Treatment for anaplasmosis. Medical search. Frequent questions

Human granulocytic anaplasmosis (HGA) is a tick-borne, infectious disease caused by Anaplasma phagocytophilum, an obligate intracellular bacterium that is typically transmitted to humans by ticks of the Ixodes ricinus species complex, including Ixodes scapularis and Ixodes pacificus in North America. (wikipedia.org)
Currently, there is no vaccine against human granulocytic anaplasmosis, so antibiotics are the only form of treatment. (wikipedia.org)
Although some clinical cases of human granulocytic anaplasmosis have been reported in Europe, mostly from Slovenia, Sweden, and Poland, most cases have occurred in the United States. (medgadget.com)
Human Granulocytic Anaplasmosis (HGA) is an infection caused by the intracellular bacterium Anaplasma phagocytophilum. (canlyme.com)
Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. (nih.gov)
A probable case of anaplasmosis (human granulocytic anaplasmosis) has been declared by Hastings Prince Edward Public Health (HPEPH) in the region. (countylive.ca)

CanLyme note: Many parents with autistic children who have also received treatment for a Lyme disease infection report similar amazing results from antibiotic treatment leading to hypotheses that some autism may be an infectious disease origin. (canlyme.com)
With prompt and appropriate antibiotic treatment, most patients with early-stage Lyme disease recover rapidly and completely. (medscape.com)
Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. (nih.gov)
Not quite as common as Lyme Disease, Anaplasmosis still presents a significant risk. (coastalpet.com)
Marx has developed numerous educational and reference materials for healthcare providers related to the treatment, management, and prevention of Lyme disease, an online data dashboard of emergency department visits for tick bites, and she has co-authored and authored many Lyme disease publications. (cdc.gov)
For this webinar, I have five primary objectives, which are to describe populations at risk of contracting Lyme disease in the U.S., to describe early signs and symptoms of Lyme disease, to identify appropriate use of diagnostic tests and antibiotic treatment for Lyme disease, and finally to promote clinician and patient education of Lyme disease, tick bite prevention, and postexposure prophylaxis. (cdc.gov)
Using a single test, your veterinarian can check for any combination of the following diseases, including all of them: heartworm disease, Lyme disease, ehrlichiosis, and anaplasmosis. (vetstreet.com)
Lyme disease, ehrlichiosis, and anaplasmosis are carried by ticks. (vetstreet.com)
Lyme disease, ehrlichiosis, and anaplasmosis are known as tick-borne diseases because they are transmitted when ticks bite and feed. (vetstreet.com)
Because ticks can carry more than one of these diseases, and dogs can be bitten by multiple ticks, infection with Lyme disease, ehrlichiosis, and anaplasmosis can occur at the same time in the same dog. (vetstreet.com)
Dogs infected with Lyme disease, ehrlichiosis, and anaplasmosis may also fail to display any clinical signs. (vetstreet.com)
Tick-borne diseases like Lyme disease, ehrlichiosis, and anaplasmosis pose a risk to dogs in many areas of the country. (vetstreet.com)
A vaccine is available to aid in preventing disease caused by Borrelia burgdorferi, the Lyme disease organism, but there are currently no vaccines to protect dogs from ehrlichiosis or anaplasmosis. (vetstreet.com)
the vast majority of these patients suffering from post-treatment Lyme disease syndrome do see significant recovery over a period of 6 to 12 months. (lifespan.org)
This is not helpful for the doctor in deciding whether your child needs treatment to prevent Lyme disease. (massgeneral.org)
In the first stage of Lyme disease, your doctor can tell if your child has Lyme disease and needs antibiotic treatment based on their exam. (massgeneral.org)
If your child has signs of a later stage of Lyme disease, the doctor may order blood tests or other tests to help figure out if your child needs treatment with antibiotics. (massgeneral.org)
Anaplasmosis is caused by a bacteria called Anaplasma phagocytophilum which is spread by the bite of an infected black-legged tick deer tick (which is also responsible for the spread of Lyme disease), or brown dog tick. (islandpethospital.com)
Anaplasmosis is caused by a type of bacteria transmitted to humans by the bite of a blacklegged tick, the same kind of tick that transmits Lyme disease. (countylive.ca)
Lyme disease diagnostic workups conducted on active and retired U.S. service members and their dependents at U.S. Air Force military treatment facilities (MTFs) in Germany between 2013 and 2017 were assessed to determine the appropriateness of laboratory testing and antibiotic prescriptions. (health.mil)
Anaplasmosis, babesiosis, ehrlichiosis, Lyme disease, and Rocky Mountain spotted fever can be spread by ticks to humans and various species of livestock and companion animals. (msu.edu)
Ticks can carry many diseases including Lyme disease, anaplasmosis, ehrlichiosis and Rocky Mountain Spotted Fever. (pamelynferdin.com)
If we are diligent in practicing the same prevention measures we've learned to prevent Lyme disease, we are protecting ourselves from other tickborne diseases including anaplasmosis. (lite987.com)
Even during the last weeks of summer, it's important to remember that pets and people are at greater risk of being infected with Lyme disease and other tick-borne diseases such as anaplasmosis, ehrlichiosis, or Rocky Mountain Spotted Fever. (avma.org)
Symptomatically, Lyme disease can be difficult to distinguish from anaplasmosis because the signs of the diseases are very similar, and they occur in essentially the same areas of the country. (avma.org)
Antibiotics usually provide effective treatment for Lyme disease. (avma.org)
During this COCA Call, clinicians will learn about the treatment, management, and prevention of tickborne diseases in the U.S., with an emphasis on Lyme disease, Rocky Mountain spotted fever and newly emerging tickborne diseases. (cdc.gov)
Review the geographic distribution of Lyme disease, Southern tick-associated rash illness (STARI), Rocky Mountain spotted fever, ehrlichiosis, anaplasmosis, and other emerging tickborne diseases. (cdc.gov)
Identify the serologic tests used to diagnose Lyme disease, Rocky Mountain spotted fever, ehrlichiosis, anaplasmosis, and emerging tickborne diseases. (cdc.gov)
Anaplasmosis is a bacterial infection that is carried by Ixodes scapularis (the deer tick), which is the same tick that also carries Lyme disease. (modernpest.com)
More commonly, it is associated with a febrile illness and can be confused with atypical Lyme disease (without a rash), ehrlichiosis , or anaplasmosis. (medscape.com)
Clinicians should pay attention to what they think might be Lyme disease, ehrlichiosis, or anaplasmosis, which may indeed represent some of these alternative infections. (medscape.com)

