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Pustijanac E, Buršić M, Millotti G, Paliaga P, Iveša N, Cvek M. Tick-Borne Bacterial Diseases in Europe: Threats to public health. Eur J Clin Microbiol Infect Dis 2024; 43:1261-1295. [PMID: 38676855 DOI: 10.1007/s10096-024-04836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Tick-borne diseases, caused by bacterial pathogens, pose a growing threat to public health in Europe. This paper provides an overview of the historical context of the discovery of the most impactful pathogens transmitted by ticks, including Borrelia burgdorferi sensu lato, Rickettsia spp., Anaplasma spp., Francisella spp., Ehrlichia spp., and Neoehrlichia mikurensis. Understanding the historical context of their discovery provides insight into the evolution of our understanding of these pathogens. METHODS AND RESULTS Systematic investigation of the prevalence and transmission dynamics of these bacterial pathogens is provided, highlighting the intricate relationships among ticks, host organisms, and the environment. Epidemiology is explored, providing an in-depth analysis of clinical features associated with infections. Diagnostic methodologies undergo critical examination, with a spotlight on technological advancements that enhance detection capabilities. Additionally, the paper discusses available treatment options, addressing existing therapeutic strategies and considering future aspects. CONCLUSIONS By integrating various pieces of information on these bacterial species, the paper aims to provide a comprehensive resource for researchers and healthcare professionals addressing the impact of bacterial tick-borne diseases in Europe. This review underscores the importance of understanding the complex details influencing bacterial prevalence and transmission dynamics to better combat these emerging public health threats.
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Affiliation(s)
- Emina Pustijanac
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia.
| | - Moira Buršić
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Gioconda Millotti
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Paolo Paliaga
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Neven Iveša
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Maja Cvek
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000, Rijeka, Croatia
- Teaching Institute of Public Health of the Region of Istria, Nazorova 23, 52100, Pula, Croatia
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Binay UD, Barkay O, Karakeçili F, Gül Ö, Tanoğlu C, Sümer B. A Case of Mediterranean Spotted Fever with Cerebral Infarction. Vector Borne Zoonotic Dis 2024; 24:451-452. [PMID: 38608220 DOI: 10.1089/vbz.2023.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Affiliation(s)
- Umut Devrim Binay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Orçun Barkay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Faruk Karakeçili
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Özlem Gül
- Department of Infectious Disease and Clinical Microbiology, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, Sisli, Turkey
| | - Ceyda Tanoğlu
- Department of Neurology, İzmir Tepecik Training and Research Hospital, Konak, Turkey
| | - Betül Sümer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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Sidhoum NR, Boucheikhchoukh M, Azzouzi C, Mechouk N, Culda CA, Ionică AM, Balmos OM, Mihalca AD, Deak G. Molecular survey of flea-borne pathogens in fleas associated with carnivores from Algeria and an Artificial Neural Network-based risk analysis of flea-borne diseases. Res Vet Sci 2024; 171:105235. [PMID: 38554609 DOI: 10.1016/j.rvsc.2024.105235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
As ectoparasites and efficient vectors of pathogens fleas constitute a source of nuisance for animals as well as a major issue for public health in Algeria. In this study, a molecular survey has been conducted to investigate the presence of pathogens in fleas infesting domestic and wild carnivores in the central north and eastern north and south of Algeria. The molecular screening that targeted Acanthocheilonema reconditum, Bartonella spp.,and Dipylidium caninum, was supplemented by a comprehensive analysis of risk factors related to flea-borne pathogens, drawing data from all documentation across multiple languages and sources from Morocco, Algeria, and Tunisia. In the current study, several Bartonella spp. 56/430 (13.02%) and Dipylidium caninum 3/430 (0.7%) were identified. The sequencing results revealed 5/23 (21.74%) B. clarridgeiae, 3/23 (13.04%) B. henselae, and 3/23 (13.04%) B. vinsonii. The two haplotypes, H1 and H2, of D. caninum were identified for the first time in North Africa. The results of the Artificial Neural Network risk analyses unveiled that the prevalence of pathogens and the presence of host generalist fleas as well as the vectorial competence are the most determinant risk factors of flea-borne diseases in Maghreb.
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Affiliation(s)
- Noureddine Rabah Sidhoum
- Department of Veterinary Sciences, Chadli Bendjedid El Tarf University, PB 73, El-Tarf 36000, Algeria; Biodiversity and Ecosystems Pollution Laboratory, Faculty of Life and Nature Sciences, Chadli Bendjedid El Tarf University, El Tarf 36000, Algeria
| | - Mehdi Boucheikhchoukh
- Department of Veterinary Sciences, Chadli Bendjedid El Tarf University, PB 73, El-Tarf 36000, Algeria.
| | - Chaima Azzouzi
- Department of Veterinary Sciences, Chadli Bendjedid El Tarf University, PB 73, El-Tarf 36000, Algeria; Biodiversity and Ecosystems Pollution Laboratory, Faculty of Life and Nature Sciences, Chadli Bendjedid El Tarf University, El Tarf 36000, Algeria
| | - Noureddine Mechouk
- Ecology of Terrestrial and Aquatics Systems Laboratory (EcoSTAq), Department of Biology, Faculty of Science, Badji Mokhtar University, Annaba 23200, Algeria; Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Mănăștur 3-5, Cluj-Napoca 400372, Romania
| | - Carla Andreea Culda
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Mănăștur 3-5, Cluj-Napoca 400372, Romania
| | - Angela Monica Ionică
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Mănăștur 3-5, Cluj-Napoca 400372, Romania; Clinical Hospital of Infectious Diseases of Cluj-Napoca, Iuliu Moldovan 23, Cluj-Napoca 400348, Romania
| | - Oana-Maria Balmos
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Mănăștur 3-5, Cluj-Napoca 400372, Romania
| | - Andrei Daniel Mihalca
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Mănăștur 3-5, Cluj-Napoca 400372, Romania
| | - Georgiana Deak
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Mănăștur 3-5, Cluj-Napoca 400372, Romania.
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Luo S, Yang S, Liu A, Wu H, Gao L, Wu X, Dong Y, Li B, Ma W, Peng L, Bao F. Serological and molecular epidemiological investigation of Mediterranean spotted fever in Yunnan Province, China. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 118:105560. [PMID: 38262571 DOI: 10.1016/j.meegid.2024.105560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Given the limited research and its potential hazards, the study aimed to determine the prevalence of Mediterranean spotted fever (MSF) caused by Rickettsia conorii (R. conorii), a tick-borne disease, in Yunnan Province, China. METHODS Through stratified sampling across five distinct regions in Yunnan, 5358 blood samples were obtained from the general healthy population. Enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence assay (IFA), and Polymerase chain reaction (PCR) were employed for analysis. RESULTS IFA identified 27 (0.50%) subjects with immunoglobulin G (IgG) positivity; none were positive for immunoglobulin M (IgM) via ELISA. PCR detected one individual with R. conorii outer membrane protein A (ompA). Significant seroprevalence variation was observed, particularly in Southern Yunnan (P = 0.032), with R. conorii subsp. conorii confirmed in the PCR-positive sample. CONCLUSIONS This research reveals a correlation between MSF prevalence, geography, and climate in Yunnan. The paucity of prior studies underscores MSF's potential diagnostic challenges in the region. Comprehensive understanding of the pathogen's distribution is pivotal for intervention. Given the study's scope and Yunnan's unique setting, additional research is advocated.
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Affiliation(s)
- Suyi Luo
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Shuyue Yang
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Aihua Liu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China; Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University, Kunming 650500, China; Yunnan Province Key Laboratory of Children's Major Diseases Research, The Affiliated Children's Hospital, Kunming, Kunming Medical University, Kunming 650030, China; Yunnan Demonstration Base of International Science and Technology Cooperation for Tropical Diseases, Kunming 650500, China
| | - Hanxin Wu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Li Gao
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Xinya Wu
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Yan Dong
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Bingxue Li
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Weijiang Ma
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Li Peng
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China
| | - Fukai Bao
- The Institute for Tropical Medicine, School of Basic Medical Sciences, Kunming Medical University, Kunming 650500, China; Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University, Kunming 650500, China; Yunnan Province Key Laboratory of Children's Major Diseases Research, The Affiliated Children's Hospital, Kunming, Kunming Medical University, Kunming 650030, China; Yunnan Demonstration Base of International Science and Technology Cooperation for Tropical Diseases, Kunming 650500, China.
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Hosseininasab A, MoradKasani S, Mostafavi E, Baseri N, Sadeghi M, Esmaeili S. Rickettsia conorii subsp. israelensis infection in a pediatric patient presenting skin rash and abdominal pain: a case report from Southeast Iran. BMC Infect Dis 2024; 24:114. [PMID: 38254000 PMCID: PMC10804630 DOI: 10.1186/s12879-024-09002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The healthcare system in Iran appears to overlook Mediterranean spotted fever (MSF) as an endemic disease, particularly in pediatric cases, indicating the need for greater attention and awareness. CASE PRESENTATION A six-year-old patient with fever, abdominal pain, headache, skin rashes, diarrhea, vomiting, and black eschar (tache noire) from southeast Iran was identified as a rickettsiosis caused by Rickettsia conorii subsp. israelensis through clinical and laboratory assessments, including IFA and real-time PCR. The patient was successfully treated with doxycycline. CONCLUSIONS Symptoms like rash, edema, eschar, and abdominal pain may indicate the possibility of MSF during the assessment of acute febrile illness, IFA and real-time PCR are the primary diagnostic methods for this disease.
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Affiliation(s)
- Ali Hosseininasab
- Research Center of Tropical and Infectious Diseases, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Safoura MoradKasani
- National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Kabudar Ahang, Akanlu, Hamadan, Iran
| | - Ehsan Mostafavi
- National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Kabudar Ahang, Akanlu, Hamadan, Iran
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Neda Baseri
- National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Kabudar Ahang, Akanlu, Hamadan, Iran
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- , Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Iran
| | - Maryam Sadeghi
- Research Center of Tropical and Infectious Diseases, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Saber Esmaeili
- National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Kabudar Ahang, Akanlu, Hamadan, Iran.
