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Wang X, Mathias DK. Surveillance of ticks (Acari: Ixodidae) and tick-borne pathogens in Eastern Central Alabama. JOURNAL OF MEDICAL ENTOMOLOGY 2024; 61:1251-1260. [PMID: 39102892 DOI: 10.1093/jme/tjae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/28/2024] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
Similar to other states in the southeastern United States, human cases of tick-borne diseases in Alabama have risen steadily over the last 2 decades. Nevertheless, limited data have been published on ticks or tick-borne pathogen (TBP) distributions since the 1990s. To better understand the risk of tick and TBP exposure in eastern central Alabama, ticks were sampled repeatedly across 8 sites associated with recreational use during May and June of 2015 to characterize tick density and diversity. Although habitats were similar across sites, tick density varied among locations. Seven species were collected, but 97.7% of 1,310 samples were the lone star tick, Amblyomma americanum (L.), the primary vector of ehrlichial agents and the tick species most commonly linked to alpha-gal syndrome and southern tick-associated rash illness. To investigate pathogen prevalence among sites, we tested A. americanum by a multiplex qPCR assay for 5 bacterial species, including 3 Ehrlichia spp. and 2 Rickettsia spp. None of the specimens tested positive for Panola Mountain Ehrlichia or Rickettsia parkeri. However, causative agents of human ehrlichiosis, Ehrlichia chaffeensis and Ehrlichia ewingii, occurred at half of the locations with, respectively, 0.27% and 0.45% of A. americanum infected on average. In contrast, Rickettsia amblyommatis, a tick endosymbiont suspected to be nonpathogenic, was found in 54.5% of the 1119 A. americanum tested. Despite low infection rates of Ehrlichia spp. in A. americanum, high encounter rates with this species in recreational deciduous woodlands suggest a moderate risk of tick bite and a low-to-moderate risk of TBP exposure in late spring.
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Affiliation(s)
- Xiaodi Wang
- Department of Entomology and Plant Pathology, 301 Funchess Hall, Auburn University, AL 36849, USA
- Department of Biology, University of Washington, Seattle, WA 98195, USA
| | - Derrick K Mathias
- Department of Entomology and Plant Pathology, 301 Funchess Hall, Auburn University, AL 36849, USA
- Florida Medical Entomology Laboratory, Department of Entomology and Nematology, University of Florida, Vero Beach, FL 32962, USA
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Murmu R, Mondal G, Biswas K, Bala AK. Prevalence, Clinico-Laboratory Features and Outcomes of Paediatric Scrub Typhus Cases in a Tertiary Care Centre in Eastern India: A prospective observational study. Sultan Qaboos Univ Med J 2024; 24:375-382. [PMID: 39234326 PMCID: PMC11370951 DOI: 10.18295/squmj.6.2024.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/19/2024] [Accepted: 06/28/2024] [Indexed: 09/06/2024] Open
Abstract
Objectives Scrub typhus is the most common rickettsial disease in India, caused by Orientia tsutsugamushi and transmitted by chigger mites. Previously prevalent in South India, a resurgence of scrub typhus cases has recently affected Eastern India. This study aimed to estimate the prevalence and describe the clinico-laboratory profile of scrub typhus in paediatric patients (1-12 years old) living in Eastern India. Methods This prospective observational study was conducted from January to December 2019 at the Dr B C Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India. All acute undifferentiated cases of febrile illness, in patients aged between 1-12 years, were tested using scrub typhus serology by ELISA. Demographic details, clinical features, laboratory findings, complications and treatment outcomes of these scrub typhus patients were extracted and analysed. Results Out of 1,473 patients with acute febrile illness, 67 (4.5%) children were diagnosed with scrub typhus. The mean age of the selected patients was 5.22 ± 3.05 years, and the majority (64.2%) had been running a fever since the preceding 7-14 days. Gastrointestinal symptoms such as vomiting (43.3%) and abdominal pain (32.8%) were most frequently observed. Major clinical signs of scrub typhus were hepatomegaly (41.8%) and splenomegaly (31.3%). Complications were observed in 74.6% of patients, with thrombocytopenia (40.3%) and meningoencephalitis (29.9%) occurring more frequently. The case fatality rate of the study sample was 1.5%. Conclusion Classical eschar was absent in three-fourth of the studied patients. Hence, this study advocates laboratory scrub typhus tests for all suspected cases in the endemic region (Eastern India). Prompt treatment with doxycycline and/or azithromycin could prevent complications such as thrombocytopenia/meningoencephalitis and reduce mortality.
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Affiliation(s)
- Raghunath Murmu
- Department of Paediatric Medicine, Midnapore Medical College and Hospital, Midnapore, India
| | - Gobinda Mondal
- Department of Paediatric Medicine, Dr. B.C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India
| | - Koushik Biswas
- Department of Biochemistry, All India Institute of Medical Sciences, Raebareli, India
| | - Ashok K. Bala
- Department of Paediatric Medicine, Dr. B.C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India
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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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Other bacterial agents (4th section). Transfusion 2024; 64 Suppl 1:S243-S270. [PMID: 38394037 DOI: 10.1111/trf.17695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/25/2024]
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Sato R, Yamada N, Kodani N, Makiishi T, Iwashita Y. Prompt diagnosis and appropriate treatment of Japanese spotted fever: A report of three cases. Heliyon 2024; 10:e23462. [PMID: 38173519 PMCID: PMC10761556 DOI: 10.1016/j.heliyon.2023.e23462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Background Japanese Spotted Fever (JSF) is a Spotted Fever Group (SFG) rickettsiosis caused by Rickettsia japonica. More than 300 cases are diagnosed annually in Japan, and the number of reported cases has been increasing. Correct diagnoses depend on the triad of symptoms and signs, including fever, rash, and eschar, which can be seen at the site of vector bites. JSF is not life-threatening if treated appropriately without diagnostic delay but there are some fatal cases every year. This negligence leads to disseminated intravascular coagulation (DIC) and multiple organ failure (MOF), and poor prognoses, consequently. Prompt diagnosis of JSF is difficult when the aforementioned triad of signs and symptoms is not initially present. Case report This report describes three JSF cases: an 87-year-old woman with fever, shock, pancytopenia, DIC, and MOF; a 79-year-old man with fever and difficulty in movement; and a 78-year-old man with fever, general fatigue, and appetite loss. All patients had a rash and eschar, which led to prompt diagnosis and appropriate treatment immediately. All patients were treated without any complications. Why should an emergency physician be aware of this? As mentioned above, JFS can be fatal with delayed diagnoses and treatment initiations. The key for a prompt diagnosis is to recognize the triad of symptoms and signs, which are not often present initially, and it makes JSF diagnosis challenging. Repeated comprehensive physical examinations are essential for prompt diagnosis and improve prognosis of JSF.
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Affiliation(s)
- Rie Sato
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Noriaki Yamada
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Nobuhiro Kodani
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Tetsuya Makiishi
- Department of General Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
| | - Yoshiaki Iwashita
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
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Lionello FCP, Rotundo S, Bruno G, Marino G, Morrone HL, Fusco P, Costa C, Russo A, Trecarichi EM, Beltrame A, Torti C. Touching Base with Some Mediterranean Diseases of Interest from Paradigmatic Cases at the "Magna Graecia" University Unit of Infectious Diseases: A Didascalic Review. Diagnostics (Basel) 2023; 13:2832. [PMID: 37685370 PMCID: PMC10486464 DOI: 10.3390/diagnostics13172832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Among infectious diseases, zoonoses are increasing in importance worldwide, especially in the Mediterranean region. We report herein some clinical cases from a third-level hospital in Calabria region (Southern Italy) and provide a narrative review of the most relevant features of these diseases from epidemiological and clinical perspectives. Further, the pathogenic mechanisms involved in zoonotic diseases are reviewed, focusing on the mechanisms used by pathogens to elude the immune system of the host. These topics are of particular concern for individuals with primary or acquired immunodeficiency (e.g., people living with HIV, transplant recipients, patients taking immunosuppressive drugs). From the present review, it appears that diagnostic innovations and the availability of more accurate methods, together with better monitoring of the incidence and prevalence of these infections, are urgently needed to improve interventions for better preparedness and response.
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Affiliation(s)
- Ferdinando Carmelo Pio Lionello
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriele Bruno
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriella Marino
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Chiara Costa
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Anna Beltrame
- College of Public Health, University of South Florida, Gainesville, FL 33620, USA;
| | - Carlo Torti
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
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Rungrojn A, Batty EM, Perrone C, Abdad MY, Wangrangsimakul T, Brummaier T, McGready R, Day NPJ, Blacksell SD. Molecular diagnosis and genotyping of Orientia tsutsugamushi in Maesot and Chiangrai, Thailand. FRONTIERS IN TROPICAL DISEASES 2023; 4:fitd.2023.1146138. [PMID: 39376595 PMCID: PMC7616666 DOI: 10.3389/fitd.2023.1146138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/09/2024] Open
Abstract
Introduction Scrub typhus is a neglected tropical disease with an estimated 1 million cases annually. The Asia-Pacific region is an endemic area for scrub typhus, especially in Thailand. Methods Between June 2018 and December 2019, 31 patients with acute undifferentiated febrile illness (AUFI) were recruited for clinical trials and tested positive by a scrub typhus IgM RDT. Results Of the 17 buffy coat patient samples tested by 47kDa real-time PCR and 56kDa type-specific antigen (TSA) nested PCR, 94% (16/17) were positive, and of the 11 patients that presented with eschar lesions, 100% (11/11) of the eschar samples were confirmed positive. Genetic analysis of the 560 bp partial 56-kDa TSA gene demonstrated that most Orientia tsutsugamushi (Ot) infections were with Karp, Gilliam, Taiwan, P23, and CM606-like strains. Discussion This is the second occasion that the CM606-like and P23-like strains were reported in northern Thailand (first reported in 2011 and 2013, respectively). This study demonstrates that 1) the eschar remains the most reliable biological sample for PCR diagnosis of scrub typhus and 2) Northwestern Thailand has significant diversity of Ot strains, which underlines the requirement for ongoing surveillance to increase our understanding of Ot diversity to ensure accurate diagnostics and treatment.
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Affiliation(s)
- Artharee Rungrojn
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Elizabeth M. Batty
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Carlo Perrone
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Mohammad Yazid Abdad
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Tri Wangrangsimakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Tobias Brummaier
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rose McGready
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Nicholas P. J. Day
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Stuart D. Blacksell
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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Warrell CE, Osborne J, Mrcp LN, Gibney B, Carter DP, Warner J, Houlihan CF, Brooks TJG, Rampling T. Imported Rickettsial Infections to the United Kingdom, 2015-2020. J Infect 2023; 86:446-452. [PMID: 36948252 DOI: 10.1016/j.jinf.2023.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The burden of imported rickettsial infection in the UK is not previously described. This retrospective review identifies rickettsial cases diagnosed at the national reference laboratory between 2015-2022. METHODS Samples testing positive for spotted fever group, typhus group and scrub typhus IgG/IgM on acute and convalescent blood samples, and/or PCR on tissue/blood were categorised as suspected, confirmed or past infection. RESULTS 220 patients had rickettsioses, the commonest import was acute spotted fever group infection (61%, 125/205), 54% (62/114) from South Africa. Acute typhus group cases, 60% (40/67) from Southeast Asia. One patient with Rickettsia typhi bacteremia died. Scrub typhus group infections (5%, 10/205) were exclusively from Asia and the Western Pacific regions. Overall, 43% of confirmed cases (39/91) had not received doxycycline prior to results. CONCLUSIONS Rickettsial infections are important and under-recognised causes of imported fever in the UK. Thorough history, examination and timely treatment with doxycycline should be considered if there is suspicion of Rickettsia infection before testing.