Anaplasmosis and other tick-borne diseases can be prevented by avoiding exposure to ticks. (lifespan.org)
The testing and treatment strategies used on dogs bitten by infected ticks were diverse, and misconceptions among veterinarians regarding the treatment of asymptomatic but B. burgdorferi -seropositive dogs were noted. (frontiersin.org)
The ticks suck the animal's blood, transmitting the anaplasmosis-causing bacteria into the bloodstream. (manmadecattle.com)
If your veterinarian believes that your dog could be infected with Anaplasmosis they will perform a full physical exam to look for signs of the disease, and any ticks that may be living on your pet. (islandpethospital.com)
Both anaplasmosis and theileriosis are insect vector transmitted, primarily through ticks. (dtnpf.com)
Anaplasmosis caused by Anaplasma phagocytophilum and babesiosis caused by several species of Babesia are transmitted by Ixodes ticks. (msu.edu)
If you notice any signs of illness in your dog after exposure to wooded areas or after removal of visible ticks, contact your veterinarian as soon as possible for testing and treatments. (dogshealth.com)

Diagnosing Anaplasmosis can be tricky since the symptoms of this condition are somewhat vague and could be associated with a range of other diseases. (islandpethospital.com)

Signs and symptoms of anaplasmosis typically begin 5-14 days after being bitten by an infected black-legged tick. (tn.gov)
Anyone who spends time outdoors in Tennessee is at risk of contracting anaplasmosis, because the black-legged tick that spreads this disease is most often found in wooded, brushy areas. (tn.gov)

Although there is no standard treatment for Babesiosis, a course of antibiotics and medications used to treat malaria has been effective in treating the disease. (lifespan.org)
However, it is possible, though rare, to contract anaplasmosis through blood transfusion and organ donations much like its fellow tick-borne illness babesiosis. (diseasedaily.org)