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.
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Xu N, Liu H, Qu C, Wen S, Zou W, Chang C, Wang G. The presence of foci of Rickettsia conorii infection in China. INFECTIOUS MEDICINE 2023; 2:334-337. [PMID: 38205175 PMCID: PMC10774659 DOI: 10.1016/j.imj.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/12/2023] [Accepted: 09/06/2023] [Indexed: 01/12/2024]
Abstract
China is not considered as an endemic area of Rickettsia conorii, so there is no routine clinical way to diagnose this infection. This study aims to determine whether 2 febrile patients who had a tick bite in East China were indeed infected with R. conorii. The citrate synthase gene (gltA) was amplified with universal rickettsial primers by real-time fluorescent PCR from the patients' blood samples. Nested PCR was used to amplify the outer membrane protein A gene (ompA) for positive specimens. PCR products were further identified and analyzed through nucleic acid sequencing. Positive amplification of the gltA and ompA genes was found in both patients. The nucleotide sequences (303 bp) of the ompA gene of the 2 patients had high homology (99%) with the R. conorii Indian tick typhus strain in GenBank. A more than 4-fold increase in IgG against R. conorii provided supportive evidence of SFG Rickettsia infection. And the rapid recovery after doxycycline treatment also supported a rickettsial cause for the disease. Physicians in East China should be aware of human infections with R. conorii. PCR-based diagnostic methods offer a rapid and precise way to diagnose rickettsiosis, improving patient identification and management.
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Affiliation(s)
- Nannan Xu
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Hui Liu
- Institute of Bacterial Disease, Jinan Center for Disease Control and Prevention, Jinan 250021, China
| | - Chunmei Qu
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Sai Wen
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Wenlu Zou
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Caiyun Chang
- Institute for Infectious Disease Control, Jinan Center for Disease Control and Prevention, Jinan 250021, China
| | - Gang Wang
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
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Yessinou RE, Cazan CD, Panait LC, Mollong E, Biguezoton AS, Bonnet SI, Farougou S, Groschup MH, Mihalca AD. New geographical records for tick-borne pathogens in ticks collected from cattle in Benin and Togo. Vet Med Sci 2023; 9:345-352. [PMID: 36508582 PMCID: PMC9856996 DOI: 10.1002/vms3.1022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Ticks are obligate hematophagous arthropods capable of transmitting a great variety of endemic and emerging pathogens causing diseases in animals and humans. OBJECTIVES The aim of this study was to investigate the presence of Bartonella spp., Rickettsia spp., Borrelia burgdorferi sensu lato (s.l.) and Anaplasma phagocytophilum in ticks collected from cattle in Benin and Togo. METHODS Overall, 396 (148 males, 205 females and 43 nymphs) ticks were collected from cattle in 17 districts (Benin and Togo) between 2019 and 2020. Ticks were pooled into groups of 2-6 ticks per pool according to individual host, location, species and developmental stage. The DNA of each pool was extracted for molecular screening. RESULTS PCR results revealed that 20 tick pools were positive for Bartonella spp. (Benin and Togo) and 23 tick pools positive for Rickettsia spp. (Benin), while all pools were negative for A. phagocytophilum and B. burgdorferi s.l. Sequence analysis of positive Rickettsia samples revealed the presence of Rickettsia aeschlimannii. CONCLUSIONS The present study highlights the presence of zoonotic agents in ticks collected from cattle in Benin and Togo. This information will raise awareness of tick-borne diseases among physicians and veterinarians, stimulate further studies to monitor these pathogens, and advise on necessary measures to control the spread of these zoonoses.
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Affiliation(s)
- Roland Eric Yessinou
- Communicable Disease Research Unit (URMaT)University of Abomey‐CalaviCotonouBenin
| | - Cristina Daniela Cazan
- Department of Parasitology and Parasitic DiseasesFaculty of Veterinary MedicineUniversity of Agricultural Sciences and Veterinary Medicine of Cluj‐NapocaCluj‐NapocaRomania
- CDS‐9, Molecular Biology and Veterinary Parasitology UnitFaculty of Veterinary MedicineUniversity of Agricultural Sciences and Veterinary Medicine of Cluj‐NapocaCluj‐NapocaRomania
| | - Luciana Cătălina Panait
- Department of Parasitology and Parasitic DiseasesFaculty of Veterinary MedicineUniversity of Agricultural Sciences and Veterinary Medicine of Cluj‐NapocaCluj‐NapocaRomania
| | - Eyabana Mollong
- Laboratory of Applied EntomologySection: Agro‐Resources Protection, Faculty of SciencesUniversity of LomeLomeTogo
| | - Abel S. Biguezoton
- Unité Maladies à Vecteurs et Biodiversité (UMaVeB)Centre International de Recherche‐Développement sur l'Elevage en zone Subhumide (CIRDES)Bobo‐DioulassoBurkina Faso
| | - Sarah Irène Bonnet
- Functional Genetics of Infectious Diseases UnitInstitut Pasteur, CNRS UMR 2000Université de Paris, Paris 7France
- Animal Health DepartmentNouzillyFrance
| | - Souaïbou Farougou
- Communicable Disease Research Unit (URMaT)University of Abomey‐CalaviCotonouBenin
| | - Martin H. Groschup
- Friedrich‐Loeffler‐Insitut (FLI)Federal Research Institute for Animal HealthInstitute of Novel and Emerging Infectious DiseasesGreifswald‐Insel RiemsGermany
| | - Andrei Daniel Mihalca
- Department of Parasitology and Parasitic DiseasesFaculty of Veterinary MedicineUniversity of Agricultural Sciences and Veterinary Medicine of Cluj‐NapocaCluj‐NapocaRomania
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Onyiche TE, Labruna MB, Saito TB. Unraveling the epidemiological relationship between ticks and rickettsial infection in Africa. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.952024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tick-borne rickettsioses are emerging and re-emerging diseases of public health concern caused by over 30 species of Rickettsia. Ticks are obligate hematophagous arthropods with over 700 species of Ixodid ticks known worldwide. The escalating geographical dispersal of tick vectors and concomitant increase in the incidences of tick-borne diseases have fueled interest in the ecology of tick-borne pathogens. This review focuses on aspects of the Rickettsia pathogen, including biology, taxonomy, phylogeny, genetic diversity, epidemiology of the disease, and the role of vertebrate host in the perpetuation of rickettsioses in Africa. Our review also highlights some of the species of Rickettsia that are responsible for disease, the role of tick vectors (both hard and soft ticks) and the species of Rickettsia associated with diverse tick species across the continent. Additionally, this article emphasizes the evolutionary perspective of rickettsiae perpetuation and the possible role of amplifying vertebrate host and other small mammals, domestic animals and wildlife in the epidemiology of Rickettsia species. We also specifically, discussed the role of avian population in the epidemiology of SFG rickettsiae. Furthermore, we highlighted tick-borne rickettsioses among travelers due to African tick-bite fever (ATBF) and the challenges to surveillance of rickettsial infection, and research on rickettsiology in Africa. Our review canvasses the need for more rickettsiologists of African origin based within the continent to further research towards understanding the biology, characterization, and species distribution, including the competent tick vectors involved in their transmission of rickettsiae across the continent in collaboration with established researchers in western countries. We further highlighted the need for proper funding to encourage research despite competing demands for resources across the various sectors. We finalize by discussing the similarities between rickettsial diseases around the world and which steps need to be taken to help foster our understanding on the eco-epidemiology of rickettsioses by bridging the gap between the growing epidemiological data and the molecular characterization of Rickettsia species.
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Investigation of Rickettsia conorii in Patients Suspected of Having Crimean-Congo Hemorrhagic Fever. Pathogens 2022; 11:pathogens11090973. [PMID: 36145405 PMCID: PMC9502110 DOI: 10.3390/pathogens11090973] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
Rickettsia conorii is the causative agent of Mediterranean spotted fever (MSF). Misdiagnosis of MSF may occur with febrile syndromes associated with rash and thrombocytopenia, such as Crimean-Congo hemorrhagic fever (CCHF). This study aimed to determine the prevalence of R. conorii among serum samples obtained from 260 suspected CCHF patients with features of MSF in Iran (2018–2020). The quantitative polymerase chain reaction (qPCR) method detected three (1.15%) positive 16S rDNA Rickettsia spp. samples that were classified as R. conorii subsp. conorii, R. conorii subsp. Israelensis, and R. helvetica using the sequencing of gltA, ompA, and 17kDa genes. Furthermore, R. conorii IgM antibodies presented in 38 (14.62%) patients by the enzyme-linked immunosorbent assay (ELISA) method. Out of 97 MSF patients with available paired serum samples, IgM seroconversion and a four-fold increase were observed in 14 (14.43%) and 12 (12.37%) patients, respectively. We concluded that rickettsial agents are present in Iran and may be misdiagnosed with other febrile syndromes.
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Latifian M, Khalili M, Farrokhnia M, Mostafavi E, Esmaeili S. Rickettsia conorii subsp. israelensis infection: a case report from southeast Iran. BMC Infect Dis 2022; 22:320. [PMID: 35365079 PMCID: PMC8974134 DOI: 10.1186/s12879-022-07291-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mediterranean spotted fever (MSF) is a zoonotic and vector-borne disease caused by Rickettsia conorii. We report a case (36 year-old-woman) of MSF caused by Rickettsia conorii from Iran. Case presentation In September 2019, the patient was admitted to the hospital in Kerman province with flu-like symptoms and maculopapular lesions. According to the laboratory results, thrombocytopenia, elevated liver enzymes, and cardiac enzymes were observed. Skin biopsy was examined for Crimean-Congo Hemorrhagic Fever (CCHF) and MSF using the Real-Time-PCR and ELISA method. Finally, the sample was positive for Rickettsia conorii subsp. israelensis and treated with doxycycline and completely recovered. Conclusions This study showed that MSF could be present in Iran. Therefore, identifying endemic areas in Iran for this disease should be on the agenda.
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Affiliation(s)
- Mina Latifian
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.,National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, KabudarAhang, Hamadan, Iran
| | - Mohammad Khalili
- Department of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mehrdad Farrokhnia
- Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.,National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, KabudarAhang, Hamadan, Iran
| | - Saber Esmaeili
- Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran. .,National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, KabudarAhang, Hamadan, Iran.