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Affiliation(s)
- Clare E Warrell
- Rare and Imported Pathogens Laboratory, Salisbury, UK; London School of Hygiene and Tropical Medicine, London, UK.
| | - Jane Osborne
- Rare and Imported Pathogens Laboratory, Salisbury, UK
| | | | - Barry Gibney
- Rare and Imported Pathogens Laboratory, Salisbury, UK
| | | | | | - Catherine F Houlihan
- Rare and Imported Pathogens Laboratory, Salisbury, UK; Hospital for Tropical Diseaess, London, UCLH, UK; Department of Clinical Virology UCLH, UK; Infection and Immunity, University College London, United Kingdom
| | | | - Tommy Rampling
- Rare and Imported Pathogens Laboratory, Salisbury, UK; Hospital for Tropical Diseaess, London, UCLH, UK; Infection and Immunity, University College London, United Kingdom
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Minahan NT, Wu WJ, Tsai KH. Rickettsia felis is an emerging human pathogen associated with cat fleas: A review of findings in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:10-19. [PMID: 36585292 DOI: 10.1016/j.jmii.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Rickettsia felis is an emerging rickettsial agent principally associated with cat fleas (Ctenocephalides felis), formerly discovered in 1990. Since then, clinical cases of R. felis infection have been identified globally by specific DNA sequences in patients with undifferentiated febrile illness, including in Taiwan, but such evidence is limited. R. felis rickettsiosis is self-limiting and easily treated with doxycycline, but its diagnosis remains a challenge. Environmental risk factors for R. felis rickettsiosis have yet to be clearly demonstrated, and its transmission biology is incompletely understood. Cat fleas are naturally infected with R. felis at varying rates, and vector competence in the transmission of R. felis has been demonstrated in animal models, including dogs, which may serve as reservoir hosts. In northern Taiwan, despite ∼20% of cat fleas infesting companion animals consistently found to be infected with R. felis, only a few cases of potential R. felis infection have been identified through a retrospective serological investigation, though without molecular confirmation. Ecological studies have identified divergent R. felis-like organisms in different arthropod hosts, but these strains appear to serve as nonpathogenic endosymbionts. Although its association with disease is limited, we believe cat flea-borne R. felis warrants increased recognition in an aging population due to immunosenescence and the proximity of companion animals to the elderly. Adopting a One Health approach involving collaboration and communication between clinicians, veterinarians, public health practitioners, and environmental scientists will improve our knowledge about this neglected pathogen and promote the prevention and control of vector-borne diseases.
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Affiliation(s)
- Nicholas T Minahan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wen-Jer Wu
- Department of Entomology, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan
| | - Kun-Hsien Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Entomology, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Muniz APM, Tolesano-Pascoli G, Vieira RBK, Polli MG, Rodrigues VDS, Gonzaga HT, Mamede CCN, Da Cunha NC, Szabó MJP, Yokosawa J. Evaluation of a mimotope of the Rickettsia outer membrane protein A (OmpA) as an antigen in enzyme-linked immunosorbent assay to detect rickettsiosis in capybaras (Hydrochoerus hydrochaeris), horses (Equus caballus), and opossums (Didelphis sp.). EXPERIMENTAL & APPLIED ACAROLOGY 2023; 89:317-327. [PMID: 36795267 DOI: 10.1007/s10493-023-00776-5] [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: 09/19/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Rickettsia rickettsii is the etiological agent of Rocky Mountain spotted fever, which is an important tick-borne zoonosis and, in Brazil, it causes Brazilian spotted fever, which has high lethality rate. This study aimed to evaluate a synthetic peptide corresponding to a segment of the outer membrane protein A (OmpA) as an antigen in a serological test for the diagnosis of rickettsial infections. The amino acid sequence of the peptide was selected by predicting B cell epitopes using B Cell Epitope Prediction (Immune Epitope Database and Analysis Resource) and Epitopia and OmpA sequences of Rickettsia rickettsii strain 'Brazil' and Rickettsia parkeri strains 'Maculatum 20' and 'Portsmouth'. A peptide with amino acid sequence common to both Rickettsia species was synthesized and arbitrarily named OmpA-pLMC. To evaluate this peptide in enzyme-linked immunosorbent assay (ELISA), serum samples of capybara (Hydrochoerus hydrochaeris), horse (Equus caballus), and opossum (Didelphis albiventris) that had been previously tested by indirect immunofluorescence assay (IFA) for rickettsial infection were separated into IFA-positive and IFA-negative groups and used in the assay. There were no significant differences in ELISA optical density (OD) values between IFA-positive and IFA-negative groups with horse samples. The mean OD values were significantly higher in the IFA-positive capybara serum samples (IFA-pos vs. IFA-neg = 2.389 ± 0.761 vs. 1.760 ± 0.840). However, receiver operating characteristic (ROC) curve analysis did not show significant diagnostic parameters. On the other hand, 12 out of 14 (85.7%) opossum samples of the IFA-positive group showed reactivity in ELISA, and this was significantly higher than of the IFA-negative group (0.7196 ± 0.440 vs. 0.2318 ± 0.098, respectively; 85.7% sensitivity, 100% specificity). Therefore, our results show that OmpA-pLMC has a potential to be used in immunodiagnostic assays to detect spotted fever group rickettsial infections.
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Affiliation(s)
- Ana Paula Mendes Muniz
- Laboratory of Microorganisms of Cerrado (Brazilian Savannah), Department of Microbiology, Instituto De Ciências Biomédicas (ICBIM), Universidade Federal de Uberlândia (UFU), Uberlândia, Brazil
| | | | - Raíssa Brauner Kamla Vieira
- Laboratory of Ixodology, Faculdade de Medicina Veterinária, UFU, Uberlândia, Brazil
- Department of Veterinary Public Health, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Mayara Garcia Polli
- Laboratory of Microorganisms of Cerrado (Brazilian Savannah), Department of Microbiology, Instituto De Ciências Biomédicas (ICBIM), Universidade Federal de Uberlândia (UFU), Uberlândia, Brazil
| | | | | | | | - Nathalie Costa Da Cunha
- Department of Veterinary Public Health, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | | | - Jonny Yokosawa
- Laboratory of Microorganisms of Cerrado (Brazilian Savannah), Department of Microbiology, Instituto De Ciências Biomédicas (ICBIM), Universidade Federal de Uberlândia (UFU), Uberlândia, Brazil.
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Condit ME, Jones E, Biggerstaff BJ, Kato CY. Procedure for spotted fever group Rickettsia isolation from limited clinical blood specimens. PLoS Negl Trop Dis 2022; 16:e0010781. [PMID: 36240222 PMCID: PMC9605293 DOI: 10.1371/journal.pntd.0010781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 10/26/2022] [Accepted: 08/30/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Current isolation techniques for spotted fever group Rickettsia from clinical samples are laborious and are limited to tissue, blood and blood derivatives with volumes ideally greater than 1 mL. We validated the use of simplified methodologies for spotted fever group Rickettsia culture isolation that overcome sample volume limitations and provide utility in clinical diagnostics and research studies. METHODOLOGY/PRINCIPAL FINDINGS A modified cell culture method is evaluated for the isolation of Rickettsia ssp. from human diagnostic samples. Culture sampling method, culture platform, and growth phase analysis were evaluated to determine best practices for optimal culture isolation conditions. Rickettsial isolates (R. conorii, R. rickettsii, and R. parkeri) were grown in Vero E6 cells over a course of 5 to 7 days at low inoculum treatments (~40 bacterial copies) to standardize the sampling strategy at a copy number reflective of the bacteremia in acute diagnostic samples. This methodology was verified using small volumes (50 μL) of 25 unprocessed clinical whole blood, plasma, and serum samples from acute samples of patients suspected of having Rocky Mountain Spotted Fever, of which 10 were previously confirmed positive via the PanR8 qPCR assay, 13 had no detectable Rickettsia DNA by the PanR8 qPCR assay, and 2 were not previously tested; these samples resulted in the cultivation of 7 new R. rickettsii isolates. CONCLUSIONS/SIGNIFICANCE We observed that rickettsial isolate growth in culture is reproducibly identified by real-time PCR testing of culture media within 72 hours after inoculation. Additionally, specimen sedimentation prior to isolation to remove red blood cells was found to decrease the amount of total organism available in the inoculum. A small volume culture method was established focusing on comparative qPCR detection rather than bacterial visualization, taking significantly shorter time to detect, and requiring less manipulation compared to traditional clinical isolate culture methods.
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Affiliation(s)
- Marah E. Condit
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emma Jones
- Office of the Director, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
| | - Brad J. Biggerstaff
- Office of the Director, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, United States of America
| | - Cecilia Y. Kato
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America,* E-mail:
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Smirnova NS, Kostarnoy AV, Kondratev AV, Gancheva PG, Grumov DA, Gintsburg AL. Diagnostic Value of IgA Antibody Measurement in Tick-Borne Spotted Fever (Astrakhan Rickettsial Fever). Microbiol Spectr 2022; 10:e0168721. [PMID: 35467375 PMCID: PMC9241626 DOI: 10.1128/spectrum.01687-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/25/2022] [Indexed: 12/29/2022] Open
Abstract
Tick-borne spotted fevers caused by Rickettsia occur worldwide. The symptoms of this bacterial infection are similar to those of viral infection, and thus, diagnostic accuracy has special clinical importance. One of the commonly used methods for the diagnosis of tick-borne spotted fever is enzyme-linked immunosorbent assay (ELISA), which is based on estimation of the presence of specific IgM antibodies in blood. However, IgA analysis has not been used for the diagnosis of rickettsial diseases thus far. We investigated the diagnostic value of IgA antibody determination using patient sera collected in the Astrakhan region of Russia, where an isolated site of Astrakhan rickettsial fever (ARF) caused by Rickettsia conorii subsp. caspia is located. Our investigation was performed on serum samples collected from 185 patients diagnosed with Astrakhan rickettsial fever from May to October 2019. Western blot analysis revealed that specific IgA antibodies, as well as IgM antibodies, from patient sera bind to high-molecular-weight pathogen proteins with similar masses. The obtained data show that the determination of IgM alone allows for serological confirmation of diagnosis in only 46.5% of cases but that the determination of both IgM and IgA increases this rate to 66.5%. Taken together, the findings show an important diagnostic value of IgA evaluation for tick-borne spotted fever rickettsiosis. IMPORTANCE Tick-borne spotted fevers caused by Rickettsia occur worldwide. The symptoms of this bacterial infection are similar to the symptoms of viral infection, and thus, diagnostic accuracy has special clinical importance. The most serious spotted fever group rickettsiosis is Rocky Mountain fever in the United States, which is caused by Rickettsia rickettsii, and disease complications can lead to hemiparesis, blindness, or amputation. Rickettsia conorii subsp. caspia causes a rickettsial spotted fever named Astrakhan rickettsial fever (ARF). One of the commonly used methods for the diagnosis of tick-borne spotted fevers is ELISA, which is based on estimation of the presence of specific IgM antibodies in blood, though IgA has not been used for the diagnosis of rickettsial diseases thus far. In this study, we showed that both IgA and IgM should be analyzed in the blood serum samples of patients to significantly enhance the accuracy of diagnostics of tick-borne spotted fever rickettsiosis.
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Affiliation(s)
- Nina S. Smirnova
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Alexey V. Kostarnoy
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Alexey V. Kondratev
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Petya G. Gancheva
- Laboratory of Immunobiotechnology, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Daniil A. Grumov
- Laboratory of Ecology of Rickettsia, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
| | - Alexander L. Gintsburg
- Laboratory of Gene Engineering of Pathogenic Microorganisms, N. F. Gamaleya National Research Center of Epidemiology and Microbiology, Moscow, Russia
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Vaca DJ, Dobler G, Fischer SF, Keller C, Konrad M, von Loewenich FD, Orenga S, Sapre SU, van Belkum A, Kempf VAJ. Contemporary diagnostics for medically relevant fastidious microorganisms belonging to the genera Anaplasma, Bartonella, Coxiella, Orientia, and Rickettsia. FEMS Microbiol Rev 2022; 46:6530194. [PMID: 35175353 PMCID: PMC9300619 DOI: 10.1093/femsre/fuac013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 12/02/2022] Open
Abstract
Many of the human infectious pathogens—especially the zoonotic or vector-borne bacteria—are fastidious organisms that are difficult to cultivate because of their strong adaption to the infected host culminating in their near-complete physiological dependence on this environment. These bacterial species exhibit reduced multiplication rates once they are removed from their optimal ecological niche. This fact complicates the laboratory diagnosis of the disease and hinders the detection and further characterization of the underlying organisms, e.g. at the level of their resistance to antibiotics due to their slow growth. Here, we describe the current state of microbiological diagnostics for five genera of human pathogens with a fastidious laboratory lifestyle. For Anaplasma spp., Bartonella spp., Coxiella burnetii, Orientia spp. and Rickettsia spp., we will summarize the existing diagnostic protocols, the specific limitations for implementation of novel diagnostic approaches and the need for further optimization or expansion of the diagnostic armamentarium. We will reflect upon the diagnostic opportunities provided by new technologies including mass spectrometry and next-generation nucleic acid sequencing. Finally, we will review the (im)possibilities of rapidly developing new in vitro diagnostic tools for diseases of which the causative agents are fastidiously growing and therefore hard to detect.
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Affiliation(s)
- Diana J Vaca
- Institute of Medical Microbiology and Infection Control, Goethe University of Frankfurt, Germany
| | - Gerhard Dobler
- Department of Virology and Rickettsiology, Bundeswehr Institute of Microbiology, Germany
| | - Silke F Fischer
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Germany
| | | | - Maik Konrad
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Germany
| | | | | | | | | | - Volkhard A J Kempf
- Institute of Medical Microbiology and Infection Control, Goethe University of Frankfurt, Germany
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15
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Serologic Diagnosis of Acute Rickettsiosis in Children in Southern Israel. Pediatr Infect Dis J 2021; 40:e521-e523. [PMID: 34420007 DOI: 10.1097/inf.0000000000003303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We assessed serology results of clinically suspected rickettsiosis episodes in the hospital setting. Overall, 322 of 963 (33%) cases were serology positive. Among those, rash rates were low (30%), murine typhus (MT) predominated over spotted fever and IgM positivity rate was higher in MT. These findings suggest that during acute rickettsiosis, serology may reliably identify MT infection but may underdiagnose spotted fever.