5% of Lyme patients have anaplasmosis [HGA] caused by the intracellular bacterium Anaplasma phagocytophilum. (canlyme.com)
Anaplasmosis is a tick-borne disease caused by the bacteria Anaplasma phagocytophilum . (tn.gov)
Anaplasmosis is diagnosed by a healthcare provider, who can order blood tests to look for evidence of Anaplasma infection. (tn.gov)
Anaplasmosis is caused by the bacterium Anaplasma marginale, which infects red blood cells in the host's body, leading to anemia and other health complications. (manmadecattle.com)
An individual might be at risk of anaplasmosis if they are bitten by a blacklegged tick carrying the Anaplasma phagocytophilum bacterium, and the tick is attached for at least 12 hours. (countylive.ca)
Anaplasmosis is caused by the bacterium Anaplasma marginale. (dtnpf.com)
Kathryn Reif, assistant professor in the diagnostic medicine and pathobiology department in the Kansas State University College of Veterinary Medicine, is leading a project that focuses on optimizing antimicrobial use to control active infection of the hemoparasitic pathogen, Anaplasma marginale, the causative agent of bovine anaplasmosis. (k-state.edu)

Anaplasmosis is a bacterial infection that spreads from animals to humans. (medgadget.com)
A compromised immune system such as patients undergoing cancer treatments, advanced human immunodeficiency virus infection, prior organ transplants may increase the risk of the severe outcome. (medgadget.com)
The length of drug treatment depends on the patient 's immune status and the site of infection. (ipl.org)
The goal is to begin treatment as soon as possible, ideally within the first five days of infection. (healthline.com)
Anaplasmosis (an infection you get from a tick bite). (clevelandclinic.org)
Also, there is no fully USDA-approved vaccine for anaplasmosis, and the experimental vaccine, available in some states, does not prevent infection. (k-state.edu)

Who is at risk of contracting anaplasmosis in Tennessee? (tn.gov)

Check out the new clinical education tool for Diagnosis and Treatment of Ehrlichiosis and Anaplasmosis . (cdc.gov)
Early diagnosis and treatment can help prevent complications associated with tickborne diseases. (georgia.gov)
A delay in diagnosis and treatment may also result in more severe illness. (countylive.ca)
CHF is taking a One Health action to address the prevalence, diagnosis, and treatment of tick-borne disease. (akcchf.org)
Early diagnosis and treatment are essential to prevent complications from disseminated disease. (health.mil)

Treatment for Rocky Mountain spotted fever involves an oral antibiotic known as doxycycline. (healthline.com)

Ehrlichiosis and anaplasmosis are tick-borne bacterial infections that cause fever, chills, muscle aches, headache, and a general feeling of illness (malaise). (merckmanuals.com)
Symptoms of ehrlichiosis and anaplasmosis are similar, but anaplasmosis is less likely to cause a rash. (merckmanuals.com)
Ehrlichiosis and anaplasmosis are treated with an antibiotic. (merckmanuals.com)
Symptoms of ehrlichiosis and anaplasmosis are similar. (merckmanuals.com)

Overview of Rickettsial Infections Rickettsial infections and related infections (such as anaplasmosis, ehrlichiosis, and Q fever) are caused by an unusual type of bacteria that can live only inside the cells of another organism. (merckmanuals.com)
According to the Centers for Disease Control and Prevention (CDC), the global burden of human anaplasmosis treatment remains high as the organism causes more than 10,000 infections per year worldwide. (medgadget.com)
Although anaplasmosis infections can occur during any time of the year, the majority of cases reported to the CDC have an illness onset during the summer months and peaks in the months of June and July. (medgadget.com)
Testing helps identify dogs that need treatment for one of these infections or an adjustment in the type of tick control being used. (vetstreet.com)
Anaplasmosis organisms enter the bloodstream and live in the animal's white blood cells, which normally aid in fighting infections. (vin.com)

More rarely, the bacteria that cause anaplasmosis can spread through direct contact with infected animals. (medgadget.com)
Anaplasmosis in Ruminants Anaplasmosis is a tickborne disease of ruminants caused by intracellular bacteria that infect red blood cells, causing fever and anemia. (msdvetmanual.com)
Additionally, the anaplasmosis-causing bacteria can be transmitted to humans through tick bites, causing flu-like symptoms and other health complications. (manmadecattle.com)