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Peregrina-Rivas JA, Guirao-Arrabal E, Ramos-Pleguezuelos FM, Hernández-Quero J. Erythema nodosum: An uncommon manifestation of Rickettsiosis. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:151-152. [PMID: 35249676 DOI: 10.1016/j.eimce.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/20/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | - Emilio Guirao-Arrabal
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain.
| | | | - José Hernández-Quero
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain
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12
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Igolkina Y, Rar V, Krasnova E, Filimonova E, Tikunov A, Epikhina T, Tikunova N. Occurrence and clinical manifestations of tick-borne rickettsioses in Western Siberia: First Russian cases of Rickettsia aeschlimannii and Rickettsia slovaca infections. Ticks Tick Borne Dis 2022; 13:101927. [DOI: 10.1016/j.ttbdis.2022.101927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/30/2022]
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13
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Bouchaib H, Amrane A, Sevestre J, Bitam I, Parola P. Mediterranean spotted fever and peripheral facial nerve palsy: a rare neurological complication. Int J Infect Dis 2022; 117:15-17. [DOI: 10.1016/j.ijid.2022.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 10/19/2022] Open
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14
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Martínez-Cisneros S, Arbués-Espinosa P, Villagrasa-Boli P. [Fever after hunting season]. Aten Primaria 2021; 54:102237. [PMID: 34902612 PMCID: PMC8666641 DOI: 10.1016/j.aprim.2021.102237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sara Martínez-Cisneros
- Servicio de Dermatología y Venereología del Hospital Clínico Universitario Lozano Blesa de Zaragoza, Zaragoza, España
| | | | - Pablo Villagrasa-Boli
- Servicio de Dermatología y Venereología del Hospital Clínico Universitario Lozano Blesa de Zaragoza, Zaragoza, España.
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15
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Mediterranean Spotted Fever: Current Knowledge and Recent Advances. Trop Med Infect Dis 2021; 6:tropicalmed6040172. [PMID: 34698275 PMCID: PMC8544691 DOI: 10.3390/tropicalmed6040172] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022] Open
Abstract
Mediterranean spotted fever (MSF) is an emerging tick-borne rickettsiosis of the spotted fever group (SFG), endemic in the Mediterranean basin. By virtue of technological innovations in molecular genetics, it has been determined that the causative agent of MSF is Rickettsia conorii subspecies conorii. The arthropod vector of this bacterium is the brown dog tick Rhipicephalus sanguineus. The true nature of the reservoir of R. conorii conorii has not been completely deciphered yet, although many authors theorize that the canine population, other mammals, and the ticks themselves could potentially contribute as reservoirs. Typical symptoms of MSF include fever, maculopapular rash, and a characteristic eschar (“tache noire”). Atypical clinical features and severe multi-organ complications may also be present. All of these manifestations arise from the disseminated infection of the endothelium by R. conorii conorii. Several methods exist for the diagnosis of MSF. Serological tests are widely used and molecular techniques have become increasingly available. Doxycycline remains the treatment of choice, while preventive measures are focused on modification of human behavior and vector control strategies. The purpose of this review is to summarize the current knowledge on the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of MSF.
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16
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Efstratiou A, Karanis G, Karanis P. Tick-Borne Pathogens and Diseases in Greece. Microorganisms 2021; 9:microorganisms9081732. [PMID: 34442811 PMCID: PMC8399993 DOI: 10.3390/microorganisms9081732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 11/18/2022] Open
Abstract
Tick-borne diseases (TBDs) are recognized as a serious and growing public health epidemic in Europe, and are a cause of major losses in livestock production worldwide. This review is an attempt to present a summary of results from studies conducted over the last century until the end of the year 2020 regarding ticks, tick-borne pathogens, and tick-borne diseases in Greece. We provide an overview of the tick species found in Greece, as well as the most important tick-borne pathogens (viruses, bacteria, protozoa) and corresponding diseases in circulation. We also consider prevalence data, as well as geographic and climatic conditions. Knowledge of past and current situations of TBDs, as well as an awareness of (risk) factors affecting future developments will help to find approaches to integrated tick management as part of the ‘One Health Concept’; it will assist in avoiding the possibility of hotspot disease emergencies and intra- and intercontinental transmission. Increased surveillance in Greece is required to ensure clear and effective policies for TBD control.
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Affiliation(s)
- Artemis Efstratiou
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan;
| | - Gabriele Karanis
- Orthopädische Rehabilitationsklinik, Eisenmoorbad Bad Schmiedeberg Kur GmbH, 06905 Bad Schmiedeberg, Germany;
| | - Panagiotis Karanis
- Medical Faculty and University Hospital, The University of Cologne, 50923 Cologne, Germany
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi. P.O. Box 24005, Nicosia CY-1700, Cyprus
- Correspondence:
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17
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Silva-Ramos CR, Hidalgo M, Faccini-Martínez ÁA. Clinical, epidemiological, and laboratory features of Rickettsia parkeri rickettsiosis: A systematic review. Ticks Tick Borne Dis 2021; 12:101734. [PMID: 33989945 DOI: 10.1016/j.ttbdis.2021.101734] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 04/05/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023]
Abstract
Rickettsia parkeri rickettsiosis is recognized as the second most prevalent tick-borne disease caused by spotted fever group rickettsiae in the Americas, where two pathogenic strains (R. parkeri sensu stricto and R. parkeri strain Atlantic rainforest) have been related to human infections and transmitted by Amblyomma spp. ticks. We developed a systematic review that evaluated all available evidence in the literature regarding clinical, epidemiological, and laboratory features of R. parkeri rickettsiosis, including confirmed and probable cases. We followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide. We excluded papers that contained missing information of some variables and publications in which it was not possible to separate data for confirmed and probable cases. A total of 77 clinical cases (32 confirmed cases and 45 probable cases) were considered for this review. Overall, our results show that R. parkeri rickettsiosis is more frequent in males in the age group of 18-64 years and that a history of tick exposure was frequent (>90%). Cases were described in the United States, Argentina, Brazil, Uruguay and Colombia. Clinically, more than 60% of the cases had fever (mean of 93%), eschar (mean of 87%), and rash (mean of 68%). Headache and myalgia were predominant nonspecific symptoms (mean of 67% and 61%, respectively). Our results show that at least 60% of R. parkeri cases had altered laboratory parameters, most often showing an increase in transaminases and leukopenia. Tetracyclines-class antibiotics were used in most (>85%) of the patients. Overall, only 9% of cases required hospitalization and there was a 100% rate of clinical recovery in all of cases.
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Affiliation(s)
- Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Marylin Hidalgo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Álvaro A Faccini-Martínez
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA; Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología, Bogotá, Colombia.
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18
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Peregrina-Rivas JA, Guirao-Arrabal E, Ramos-Pleguezuelos FM, Hernández-Quero J. Erythema nodosum: An uncommon manifestation of Rickettsiosis. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00031-8. [PMID: 33622497 DOI: 10.1016/j.eimc.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/20/2022]
Affiliation(s)
| | - Emilio Guirao-Arrabal
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain.
| | | | - José Hernández-Quero
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain
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19
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Buczek A, Buczek W. Importation of Ticks on Companion Animals and the Risk of Spread of Tick-Borne Diseases to Non-Endemic Regions in Europe. Animals (Basel) 2020; 11:ani11010006. [PMID: 33375145 PMCID: PMC7822119 DOI: 10.3390/ani11010006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/14/2022] Open
Abstract
Increased human mobility elevates the risk of exposure of companion animals travelling with their owners or imported from other regions to tick attacks. In this study, we highlight the potential role of dogs and cats taken for tourist trips or imported animals in the spread of ticks and tick-borne pathogens. The Rhipicephalus sanguineus tick, which is a vector of numerous pathogens causing diseases in animals and humans, is imported most frequently from endemic areas to many European countries. Additionally, alien tick species with high epizootic and epidemiological importance can be imported on dogs from other continents. Companion animals play an even greater role in the spread of autochthonous tick species and transmission of tick pathogens to other animals and humans. Although the veterinary and medical effects of the parasitism of ticks carried by companion animals travelling with owners or imported animals are poorly assessed, these animals seem to play a role in the rapid spread of tick-borne diseases. Development of strategies for protection of the health of companion animals in different geographic regions should take into account the potential emergence of unknown animal tick-borne diseases that can be transmitted by imported ticks.
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20
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Stewart AGA, Smith S, Hanson J. Prompt defervescence after initiation of treatment for rickettsial infections - time to dispense with the dogma? Int J Infect Dis 2020; 102:132-135. [PMID: 33075531 DOI: 10.1016/j.ijid.2020.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Clinicians are commonly taught that if patients with suspected rickettsial disease have continuing fever after 48 hours of anti-rickettsial therapy, an alternative diagnosis is likely. METHODS This retrospective study of patients hospitalised with scrub typhus and Queensland tick typhus (QTT) in tropical Australia, examined the time to defervescence after initiation of the patients' anti-rickettsial therapy. It also identified factors associated with delayed defervescence (time to defervescence >48 hours after antibiotic commencement). RESULTS Of the 58 patients, 32 (56%) had delayed defervescence. The median (interquartile range (IQR)) age of patients with delayed defervescence was 52 (37-62) versus 40 (28-53) years in those who defervesced within 48 hours (p = 0.05). Patients with delayed defervescence were more likely to require Intensive Care Unit (ICU) admission than those who defervesced within 48 hours (12/32 (38%) versus 3/26 (12%), p = 0.02). Even among patients not requiring ICU care, patients with delayed defervescence required a longer hospitalisation than that those who defervesced within 48 hours (median (IQR): 6 (3-8) versus 3 (2-5) days, p = 0.006). CONCLUSIONS A significant proportion of patients with confirmed scrub typhus and QTT will remain febrile for >48 hours after appropriate anti-rickettsial therapy. Delayed defervescence is more common in patients with severe disease.