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An Update on the Laboratory Diagnosis of Rickettsia spp. Infection. Pathogens 2021; 10:pathogens10101319. [PMID: 34684267 PMCID: PMC8541673 DOI: 10.3390/pathogens10101319] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/25/2021] [Accepted: 10/11/2021] [Indexed: 01/10/2023] Open
Abstract
Rickettsia species causing human illness are present globally and can cause significant disease. Diagnosis and identification of this intracellular bacteria are challenging with many available diagnostic modalities suffering from several shortcomings. Detection of antibodies directed against Rickettsia spp. via serological methods remains widely used with a broad range of sensitivity and specificity values reported depending on the assay. Molecular methods, including polymerase chain reaction (PCR) testing, enables species-specific identification with a fast turnaround time; however, due to resource requirements, use in some endemic settings is limited. Reports on the use of next-generation sequencing (NGS) and metagenomics to diagnose Rickettsia spp. infection have been increasing. Despite offering several potential advantages in the diagnosis and surveillance of disease, genomic approaches are currently only limited to reference and research laboratories. Continued development of Rickettsia spp. diagnostics is required to improve disease detection and epidemiological surveillance, and to better understand transmission dynamics.
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Bhesania S, Arora KS, Tokarski M, Ariff M, Khan F, Bhesania J, Haq SA. A Case of Tick Bite Induced Babesiosis With Lyme Disease. Cureus 2021; 13:e17401. [PMID: 34589312 PMCID: PMC8459803 DOI: 10.7759/cureus.17401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
The Ixodes tick may transmit multiple pathogens, Lyme disease being the most common. Early detection of tick bites and using prophylaxis measures is the key to prevent tick bite-associated diseases like babesiosis, anaplasmosis, and Lyme disease. It is recommended to follow preventive measures like using diethyltoluamide (DEET) on the skin, applying permethrin on clothes while visiting the tick-infested areas. Co-infection is an uncommon occurrence but still representative in endemic areas. If there is delayed initiation of therapy in these kinds of patients, there may be dire consequences that may require aggressive therapy. Clinicians should consider co-infection when suspecting tick-borne disease which can prove to be fatal if not addressed promptly. Here, we present the case of a 72-year-old female with atypical symptoms, who was found to have coinfection with Lyme disease and Babesiosis on serology testing and peripheral smear and was diagnosed and treated promptly.
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Affiliation(s)
- Siddharth Bhesania
- Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
| | | | - Michal Tokarski
- Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
| | - Madiha Ariff
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Fastina Khan
- Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
| | - Janki Bhesania
- Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
| | - Salman A Haq
- Internal Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
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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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Seroprevalence of Spotted Fever Group Rickettsiae in extensively managed sheep and goats in Nigeria, West Africa. Trop Anim Health Prod 2021; 53:425. [PMID: 34338946 DOI: 10.1007/s11250-021-02868-z] [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: 06/08/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Sheep and goats raised extensively are frequently infested by Ixodid ticks that may act as vectors or reservoirs of Spotted Fever Group Rickettsiae (SFGR). A study to determine the seroprevalence of SFGR infection in 300 sheep and goats in Plateau State, Nigeria was conducted from September to November, 2018 using the Indirect Fluorescence Antibody Test (IFAT). Overall, 85 out of 300 animals (28.3%) were seropositive to SFGR. Relatively higher seroprevalence was recorded in sheep than goats (28.8% vs 28.0%) but the difference was not statistically significant (p > 0.05). Furthermore, seropositivity was not affected by age, sex or location of the animals screened in this study. This is the first serological study to report the prevalence of SFGR in sheep and goats using IFAT in this study area. The presence of SFGR antibodies in domestic ruminants is of public health concern considering the close association between farmers and their animals occasioned by the management system practiced in the study area. This finding calls for further studies to evaluate the level of human exposure to this group of pathogen.
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Tokarz R, Lipkin WI. Discovery and Surveillance of Tick-Borne Pathogens. JOURNAL OF MEDICAL ENTOMOLOGY 2021; 58:1525-1535. [PMID: 33313662 PMCID: PMC8285023 DOI: 10.1093/jme/tjaa269] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Indexed: 05/06/2023]
Abstract
Within the past 30 yr molecular assays have largely supplanted classical methods for detection of tick-borne agents. Enhancements provided by molecular assays, including speed, throughput, sensitivity, and specificity, have resulted in a rapid increase in the number of newly characterized tick-borne agents. The use of unbiased high throughput sequencing has enabled the prompt identification of new pathogens and the examination of tick microbiomes. These efforts have led to the identification of hundreds of new tick-borne agents in the last decade alone. However, little is currently known about the majority of these agents beyond their phylogenetic classification. Our article outlines the primary methods involved in tick-borne agent discovery and the current status of our understanding of tick-borne agent diversity.
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Affiliation(s)
- Rafal Tokarz
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Corresponding author, e-mail:
| | - W Ian Lipkin
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY
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Serological Survey on the Occurrence of Rickettsia spp., Neospora caninum, Bartonella henselae and Toxoplasma gondii in Cats from Tuscany (Central Italy). Animals (Basel) 2021; 11:ani11061842. [PMID: 34205734 PMCID: PMC8234574 DOI: 10.3390/ani11061842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Domestic and stray cats are frequently infected by pathogens, some of which are zoonotic. The occurrence of microorganisms such as Bartonella henselae and Toxoplasma gondii, even though they are well known, could be underestimated because they are not regularly investigated in cats. Other pathogens, such as Neospora caninum and Rickettsia spp., have not been largely studied in feline populations and data about their spreading in Italian cats are very scanty. Monitoring of domestic and stray cats for these pathogens is important to evaluate the health status of the animals, but also, regarding B. henselae, Rickettsia spp. and T. gondii, from a One Health perspective. Abstract Asymptomatic cats often harbor pathogens, some of which have not been largely investigated in feline populations. The aim of this study was to evaluate the occurrence of antibodies against Rickettsia conorii, Rickettsia felis, Rickettsia typhi, Neospora caninum, Bartonella henselae and Toxoplasma gondii in cats from Tuscany. Ninety-five blood serum samples, previously collected, were analyzed by indirect immunofluorescence assay. Fifty-six (58.94%) cats had antibodies to at least one investigated pathogen: 28 (29.47%) cats were positive for B. henselae, 17 (17.89%) for R. felis, 14 (14.73%) for R. conorii, 14 (14.73%) for T. gondii, 2 (2.1%) for N. caninum. No cats were positive for R. typhi. Positive reactions to two or more pathogens were detected in 18 (18.94%) cats. The occurrence of antibodies against these microorganisms suggests that cats, even though asymptomatic, may be infected by pathogens, often zoonotic, and thus may be a source of infections for other animals and humans.
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Mathews KO, Phalen D, Norris JM, Stenos J, Toribio JA, Wood N, Graves S, Sheehy PA, Nguyen C, Bosward KL. Serological Evidence of Exposure to Spotted Fever Group and Typhus Group Rickettsiae in Australian Wildlife Rehabilitators. Pathogens 2021; 10:pathogens10060745. [PMID: 34204809 PMCID: PMC8231516 DOI: 10.3390/pathogens10060745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/15/2021] [Accepted: 05/28/2021] [Indexed: 12/14/2022] Open
Abstract
Rickettsioses are arthropod-borne zoonotic diseases, several of which occur in Australia. This study aimed to assess the exposure levels and risk factors for Rickettsia spp. among Australian wildlife rehabilitators (AWRs) using serology, PCR and a questionnaire. Antibody titres against Spotted Fever Group (SFG), Typhus Group (TG) and Scrub Typhus Group (STG) antigens were determined using an immunofluorescence assay. PCR targeting the gltA gene was performed on DNA extracts from whole blood and serum. Logistic regression was used to identify risk factors associated with seropositivity. Of the 27 (22.1%; 27/122) seropositive participants all were seropositive for SFG, with 5/27 (4.1%) also positive for TG. Of the 27 positive sera, 14.8% (4/27) were further classified as exposure to R. australis, 3.7% (1/27) to R. honei, 3.7% (1/27) to R. felis and 77.8% (21/27) were classified as ‘indeterminate’—most of which (85.7%; 18/21) were indeterminate R. australis/R. honei exposures. Rickettsia DNA was not detected in whole blood or serum. Rehabilitators were more likely to be seropositive if more than one household member rehabilitated wildlife, were older than 50 years or had occupational animal contact. These findings suggest that AWRs are at increased risk of contracting Rickettsia-related illnesses, however the source of the increased seropositivity remains unclear.
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Affiliation(s)
- Karen O. Mathews
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia; (D.P.); (J.M.N.); (J.-A.T.); (P.A.S.)
- Correspondence: (K.O.M.); (K.L.B.)
| | - David Phalen
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia; (D.P.); (J.M.N.); (J.-A.T.); (P.A.S.)
| | - Jacqueline M. Norris
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia; (D.P.); (J.M.N.); (J.-A.T.); (P.A.S.)
| | - John Stenos
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia; (J.S.); (S.G.); (C.N.)
| | - Jenny-Ann Toribio
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia; (D.P.); (J.M.N.); (J.-A.T.); (P.A.S.)
| | - Nicholas Wood
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia;
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia; (J.S.); (S.G.); (C.N.)
| | - Paul A. Sheehy
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia; (D.P.); (J.M.N.); (J.-A.T.); (P.A.S.)
| | - Chelsea Nguyen
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia; (J.S.); (S.G.); (C.N.)
| | - Katrina L. Bosward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW 2570, Australia; (D.P.); (J.M.N.); (J.-A.T.); (P.A.S.)
- Correspondence: (K.O.M.); (K.L.B.)
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Quadros APND, Rêgo GMSD, Silva TFD, Carvalho ADM, Martins TF, Binder LDC, Castro MBD, Mattos PSRD, Labruna MB, Paludo GR. Capybara (Hydrochoerus hydrochaeris) exposure to Rickettsia in the Federal District of Brazil, a non-endemic area for Brazilian spotted fever. ACTA ACUST UNITED AC 2021; 30:e028720. [PMID: 34076060 DOI: 10.1590/s1984-29612021035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/22/2021] [Indexed: 11/21/2022]
Abstract
In this study, whole blood samples and ticks were collected from 57 capybaras in recreational areas in the Federal District, Brazil, aiming to investigate the presence of Rickettsia spp. using polymerase chain reaction (PCR) and indirect immunofluorescence (IFAT) assays. None of the capybara blood samples yielded rickettsial DNA by PCR. Among 55 capybara serum samples tested by IFAT, 53 (96.3%) reacted to Rickettsia spp. Among these, 21 (39.6%) identified the R. bellii antigen as the probable antigen involved in a homologous reaction (PAIHR), whereas 2 (3.8%) identified the R. parkeri antigen. Ticks collected from capybaras were identified as 173 Amblyomma sculptum and 410 A. dubitatum, in addition to nine Amblyomma spp. larvae. A sample of 231 ticks was subjected to DNA extraction and PCR for Rickettsia species. None of 122 A. sculptum yielded rickettsial DNA. Molecular evidence of R. bellii was found in 25/108 (23.1%) and of Rickettsia sp. strain Cooperi (R. parkeri-like agent) in 2/108 (1.9%) of the A. dubitatum samples. These results suggest a greater exposure to R. bellii in these capybara populations, in addition to a more significant number of A. dubitatum, which might characterize the Federal District region as not endemic for Brazilian spotted fever.
