Esmeralda Inácio

Once regarded as a benign, clinically overlooked organism, Theileria orientalis has undergone a paradigm shift in its perceived status and is now recognised as a tick-borne haemoparasite of clinical and economic importance. Severe outbreaks characterised by haemolytic anaemia, reproductive losses, and mortality, primarily associated with the Ikeda and Chitose genotypes, have been increasingly reported in Australasia, Asia, and North America. In Europe and parts of Africa, however, the epidemiological status of T. orientalis remains poorly defined, despite increasing molecular evidence of circulation and reports of predominantly subclinical infections. The parasite is transmitted transstadially in ixodid ticks, with Haemaphysalis longicornis as the principal confirmed biological vector, although vector competence remains unverified for most suspected tick species. This narrative review was based on a comprehensive PubMed search from database inception up to the date of initial manuscript submission, supplemented by reference-list screening and targeted searches. This review synthesises current knowledge on taxonomy, life cycle, transmission, genetic diversity based on the major piroplasm surface protein gene, global epidemiology, pathogenesis, clinical manifestations, co-infections, production losses, diagnostics, and control strategies. Key gaps include limited understanding of the mechanisms driving erythrocyte destruction, insufficient experimental confirmation of vector competence, absence of licensed vaccines, and incomplete epidemiological data in several regions. Future research priorities are discussed in the context of climate change and the expanding geographic distribution of tick vectors.