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Affiliation(s)
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia; The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
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21
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Leibovitz E, Kapelushnik J, Alsanaa S, Tschernin D, Sergienko R, Leibovitz R, Mazar J, Fruchtman Y. Comparison of the etiologic, microbiologic, clinical and outcome characteristics of febrile vs. non-febrile neutropenia in hospitalized immunocompetent children. Eur J Clin Microbiol Infect Dis 2020; 39:2415-2426. [PMID: 32720090 PMCID: PMC7384562 DOI: 10.1007/s10096-020-03938-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/01/2020] [Indexed: 11/30/2022]
Abstract
We compared the etiologic, microbiologic, clinical, and outcome picture among febrile and non-febrile immunocompetent children hospitalized during 2013–2015 with acute neutropenia (absolute neutrophil count < 1.5 × 109/L). Serious bacterial infections (SBI) were defined as culture-positive blood, urine, cerebrospinal fluid, articular fluid or stool infections, pneumonia, brucellosis, and rickettsiosis. Overall, 664 children < 18 years of age were enrolled; 407 (62.2%) had fever > 38.0 °C and 247 (37.8%) were non-febrile at admission. There were 425 (64.0%), 125 (18.8%), 48 (7.2%), and 66 (9.9%) patients aged 0–24 months, 2-6, 7–12, and > 12 years, respectively. No differences were recorded in the distribution of febrile vs. non-febrile patients among the age groups nor among the 3 neutropenia severity groups (< 0.5, 0.5–1.0 and 1.0–1.5 × 109/L). SBI infections were diagnosed in 98 (14.8%) patients, with higher rates among febrile patients vs. non-febrile patients (16.8% vs. 11.5%, P = 0.06). Brucellosis and rickettsiosis were diagnosed in 15.4% and 23.1% tests performed, respectively. 295/688 (42.9%) virologic examinations returned positive. Among patients < 24 months, more febrile ones had viral infectious compared with afebrile patients (P = 0.025). Acute leukemia was diagnosed in 6 patients. Neutropenia resolved in 163/323 (50.5%) patients during a 1-month follow-up. No differences were recorded in neutropenia resolution between febrile and non-febrile children among all 3 severity groups. Severe neutropenia was rare and occurred mainly in very young patients. SBIs were more common among febrile patients compared with non-febrile patients, but there was no association between severity of neutropenia or its resolution and the presence or absence of fever at diagnosis.
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Affiliation(s)
- Eugene Leibovitz
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel. .,Soroka University Medical Center, Beer Sheva, Israel. .,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel. .,Pediatric Infectious Disease Unit, Soroka University Medical Center, P.O. Box 151, 84101, Beer Sheva, Israel.
| | - Joseph Kapelushnik
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Sabrin Alsanaa
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Dov Tschernin
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Ruslan Sergienko
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.,Epidemiology Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Ron Leibovitz
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Julia Mazar
- Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.,Laboratory of Hematology, Soroka University Medical Center, Beer Sheva, Israel
| | - Yariv Fruchtman
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
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22
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Biswal M, Zaman K, Suri V, Gopi S, Kumar A, Gopi T, Vig S, Sharma N, Bhalla A. Molecular confirmation & characterization of Rickettsia conorii in north India: A report of three cases. Indian J Med Res 2020; 151:59-64. [PMID: 32134015 PMCID: PMC7055166 DOI: 10.4103/ijmr.ijmr_92_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background & objectives In India, spotted fever group rickettsiae (SFGR) are an underdiagnosed cause of acute febrile illness (AFI). The non-specific Weil-Felix test is the first diagnostic modality for the diagnosis of SFGR in many laboratories due to the lack of advanced diagnostic facilities in developing countries. The aim of this study was to detect SFGR using molecular methods in the patients, presenting with AFI in a tertiary care centre in north India. Methods Consecutive patients (>14 yr of age) with AFI were enrolled over a six month period. Standard investigations for common pathogens causing AFI in India (malaria, dengue, scrub typhus, leptospirosis and enteric fever) were carried out. In patients who were negative for all of the above investigations, blood was subjected to polymerase chain reaction (PCR) targeting outer membrane protein A (ompA) gene of Rickettsia. Results Of the 51 patients with an undiagnosed aetiology, three were positive by ompA PCR. Two of the PCR products produced good sequences and BLAST identification confirmed them as Rickettsia conorii. The sequences of R. conorii reported from south India clustered with two previously reported novel rickettsial genotypes. The study sequences clustered in a group different from that of Rickettsia spp. of the south Indian sequences reported earlier. Interpretation & conclusions This study showed the existence of R. conorii in north India. Testing for SFGR may be included in the diagnostic workup of AFI for better disease management.
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Affiliation(s)
- Manisha Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kamran Zaman
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Vikas Suri
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Srikanth Gopi
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Abhay Kumar
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - T Gopi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Shashi Vig
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Navneet Sharma
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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23
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Romaní Vidal A, Fernández-Martínez B, Herrador Z, León Gómez I, Gómez Barroso D. Spatial and temporal trends of Mediterranean spotted fever in Spain, 2005-2015. Ticks Tick Borne Dis 2019; 11:101353. [PMID: 31839472 DOI: 10.1016/j.ttbdis.2019.101353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mediterranean spotted fever (MSF) is a zoonotic disease caused by Rickettsia conorii and transmitted by Rhipicephalus sanguineus sensu lato. The aim of this study is to understand the epidemiology and trends regarding the disease in Spain, based on notifications to the Spanish National Epidemiology Surveillance Network (RENAVE) and the National Hospital Discharge Database (CMBD) between 2005 and 2015. METHODS We carried out a retrospective cross-sectional study of the cases and the outbreaks reported to the RENAVE and of those found in the CMBD between January 1st, 2005 and December 31st, 2015. We studied the characteristics of the cases and analyzed their spatio-temporal distribution. RESULTS 1603 cases notified to the RENAVE and 1789 cases registered in the CMBD were analyzed. The most affected group were men between 45 and 64. There were 8 MSF outbreaks during the study period. RENAVE registered lower rates until 2012, when it was decided that MSF in Spain would become a notifiable disease. Across the temporal series we saw that there was seasonality with an increase in cases in summer, and an overall upward trend according to the RENAVE data and descending according to the CMBD. The geographic distribution was heterogeneous throughout the territory, with maximum rates in La Rioja at 1.87 cases and 2.01 cases per 100,000 inhabitants according to the RENAVE and the CMBD, respectively. CONCLUSIONS It is of great importance to continue monitoring the disease since it appears to be endemic throughout Spain. There is a need for a common strategy on monitoring and reporting, which would facilitate a more accurate picture on the MSF epidemiological scenario. Entomological information will be of added value.
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Affiliation(s)
- Adriana Romaní Vidal
- Public Health and Preventive Medicine Service, Ramón y Cajal University Hospital, Ctra. Colmenar Viejo, Km. 9, 100, 28034, Madrid, Spain.
| | - Beatriz Fernández-Martínez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, Calle De Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Zaida Herrador
- National Centre of Tropical Medicine, Instituto De Salud Carlos III, Calle De Monforte De Lemos Nº 5, 28019, Madrid, Spain; Network Biomedical Research on Tropical Diseases (RICET), Madrid, Spain
| | - Inmaculada León Gómez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, Calle De Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Diana Gómez Barroso
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, Calle De Melchor Fernández Almagro, 5, 28029, Madrid, Spain
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24
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Ogawa M, Takahashi M, Matsutani M, Takada N, Noda S, Saijo M. Obligate intracellular bacteria diversity in unfed Leptotrombidium scutellare larvae highlights novel bacterial endosymbionts of mites. Microbiol Immunol 2019; 64:1-9. [PMID: 31549736 DOI: 10.1111/1348-0421.12745] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/27/2019] [Accepted: 09/17/2019] [Indexed: 11/30/2022]
Abstract
It is well known that the mite Leptotrombidium scutellare carries the pathogen of scrub typhus, Orientia tsutsugamushi. However, our understanding of other bacterial endosymbionts of mites is limited. This study investigated the diversity of the obligate intracellular bacteria carried by L. scutellare using 16S rRNA gene amplicon analysis with next-generation sequencing. The results showed that the detected bacteria were classified into the genera Rickettsia, Wolbachia, and Rickettsiella and an unknown genus of the order Rickettsiales. For further classification of the detected bacteria, a representative read that was most closely related to the assigned taxonomic classification was subjected to homology search and phylogenic analysis. The results showed that some bacteria of the genus Rickettsia were identical or very close to the human pathogens Rickettsia akari, Rickettsia aeschlimannii, Rickettsia felis, and Rickettsia australis. The genetic distance between the genus Wolbachia bacteria in the present study and in previous reports is highly indicative that the bacteria in the present study can be classified as a new taxon of Wolbachia. This study detected obligate intracellular bacteria from unfed mites; thus, the mites did not acquire bacteria from infected animals or any other infectious sources. Finally, the present study demonstrated that various and novel bacterial endosymbionts of mites, in addition to O. tsutsugamushi, might uniquely evolve with the host mites throughout overlapping generations of the mite life cycle. The roles of the bacteria in mites and their pathogenicity should be further examined in studies based on bacterial isolation.