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Affiliation(s)
- Ana Paula Nunes de Quadros
- Laboratório de Patologia Clínica Veterinária, Faculdade de Agronomia e Veterinária - FAV, Universidade de Brasília - UnB, Brasília, DF, Brasil
| | - George Magno Sousa do Rêgo
- Laboratório de Patologia Clínica Veterinária, Faculdade de Agronomia e Veterinária - FAV, Universidade de Brasília - UnB, Brasília, DF, Brasil
| | - Thamiris Figueiredo da Silva
- Laboratório de Patologia Clínica Veterinária, Faculdade de Agronomia e Veterinária - FAV, Universidade de Brasília - UnB, Brasília, DF, Brasil
| | - Andréa de Moraes Carvalho
- Laboratório de Patologia Clínica Veterinária, Faculdade de Agronomia e Veterinária - FAV, Universidade de Brasília - UnB, Brasília, DF, Brasil
| | - Thiago Fernandes Martins
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo - USP, São Paulo, SP, Brasil
| | - Lina de Campos Binder
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo - USP, São Paulo, SP, Brasil
| | - Márcio Botelho de Castro
- Laboratório de Patologia Veterinária, Faculdade de Agronomia e Veterinária - FAV, Universidade de Brasília - UnB, Brasília, DF, Brasil
| | - Paulo Sérgio Ribeiro de Mattos
- Laboratório de Sanidade Animal, Centro Nacional de Recursos Genéticos e Biotecnologia, Empresa Brasileira de Pesquisa Agropecuária - EMBRAPA, Brasília, DF, Brasil
| | - Marcelo Bahia Labruna
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo - USP, São Paulo, SP, Brasil
| | - Giane Regina Paludo
- Laboratório de Patologia Clínica Veterinária, Faculdade de Agronomia e Veterinária - FAV, Universidade de Brasília - UnB, Brasília, DF, Brasil
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de Vries SG, van Eekeren LE, van der Linden H, Visser BJ, Grobusch MP, Wagenaar JFP, Goris MGA, Goorhuis A. Searching and Finding the Hidden Treasure: A Retrospective Analysis of Rickettsial Disease Among Dutch International Travelers. Clin Infect Dis 2021; 72:1171-1178. [PMID: 31998942 PMCID: PMC8028097 DOI: 10.1093/cid/ciaa091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/28/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Rickettsial disease (RD) is a prevalent and underestimated cause of febrile illness worldwide, especially in the absence of an inoculation eschar. We attempted to quantify this underestimation at our clinic, by investigating past cases of febrile illness in travelers who had tested negative for leptospirosis, a disease that can initially present similarly to non-eschar RD, and which we routinely consider when other important causes of unspecified febrile illness have tested negative. METHODS We performed a retrospective analysis in febrile returned travelers from Asia, Africa, or the Americas between 2010 and 2017, who had tested negative for leptospirosis. Serologic immunofluorescence assays were performed for Orientia tsutsugamushi (scrub typhus), typhus group, and spotted fever group RD. We performed a medical records review of all patients who tested positive. In case of a fitting medical history, cases were deemed either confirmed (based on convalescent serology) or suspected (based on single serology). RESULTS Among 97 patients, convalescent serology was available in 16 (16.5%) patients, and a single serology in 81 (83.5%) patients. RD was the likely diagnosis in 8 of 16 (50.0%) patients with convalescent serology, and in 8 of 81 (9.9%) with single serology. Of the 16 confirmed/suspected cases, 11 (69%) had been missed and 7 (44%) had not received adequate empiric antibiotic therapy. CONCLUSIONS This study shows that non-eschar RD is an important and poorly recognized cause of illness in travelers, even in a specialized travel clinic. A lower threshold to test and treat for RD is warranted in returning travelers with febrile illness.
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Affiliation(s)
- Sophia G de Vries
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Louise E van Eekeren
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Hans van der Linden
- Leptospirosis Reference Center, Department of Medical Microbiology, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Benjamin J Visser
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jiri F P Wagenaar
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Leptospirosis Reference Center, Department of Medical Microbiology, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marga G A Goris
- Leptospirosis Reference Center, Department of Medical Microbiology, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Abraham Goorhuis
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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25
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Turebekov N, Abdiyeva K, Yegemberdiyeva R, Kuznetsov A, Dmitrovskiy A, Yeraliyeva L, Shapiyeva Z, Batyrbayeva D, Tukhanova N, Shin A, Musralina L, Hoelscher M, Froeschl G, Dobler G, Freimueller K, Wagner E, Frey S, Essbauer S. Occurrence of Anti-Rickettsia spp. Antibodies in Hospitalized Patients with Undifferentiated Febrile Illness in the Southern Region of Kazakhstan. Am J Trop Med Hyg 2021; 104:2000-2008. [PMID: 33901004 DOI: 10.4269/ajtmh.20-0388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/09/2021] [Indexed: 12/16/2022] Open
Abstract
Undifferentiated febrile illness still represents a demanding medical problem all over the world, but primarily in low- and middle-income countries. Scientific and clinical investigations related to undifferentiated febrile illness and rickettsial diseases in Kazakhstan are lacking. This study reflects the investigation of antibodies against spotted fever group (SFG) and typhus group (TG) rickettsiae in patients with undifferentiated febrile illness in the southern region of Kazakhstan (Almaty and Kyzylorda oblasts). Paired serum samples were gathered from 13 hospitals in these two oblasts and explored for the presence of IgM and IgG antibodies against typhus group and IgG antibodies against spotted fever group rickettsiae using ELISA. Patient's questionnaires were statistically analyzed. In total, 802 inpatients from Almaty (N = 9) and Kyzylorda (N = 4) hospitals were included in this research. Based on ELISA results, 250 patients out of 802 (31.2%) from both oblasts had IgG antibodies against SFG rickettsiae. Results from 11 (1.4%) patients indicated acute infection with tick-borne rickettsiosis. Regarding TG rickettsiae (R. typhi), a past infection was detected in 248 (30.9%) febrile patients and acute infection in 22 (2.7%) patients in the two selected oblasts. The data indicated that SFG and TG rickettsioses are present in Kazakhstan. Kazakh physicians should be aware of these emerging diseases in both investigated oblasts because the occurrence of these diseases is not suspected during day-to-day clinical practice. The identification of rickettsial pathogens and implementation of modern laboratory methods for the diagnostics of rickettsioses are in need throughout Kazakhstan.
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Affiliation(s)
- Nurkeldi Turebekov
- 1Central Reference Laboratory, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Karlygash Abdiyeva
- 1Central Reference Laboratory, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Ravilya Yegemberdiyeva
- 2Department of Infectious and Tropical Diseases, Kazakh National Medical University, Almaty, Kazakhstan
| | - Andrey Kuznetsov
- 3National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Andrey Dmitrovskiy
- 3National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan
| | - Lyazzat Yeraliyeva
- 4Department of Children's Infectious Diseases, Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanna Shapiyeva
- 5Scientific Practical Center of Sanitary Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Dinara Batyrbayeva
- 6Scientific Clinical Diagnostic Laboratory, Kazakh National Medical University, Almaty, Kazakhstan
| | - Nur Tukhanova
- 7Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Anna Shin
- 7Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Lyazzat Musralina
- 8Al-Farabi Kazakh National University, Almaty, Kazakhstan.,9Institute of General Genetics and Cytology, Almaty, Kazakhstan
| | - Michael Hoelscher
- 10Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Guenter Froeschl
- 7Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.,10Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Gerhard Dobler
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Klaus Freimueller
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Edith Wagner
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
| | - Stefan Frey
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany.,12Bundeswehr Research Institute for Protective Technologies and CBRN Protection, Munster, Germany
| | - Sandra Essbauer
- 11Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany
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Imported scrub typhus in Europe: Report of three cases and a literature review. Travel Med Infect Dis 2021; 42:102062. [PMID: 33862243 DOI: 10.1016/j.tmaid.2021.102062] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Scrub typhus is a vector-borne rickettsial infection, which can cause relevant morbidity and mortality. While the number of cases is around a million per year globally, the infection is seldom diagnosed in travellers from Europe. METHODS We herein report three cases diagnosed in Italian travellers and review the literature about imported cases in Europe in the last 60 years. RESULTS Three participants to the same hiking trip to the forest of northern Laos presented fever and other symptoms, including eschars (2 individuals) and skin rash (2 individuals). Overall, they didn't report complications, and recovered soon after doxycycline treatment. Diagnosis was retrospectively confirmed with PCR in one of them. The review collected data from 40 patients. Almost all of them (95%) presented fever, more than a half had headache, skin rash, eschars, arthromyalgias. 73% of them were hospitalized, and 16.2% needed intensive care. Diagnosis was confirmed by serology in almost all cases (94.6%). Most patients (88%) were treated with doxycycline. All patients survived, although one case resulted in incomplete tetraparesis. CONCLUSIONS Scrub typhus should be considered in all travellers coming back from endemic areas and presenting with acute febrile illness. Laboratory diagnosis can be challenging, as specific tests are not widely available. In case of clinical suspicion, a prompt treatment with oral doxycycline could avoid severe complications.
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Scrub Typhus and Molecular Characterization of Orientia tsutsugamushi from Central Nepal. Pathogens 2021; 10:pathogens10040422. [PMID: 33916224 PMCID: PMC8066985 DOI: 10.3390/pathogens10040422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022] Open
Abstract
Scrub typhus is a vector-borne, acute febrile illness caused by Orientia tsutsugamushi. Scrub typhus continues to be an important but neglected tropical disease in Nepal. Information on this pathogen in Nepal is limited to serological surveys with little information available on molecular methods to detect O. tsutsugamushi. Limited information exists on the genetic diversity of this pathogen. A total of 282 blood samples were obtained from patients with suspected scrub typhus from central Nepal and 84 (30%) were positive for O. tsutsugamushi by 16S rRNA qPCR. Positive samples were further subjected to 56 kDa and 47 kDa molecular typing and molecularly compared to other O. tsutsugamushi strains. Phylogenetic analysis revealed that Nepalese O. tsutsugamushi strains largely cluster together and cluster away from other O. tsutsugamushi strains from Asia and elsewhere. One exception was the sample of Nepal_1, with its partial 56 kDa sequence clustering more closely with non-Nepalese O. tsutsugamushi 56 kDa sequences, potentially indicating that homologous recombination may influence the genetic diversity of strains in this region. Knowledge on the circulating strains in Nepal is important to the development of diagnostic tests and vaccines to support public health measures to control scrub typhus in this country.
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28
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Straily A, Stuck S, Singleton J, Brennan S, Marcum S, Condit M, Lee C, Kato C, Tonnetti L, Stramer SL, Paddock CD. Antibody Titers Reactive With Rickettsia rickettsii in Blood Donors and Implications for Surveillance of Spotted Fever Rickettsiosis in the United States. J Infect Dis 2021; 221:1371-1378. [PMID: 31267128 DOI: 10.1093/infdis/jiz316] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since 2000, the reported prevalence of tick-borne spotted fever rickettsiosis has increased considerably. We compared the level of antibody reactivity among healthy blood donors from 2 widely separated regions of the United States and evaluated the impact of antibody prevalence on public health surveillance in one of these regions. METHODS Donor serum samples were evaluated by indirect immunofluorescence antibody assay to identify immunoglobulin G (IgG) antibodies reactive with Rickettsia rickettsii. The Georgia Department of Public Health (GDPH) analyzed characteristics of cases from 2016 surveillance data to evaluate the utility of laboratory surveillance for case assessment. RESULTS Of the Georgia donors (n = 1493), 11.1% demonstrated antibody titers reactive with R. rickettsii at titers ≥64, whereas 6.3% of donors from Oregon and Washington (n = 1511) were seropositive. Most seropositive donors had a titer of 64; only 3.1% (n = 93) of all donors had titers ≥128. During 2016, GDPH interviewed 243 seropositive case patients; only 28% (n = 69) met inclusion criteria in the national case definition for spotted fever rickettsiosis. CONCLUSIONS These findings suggest that a single IgG antibody titer is an unreliable measure of diagnosis and could inaccurately affect surveillance estimates that define magnitude and clinical characteristics of Rocky Mountain spotted fever and other spotted fever rickettsioses.
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Affiliation(s)
- Anne Straily
- Epidemic Intelligence Service, Atlanta.,Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
| | | | - Joseph Singleton
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
| | | | - Stephanie Marcum
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
| | - Marah Condit
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
| | - Christopher Lee
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
| | - Cecilia Kato
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
| | - Laura Tonnetti
- American Red Cross, Rockville and Gaithersburg, Maryland
| | | | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta
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29
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Elders PND, Swe MMM, Phyo AP, McLean ARD, Lin HN, Soe K, Htay WYA, Tanganuchitcharnchai A, Hla TK, Tun NN, Nwe TT, Moe MM, Thein WM, Zaw NN, Kyaw WM, Linn H, Htwe YY, Smithuis FM, Blacksell SD, Ashley EA. Serological evidence indicates widespread distribution of rickettsioses in Myanmar. Int J Infect Dis 2020; 103:494-501. [PMID: 33310022 PMCID: PMC7862081 DOI: 10.1016/j.ijid.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022] Open
Abstract
Diagnosis of rickettsial infections is difficult in low-resource settings; this leads to delays in receiving appropriate treatment. Before this study, the distribution of rickettsioses in Myanmar was not known. This serosurvey shows that rickettsioses are widespread in Myanmar. Particularly high prevalence of scrub typhus was found in central and northern regions.
Background Little research has been published on the prevalence of rickettsial infections in Myanmar. This study determined the seroprevalence of immunoglobulin G (IgG) antibodies to rickettsial species in different regions of Myanmar. Methods Seven hundred leftover blood samples from patients of all ages in primary care clinics and hospitals in seven regions of Myanmar were collected. Samples were screened for scrub typhus group (STG), typhus group (TG) and spotted fever group (SFG) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Immunofluorescence assays were performed for the same rickettsial groups to confirm seropositivity if ELISA optical density ≥0.5. Results Overall IgG seroprevalence was 19% [95% confidence interval (CI) 16–22%] for STG, 5% (95% CI 3–7%) for TG and 3% (95% CI: 2–5%) for SFG. The seroprevalence of STG was particularly high in northern and central Myanmar (59% and 19–33%, respectively). Increasing age was associated with higher odds of STG and TG seropositivity [per 10-year increase, adjusted odds ratio estimate 1.68 (p < 0.01) and 1.24 (p = 0.03), respectively]. Conclusion Rickettsial infections are widespread in Myanmar, with particularly high seroprevalence of STG IgG antibodies in central and northern regions. Healthcare workers should consider rickettsial infections as common causes of fever in Myanmar.
