Distribution of and Associated Pathogens: Meta-Analysis of Global Published Data and a Field Survey in China.

is an obligate blood sucking arthropod and transmits various pathogens to humans and domestic animals. Recently several new viruses were detected in as an emerging disease threat. In this study, we aimed to analyze its geographical distribution and associated pathogens. Data were collected from multiple sources, including a field survey, reference book, and literature review. We searched various electronic databases with the terms "" OR "" for studies published since 1963 and the positive rates for -associated pathogens were estimated by meta-analysis. was found only in four countries in Eurasia, ranging from 22° N to 57° N latitude. At least 20 human pathogens were associated with , including five species of spotted fever group rickettsiae, three species in the family of Anaplasmataceae, three genospecies in the complex sensu lato, and five species of virus. Among them, was widely detected in , showing the highest pooled positive rate (25.15%; 95% CI 13.31-39.27). Our work presents the most comprehensive data and analysis (to our knowledge) for the geographical distribution of and associated pathogens, revealing an emerging threat to public health and stocking farming. Continued surveillance and further investigations should be enhanced.