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Affiliation(s)
- Motohiko Ogawa
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mamoru Takahashi
- Department of Anesthesiology, Saitama Medical University, Saitama, Japan
| | - Minenosuke Matsutani
- NODAI Genome Research Center, Tokyo University of Agriculture, Setagaya, Tokyo, Japan
| | - Nobuhiro Takada
- Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Shinichi Noda
- Research Center for the Pacific Islands, Kagoshima University, Kagoshima, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
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25
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Gawie-Rotman M, Hazan G, Fruchtman Y, Cavari Y, Ling E, Lazar I, Leibovitz E. Purpuric rash and fever among hospitalized children aged 0-18 years: Comparison between clinical, laboratory, therapeutic and outcome features of patients with bacterial versus viral etiology. Pediatr Neonatol 2019; 60:556-563. [PMID: 30922715 PMCID: PMC7102717 DOI: 10.1016/j.pedneo.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The evaluation of children with purpuric rash and fever (PRF) is controversial. Although many of them have viral infections, on occasion such patients may be infected with Neisseria meningitidis. We described all children aged 0-18 years with PRF in southern Israel during the period 2005 ̶ 2016 and compared their microbiologic, laboratory, clinical and outcome characteristics in relation to various etiologies of this syndrome. METHODS Data were summarized from electronic patient and microbiology files. Viral diagnoses were made by serology and/or PCR. RESULTS Sixty-nine children with PRF were admitted; 30 (43.48%), 9 (13.04%) and 30 (43.48%) had a syndrome of bacterial, viral or non-established etiology, respectively. N. meningitidis infection was diagnosed in 16/69 (23.19%) patients and in 16/30 (53.33%) patients with bacterial etiology; 14/30 (46.67%) patients suffered from a non-invasive bacterial disease (9 with Rickettsial disease). Adenovirus and Influenza B (3 and 2 cases, respectively) represented the most frequent etiologic agents among patients with viral etiology. More patients with PRF of bacterial etiology were older, of Bedouin ethnicity, looked ill on admission, had higher rates of meningitis and were treated more frequently with antibiotics compared with patients with non-bacterial PRF. Fatality rates among patients with bacterial, viral and non-established etiology were 5/30 (16.7%), 0% and 2/39 (5.1%). CONCLUSIONS Although PFR was uncommon, high rates of meningococcal infections were recorded in children with PRF, which was associated with high fatality rates. Rickettsial infections were frequent, emphasizing the need for a high index of suspicion for this disease in endemic geographic areas.
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Affiliation(s)
- Moran Gawie-Rotman
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel,Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel
| | - Guy Hazan
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel,Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel
| | - Yariv Fruchtman
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel,Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel
| | - Yuval Cavari
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel,Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel,Pediatric Intensive Care Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Eduard Ling
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel,Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel
| | - Isaac Lazar
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel,Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel,Pediatric Intensive Care Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Eugene Leibovitz
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Pediatric Division, Soroka University Medical Center, Beer-Sheva, Israel; Pediatric Research Unit, Soroka University Medical Center, Beer-Sheva, Israel.
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Mediterranean spotted fever in the elderly: a prospective cohort study. Eur J Clin Microbiol Infect Dis 2019; 38:1333-1337. [PMID: 30972588 DOI: 10.1007/s10096-019-03558-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022]
Abstract
The objective of this study is to evaluate the characteristics and outcome of elderly patients with Mediterranean spotted fever (MSF). This study was a prospective observational cohort study of all adult cases with confirmed MSF treated in a teaching hospital (1984-2015) to compare the characteristics of elderly patients (> 65 years) with younger adults. We identified 263 adult patients with MSF, and 53 (20.2%) were elderly. Severe MSF was more frequent in the elderly (26.4% vs. 10.5%; p = 0.002). Gastrointestinal symptoms, impaired consciousness, lung infiltrate, oedema, acute hearing loss, raised alanine transaminase, hyponatremia, and thrombocytopenia occurred more frequently in elderly patients, and arthromyalgia occurred less frequently. Most patients were treated with a single-day doxycycline regimen (two oral doses of 200 mg for 1 day). All patients recovered uneventfully. Fever disappeared 2.55 ± 1.16 days after treatment initiation in elderly patients, and the remaining symptoms disappeared after 3.65 ± 1.42 days. These figures were similar to non-elderly patients. Severe MSF was more frequent in elderly patients. Some clinical manifestations occurred with different frequencies in the elderly compared with younger patients. Single-day doxycycline therapy is an effective and well-tolerated treatment for MSF in elderly patients.
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Youssoufou Souley AS, El Ouatassi N, Alsubari A, Zerrouk R, Reda K, Oubaaz A. [Macular atrophy secondary to bilateral involvement in Mediterranean spotted fever]. J Fr Ophtalmol 2019; 42:e47-e50. [PMID: 30683535 DOI: 10.1016/j.jfo.2018.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 11/17/2022]
Affiliation(s)
- A S Youssoufou Souley
- Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc.
| | - N El Ouatassi
- Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc
| | - A Alsubari
- Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc
| | - R Zerrouk
- Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc
| | - K Reda
- Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc
| | - A Oubaaz
- Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc
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Abdeljelil M, Sakly H, Kooli I, Marrakchi W, Aouam A, Loussaief C, Toumi A, Ben Brahim H, Chakroun M. Mediterranean spotted fever as a cause of septic shock. IDCases 2019; 15:e00528. [PMID: 30976518 PMCID: PMC6441820 DOI: 10.1016/j.idcr.2019.e00528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 11/05/2022] Open
Abstract
Mediterranean spotted fever presents with various non‐specific symptoms. There is no reliable test to diagnose the infection in its early stages. Doxycycline should be used upon suspicion of MSF, without awaiting laboratory confirmation.
Mediterranean spotted fever is a generally benign disease but with the potential of serious manifestations. We report a case of Mediterranean spotted fever in a 56-year–old woman, with pet dog exposure, who presented with a septic shock pattern. Based on clinical symptoms, history, and laboratory results, the diagnosis of Mediterranean spotted fever was suspected and the outcome was favorable with doxycycline treatment. Although rickettsiae remain an uncommon cause of the sepsis syndrome, it is important to consider it, especially as people are now traveling to endemic areas more frequently.
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Prospective Cohort Study of Single-Day Doxycycline Therapy for Mediterranean Spotted Fever. Antimicrob Agents Chemother 2018; 62:AAC.00978-18. [PMID: 30150470 DOI: 10.1128/aac.00978-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 08/17/2018] [Indexed: 11/20/2022] Open
Abstract
The objective of this study is to evaluate the results of single-day doxycycline therapy for Mediterranean spotted fever (MSF). This is a prospective cohort study of cases with confirmed MSF treated with the single-day doxycycline regimen in a teaching hospital from 1990 to 2015. Patients received two oral doses of 200 mg of doxycycline for 1 day. The outcomes evaluated were the time interval between the start of treatment and apyrexia, the time interval between the start of treatment and disappearance of other symptoms, and the adverse reactions to treatment and death. The study included 158 subjects, 18 of whom (11.4%) had a severe form of MSF and 31 (19.6%) were >65 years. The interval between onset of symptoms and start of treatment was 4.31 ± 1.54 days. All patients recovered uneventfully. Fever disappeared 2.55 ± 1.14 days after the start of treatment. The remaining symptoms (headache, arthromyalgia) disappeared 3.63 ± 1.35 days after the start of treatment. Only one patient had a delay in reaching apyrexia (8 days). The fever disappeared somewhat later in severe cases (median, 3 days; interquartile range [IQR], 2 to 4 days) than in nonsevere cases (median, 2 days; IQR, 2 to 3 days). Likewise, the remaining symptoms disappeared later in severe cases (median, 5 days; IQR, 4 to 6 days) than in nonsevere cases (median, 3 days; IQR, 3 to 4 days). The outcome was similar in both elderly and nonelderly patients. Eight patients had mild adverse effects possibly related to treatment. The results of the study confirm that single-day doxycycline therapy is an effective and well-tolerated treatment for MSF, including elderly patients and severe cases.
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Buchanan R. Typhus and the spotted fevers. Br J Hosp Med (Lond) 2018; 79:C146-C149. [DOI: 10.12968/hmed.2018.79.10.c146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ruaridh Buchanan
- Senior Clinical Fellow, National Mycobacterium Reference Service – South, National Infection Service, Public Health England, London NW9 5EQ
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David O, Fruchtman Y, Sergienko R, Kapelushnik J, Leibovitz E. The Infectious and Noninfectious Etiology, Clinical Picture and Outcome of Neutropenia in Immunocompetent Hospitalized Children. Pediatr Infect Dis J 2018; 37:570-575. [PMID: 29319583 DOI: 10.1097/inf.0000000000001893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acquired neutropenia in immunocompetent children is common, and its differential diagnosis ranges from benign causes to life-threatening diseases. We described the etiology, clinical picture and outcome of new-onset neutropenia in immunocompetent children assessed in the emergency department and hospitalized at our medical center. METHODS Previously healthy children admitted with neutropenia (absolute neutrophil count <1.5 × 10(9)/L) were included. Serious bacterial infections were defined as culture-positive blood, urine, cerebrospinal fluid, articular fluid or stool infections, pneumonia, Brucellosis and Rickettsiosis. RESULTS A total of 601 patients (5 days-202 months old) were enrolled; 3 (0.5%), 48 (8%), 165 (27.5%) and 385 (64%) had absolute neutrophil counts <0.2, 0.2-0.5, 0.5-1.0 and 1.0-1.5 × 10(9)/L, respectively. Associated leukopenia and thrombocytopenia were diagnosed in 186 (39%) and 71 (11.8%) patients. Three hundred sixteen of 601 (52.6%) and 519 of 601 (86.4%) were <2 or 36 months of age, respectively. Fever at admission was present in 27.6% patients. Serious bacterial infections were diagnosed in 106 (17.6%) patients. Brucellosis and rickettsiosis were diagnosed in 8 of 52 (15.4%) and 9 of 39 (23.1%) tests obtained. Respiratory syncytial virus was diagnosed in 17 of 33 (51.5%) nasal washes. An infectious etiology was determined in 171 (28.5%) patients. Acute leukemia was diagnosed in 6 patients. A significant correlation was found between resolution of neutropenia and patient age, infectious etiology and severity of neutropenia. CONCLUSIONS (1) Severe neutropenia was rare; (2) More than half of patients were <2 months of age; (3) An infectious etiology was diagnosed in a high number of patients, and serious bacterial infections were frequent and (4) Brucella spp. and rickettsial infections were frequent etiologies associated with neutropenia in our setting.