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Affiliation(s)
| | | | | | - Alistair R D McLean
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Kyaw Soe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | | | - Ampai Tanganuchitcharnchai
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thel K Hla
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Medical Action Myanmar, Yangon, Myanmar
| | - Ni Ni Tun
- Medical Action Myanmar, Yangon, Myanmar
| | - Thin Thin Nwe
- Magway General Hospital and University of Medicine, Magway, Myanmar; University of Medicine 2, Yangon, Myanmar
| | - Myat Myat Moe
- Magway General Hospital and University of Medicine, Magway, Myanmar
| | - Win May Thein
- Mandalay General Hospital and University of Medicine, Mandalay, Myanmar
| | - Ni Ni Zaw
- Mandalay General Hospital and University of Medicine, Mandalay, Myanmar
| | | | - Htun Linn
- Monywa General Hospital, Monywa, Myanmar
| | | | - Frank M Smithuis
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Medical Action Myanmar, Yangon, Myanmar
| | - Stuart D Blacksell
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Elizabeth A Ashley
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic.
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Souza Z, Moraes B, Krawczak F, Zulzke L, Carvalho T, Sousa A, Agopian R, Marcili A, Labruna M, Moraes-Filho J. Detecção de anticorpos anti-Rickettsia rickettsii em cães residentes em área negligenciada no município de São Paulo, SP, Brasil. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A febre maculosa brasileira (FMB), descrita inicialmente nos Estados Unidos como febre maculosa das Montanhas Rochosas, é uma antropozoonose relatada apenas no continente americano e causada pela bactéria Rickettsia rickettsii. No Brasil a transmissão ocorre sobretudo pela picada de carrapatos do gênero Amblyomma spp. A doença foi inicialmente descrita como de transmissão em áreas rurais e silvestres, no entanto áreas periurbanas e urbanas vêm apresentando casos, principalmente relacionados com a presença de humanos residindo em pequenos fragmentos de mata ciliar. O presente estudo teve por objetivo elucidar a dispersão da FMB nas proximidades dos reservatórios Guarapiranga e Billings, na cidade de São Paulo, SP. Para tanto, a presença de anticorpos anti-R. rickettsii, Rickettsia parkeri e Rickettsia bellii foi avaliada em cães atendidos nas campanhas de esterilização cirúrgica e residentes ao redor dos reservatórios. Foram coletadas amostras de 393 cães, e as amostras de soro foram analisadas pela reação de imunofluorescência indireta (RIFI), com ponto de corte de 1:64. Os títulos para R. rickettsii variaram de 256 a 4096, com positividade de 3,3% (13/393); para R. bellii, de 128 a 1024 e 4,1% (16/393) de positivos, e um único animal (0,25%) foi soropositivo para R. parkeri, com título de 128. Os achados permitem concluir que a região de estudo apresenta condições de se tornar uma possível área com casos de FMB, pois comporta fragmentação de Mata Atlântica, condições essas ideais para a manutenção do vetor do gênero Amblyomma já descrito na região, bem como para a presença da Rickettsia rickettsii circulante entre os cães, confirmada pela existência de anticorpos. Condutas referentes à conscientização da população por meio de trabalhos educacionais devem ser implantadas para a prevenção da doença na população da área.
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Affiliation(s)
| | - B.V. Moraes
- Universidade Santo Amaro, Brazil; Universidade de São Paulo, Brazil
| | | | | | | | | | | | - A. Marcili
- Universidade Santo Amaro, Brazil; Universidade de São Paulo, Brazil
| | | | - J. Moraes-Filho
- Universidade Santo Amaro, Brazil; Universidade de São Paulo, Brazil
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Targeted Metagenomics for Clinical Detection and Discovery of Bacterial Tick-Borne Pathogens. J Clin Microbiol 2020; 58:JCM.00147-20. [PMID: 32878950 DOI: 10.1128/jcm.00147-20] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/21/2020] [Indexed: 01/31/2023] Open
Abstract
Tick-borne diseases, due to a diversity of bacterial pathogens, represent a significant and increasing public health threat throughout the Northern Hemisphere. A high-throughput 16S V1-V2 rRNA gene-based metagenomics assay was developed and evaluated using >13,000 residual samples from patients suspected of having tick-borne illness and >1,000 controls. Taxonomic predictions for tick-borne bacteria were exceptionally accurate, as independently validated by secondary testing. Overall, 881 specimens were positive for bacterial tick-borne agents. Twelve tick-borne bacterial species were detected, including two novel pathogens, representing a 100% increase in the number of tick-borne bacteria identified compared to what was possible by initial PCR testing. In three blood specimens, two tick-borne bacteria were simultaneously detected. Seven bacteria, not known to be tick transmitted, were also confirmed to be unique to samples from persons suspected of having tick-borne illness. These results indicate that 16S V1-V2 metagenomics can greatly simplify diagnosis and accelerate the discovery of bacterial tick-borne pathogens.
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Epidemiology, Clinical Aspects, Laboratory Diagnosis and Treatment of Rickettsial Diseases in the Mediterranean Area During COVID-19 Pandemic: A Review of the Literature. Mediterr J Hematol Infect Dis 2020; 12:e2020056. [PMID: 32952967 PMCID: PMC7485464 DOI: 10.4084/mjhid.2020.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/04/2020] [Indexed: 01/12/2023] Open
Abstract
The purpose of the present review is to give an update regarding the classification, epidemiology, clinical manifestation, diagnoses, and treatment of the Rickettsial diseases present in the Mediterranean area. We performed a comprehensive search, through electronic databases (Pubmed – MEDLINE) and search engines (Google Scholar), of peer-reviewed publications (articles, reviews, and books). The availability of new diagnostic tools, including Polymerase Chain Reaction and nucleotide sequencing has significantly modified the classification of intracellular bacteria, including the order Rickettsiales with more and more new Rickettsia species recognized as human pathogens. Furthermore, emerging Rickettsia species have been found in several countries and are often associated with unique clinical pictures that may challenge the physician in the early detection of the diseases. Rickettsial infections include a wide spectrum of clinical presentations ranging from a benign to a potentially life treating disease that requires prompt recognition and proper management. Recently, due to the spread of SARS-CoV-2 infection, the differential diagnosis with COVID-19 is of crucial importance. The correct understanding of the clinical features, diagnostic tools, and proper treatment can assist clinicians in the management of Rickettsioses in the Mediterranean area.
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Dhawan S, Robinson MT, Stenos J, Graves SR, Wangrangsimakul T, Newton PN, Day NPJ, Blacksell SD. Selection of Diagnostic Cutoffs for Murine Typhus IgM and IgG Immunofluorescence Assay: A Systematic Review. Am J Trop Med Hyg 2020; 103:55-63. [PMID: 32274984 PMCID: PMC7356422 DOI: 10.4269/ajtmh.19-0818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/18/2020] [Indexed: 11/16/2022] Open
Abstract
Murine typhus is a neglected but widespread infectious disease that results in acute fever. The immunofluorescence assay (IFA) is the "gold standard" to identify IgM or IgG antibodies, although there is a lack of standardization in methodologies. The objective of this review is to summarize 1) the differences in published methodologies, 2) the diagnostic cutoff titers, and 3) the justification of diagnostic cutoffs. Searches were performed by combining the following search terms: "murine typhus," "rickettsia typhi," "immunofluorescence," "IFA," and "serologic" with restrictions (i.e., "rickettsia typhi" or "murine typhus," and "IFA" or "immunofluorescence," or "serologic*"). The search identified 78 studies that used IFA or immunoperoxidase assay (IIP) antibody cutoffs to diagnose murine typhus, 39 of which were case series. Overall, 45 studies (57.7%) provided little to no rationale as to how the cutoff was derived. Variation was seen locally in the cutoff titers used, but a 4-fold or greater increase was often applied. The cutoffs varied depending on the antibody target. No consensus was observed in establishing a cutoff, or for a single-value diagnostic cutoff. In conclusion, there is a lack of consensus in the establishment of a single-value cutoff. Further studies will need to be executed at each distinct geographic location to identify region-specific cutoffs, while also considering background antibody levels to distinguish between healthy and infected patients.
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Affiliation(s)
- Sandhya Dhawan
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Matthew T. Robinson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - John Stenos
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, Australia
| | - Stephen R. Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, Australia
| | - Tri Wangrangsimakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Paul N. Newton
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Nicholas P. J. Day
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Stuart D. Blacksell
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
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Lin IF, Lin JN, Tsai CT, Wu YY, Chen YH, Lai CH. Serum C-reactive protein and procalcitonin values in acute Q fever, scrub typhus, and murine typhus. BMC Infect Dis 2020; 20:334. [PMID: 32398008 PMCID: PMC7216490 DOI: 10.1186/s12879-020-05058-8] [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] [Received: 03/05/2020] [Accepted: 04/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background Although C-reactive protein (CRP) and procalcitonin (PCT) are widely used inflammatory markers for infectious diseases, their role and potential application for rickettsioses were rarely studied. Methods A retrospective chart review and serological study were conducted in patients with rickettsioses. The clinical presentations, characteristics, laboratory data, and treatment responses were recorded and their associations with CRP and PCT values were analyzed. Results A total of 189 cases of rickettsioses, including 115 cases of acute Q fever (60.8%), 55 cases of scrub typhus (29.1%), and 19 cases of murine typhus (10.1%) were investigated. Both CRP and PCT values increased in the acute phase and declined in the convalescent phase. In the acute phase, mean CRP and PCT values were 78.2 ± 63.7 mg/L and 1.05 ± 1.40 ng/mL, respectively. Percentages of patients falling under different cut-off values of CRP and PCT were calculated systematically. Only 10.8% of CRP was > 150 mg/L and 14.2% of PCT was > 2.0 ng/mL. Patients with delayed responses to doxycycline treatment (> 3 days from treatment to defervescence) had significantly higher CRP values (102.7 ± 77.1 vs. 72.2 ± 58.2 mg/L, p = 0.041) and more PCT > 1.0 ng/ml (48.4% vs. 26.0%, p = 0.019) in the acute phase; higher CRP values (19.1 ± 37.4 vs. 3.6 ± 13.1 mg/L, p = 0.049) and more PCT > 0.5 ng/ml (19.2% vs. 1.4%, p = 0.005) in the convalescent phase. Correlation analysis was conducted for patients with acute Q fever. CRP and PCT values were positively correlated to each other, and both markers also had a positive correlation with serum aspartate transaminase values. Both CRP and PCT values and white blood cell counts were positively correlated to the days needed from doxycycline treatment to defervescence. Conclusion CRP and PCT values might be useful in clinical investigations for patients with suspected rickettsioses and in predicting the response to doxycycline treatment for rickettsioses.
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Affiliation(s)
- I-Fan Lin
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City, 824, Taiwan
| | - Jiun-Nong Lin
- School of Medicine, College of Medicine, I-Shou University, No.1, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City, 824, Taiwan.,Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Chia-Ta Tsai
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City, 824, Taiwan.,Department of Infection Control, E-Da Hospital, I-Shou University, Kaohsiung City, 824, Taiwan
| | - Yu-Ying Wu
- Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung City, 824, Taiwan
| | - Yen-Hsu Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsung, Taiwan.,School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, Center of Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsung, Taiwan.,Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Chung-Hsu Lai
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, No.1, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City, 824, Taiwan. .,School of Medicine, College of Medicine, I-Shou University, No.1, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City, 824, Taiwan.
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COYOTES (CANIS LATRANS) IN ARIZONA, USA, EXHIBIT IMMUNE AND GENETIC EVIDENCE OF RICKETTSIAL INFECTIONS. J Wildl Dis 2020. [DOI: 10.7589/2019-01-012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Swei A, Couper LI, Coffey LL, Kapan D, Bennett S. Patterns, Drivers, and Challenges of Vector-Borne Disease Emergence. Vector Borne Zoonotic Dis 2020; 20:159-170. [PMID: 31800374 PMCID: PMC7640753 DOI: 10.1089/vbz.2018.2432] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Vector-borne diseases are emerging at an increasing rate and comprise a disproportionate share of all emerging infectious diseases. Yet, the key ecological and evolutionary dimensions of vector-borne disease that facilitate their emergence have not been thoroughly explored. This study reviews and synthesizes the existing literature to explore global patterns of emerging vector-borne zoonotic diseases (VBZDs) under changing global conditions. We find that the vast majority of emerging VBZDs are transmitted by ticks (Ixodidae) and mosquitoes (Culicidae) and the pathogens transmitted are dominated by Rickettsiaceae bacteria and RNA viruses (Flaviviridae, Bunyaviridae, and Togaviridae). The most common potential driver of these emerging zoonoses is land use change, but for many diseases, the driver is unknown, revealing a critical research gap. While most reported VBZDs are emerging in the northern latitudes, after correcting for sampling bias, Africa is clearly a region with the greatest share of emerging VBZD. We highlight critical gaps in our understanding of VBZD emergence and emphasize the importance of interdisciplinary research and consideration of deeper evolutionary processes to improve our capacity for anticipating where and how such diseases have and will continue to emerge.
