Apr 2019
  2. Study start15 May 2019
  3. Primary completion4 Apr 2025
  4. Study completion4 Apr 2025

Why it stopped: Enrollment in the study was rendered unfeasible due to restrictions and disruptions caused by the COVID-19 pandemic.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03932448
Sponsor's protocol ID
FATB Study Group
Acronym
FATB
Status last verified
Apr 2025
First submitted
16 Apr 2019
Last updated
9 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Tick-Bite; Fever and Tick Fever, run by Göteborg University at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 9 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Etiology of fever (≥38°C) developing within 2 weeks after a tick bite. (time frame: Up to two weeks after the tick bite.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Apr 2025.

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