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Affiliation(s)
- Odeya David
- From the Pediatric Hematology/Oncology Department.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yariv Fruchtman
- From the Pediatric Hematology/Oncology Department.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ruslan Sergienko
- Public Health Department.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Joseph Kapelushnik
- From the Pediatric Hematology/Oncology Department.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eugene Leibovitz
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Identification of rickettsial immunoreactive proteins using a proximity ligation assay Western blotting and the traditional immunoproteomic approach. Comp Immunol Microbiol Infect Dis 2018; 58:17-25. [DOI: 10.1016/j.cimid.2018.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/16/2018] [Accepted: 06/10/2018] [Indexed: 11/23/2022]
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Torpiano P, Pace D. Clinically-diagnosed Mediterranean Spotted Fever in Malta. Travel Med Infect Dis 2018; 26:16-24. [PMID: 29462726 DOI: 10.1016/j.tmaid.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/13/2018] [Accepted: 02/16/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Mediterranean Spotted Fever (MSF) is a tick-borne zoonosis caused by Rickettsia conorii which is endemic in Malta, an island in the South Mediterranean that is a popular tourist destination. Diagnosis is frequently based on clinical manifestations as laboratory results are often limited to a retrospective diagnosis. We describe the clinical presentation, diagnosis and treatment of children <16 years who presented with MSF from 2011 to 2016. METHOD The demographics, clinical findings, laboratory results, management and outcome of all children hospitalised with suspected MSF based on the presence of fever and an eschar, were retrieved from their case notes. RESULTS Over the five-year study period six children, aged between 17 months and 15 years, were diagnosed with MSF. All children had contact with ticks and the majority presented in summer. Laboratory results were non-specific and included elevated inflammatory markers, lymphocytosis/lymphopenia and hyponatraemia. Serological and molecular techniques were used for diagnosis. Response to clarithromycin or doxycycline was immediate. CONCLUSION MSF should be included in the differential diagnosis of fever, rash and an eschar in children who travel to Malta. Despite advances in molecular diagnostics, clinical diagnosis remains important in the management of children with suspected MSF.
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Affiliation(s)
- Paul Torpiano
- Department of Paediatrics, Mater Dei Hospital, Tal-Qroqq, Msida, MSD 2090, Malta.
| | - David Pace
- Department of Paediatrics, Mater Dei Hospital, Tal-Qroqq, Msida, MSD 2090, Malta
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Kim YS, Choi YJ, Lee KM, Ahn KJ, Kim HC, Klein T, Jiang J, Richards A, Park KH, Jang WJ. First isolation of Rickettsia monacensis from a patient in South Korea. Microbiol Immunol 2017; 61:258-263. [PMID: 28593634 DOI: 10.1111/1348-0421.12496] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 05/20/2017] [Accepted: 06/01/2017] [Indexed: 11/28/2022]
Abstract
A Rickettsia sp. was isolated from the blood of a patient with an acute febrile illness using the shell vial technique; the isolate was named CN45Kr and was identified by molecular assay as Rickettsia monacensis, which was first recognized as a pathogen in Spain. Sequencing analysis showed that the gltA sequence of the isolate was identical to that of Rickettsia sp. IRS3. The ompA-5mp fragment sequence showed 100% identity to those of R. monacensis and Rickettsia sp. In56 and ompA-3pA In56 and 100% identity to that of Rickettsia sp. IRS3. The ompB sequence was found to have 99.9% similarity to that of R. monacensis IrR/Munich. This study confirms the pathogenicity of this agent and provides additional information about its geographic distribution.
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Affiliation(s)
- Yeon-Sook Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Munhwa-ro 282, Jung-gu, Daejeon 35015
| | - Yeon-Joo Choi
- Department of Microbiology, Konkuk University College of Medicine, Institute of Biomedical Science Building. Neungdong-ro 120, Gwangjin-gu, Seoul 05029
| | - Kyung-Min Lee
- Department of Microbiology, Konkuk University College of Medicine, Institute of Biomedical Science Building. Neungdong-ro 120, Gwangjin-gu, Seoul 05029.,International Vaccine Institute, SNU Research Park, Gwanak-ro 1, Gwanak-gu, Seoul, 151742
| | - Kyu-Joong Ahn
- Department of Dermatology, Konkuk University College of Medicine, Neungdong-ro 120-1, Gwangjin-gu, Seoul, 05029, South Korea
| | - Heung-Chul Kim
- Fifth Medical Detachment, 168th Multifunctional Medical Battalion, 65th Medical Brigade, Unit 15247, APO AP 96205-5247
| | - Terry Klein
- Force Health Protection and Preventive Medicine, 65th Medical Brigate/USAMEDDAC-K, Unit 15281, APO AP 96205-528
| | - Ju Jiang
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, MD 20910, USA
| | - Allen Richards
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, MD 20910, USA
| | - Kyung-Hee Park
- Department of Microbiology, Konkuk University College of Medicine, Institute of Biomedical Science Building. Neungdong-ro 120, Gwangjin-gu, Seoul 05029
| | - Won-Jong Jang
- Department of Microbiology, Konkuk University College of Medicine, Institute of Biomedical Science Building. Neungdong-ro 120, Gwangjin-gu, Seoul 05029
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Herrador Z, Fernandez-Martinez A, Gomez-Barroso D, León I, Vieira C, Muro A, Benito A. Mediterranean spotted fever in Spain, 1997-2014: Epidemiological situation based on hospitalization records. PLoS One 2017; 12:e0174745. [PMID: 28355307 PMCID: PMC5371374 DOI: 10.1371/journal.pone.0174745] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/14/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Mediterranean spotted fever (MSF) is a zoonotic disease caused by Rickettsia conorii. In Spain, deficiencies in the official reporting result in misreporting of this disease. This study aims to describe the clinical and temporal-spatial characteristics of MSF hospitalizations between 1997 and 2014. Materials and methods We performed a retrospective descriptive study using the Hospitalization Minimum Data Set (CMBD). All CMBD’s hospital discharges with ICD-9 CM code 082.1 were analyzed. Hospitalization rates were calculated and clinical characteristics were described. Spatial distribution of cases and their temporal behavior were also assessed. Results A total of 4,735 hospitalizations with MSF diagnosis were recorded during the study period, out of which 62.2% were male, mean age of 48. Diabetes mellitus, alcohol dependence syndrome, and chronic liver disease occurred in 10.8%, 2.4% and 2.8% hospitalizations, respectively. The median annual hospitalization rate showed a decreasing trend from a maximum of 12.9 in 1997 to a minimum rate of 3.1 in 2014. Most admissions occurred during the summer, showing a significant annual seasonal behavior. Important regional differences were found. Discussion Although MSF hospitalization rates have decreased considerably, it remains a public health problem due to its severity and economic impact. Therefore, it would be desirable to improve its oversight and surveillance.
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Affiliation(s)
- Zaida Herrador
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
- * E-mail:
| | - Amalia Fernandez-Martinez
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
| | - Diana Gomez-Barroso
- Network Biomedical Research Centre in Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain
- National Centre of Epidemiology, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
| | - Inmaculada León
- Network Biomedical Research Centre in Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain
- National Centre of Epidemiology, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
| | - Carmen Vieira
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Antonio Muro
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
- Unidad de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Agustín Benito
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
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ESPEJO E, ANDRÉS M, PÉREZ J, PRAT J, GUERRERO C, MUÑOZ MT, ALEGRE MD, LITE J, BELLA F. Prevalence of antibodies to Rickettsia conorii in human beings and dogs from Catalonia: a 20-year perspective. Epidemiol Infect 2016; 144:1889-94. [PMID: 26899636 PMCID: PMC9150624 DOI: 10.1017/s0950268816000261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 12/28/2015] [Accepted: 01/29/2016] [Indexed: 11/07/2022] Open
Abstract
The incidence of Mediterranean spotted fever (MSF) in Catalonia (Spain) has decreased in the last two decades. The prevalence of antibodies to Rickettsia conorii in human beings and dogs in the region of Vallès Occidental (Catalonia) was assessed by indirect immunofluorescence, and the results compared with those obtained in a similar study from 1987. Nineteen (5·0%) out of 383 human serum samples had antibodies to R. conorii. This seroprevalence was significantly lower (11·5%) (P = 0·003) than that recorded in the 1987 survey. Forty-two out (42·0%) of 100 canine serum samples had antibodies to R. conorii. A high proportion of the studied dogs (91·0%) were receiving anti-tick treatment, mainly with permethrin-imidacloprid spot-on (Advantix, Bayer, Germany). The current canine seroprevalence was not significantly different from that recorded in the 1987 survey (36.9%). In conclusion, this study shows a significant decrease in the prevalence of antibodies to R. conorii in the human population of Catalonia in the last 20 years, which corresponds with a decrease in the number of cases of MSF. We suggest that the widespread use of anti-tick treatment in dogs could limit the introduction of ticks to humans due to a reduction of infestation duration in dogs, thus contributing to the decrease in MSF incidence.
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Affiliation(s)
- E. ESPEJO
- Infectious Diseases Unit, Internal Medicine Service, Hospital de Terrassa, Terrassa, Spain
| | - M. ANDRÉS
- Infectious Diseases Unit, Internal Medicine Service, Hospital de Terrassa, Terrassa, Spain
| | - J. PÉREZ
- Microbiology Laboratory, Catlab, Terrassa, Spain
| | - J. PRAT
- Hospital Veterinari J. Prat Morera, Terrassa, Spain
| | - C. GUERRERO
- Internal Medicine Service, Hospital de Terrassa, Terrassa, Spain
| | - M. T. MUÑOZ
- Internal Medicine Service, Hospital de Terrassa, Terrassa, Spain
| | - M. D. ALEGRE
- Microbiology Laboratory, Catlab, Terrassa, Spain
| | - J. LITE
- Microbiology Laboratory, Catlab, Terrassa, Spain
| | - F. BELLA
- Infectious Diseases Unit, Internal Medicine Service, Hospital de Terrassa, Terrassa, Spain
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Biggs HM, Behravesh CB, Bradley KK, Dahlgren FS, Drexler NA, Dumler JS, Folk SM, Kato CY, Lash RR, Levin ML, Massung RF, Nadelman RB, Nicholson WL, Paddock CD, Pritt BS, Traeger MS. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States. MMWR Recomm Rep 2016; 65:1-44. [PMID: 27172113 DOI: 10.15585/mmwr.rr6502a1] [Citation(s) in RCA: 311] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Tickborne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low-cost, effective antibacterial therapy. Recognition early in the clinical course is critical because this is the period when antibacterial therapy is most effective. Early signs and symptoms of these illnesses are nonspecific or mimic other illnesses, which can make diagnosis challenging. Previously undescribed tickborne rickettsial diseases continue to be recognized, and since 2004, three additional agents have been described as causes of human disease in the United States: Rickettsia parkeri, Ehrlichia muris-like agent, and Rickettsia species 364D. This report updates the 2006 CDC recommendations on the diagnosis and management of tickborne rickettsial diseases in the United States and includes information on the practical aspects of epidemiology, clinical assessment, treatment, laboratory diagnosis, and prevention of tickborne rickettsial diseases. The CDC Rickettsial Zoonoses Branch, in consultation with external clinical and academic specialists and public health professionals, developed this report to assist health care providers and public health professionals to 1) recognize key epidemiologic features and clinical manifestations of tickborne rickettsial diseases, 2) recognize that doxycycline is the treatment of choice for suspected tickborne rickettsial diseases in adults and children, 3) understand that early empiric antibacterial therapy can prevent severe disease and death, 4) request the appropriate confirmatory diagnostic tests and understand their usefulness and limitations, and 5) report probable and confirmed cases of tickborne rickettsial diseases to public health authorities.