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Affiliation(s)
- Andrea Swei
- Department of Biology, San Francisco State University, San Francisco, California
| | - Lisa I. Couper
- Department of Biology, Stanford University, Palo Alto, California
| | - Lark L. Coffey
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Durrell Kapan
- Institute for Biodiversity Science and Sustainability, California Academy of Sciences, San Francisco, California
| | - Shannon Bennett
- Institute for Biodiversity Science and Sustainability, California Academy of Sciences, San Francisco, California
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Gautam R, Parajuli K, Tshokey T, Stenos J, Sherchand JB. Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal. BMC Infect Dis 2020; 20:138. [PMID: 32054525 PMCID: PMC7020552 DOI: 10.1186/s12879-020-4861-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 02/06/2020] [Indexed: 06/15/2024] Open
Abstract
Background Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium, Orientia tsutsugamushi. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. Method Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit and an in-house IgM IFA. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. Result Statistical analysis of IgM ELISA results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73–87.68%), specificity 94.82% (95% CI: 93.43–95.99%), positive likelihood ratio 16.21% (95% CI: 12.71–20.67%), negative likelihood ratio 0.17% (95% CI: 0.13–0.21%), disease prevalence 22.08% (95% CI: 20.06 -24.21%), positive predictive value 82.12% (95% CI: 78.28–85.42%) and negative predictive value 95.44% (95% CI: 94.27–96.38%) respectively. Conclusion Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.
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Affiliation(s)
- Rajendra Gautam
- Department of Microbiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
| | - Keshab Parajuli
- Department of Microbiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Tshokey Tshokey
- Australian rickettsial reference laboratory, Geelong, Victoria, Australia
| | - John Stenos
- Australian rickettsial reference laboratory, Geelong, Victoria, Australia
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Mendes JCR, Kmetiuk LB, Martins CM, Canavessi AMO, Jimenez T, Pellizzaro M, Martins TF, Morikawa VM, Santos APD, Labruna MB, Biondo AW. Serosurvey of Rickettsia spp. in cats from a Brazilian spotted fever-endemic area. ACTA ACUST UNITED AC 2020; 28:713-721. [PMID: 31721931 DOI: 10.1590/s1984-29612019092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/11/2019] [Indexed: 11/22/2022]
Abstract
Rickettsia spp. bacteria are responsible for tick-borne diseases worldwide, mostly maintained by rickettsial amplifiers capybaras in Brazilian endemic areas. The campus of the University of São Paulo, in southeastern Brazil, is an area endemic for Brazilian spotted fever (BSF), with high density of capybaras and Amblyomma spp., along with confirmed human cases. Besides capybaras, the university has also an in-campus high population of sheltered and free-roaming cats. Accordingly, the aim of this study was to determine the prevalence and characteristics associated with Rickettsia rickettsii, Rickettsia parkeri and Rickettsia felis exposure among cats in a BSF-endemic area. Out of 51 cats sampled, 23/35 shelter (65.7%) and 5/16 free-roaming (31.2%) were positive (titers ≥ 64) for at least one Rickettsia species. Ticks species were present in 3/16 free-roaming cats (18.8%), consisting of Amblyomma spp., nymphs of Amblyomma sculptum and adult Rhipicephalus sanguineus sensu lato. Despite sharing the capybaras environment, the seropositivity among the free-roaming and shelter cats was lower than owned cats in other endemic areas. Whether equally or less exposed to rickettsial infection, compared with owned cats in endemic areas, free-roaming and shelter cats may be used as environmental sentinels for human exposure to rickettsiae in such areas.
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Affiliation(s)
| | - Louise Bach Kmetiuk
- Departamento de Biologia Celular e Molecular, Universidade Federal do Paraná - UFPR, Curitiba, PR, Brasil
| | - Camila Marinelli Martins
- Departamento de Enfermagem e Saúde Pública, Universidade Estadual de Ponta Grossa - UEPG, Ponta Grossa, PR, Brasil
| | | | - Tatiana Jimenez
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Escola de Medicina Veterinária e Saúde Animal, Universidade de São Paulo - USP, São Paulo, SP, Brasil
| | - Maysa Pellizzaro
- Departamento de Higiene Veterinária e Saúde Pública, Escola de Medicina Veterinária, Universidade Estadual Paulita - UNESP, Botucatu, SP, Brasil
| | - Thiago Fernandes Martins
- Departamento de Higiene Veterinária e Saúde Pública, Escola de Medicina Veterinária, Universidade Estadual Paulita - UNESP, Botucatu, SP, Brasil
| | - Vivien Midori Morikawa
- Departamento de Saúde Coletiva, Universidade Federal do Paraná - UFPR, Curitiba, PR, Brasil
| | | | - Marcelo Bahia Labruna
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Escola de Medicina Veterinária e Saúde Animal, Universidade de São Paulo - USP, São Paulo, SP, Brasil
| | - Alexander Welker Biondo
- Departamento de Biologia Celular e Molecular, Universidade Federal do Paraná - UFPR, Curitiba, PR, Brasil
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Foley J, Tinoco-Gracia L, Rodriguez-Lomelí M, Estrada-Guzmán J, Fierro M, Mattar-Lopez E, Peterson A, Pascoe E, Gonzalez Y, Hori-Oshima S, Armstrong PA, Lopez G, Jacome-Ibarra M, Paddock CD, Zazueta OE. Unbiased Assessment of Abundance of Rhipicephalus sanguineus sensu lato Ticks, Canine Exposure to Spotted Fever Group Rickettsia, and Risk Factors in Mexicali, México. Am J Trop Med Hyg 2020; 101:22-32. [PMID: 31094313 DOI: 10.4269/ajtmh.18-0878] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
An epidemic of Rocky Mountain spotted fever (RMSF) is ongoing in Mexicali, México. We visited 100 neighborhoods with diagnosed human cases and 100 control neighborhoods to evaluate knowledge of the epidemic; obtain data on the spatial distribution of dogs, canine seroprevalence and active infection, tick infestations, and presence of rickettsial DNA in ticks; and evaluate risk factors for human cases, seropositivity, and tick infestation within an unbiased study design. The majority (80%) of residents had heard of RMSF, but only 48% used acaricides in the home or on dogs. Case neighborhoods and those with high canine seroprevalence tended to be on the city periphery or in the agricultural valley. No dogs were polymerase chain reaction (PCR) positive for Rickettsia rickettsii, and the overall seroprevalence was 65% (titers from 64 to 1,024). PCR prevalence in ticks was 0.70%, confirmed by DNA sequencing as R. rickettsii; neighborhood prevalence ranged from 0.7% to 6.1%. Twelve percent of dogs had high tick burdens, and all ticks were Rhipicephalus sanguineus. Epidemiologically significant risk factors were ground covering for a neighborhood having a human case; dogs having poor body condition and weighing < 10 kg for canine seropositivity; dogs living at the home for the number of ticks in the environment; and being near canals, having trash on the patio, and a dog being thin for tick burdens on dogs. A One Health approach is crucial to understanding RMSF and brown dog ticks.
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Affiliation(s)
- Janet Foley
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Luis Tinoco-Gracia
- Laboratorio de Salud Pública Veterinaria, Instituto de Investigaciones en Ciencias Veterinarias, Universidad Autónoma de Baja California, Mexicali, México
| | | | | | - Maria Fierro
- Public Health Department, Imperial County, California
| | - Elva Mattar-Lopez
- Facultad de Medicina, Universidad Autónoma de Baja California, Mexicali, México
| | - Amy Peterson
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily Pascoe
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Yolanda Gonzalez
- Laboratorio de Salud Pública Veterinaria, Instituto de Investigaciones en Ciencias Veterinarias, Universidad Autónoma de Baja California, Mexicali, México
| | - Sawako Hori-Oshima
- Laboratorio de Salud Pública Veterinaria, Instituto de Investigaciones en Ciencias Veterinarias, Universidad Autónoma de Baja California, Mexicali, México
| | - Paige A Armstrong
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gilberto Lopez
- Laboratorio de Salud Pública Veterinaria, Instituto de Investigaciones en Ciencias Veterinarias, Universidad Autónoma de Baja California, Mexicali, México
| | - Mariana Jacome-Ibarra
- Laboratorio de Salud Pública Veterinaria, Instituto de Investigaciones en Ciencias Veterinarias, Universidad Autónoma de Baja California, Mexicali, México
| | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Oscar E Zazueta
- Dirección de Enseñanza y Vinculación, Instituto de Servicios de Salud Pública del Estado de Baja California, Mexicali, México
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Potts R, Molina I, Sheele JM, Pietri JE. Molecular detection of Rickettsia infection in field-collected bed bugs. New Microbes New Infect 2020; 34:100646. [PMID: 32025311 PMCID: PMC6997558 DOI: 10.1016/j.nmni.2019.100646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/05/2019] [Accepted: 12/27/2019] [Indexed: 11/26/2022] Open
Abstract
Bed bugs are now one of the most prevalent human-associated, blood-feeding pests in the urban world, but few studies of their association with human pathogens have been conducted since their resurgence. Here, we used PCR to screen samples of field-collected bed bugs (Cimex spp.) for the presence of Rickettsia bacteria and we describe the first detection of an uncharacterized Rickettsia in Cimex lectularius in nature. Rickettsia was detected in 5/39 (12.8%) of the bed bug samples tested. In particular, three pools from the USA and two individual insects from the UK were positive for Rickettsia DNA. Sequencing and analysis of a fragment of the citrate synthase gene (gltA) from positive samples from each country revealed that the Rickettsia detected in both were identical and were closely related to a Rickettsia previously detected in the rat flea Nosopsyllus laeviceps. Additional experiments indicated that the Rickettsia localizes to multiple tissues in the bed bug and reaches high titres. Attempts were made to infect mammalian cells in culture but these efforts were inconclusive. Our findings suggest that Rickettsia are secondary endosymbionts of bed bugs and have potential implications for both bed bug control and public health. However, further investigation is required to determine the pathogenicity of this Rickettsia, its transmission mechanisms, and its contributions to bed bug physiology.
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Affiliation(s)
- R Potts
- University of South Dakota, Sanford School of Medicine, Division of Basic Biomedical Sciences, Vermillion, SD, USA
| | - I Molina
- University of South Dakota, Sanford School of Medicine, Division of Basic Biomedical Sciences, Vermillion, SD, USA
| | - J M Sheele
- Mayo Clinic, Department of Emergency Medicine, Jacksonville, FL, USA
| | - J E Pietri
- University of South Dakota, Sanford School of Medicine, Division of Basic Biomedical Sciences, Vermillion, SD, USA
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Satjanadumrong J, Robinson MT, Hughes T, Blacksell SD. Distribution and Ecological Drivers of Spotted Fever Group Rickettsia in Asia. ECOHEALTH 2019; 16:611-626. [PMID: 30993545 PMCID: PMC6910891 DOI: 10.1007/s10393-019-01409-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/30/2023]
Abstract
Spotted fever group and related rickettsia (SFGR) are a neglected group of pathogens that belong to the genus Rickettsia. SFGR are zoonotic and are transmitted by arthropod vectors, primarily ticks, fleas and mites to accidental hosts. These emerging and re-emerging infections are widely distributed throughout the world. Land-use change and increasing human-wildlife conflict compound the risk of SFGR infection to local people in endemic areas and travelers to these regions. In this article, we discuss the rickettsial organisms causing spotted fever and related diseases, their arthropod vectors in Asia and the impact of land-use change on their spread.
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Affiliation(s)
- Jaruwan Satjanadumrong
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand
| | - Matthew T Robinson
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7FZ, UK
| | - Tom Hughes
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand
- EcoHealth Alliance, 460 West 34th Street, 17th Floor, New York, NY, USA
| | - Stuart D Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand.
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7FZ, UK.