On the basis of the treatment, the market is segmented into antibiotics, vaccines, and others. (medgadget.com)
In most patients with carditis, prompt institution of appropriate antibiotics is the only treatment needed. (medscape.com)
If you don't begin receiving treatment within the first five days, you might require intravenous (IV) antibiotics in the hospital. (healthline.com)
Antibiotics are the only treatment for Anaplasmosis. (coastalpet.com)
Antibiotics are the first-line treatment for anaplasmosis among adults and children of all ages. (lifespan.org)
He is currently undergoing the prescribed treatment, which involves a course of antibiotics. (adoptapet.com)
Some anaplasmosis in dogs is asymptomatic, and your dog may never show symptoms or require treatment, but those that do frequently develop a fever and respond quickly to antibiotics. (islandpethospital.com)

Bed rest and treatment of symptoms such as cough, fever, or chest discomfort may be advised. (ipl.org)
If anaplasmosis is treated within the first five days, fever should subside in 24 to 72 hours. (lifespan.org)

Clinicians can help prevent complications associated with tickborne diseases with early recognition and prompt treatment. (cdc.gov)

Cattle producers in Kansas and beyond are concerned that the current FDA-approved anaplasmosis treatment regimens are not sufficiently controlling diseases," Reif said. (k-state.edu)
Anaplasmosis fits into a larger picture of increasing tick-borne diseases in the United States. (diseasedaily.org)

In many cases, antibiotic treatment "just in case" is not safe or does not work well. (massgeneral.org)
Most dogs show an improvement within 24- 48 hours after beginning the antibiotic treatment. (islandpethospital.com)

It is concluded that the splenectomized cattle died due to anaplasmosis caused by the inoculated strain and the buffalo were more resistant compared to cattle. (scielo.br)
Buffaloes can be an alternative to cattle rearing in areas with a high occurrence of clinical cases of anaplasmosis. (scielo.br)
Anaplasmosis is a tick-borne disease that affects both domestic and wild animals, including cattle, sheep, goats, and deer. (manmadecattle.com)
The most common mode of transmission of anaplasmosis in cattle is through tick bites. (manmadecattle.com)
The early-stage symptoms of anaplasmosis in cattle may be mild or nonexistent. (manmadecattle.com)
The clinical presentation of anaplasmosis in cattle may vary depending on the severity of the disease, the age and health status of the animal, and other factors. (manmadecattle.com)
Veterinarians can diagnose anaplasmosis in cattle through a physical examination of the animal and laboratory tests. (manmadecattle.com)
It's always good news when researchers find new paths to diagnostic testing and treatments for cattle. (dtnpf.com)
We are using a combination of A. marginale strains, some of which we recently isolated from Kansas cattle herds, to help determine how strains differ in their susceptibility to tetracycline antimicrobials, specifically chlortetracycline, the most common antimicrobial used to control anaplasmosis. (k-state.edu)
We hope that by looking at three different chlortetracycline treatment protocols for cattle, we can provide practical recommendations for the Food and Drug Administration and ultimately for cattle producers toward controlling this disease. (k-state.edu)
Efficacy concerns over the current anaplasmosis control measures underscore the need for updated science-based recommendations to help cattle producers manage this disease. (k-state.edu)

Cases of anaplasmosis have been on the rise in our state since 2014, and in 2022 (13 cases), there was a significant increase of anaplasmosis cases compared to 2021 (10 cases). (tn.gov)
The gradient on the map below refers to average anaplasmosis incidence rates for each county in Tennesee from 2012-2022, which was calculated using county population data from the 2020 U.S. Census. (tn.gov)
Note: The n=74 in this chart refers to reported cases of anaplasmosis from 2012-2022 with recorded illness onset dates. (tn.gov)

A few people have developed anaplasmosis after they had a blood transfusion from a person who had been recently infected or who was infected but had no symptoms. (merckmanuals.com)
While it is rare, it is possible for HGA to be transmitted human-to-human via a blood transfusion, in which case it is called Transfusion-Transmitted Anaplasmosis (TTA). (wikipedia.org)

Spread by the black-legged deer tick, Anaplasmosis is one such disease in dogs. (islandpethospital.com)