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Affiliation(s)
- Holly M Biggs
- National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia
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Bizzini A, Péter O, Baud D, Edouard S, Meylan P, Greub G. Evaluation of a new serological test for the detection of anti-Coxiella and anti-Rickettsia antibodies. Microbes Infect 2015; 17:811-6. [PMID: 26432518 DOI: 10.1016/j.micinf.2015.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/15/2015] [Accepted: 09/17/2015] [Indexed: 11/17/2022]
Abstract
Coxiella burnetii and members of the genus Rickettsia are obligate intracellular bacteria. Since cultivation of these organisms requires dedicated techniques, their diagnosis usually relies on serological or molecular biology methods. Immunofluorescence is considered the gold standard to detect antibody-reactivity towards these organisms. Here, we assessed the performance of a new automated epifluorescence immunoassay (InoDiag) to detect IgM and IgG against C. burnetii, Rickettsia typhi and Rickettsia conorii. Samples were tested with the InoDiag assay. A total of 213 sera were tested, of which 63 samples from Q fever, 20 from spotted fever rickettsiosis, 6 from murine typhus and 124 controls. InoDiag results were compared to micro-immunofluorescence. For acute Q fever, the sensitivity of phase 2 IgG was only of 30% with a cutoff of 1 arbitrary unit (AU). In patients with acute Q fever with positive IF IgM, sensitivity reached 83% with the same cutoff. Sensitivity for chronic Q fever was 100% whereas sensitivity for past Q fever was 65%. Sensitivity for spotted Mediterranean fever and murine typhus were 91% and 100%, respectively. Both assays exhibited a good specificity in control groups, ranging from 79% in sera from patients with unrelated diseases or EBV positivity to 100% in sera from healthy patients. In conclusion, the InoDiag assay exhibits an excellent performance for the diagnosis of chronic Q fever but a very low IgG sensitivity for acute Q fever likely due to low reactivity of phase 2 antigens present on the glass slide. This defect is partially compensated by the detection of IgM. Because it exhibits a good negative predictive value, the InoDiag assay is valuable to rule out a chronic Q fever. For the diagnosis of rickettsial diseases, the sensitivity of the InoDiag method is similar to conventional immunofluorescence.
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Affiliation(s)
- Alain Bizzini
- Institute of Microbiology, University of Lausanne, University Hospital Center, Lausanne, Switzerland
| | - Olivier Péter
- Department of Infectious Diseases, Central Institute of Valais, Sion, Switzerland
| | - David Baud
- Institute of Microbiology, University of Lausanne, University Hospital Center, Lausanne, Switzerland; Department of Obstetrics and Gynaecology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Sophie Edouard
- URMITE UMR 6236, Faculté de Médecine et de Pharmacie, Marseille, France
| | - Pascal Meylan
- Institute of Microbiology, University of Lausanne, University Hospital Center, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, University of Lausanne, University Hospital Center, Lausanne, Switzerland.
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Crespo P, Seixas D, Marques N, Oliveira J, da Cunha S, Meliço-Silvestre A. Mediterranean spotted fever: case series of 24 years (1989-2012). SPRINGERPLUS 2015; 4:272. [PMID: 26090319 PMCID: PMC4469589 DOI: 10.1186/s40064-015-1042-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 05/13/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE Mediterranean spotted fever (MSF) is the most prevalent zoonosis in Portugal. To characterize it's evolution between 1989 and 2012, the authors reviewed the cases diagnosed at their unit during this period. METHODS Review of clinical records of patients with MSF diagnosis, between 1989 and 2012. RESULTS Data from 250 patients was included, 54% male. Mean age at diagnosis was 58 years (11-92). Mean annual incidence was 10 cases, with clear summer predominance. Most patients, 78% lived in rural areas, 34% had contact with dogs and 10% noticed the tick bite. Most common symptoms were: fever (98%), myo-arthralgia (64%) and headache (48%). Maculopapular rash was noticed in 87%, affecting palms in 77% and soles in 69%. Inoculation eschar was found in 60%, mostly located on the trunk. Treatment included doxycycline in 86% and chloramphenicol in 12%, with a mean duration of 8 days. Most frequent blood test abnormalities were C-reactive protein, lactate dehydrogenase, aspartate aminotransferase and alanine transaminase elevations and thrombocytopenia. First serologic evaluation was positive in 37% (78/212), having seroconversion been documented in 85% (72/85). Most frequent complication was acute renal injury. ICU admission occurred in 5%. Average length of hospital stay was 11.2 days (1-106), with a mortality of 3.6%. CONCLUSIONS In our series, there was clear summer predominance of MSF, which had rural origin in 78%. Most common symptoms were fever, myo-arthralgia and headache. Maculopapular rash was noticed in 87% of cases and inoculation eschar in 60%. Most cases had favourable outcome, having 5% been admitted to ICU. Mortality was 3.6%.
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Affiliation(s)
- Pedro Crespo
- Infectious Diseases Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Diana Seixas
- Infectious Diseases Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Nuno Marques
- Infectious Diseases Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Joaquim Oliveira
- Infectious Diseases Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Saraiva da Cunha
- Infectious Diseases Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - A Meliço-Silvestre
- Infectious Diseases Unit, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
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Hai VV, Almeras L, Socolovschi C, Raoult D, Parola P, Pagès F. Monitoring human tick-borne disease risk and tick bite exposure in Europe: available tools and promising future methods. Ticks Tick Borne Dis 2014; 5:607-19. [PMID: 25178542 DOI: 10.1016/j.ttbdis.2014.07.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 12/30/2022]
Abstract
Ticks are the main vector for infectious disease pathogens in both humans and animals, and tick-borne diseases are currently spreading throughout Europe. Various surveillance methods have been developed to estimate the burden and risk of tick-borne diseases and host exposure to tick bites. The ultimate aims of these approaches are to determine the risk level of a tick-borne disease in a given area, determine its health priority, identify the at-risk population and propose specific countermeasures or complementary studies as needed. The purpose of this review is to present the current methods for monitoring the circulation of tick-borne diseases and to highlight the use of salivary antigens as original and recently developed serological tools that could be useful for tick bite risk assessment and could improve the current surveillance methods.
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Affiliation(s)
- Vinh Vu Hai
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France; Institut de Recherche Biomédicale des Armées (IRBA), Antenne Marseille, Unité de Parasitologie, URMITE UMR 6236, GSBdD de Marseille Aubagne, 111 Avenue de la Corse BP 40026, 13568 Marseille Cedex 02, France
| | - Lionel Almeras
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France; Institut de Recherche Biomédicale des Armées (IRBA), Antenne Marseille, Unité de Parasitologie, URMITE UMR 6236, GSBdD de Marseille Aubagne, 111 Avenue de la Corse BP 40026, 13568 Marseille Cedex 02, France
| | - Cristina Socolovschi
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Didier Raoult
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Philippe Parola
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France.
| | - Frédéric Pagès
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France; CIRE/ARS Océan Indien, 2 bis Avenue Georges Brassens CS 60050, 97408 Saint Denis Cedex 9, Reunion.
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Santos-Antunes J, Nunes ACR, Macedo G. Mediterranean spotted fever in a patient with Crohn's disease under adalimumab: First case report and review of the literature. GASTROENTEROLOGIA Y HEPATOLOGIA 2014; 38:379-80. [PMID: 25073681 DOI: 10.1016/j.gastrohep.2014.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/18/2014] [Accepted: 05/26/2014] [Indexed: 11/15/2022]
Affiliation(s)
- João Santos-Antunes
- Gastroenterology Department, Faculty of Medicine, Hospital de São João, Porto, Portugal; Department of Biochemistry (U38-FCT), Faculty of Medicine, University of Porto, Portugal.
| | - Amadeu C R Nunes
- Gastroenterology Department, Faculty of Medicine, Hospital de São João, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Faculty of Medicine, Hospital de São João, Porto, Portugal
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Identification of rickettsial pathogens in ixodid ticks in northern Senegal. Ticks Tick Borne Dis 2014; 5:552-6. [PMID: 24908548 DOI: 10.1016/j.ttbdis.2014.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 03/13/2014] [Accepted: 04/01/2014] [Indexed: 11/22/2022]
Abstract
The spotted fevers, caused by the Rickettsia bacteria, are a group of emerging diseases that are responsible for significant human morbidity. In Africa, the distribution of different species of Rickettsia in their tick vectors is poorly studied. We have collected 1169 hard ticks from 5 different species in the northern Senegal, close to the Saharan border. In a far northern collection site, corresponding to the Rickettsia africae distribution area, we collected three Amblyomma variegatum ticks infected by R. africae. Rickettsia africae was also identified in a Hyalomma marginatum rufipes tick, which may represent the secondary host for the pathogen. Rickettsia aeschlimannii was identified in H. m. rufipes, Rhipicephalus evertsi evertsi, and Hyalomma impeltatum ticks.