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Jiang Y, Hou X, Zhang L, Tan Y, Lu C, Xiao D, Li H, Hao Q, Wan K. Case report: A patient coinfected by Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae in Urumqi, China. Medicine (Baltimore) 2019; 98:e17977. [PMID: 31725662 PMCID: PMC6867798 DOI: 10.1097/md.0000000000017977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Both Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae (SFGR) are pathogens carried by ticks. There is a possibility of co-infection with these tick-borne diseases. PATIENT CONCERNS Male patient, 63 years-of-age, admitted to hospital with skin rash presenting for 1 week and fever with cough and expectoration for 3 days before admission. DIAGNOSES We diagnosed that the patient was co-infected by B burgdorferi sl and SFGR using laboratory test results and the patient's clinical manifestations. INTERVENTIONS The patient started therapy with oral minocycline, then levofloxacin by intravenous injection for SFGR. Meanwhile, he was treated with penicillin G sodium, cefoperazone sulbactam sodium and ceftriaxone by intravenous injection for B burgdorferi sl. OUTCOMES After the patient was in stable condition, he was discharged from hospital. LESSONS This case report highlights the possibility of co-infection by 2 tick-borne diseases in Urumqi, Xinjiang Uygur Autonomous Region, China. The antibiotic therapy should be based on the detection of pathogenic bacteria, and the different susceptibilities of co-infecting bacteria should be considered.
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Affiliation(s)
- Yi Jiang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention / State Key Laboratory for Infectious Disease Prevention and Control, Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou
| | - Xuexia Hou
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention / State Key Laboratory for Infectious Disease Prevention and Control, Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou
| | - Lin Zhang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention / State Key Laboratory for Infectious Disease Prevention and Control, Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou
| | - Yuhui Tan
- Department of Neurology, Xinjiang Uygur Autonomous Region Hospital, Urumqi, PR China
| | - Chen Lu
- Department of Neurology, Xinjiang Uygur Autonomous Region Hospital, Urumqi, PR China
| | - Dong Xiao
- Department of Neurology, Xinjiang Uygur Autonomous Region Hospital, Urumqi, PR China
| | - Hongyan Li
- Department of Neurology, Xinjiang Uygur Autonomous Region Hospital, Urumqi, PR China
| | - Qin Hao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention / State Key Laboratory for Infectious Disease Prevention and Control, Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou
| | - Kanglin Wan
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention / State Key Laboratory for Infectious Disease Prevention and Control, Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou
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Li H, Zhang PH, Huang Y, Du J, Cui N, Yang ZD, Tang F, Fu FX, Li XM, Cui XM, Fan YD, Xing B, Li XK, Tong YG, Cao WC, Liu W. Isolation and Identification of Rickettsia raoultii in Human Cases: A Surveillance Study in 3 Medical Centers in China. Clin Infect Dis 2019; 66:1109-1115. [PMID: 29069294 DOI: 10.1093/cid/cix917] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/19/2017] [Indexed: 11/14/2022] Open
Abstract
Background Rickettsia raoultii is frequently detected in multiple tick species, whereas human infection remains scarcely studied. Methods A surveillance study was performed at 3 sentinel hospitals in China, to recruit participants with suspected tick exposure. Rickettsia raoultii infection was identified through polymerase chain reaction, followed by sequencing, and confirmed serologically. Isolation by cell culture was performed and the isolates were genome sequenced. Results Twenty-six subjects were determined to have R. raoultii infection, including 7 with asymptomatic infection, 15 with mild to moderate illness, and 4 with severe illness. Common nonspecific manifestations in the 19 patients with mild to moderate or severe illness included fever (100%), malaise (95%), myalgia (58%), lymphadenopathy (53%), and nausea (42%). Only 5% of them had rash, and 16% had eschar. Scalp eschar and neck lymphadenopathy after a tick bite syndrome was only seen in 2 patients. Of the 4 patients with severe complications, 3 developed pulmonary edema, and 1 developed clouding of consciousness and lethargy. Frequent abnormalities of laboratory testing included leukopenia, thrombocytopenia, lymphopenia, neutropenia, hypoproteinemia, and elevated levels of total bilirubin, hepatic aminotransferases, lactate dehydrogenase, and creatine kinase. All the 19 patients recovered without sequelae after receiving doxycycline treatment. Two R. raoultii strains were isolated, and a significantly less degraded genome was observed than other more virulent Rickettsia strains, indicating a low pathogenicity of the current strain. Conclusions Human infection with R. raoultii has a wide clinical spectrum that ranged from subclinical infection to severe complications. Physicians need to be aware of the high potential and clinical complexity of R. raoultii infection, to ensure appropriate testing and treatment in endemic regions.
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Affiliation(s)
- Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Pan-He Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Yong Huang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Juan Du
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Ning Cui
- The 154 Hospital, People's Liberation Army, Xinyang
| | | | - Fang Tang
- Center for Disease Control and Prevention of the Chinese Peoples' Armed Police Forces, Beijing
| | - Fei-Xiang Fu
- Center for Disease Control and Prevention of the Chinese Peoples' Armed Police Forces, Beijing
| | - Xiao-Mei Li
- Taishan Medical University, Tai'an, People's Republic of China
| | - Xiao-Ming Cui
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Ya-Di Fan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Bo Xing
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Xiao-Kun Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Yi-Gang Tong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Wu-Chun Cao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology
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Abstract
Spotted fever group rickettsiae (SFG) are a neglected group of bacteria, belonging to the genus Rickettsia, that represent a large number of new and emerging infectious diseases with a worldwide distribution. The diseases are zoonotic and are transmitted by arthropod vectors, mainly ticks, fleas and mites, to hosts such as wild animals. Domesticated animals and humans are accidental hosts. In Asia, local people in endemic areas as well as travellers to these regions are at high risk of infection. In this review we compare SFG molecular and serological diagnostic methods and discuss their limitations. While there is a large range of molecular diagnostics and serological assays, both approaches have limitations and a positive result is dependent on the timing of sample collection. There is an increasing need for less expensive and easy-to-use diagnostic tests. However, despite many tests being available, their lack of suitability for use in resource-limited regions is of concern, as many require technical expertise, expensive equipment and reagents. In addition, many existing diagnostic tests still require rigorous validation in the regions and populations where these tests may be used, in particular to establish coherent and worthwhile cut-offs. It is likely that the best strategy is to use a real-time quantitative polymerase chain reaction (qPCR) and immunofluorescence assay in tandem. If the specimen is collected early enough in the infection there will be no antibodies but there will be a greater chance of a PCR positive result. Conversely, when there are detectable antibodies it is less likely that there will be a positive PCR result. It is therefore extremely important that a complete medical history is provided especially the number of days of fever prior to sample collection. More effort is required to develop and validate SFG diagnostics and those of other rickettsial infections.
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Luz HR, Costa FB, Benatti HR, Ramos VN, de A Serpa MC, Martins TF, Acosta ICL, Ramirez DG, Muñoz-Leal S, Ramirez-Hernandez A, Binder LC, Carvalho MP, Rocha V, Dias TC, Simeoni CL, Brites-Neto J, Brasil J, Nievas AM, Monticelli PF, Moro MEG, Lopes B, Aguiar DM, Pacheco RC, Souza CE, Piovezan U, Juliano R, Ferraz KMPMB, Szabó MPJ, Labruna MB. Epidemiology of capybara-associated Brazilian spotted fever. PLoS Negl Trop Dis 2019; 13:e0007734. [PMID: 31490924 PMCID: PMC6750615 DOI: 10.1371/journal.pntd.0007734] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/18/2019] [Accepted: 08/26/2019] [Indexed: 01/13/2023] Open
Abstract
Background Brazilian spotted fever (BSF), caused by the bacterium Rickettsia rickettsii, has been associated with the transmission by the tick Amblyomma sculptum, and one of its main hosts, the capybara (Hydrochoerus hydrochaeris). Methods During 2015–2019, we captured capybaras and ticks in seven highly anthropic areas of São Paulo state (three endemic and four nonendemic for BSF) and in two natural areas of the Pantanal biome, all with established populations of capybaras. Results The BSF-endemic areas were characterized by much higher tick burdens on both capybaras and in the environment, when compared to the BSF-nonendemic areas. Only two tick species (A. sculptum and Amblyomma dubitatum) were found in the anthropic areas; however, with a great predominance of A. sculptum (≈90% of all ticks) in the endemic areas, in contrast to a slight predominance of A. dubitatum (≈60%) in the nonendemic areas. Tick species richness was higher in the natural areas, where six species were found, albeit with a predominance of A. sculptum (≈95% of all ticks) and environmental tick burdens much lower than in the anthropic areas. The BSF-endemic areas were characterized by overgrowth populations of A. sculptum that were sustained chiefly by capybaras, and decreased populations of A. dubitatum. In contrast, the BSF-nonendemic areas with landscape similar to the endemic areas differed by having lower tick burdens and a slight predominance of A. dubitatum over A.sculptum, both sustained chiefly by capybaras. While multiple medium- to large-sized mammals have been incriminated as important hosts for A. sculptum in the natural areas, the capybara was the only important host for this tick in the anthropic areas. Conclusions The uneven distribution of R. rickettsii infection among A. sculptum populations in highly anthropic areas of São Paulo state could be related to the tick population size and its proportion to sympatric A. dubitatum populations. Brazilian spotted fever (BSF), caused by the bacterium Rickettsia rickettsii, is the deadliest tick-borne disease of the New World. In southeastern Brazil, where 489 patients succumbed to the disease from 2001 to 2018, R. rickettsii is transmitted to humans mainly by the tick Amblyomma sculptum, which uses the capybara (Hydrochoerus hydrochaeris) as its main host. During 2015–2019, we captured capybaras and ticks in seven highly anthropic areas of São Paulo state (three endemic and four nonendemic for BSF) and in two natural areas of the Pantanal biome. The BSF-endemic areas were characterized by much higher tick burdens on both capybaras and in the environment, with a predominance of Amblyomma sculptum. In the BSF-nonendemic areas, another tick species, Amblyomma dubitatum, outnumbered A. sculptum. In the natural areas, six tick species were found; however, with much lower numbers than in the anthropic areas. The BSF-endemic areas were characterized by overgrowth populations of A. sculptum that were sustained chiefly by capybaras, and decreased populations of A. dubitatum. Results of this study support the idea that any intervention resulting in a drastic reduction of the A. sculptum population shall eliminate the R. rickettsii infection from the tick population, and consequently, prevent new BSF cases.
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Affiliation(s)
- Hermes R Luz
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.,Departamento de Patologia, Programa de Pós Graduação em Biotecnologia do Renorbio, Ponto Focal Maranhão, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Francisco B Costa
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.,Departamento de Patologia, Faculdade de Medicina Veterinária, Universidade Estadual do Maranhão, São Luís, MA, Brazil
| | - Hector R Benatti
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vanessa N Ramos
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.,Pós-Doutorado em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Maria Carolina de A Serpa
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Thiago F Martins
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Igor C L Acosta
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Diego G Ramirez
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.,Departamento de Parasitologia Animal, Instituto de Medicina Veterinária, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
| | - Sebastián Muñoz-Leal
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alejandro Ramirez-Hernandez
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Lina C Binder
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Vlamir Rocha
- Centro de Ciências Agrárias, Universidade Federal de São Carlos, Araras, SP, Brazil
| | - Thiago C Dias
- Centro de Ciências Agrárias, Universidade Federal de São Carlos, Araras, SP, Brazil.,Programa de Pós-graduação em Ecologia e Recursos Naturais, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Camila L Simeoni
- Centro de Ciências Agrárias, Universidade Federal de São Carlos, Araras, SP, Brazil
| | - José Brites-Neto
- Departamento de Vigilância Epidemiológica, Secretaria Municipal de Saúde, Americana, SP, Brazil
| | - Jardel Brasil
- Departamento de Vigilância Epidemiológica, Secretaria Municipal de Saúde, Americana, SP, Brazil
| | - Ana Maria Nievas
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Patricia Ferreira Monticelli
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Maria Estela G Moro
- Departamento de Zootecnia, Faculdade de Zootecnia e Engenharia de Alimentos, Universidade de São Paulo, Pirassununga, SP, Brazil
| | - Beatriz Lopes
- Departamento de Ciências Florestais, Escola Superior de Agricultura Luiz de Queiroz, Universidade de São Paulo, Piracicaba, SP, Brazil
| | - Daniel M Aguiar
- Programa de Pós-graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil
| | - Richard C Pacheco
- Programa de Pós-graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil
| | - Celso Eduardo Souza
- Laboratório de Carrapatos, Superintendência de Controle de Endemias, Mogi Guaçu, SP, Brazil
| | - Ubiratan Piovezan
- Embrapa Pantanal, Corumbá, MS, Brazil.,Embrapa Tabuleiros Costeiros, Aracaju, SE, Brazil
| | | | - Katia Maria P M B Ferraz
- Departamento de Ciências Florestais, Escola Superior de Agricultura Luiz de Queiroz, Universidade de São Paulo, Piracicaba, SP, Brazil
| | - Matias P J Szabó
- Laboratório de Ixodologia, Faculdade de Medicina Veterinária, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Marcelo B Labruna
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
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Bang MS, Kim CM, Park JW, Chung JK, Kim DM, Yun NR. Prevalence of Orientia tsutsugamushi, Anaplasma phagocytophilum and Leptospira interrogans in striped field mice in Gwangju, Republic of Korea. PLoS One 2019; 14:e0215526. [PMID: 31419222 PMCID: PMC6697328 DOI: 10.1371/journal.pone.0215526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/03/2019] [Indexed: 11/18/2022] Open
Abstract
This study investigated the prevalence of Orientia tsutsugamushi, Anaplasma phagocytophilum, and Leptospira interrogans in wild rodents through molecular detection using organ samples and through serological assay using blood samples of mice collected from two distinct sites in Gwangju Metropolitan City, Republic of Korea (ROK). A total of 47 wild rodents, identified as Apodemus agrarius (A. agrarius), were captured from June to August 2016. The seroprevalence of antibodies against bacterial pathogens in A. agrarius sera was analyzed; 17.4% (8/46) were identified as O. tsutsugamushi through indirect immunofluorescence assay and 2.2% (1/46) were identified as Leptospira species through passive hemagglutination assay. Using polymerase chain reaction, the spleen, kidney and blood samples were investigated for the presence of O. tsutsugamushi, A. phagocytophilum, and L. interrogans. Out of the 47 A. agrarius, 19.1% (9/47) were positive for A. phagocytophilum and 6.4% (3/47) were positive for L. interrogans, while none were positive for O. tsutsugamushi. Four out of 46 (8.7%) blood samples, six out of 45 (13.3%) spleen samples, and one out of 47 (2.1%) kidney samples were positive for A. phagocytophilum. Three out of 47 (6.4%) kidney samples were positive for L. interrogans. The sequencing results of PCR positive samples demonstrated > 99% similarity with A. phagocytophilum and L. interrogans sequences. A. phagocytophilum was mostly detected in the spleen, whereas L. interrogans was mostly detected in the kidneys. Notably, A. phagocytophilum and L. interrogans were detected in A. agrarius living in close proximity to humans in the metropolitan suburban areas. The results of this study indicate that rodent-borne bacteria may be present in wild rodents in the metropolitan suburban areas of ROK.