What are the signs and symptoms of anaplasmosis? (tn.gov)
Signs and symptoms of anaplasmosis typically develop within 1-2 weeks after being bitten by an infected tick. (tn.gov)
For more information, see the CDC's Anaplasmosis Signs and Symptoms web page. (tn.gov)
Although some dogs with anaplasmosis show no symptoms at all, the most common signs are small to severe flu symptoms. (islandpethospital.com)

A rash may develop on the torso, arms, and legs in some people with ehrlichiosis but is uncommon in people with anaplasmosis. (merckmanuals.com)
The goal is to begin treatment before this rash appears . (healthline.com)

Six cases of anaplasmosis, a rare tick-borne disease, have been reported this year. (lite987.com)

Anaplasmosis is a bacterial disease that affects both domestic and wild animals. (manmadecattle.com)

The global market for anaplasmosis treatment is expected to grow at a CAGR of approximately 6.3% during the forecast period 2017-2023. (medgadget.com)
HPEPH states this is the first probable case of anaplasmosis identified in the region since the disease was identified as a reportable disease of public health significance in Ontario on July 1, 2023. (countylive.ca)
By leveraging existing data from clinical studies for approved drugs, working with drug sponsors to identify data gaps, and supporting targeted new research to establish effective minimum durations of treatment, FDA can still achieve its goal of establishing duration limits before the close of the five-year plan in 2023. (pewtrusts.org)

In Tennessee, illness onset for cases of anaplasmosis is mainly reported in the warmer months of the year. (tn.gov)
If treatment is delayed or if there are other medical conditions present, anaplasmosis can, in rare cases, cause severe illness. (tn.gov)
Public health states that for most people, anaplasmosis is a mild illness. (countylive.ca)
Treatment may be given at home or in the hospital based on your illness. (epnet.com)
Anaplasmosis can cause severe illness and even death in rare cases. (lite987.com)
If symptoms begin, contact a physician immediately and a simple treatment regimen with Doxycycline , a broad-spectrum antibiotic, will most likely resolve the illness. (diseasedaily.org)

Late treatment can lead to permanent organ damage. (coastalpet.com)
Some long-term effects of anaplasmosis in dogs can include respiratory failure, bleeding issues, and organ problems. (islandpethospital.com)
Left untreated Anaplasmosis can result in serious health complications for your dog including respiratory failure, organ failure, and bleeding problems. (islandpethospital.com)

No vaccine is available to prevent anaplasmosis. (vin.com)

Kansas State University researchers have developed a unique bovine test for both anaplasmosis and theileriosis. (dtnpf.com)
Producers and other individuals interested in learning more about anaplasmosis can register for at vet.k-state.edu/education/continuing/conferences/Bovine-Symposium/index.html . (k-state.edu)

European market is projected to hold the second largest share of the global anaplasmosis treatment market as due to the eradication of these disease from Europe. (medgadget.com)
For more information about this disease, see the CDC's Anaplasmosis Home Page . (tn.gov)
Depending on how advanced the disease is, dogs may also need other therapeutic treatments. (coastalpet.com)
Kansas State University researchers have developed new screening tests for anaplasmosis and the emerging disease theileriosis. (dtnpf.com)
The Maine Center for Disease Control and Prevention (CDC) issued an alert on August 9 about an increase in anaplasmosis cases this year. (diseasedaily.org)
Anaplasmosis is an emerging infectious disease in Maine. (diseasedaily.org)

Sometimes anaplasmosis can be diagnosed by finding the organisms in a blood sample by using a microscope. (vin.com)

With proper treatment and continual preventative measures, most dogs recover easily. (coastalpet.com)
Today, our Las Vegas veterinarians share the symptoms of Anaplasmosis in dogs and how this potentially serious condition is treated. (islandpethospital.com)
Remember, undiagnosed anaplasmosis in dogs can potentially be fatal. (islandpethospital.com)
Does anaplasmosis go away in dogs? (islandpethospital.com)
In very severe cases Anaplasmosis in dogs can be fatal. (islandpethospital.com)
How is Anaplasmosis diagnosed in dogs? (islandpethospital.com)
The first symptoms of Anaplasmosis will typically appear in dogs between 2 - 4 weeks after being bitten by an infected tick. (islandpethospital.com)
Anaplasmosis in dogs can be treated with a course of an antibiotic such as Doxycycline, Minocycline, Tetracycline, or Chloramphenicol. (islandpethospital.com)
One of the most reliable ways to help prevent Anaplasmosis in dogs is by keeping your pet on tick-prevention meds year-round. (islandpethospital.com)