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43
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Lledó L, Domínguez-Peñafiel G, Giménez-Pardo C, Gegúndez I, González R, Saz JV. Molecular and serological study of rickettsial infection in humans, and in wild and farm animals, in the province of Burgos, Spain. Vector Borne Zoonotic Dis 2014; 14:383-8. [PMID: 24866558 DOI: 10.1089/vbz.2013.1513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Limited information is available on the presence of rickettsial infection in humans and animal reservoirs in Spain. Exposure to spotted fever group rickettsia in healthy humans and in farm and wild animals in the Province of Burgos, Spain, was examined by serological methods. Rickettsial DNA was also sought by PCR in animal samples. Of 102 human serum samples examined by indirect immunofluorescence assays (IFA), 5.88% were positive for antibodies against Rickettsia conorii (titers 1/128-1/512). Significant differences were detected in human seroprevalence with respect to age. In further IFAs, 102 out of 375 (27.2%) serum samples from the wild animals reacted with R. conorii antigens (titers 1/64-1/1024); 32 out of 281 (11.38%) samples from farm animals were also positive for R. conorii (titers 1/64-1/2048). The prevalence detected among total wild animals was significantly higher than among total farm animals. No rickettsial DNA was found by PCR in any farm or wild animal sample.
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Affiliation(s)
- Lourdes Lledó
- 1 Departamento de Biomedicina y Biotecnología, Universidad de Alcalá , Alcalá de Henares, Spain
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44
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Parola P, Paddock CD, Socolovschi C, Labruna MB, Mediannikov O, Kernif T, Abdad MY, Stenos J, Bitam I, Fournier PE, Raoult D. Update on tick-borne rickettsioses around the world: a geographic approach. Clin Microbiol Rev 2013; 26:657-702. [PMID: 24092850 PMCID: PMC3811236 DOI: 10.1128/cmr.00032-13] [Citation(s) in RCA: 929] [Impact Index Per Article: 84.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted fever group of the genus Rickettsia. These zoonoses are among the oldest known vector-borne diseases. However, in the past 25 years, the scope and importance of the recognized tick-associated rickettsial pathogens have increased dramatically, making this complex of diseases an ideal paradigm for the understanding of emerging and reemerging infections. Several species of tick-borne rickettsiae that were considered nonpathogenic for decades are now associated with human infections, and novel Rickettsia species of undetermined pathogenicity continue to be detected in or isolated from ticks around the world. This remarkable expansion of information has been driven largely by the use of molecular techniques that have facilitated the identification of novel and previously recognized rickettsiae in ticks. New approaches, such as swabbing of eschars to obtain material to be tested by PCR, have emerged in recent years and have played a role in describing emerging tick-borne rickettsioses. Here, we present the current knowledge on tick-borne rickettsiae and rickettsioses using a geographic approach toward the epidemiology of these diseases.
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Affiliation(s)
- Philippe Parola
- Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, France
| | | | - Cristina Socolovschi
- Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, France
| | - Marcelo B. Labruna
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia Universidade de São Paulo, Cidade Universitária, São Paulo, SP, Brazil
| | - Oleg Mediannikov
- Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, France
| | - Tahar Kernif
- Service d'Ecologie des Systèmes Vectoriels, Institut Pasteur d'Algérie, Algiers, Algeria
| | - Mohammad Yazid Abdad
- Division of Veterinary and Biomedical Science, Murdoch University, Australian Rickettsial Reference Laboratory, Barwon Health, Geelong, Victoria, Australia
| | - John Stenos
- Division of Veterinary and Biomedical Science, Murdoch University, Australian Rickettsial Reference Laboratory, Barwon Health, Geelong, Victoria, Australia
| | - Idir Bitam
- University of Boumerdes, Boumerdes, Algeria
| | - Pierre-Edouard Fournier
- Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, France
| | - Didier Raoult
- Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, France
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Abstract
The field of rickettsiology is rapidly evolving. Rickettsiae are small Gram-negative bacteria that can be transmitted to humans by arthropods. In most cases they are transmitted transovarially in the arthropod; human beings are incidental hosts. In recent years the use of cell culture and molecular biology has profoundly changed our knowledge of rickettsiae and has led to the description of several new species. New rickettsial diseases have been found in three main situations: firstly, in places where no new species have been identified, typical rickettsial symptoms have been observed (Japan, China); secondly, typical rickettsioses have been found to be caused by different organisms - in such cases a new Rickettsia species has been misdiagnosed as a previously identified bacterium (for example, R. parkeri was confused with R. rickettsii); thirdly, atypical clinical symptoms have been found to be caused by rickettsial organisms such as R. slovaca. These findings challenge the old dogma that only one tick-borne rickettsiosis is prevalent in one geographical area. Many Rickettsia spp. have been identified in ticks, but have not yet been implicated in human pathology. These rickettsiae should be considered as potential pathogens. All known or suspected rickettsial diseases should be treated (including in children) with doxycycline.
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Affiliation(s)
- Aurélie Renvoisé
- Unité des Rickettsies, CNRS-IRD UMR6236-198, Université de la Méditerranée, Faculté de Médecine, 27 bd Jean Moulin, 13385 Marseille cedex 5, France
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Foissac M, Socolovschi C, Raoult D. [Update on SENLAT syndrome: scalp eschar and neck lymph adenopathy after a tick bite]. Ann Dermatol Venereol 2013; 140:598-609. [PMID: 24090889 DOI: 10.1016/j.annder.2013.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 04/03/2013] [Accepted: 07/01/2013] [Indexed: 11/26/2022]
Abstract
SENLAT syndrome, also known as TIBOLA/DEBONEL, is an emerging disease in France. The major symptoms are necrotic eschar on the scalp associated with painful cervical lymphadenopathy. It occurs mainly in women and children during the cold seasons after a bite by a Dermacentor tick, responsible for transmitting Rickettsia slovaca or Rickettsia raoultii. Cutaneous swabs are safe, easy and reliable tools that should be used routinely by physicians to confirm diagnosis. In this particular disease, they should be preferred to serology, which is less sensitive. Doxycycline is the antibiotic of choice for this syndrome.
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Affiliation(s)
- M Foissac
- Aix Marseille université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France
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Abstract
Many viral, bacterial and parasitic pathogens have been associated with tick transmission, including several recently identified pathogens in both humans and domestic animals, especially dogs. The emergence in dogs of these tick-borne infections has a multi factorial origin. Better animal care, better diagnostic tools, and a broader distribution of the vectors in favorable habitats through population migrations including travel with owned pets, translocation or commercial trade of pet dogs, are some of the factors contributing to the emergence and recognition of these new pathogens. The present review focuses on the recent epidemiological studies which support the emergence or re-emergence of tick-borne pathogens in dogs around the world, as well as give some insight on newly recognized potentially tick-borne pathogens, such as Bartonella infections.
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Affiliation(s)
- Bruno Chomel
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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48
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Merhej V, Georgiades K, Raoult D. Postgenomic analysis of bacterial pathogens repertoire reveals genome reduction rather than virulence factors. Brief Funct Genomics 2013; 12:291-304. [PMID: 23814139 DOI: 10.1093/bfgp/elt015] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In the pregenomic era, the acquisition of pathogenicity islands via horizontal transfer was proposed as a major mechanism in pathogen evolution. Much effort has been expended to look for the contiguous blocks of virulence genes that are present in pathogenic bacteria, but absent in closely related species that are nonpathogenic. However, some of these virulence factors were found in nonpathogenic bacteria. Moreover, and contrary to expectation, pathogenic bacteria were found to lack genes (antivirulence genes) that are characteristic of nonpathogenic bacteria. The availability of complete genome sequences has led to a new era of pathogen research. Comparisons of genomes have shown that the most pathogenic bacteria have reduced genomes, with less ribosomal RNA and unorganized operons; they lack transcriptional regulators but have more genes that encode protein toxins, toxin-antitoxin (TA) modules, and proteins for DNA replication and repair, when compared with less pathogenic close relatives. These findings questioned the paradigm of virulence by gene acquisition and put forward the notion of genomic repertoire of virulence.
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Nilsson K, Wallménius K, Hartwig S, Norlander T, Påhlson C. Bell's palsy and sudden deafness associated with Rickettsia spp. infection in Sweden. A retrospective and prospective serological survey including PCR findings. Eur J Neurol 2013; 21:206-14. [PMID: 23790098 PMCID: PMC4232316 DOI: 10.1111/ene.12218] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 05/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Sixty patients with facial palsy and 67 with sudden deafness were retrospectively or prospectively examined for serological evidence of rickettsial infection; in six cases where cerebrospinal fluid was available, patients were also examined for presence of rickettsial DNA. METHODS Rickettsial antibodies were detected in single or paired serum samples using immunofluorescence with Rickettsia helvetica as the antigen and in four cases also using western blot. Using PCR and subsequent direct cycle sequencing, the nucleotide sequences of the amplicons (17 kDa protein gene) in cerebrospinal fluid were analysed. RESULTS Five out of 60 (8.3%) patients with facial palsy and eight of 67 (11.9%) with hearing loss showed confirmative serological evidence of infection with Rickettsia spp. An additional three and four patients in the facial palsy and hearing loss groups, respectively, showed evidence of having a recent or current infection or serological findings suggestive of infection. In four cases, the specificity of the reaction was confirmed by western blot. An additional 70 patients were seroreactive with IgG or IgM antibodies higher than or equal to the cut-off of 1:64, whereas 37 patients were seronegative. Only two of 127 patients had detectable antibodies to Borrelia spp. In three of six patients, rickettsial DNA was detected in the cerebrospinal fluid, where the obtained sequences (17 kDa) shared 100% similarity with the corresponding gene sequence of Rickettsia felis. CONCLUSIONS These results highlight the importance of considering Rickettsia spp. as a cause of neuritis, and perhaps as a primary cause of neuritis unrelated to neuroborreliosis.
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Affiliation(s)
- K Nilsson
- Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden; Centre of Clinical Research, Falu Hospital, Falun, Sweden
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Gray J, Dantas-Torres F, Estrada-Peña A, Levin M. Systematics and ecology of the brown dog tick, Rhipicephalus sanguineus. Ticks Tick Borne Dis 2013; 4:171-80. [DOI: 10.1016/j.ttbdis.2012.12.003] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 12/13/2012] [Accepted: 12/14/2012] [Indexed: 11/27/2022]
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