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Affiliation(s)
- Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jung Wook Park
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
| | - Jae Keun Chung
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Pacheco-Solano K, Barrantes-González A, Dolz G, Troyo A, Jiménez-Rocha AE, Romero-Zuñiga JJ, Taylor L. Exposure of dogs to Rickettsia spp. in Costa Rica: Risk factors for PCR-positive ectoparasites and seropositivity. Parasite Epidemiol Control 2019; 7:e00118. [PMID: 31489383 PMCID: PMC6717101 DOI: 10.1016/j.parepi.2019.e00118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/19/2019] [Accepted: 08/11/2019] [Indexed: 11/19/2022] Open
Abstract
Infection of dogs with Rickettsia spp. can result in inapparent, mild, or severe disease. Moreover, common dog ticks and fleas are able to transmit rickettsiae to nearby humans. In this study, the seroprevalence of spotted fever group (SFG) rickettsiae was determined in dogs of Costa Rica, as well as possible risk factors associated with exposure. An interview of owners and clinical examinations were performed in a country-wide sample of 441 dogs. IgG antibodies were determined in 399 dogs by indirect immunofluorescence assay (IFA) using antigens of Rickettsia rickettsii, R. amblyommatis, and R. felis. The presence of Rickettsia spp. gltA gene was evaluated by PCR in ticks and fleas. Poisson regression was performed to assess possible risk factors associated with seropositivity, as well as with having PCR-positive ticks and fleas. The overall seroprevalence to SFG rickettsiae was 10.0% (end titers 64 to 256). Rhipicephalus sanguineus s.l. (116/441; 26.3%) and Ctenocephalides felis (153/441; 34.7%) were the most common ectoparasites. Rickettsia DNA was detected in 30% (39/130) and 32.3% (56/173) of tick and flea pools, respectively. Seropositivity was significantly associated with mean age of 2 to 7 years, scrotal edema, walking problems, large size, and tick and flea infestation. Being a purebred dog was a possible protective factor. The presence of Rickettsia PCR-positive ticks was associated with being a purebred dog, while flea treatment was protective. Having PCR-positive fleas was associated with being purebred and the number of people in the dog's environment; protective factors were free roaming and being an outdoor dog. Results confirm that dogs in Costa Rica are exposed to different species of SFG rickettsiae. This may represent a risk to human health and underscores the need for accurate diagnosis in dogs and humans. Surveillance of rickettsial infection in canines may provide useful indicators to understand the epidemiology of these zoonoses. 10% of dogs were exposed to different species of SFG rickettsiae in Costa Rica. Risk factors included age, large size, and tick and flea infestation. Rickettsiae were detected in approximately 30% of flea and tick pools. Flea treatment and free roaming were protective against infected ticks and fleas. Surveillance and accurate diagnosis are required in dogs and humans.
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Affiliation(s)
- Katherine Pacheco-Solano
- Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Alexander Barrantes-González
- Programa de Investigación en Medicina Poblacional, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Gaby Dolz
- Programa de Investigación en Medicina Poblacional, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Adriana Troyo
- Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
- Corresponding author at: Centro de Investigación en Enfermedades Tropicales, Departamento de Parasitología, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
| | - Ana E. Jiménez-Rocha
- Laboratorio de Parasitología, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Juan José Romero-Zuñiga
- Programa de Investigación en Medicina Poblacional, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Lizeth Taylor
- Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
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Stewart AGA, Smith S, Binotto E, McBride WJH, Hanson J. The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management. PLoS Negl Trop Dis 2019; 13:e0007583. [PMID: 31318873 PMCID: PMC6667154 DOI: 10.1371/journal.pntd.0007583] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/30/2019] [Accepted: 06/27/2019] [Indexed: 12/12/2022] Open
Abstract
Background Rickettsial infections are a common cause of hospitalization in tropical settings, although early diagnosis is challenging in the rural locations where these infections are usually seen. Methods This retrospective, clinical audit of microbiologically-confirmed cases of scrub typhus or spotted fever group (SFG) rickettsial infection between 1997 and 2016 was performed a tertiary referral hospital in tropical Australia. Clinical, laboratory and radiological findings at presentation were correlated with the patients’ subsequent clinical course. Results There were 135 locally-acquired cases (95 scrub typhus, 37 SFG, 3 undifferentiated). There were nine hospitalizations during the first 5 years of the study period and 81 in the last 5 years (p for trend = 0.003). Eighteen (13%) of the 135 cases required ICU admission, all of whom were adults. A greater proportion of patients with SFG infection required ICU support (8/37 (22%) compared with 10/95 (11%) scrub typhus cases), although this difference did not reach statistical significance (p = 0.10). Three (8%) of the 37 patients with SFG infection had severe disease (1 died, 2 developed permanent disability) versus 0/95 scrub typhus patients (p = 0.02). Adults with a high admission qSOFA score (≥2) had an odds ratio (OR) of 19 (95% CI:4.8–74.5) for subsequent ICU admission (p<0.001); adults with a high NEWS2 score (≥7) had an OR of 14.3 (95% CI:4.5–45.32) for ICU admission (p<0.001). A patient’s respiratory rate at presentation had strong prognostic utility: if an adult had an admission respiratory rate <22 breaths/minute, the negative predictive value for subsequent ICU admission was 95% (95% CI 88–99). Conclusions In the well-resourced Australian health system outcomes are excellent, but the local burden of rickettsial disease appears to be increasing and the clinical phenotype of SFG infections may be more severe than previously believed. Simple, clinical assessment on admission has prognostic utility and may be used to guide management. Rickettsial infections are a common cause of hospitalization in tropical settings, although early, definitive diagnosis is challenging in the rural and remote locations where they are usually seen. It is important to recognise rickettsial infections early in their disease course as they can lead to life-threatening multi-organ failure if specific anti-rickettsial antimicrobial therapy is not prescribed promptly. In tropical Australia, scrub typhus and spotted fever group (SFG) rickettsiae are the dominant rickettsial pathogens and this twenty-year retrospective series examines the clinical and laboratory findings which might facilitate their recognition. The study highlights the infections’ increasing local clinical burden and reports that over 20% of the SFG cases in the series required Intensive Care Unit (ICU) admission, suggesting that severe SFG disease may be more common than previously believed. Simple, clinical prediction scores—calculated at presentation—identified patients who would subsequently require ICU admission. Importantly, they were also able to identify patients at low risk of disease progression. These entirely clinical scores—which can be calculated rapidly at the bedside—have the potential to facilitate the management of patients with scrub typhus and SFG infection, particularly in resource-limited settings which have the greatest burden of disease.
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Affiliation(s)
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Enzo Binotto
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | | | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Australia
- Kirby Institute, University of New South Wales, Sydney, Australia
- * E-mail:
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Pascoe EL, Stephenson N, Abigana A, Clifford D, Gabriel M, Wengert G, Brown R, Higley M, Bloch EM, Foley JE. Human Seroprevalence of Tick-Borne Anaplasma phagocytophilum, Borrelia burgdorferi, and Rickettsia Species in Northern California. Vector Borne Zoonotic Dis 2019; 19:871-878. [PMID: 31295054 DOI: 10.1089/vbz.2019.2489] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is a paucity of data on human exposure to tick-borne pathogens in the western United States. This study reports prevalence of antibodies against three clinically important tick-borne pathogens (Borrelia burgdorferi, Anaplasma phagocytophilum, and Rickettsia spp.) among 249 people in five counties in northern California. Individuals from Humboldt County were recruited and answered a questionnaire to assess risk of exposure to tick-borne pathogens. Samples from other counties were obtained from a blood bank and were anonymized. Seventeen (6.8%) samples were seropositive for antibodies against at least one pathogen: five for A. phagocytophilum, eight for B. burgdorferi, and four for Rickettsia spp. Women and people aged 26-35 had higher seroprevalence compared to other demographic groups. Santa Cruz County had no seropositive individuals, northern Central Valley counties had three seropositive individuals (all against A. phagocytophilum), and Humboldt County had 14 (all three pathogens), a significant, four-fold elevated risk of exposure. The Humboldt County questionnaire revealed that a bird feeder in the yard was statistically associated with exposure to ticks, and lifetime number of tick bites was associated with increasing age, time watching wildlife, and time hiking. Three-quarters of respondents were concerned about tick-associated disease, 81.0% reported experiencing tick bites, and 39.0% of those bitten reported a tick-borne disease symptom, including skin lesions (76.4%), muscle aches (49.1%), joint pain (25.5%), or fever (23.6%). Despite high levels of concern, many individuals who had been bitten by a tick were not tested for a tick-borne pathogen, including those with consistent symptoms. We highlight the need for further research and dissemination of information to residents and physicians in Northern California regarding tick-associated disease, so that appropriate medical attention can be rapidly sought and administered.
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Affiliation(s)
- Emily L Pascoe
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Nicole Stephenson
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Ashley Abigana
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Deana Clifford
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California.,Wildlife Investigations Laboratory, California Department of Fish and Wildlife, Rancho Cordova, California
| | | | - Greta Wengert
- Integral Ecology Research Center, Blue Lake, California
| | - Richard Brown
- Department of Wildlife, Humboldt State University, Arcata, California
| | - Mark Higley
- Wildlife Department, Hoopa Tribal Forestry, Hoopa, California
| | - Evan M Bloch
- Department of Pathology and Transfusion Medicine, John Hopkins University, Baltimore, Maryland
| | - Janet E Foley
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
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50
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Serological Evidence of Anaplasma phagocytophilum and Spotted Fever Group Rickettsia spp. Exposure in Horses from Central Italy. Pathogens 2019; 8:pathogens8030088. [PMID: 31247976 PMCID: PMC6789761 DOI: 10.3390/pathogens8030088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 11/16/2022] Open
Abstract
Anaplasma phagocytophilum and Rickettsia spp. are tick-borne bacteria of veterinary and human concern. In view of the One-Health concept, the present study wanted to evaluate the spreading of these pathogens in horses living in central Italy. In particular, the aim of the investigation was to verify the exposure to A. phagocytophilum in order to update the prevalence of this pathogen in the equine population from this area, and to spotted fever group (SFG) Rickettsia spp. to evaluate a possible role of horses in the epidemiology of rickettsiosis. Indirect immunofluorescent assay was carried out to detect antibodies against A. phagocytophilum and SFG (spotted fever group) Rickettsia spp. in blood serum samples collected from 479 grazing horses living in central Italy during the period from 2013 to 2018. One hundred and nine (22.75%) horses were positive for A. phagocytophilum, 72 (15.03%) for SFG Rickettsia spp., and 19 (3.96%) for both antigens. The obtained results confirm the occurrence of A. phagocytophilum in equine populations, and also suggest the involvement of horses in the epidemiology of SFG rickettsiosis. In both cases, in view of the zoonotic aspect of these pathogens and the frequent contact between horses and humans, the monitoring of equine populations could be useful for indication about the spreading of the tick-borne pathogens in a certain geographic area.
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