Our case series further serves to highlight the critical importance of prompt antimicrobial treatment to reduce morbidity and potential mortality. (canlyme.com)
Reif said that treatment policies should be based on a firm understanding of how antimicrobial therapeutic effect can be maximized while minimizing risk of resistance development. (k-state.edu)

Where does anaplasmosis occur in Tennessee? (tn.gov)
64% of anaplasmosis cases occur in the mid to late summer months between June and September. (tn.gov)

The frequency of reported cases of anaplasmosis is highest among people over 40 years of age. (medgadget.com)
Dickson County reported 12 anaplasmosis cases (or 12% of all reported cases) during that time. (tn.gov)
The number of reported anaplasmosis cases is lowest in the winter (December-February), slightly increases in the spring (March-May), peaks in the mid to late summer (June-September), and then gradually declines through autumn (October-November). (tn.gov)
Thus, this figure only accounts for a portion of the total number of anaplasmosis cases reported during this time period. (tn.gov)
However, most cases of anaplasmosis are reported in residents between the ages of 35 and 70. (tn.gov)
What are the trends of anaplasmosis cases in Tennessee over time? (tn.gov)
TREATMENT In general, people with mild cases do not benefit from antifungal medicine. (ipl.org)
Six states (New York, Connecticut, Massachusetts, Rhode Island, Minnesota and Wisconsin) report 88 percent of all cases of anaplasmosis. (lifespan.org)
For symptomatic cases, treatment is recommended. (medscape.com)
So far this year, 38 cases of anaplasmosis have been reported in Maine, an increase from the 26 of 2011. (diseasedaily.org)
Since the mid-1990s anaplasmosis nationwide has exhibited a steadily increasing curve from near non-existence to a thousand incident cases annually. (diseasedaily.org)

We offer diagnostic and treatment options for common and complex medical conditions. (massgeneral.org)

About as common as Anaplasmosis, chronic Ehrlichiosis can cause anemia, eye and neurological problems, and joint issues. (coastalpet.com)

Prompt treatment increases the likelihood of therapeutic success. (medscape.com)

Usually, anaplasmosis is more common in males than in females and are generally not occurring in infants. (medgadget.com)

Doxycycline is the treatment of choice. (wikipedia.org)
If anaplasmosis is suspected, treatment should not be delayed while waiting for a definitive laboratory confirmation, as prompt doxycycline therapy has been shown to improve outcomes. (wikipedia.org)

Anaplasmosis treatment is now being controlled in North America due to numerous veterinary control measures such as routine screening and vaccination of domestic livestock. (medgadget.com)
Anaplasmosis is prevalent in tropical and subtropical regions, where it can cause significant economic losses in the livestock industry. (manmadecattle.com)

Anaplasmosis occurs in the Northeast, mid-Atlantic states, upper Midwest, and West Coast of the United States. (merckmanuals.com)
Anaplasmosis also occurs in Europe. (merckmanuals.com)

Anatomy2

Organisms14

Diseases11

Chemicals and Drugs3

Analytical, Diagnostic and Therapeutic Techniques and Equipment4

Health Care3

Geographicals1

Human granulocytic6

Lyme Disease32

Ticks7

Diagnosing Anaplasmosis1

Black-legged tick2

Babesiosis2

Anaplasma7

Infection6

Risk of contracting1

Diagnosis and Treatment5

Rocky Mount1

Ehrlichiosis and Anaplasmosis4

Infections5

Bacteria3

Antibiotics7

Fever2

Tickborne diseases1

Diseases2

Antibiotic treatment2

Cattle11

20223

Blood transfusion2

Deer1

Signs4

Rash2

Rare tick-borne d1

Bacterial1

20233

Illness6

Organ3

Vaccine1

Bovine2

Disease6

Organisms1

Dogs9

Antimicrobial2

Occur2

Cases11

Diagnostic1

Anemia1

Therapeutic1

Common1

Doxycycline2

Livestock2

Occurs2