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Abdelbaset AE, Kwak ML, Nonaka N, Nakao R. Human-biting ticks and zoonotic tick-borne pathogens in North Africa: diversity, distribution, and trans-Mediterranean public health challenges. One Health 2023; 16:100547. [PMID: 37363219 PMCID: PMC10288109 DOI: 10.1016/j.onehlt.2023.100547] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/28/2023] Open
Abstract
North Africa is home to more than 200 million people living across five developing economies (Egypt, Libya, Tunisia, Algeria, and Morocco) and two Spanish exclaves (Ceuta and Melilla), many of whom are impacted by ticks and tick-borne zoonoses. Populations in Europe are also increasingly vulnerable to North African ticks and tick-borne zoonoses due to a combination of climate change and the movement of ticks across the Mediterranean on migratory birds, human travellers, and trafficked wildlife. The human-biting ticks and tick-borne zoonoses in North Africa are reviewed along with their distribution in the region. We also assess present and future challenges associated with ticks and tick-borne zoonoses in North African and highlight opportunities for collaboration and coordination between governments in Europe and North Africa to address public health challenges posed by North African ticks and tick-borne zoonoses.
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Affiliation(s)
- Abdelbaset Eweda Abdelbaset
- Laboratory of Parasitology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, N18 W9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
- Clinical Laboratory Diagnosis, Department of Animal Medicine, Faculty of Veterinary Medicine, Assiut University, Assiut 71515, Egypt
| | - Mackenzie L. Kwak
- Laboratory of Parasitology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, N18 W9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
| | - Nariaki Nonaka
- Laboratory of Parasitology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, N18 W9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
| | - Ryo Nakao
- Laboratory of Parasitology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, N18 W9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
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Hamzaoui BE, Zurita A, Cutillas C, Parola P. Fleas and flea-borne diseases of North Africa. Acta Trop 2020; 211:105627. [PMID: 32652054 DOI: 10.1016/j.actatropica.2020.105627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
North Africa has an interesting and rich wildlife including hematophagous arthropods, and specifically fleas, which constitute a large part of the North African fauna, and are recognised vectors of several zoonotic bacteria. Flea-borne organisms are widely distributed throughout the world in endemic disease foci, where components of the enzootic cycle are present. Furthermore, flea-borne diseases could re-emerge in epidemic form because of changes in the vector-host ecology due to environmental and human behaviour modifications. We need to know the real incidences of flea-borne diseases in the world due to this incidence could be much greater than are generally recognized by physicians and health authorities. As a result, diagnosis and treatment are often delayed by health care professionals who are unaware of the presence of these infections and thus do not take them into consideration when attempting to determine the cause of a patient's illness. In this context, this bibliographic review aims to summarise the main species of fleas present in North Africa, their geographical distribution, flea-borne diseases, and their possible re-emergence.
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Affiliation(s)
- Basma El Hamzaoui
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME; IHU Méditerranée Infection, Marseille, France.
| | - Antonio Zurita
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Profesor García González 2, 41012 Seville, Spain.
| | - Cristina Cutillas
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Profesor García González 2, 41012 Seville, Spain.
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME; IHU Méditerranée Infection, Marseille, France.
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Bouchaib H, Eldin C, Laroche M, Raoult D, Parola P. Tick- and flea-borne rickettsioses in Tizi-Ouzou, Algeria: Implications for travel medicine. Travel Med Infect Dis 2018; 26:51-57. [PMID: 30419355 DOI: 10.1016/j.tmaid.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/04/2018] [Accepted: 11/08/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Algeria, Mediterranean spotted fever (MSF), caused by Rickettsia conorii conorii and transmitted by Rhipicephalus sanguineus, is endemic. However, the documentation of cases is rare due to a lack of laboratory facilities. Our aim was to screen for rickettsioses in patients with fever, rash and a possible inoculation eschar. MATERIALS AND METHODS Between 2013 and 2015, patients with a fever and a rash presenting at hospitals in the Tizi-Ouzou region were prospectively included in our study. Sera were screened using Indirect Immunofluorescence Assay (IFA) and qPCR was performed on swab samples from eschars. RESULTS One hundred and sixty-six patients were included. For 57 patients, MSF due to R. conorii conorii was diagnosed by serology and qPCR on a swab eschar sample. Three patients were diagnosed with murine typhus, a flea borne rickettsiosis. In addition, two patients had a positive serology in IgM for R. felis. For nine patients, serology for rickettsiosis was positive, but the specific rickettsia involved could not be determined. Nine patients had a severe disease with neurological involvement or multi-organ failure. CONCLUSION Clinicians should routinely screen for rickettsioses in patients and travellers presenting with a rash upon return from Algeria. Doxycycline treatment must be given promptly because the prognosis can be severe.
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Affiliation(s)
- Hayet Bouchaib
- Service des Maladies Infectieuses, Centre Hospitalo-Universitaire de Tizi- Ouzou, Algeria
| | - Carole Eldin
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Maureen Laroche
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.
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4
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Chochlakis D, Germanakis A, Chaliotis G, Kapetanaki S, Kalogeraki L, Gkika E, Partalis N, Polymili G, Tselentis Y, Psaroulaki A. Potential exposure of humans to Rickettsia felis in Greece. Acta Trop 2018; 178:40-45. [PMID: 29079185 DOI: 10.1016/j.actatropica.2017.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
Abstract
Rickettsia felis is a flea-transmitted pathogen however, in Greece, much work has been done on another flea-borne pathogen, R. typhi; human cases have been described and high-risk areas have been characterized. Nevertheless, little is known about human infections caused by R. felis in the country since human cases are not routinely tested for antibodies against this pathogen. During the past seven years, we have set up a protocol at the National Reference Centre in order to improve the testing of tick-borne diseases in Greece. Based on this protocol, R. conorii, R. typhi R. slovaca, R. felis, and R. mongolotimonae have been added into the routine analysis; during these last years, eight (8) cases of potential exposure to R. felis were identified by serology. On an environmental investigation carried out at the residences of the patients, the pathogen was detected in C. felis only. The demonstration of R. felis potential presence highlights the need for better testing and surveillance of the pathogen.
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Gautret P, Mouffok N, Parola P. North Africa. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Philippe Gautret
- Unité de Recherche sur les maladies Infectieuses et Tropicales Emergentes; Aix-Marseille Université; Marseille France
| | - Nadjet Mouffok
- Service des Maladies Infectieuses; Centre Hospitalier Universitaire d'Oran; Oran Algeria
| | - Philippe Parola
- Unité des Rickettsies, Faculté de Médecine; Université de la Méditerranée; Marseille France
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Rickettsia conorii specific Ig G antibodies: a seroepidemiologic survey in Constanta and Tulcea counties and Bucharest, Romania, 2009. REV ROMANA MED LAB 2013. [DOI: 10.2478/rrlm-2013-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kernif T, Socolovschi C, Bitam I, Raoult D, Parola P. Vector-Borne Rickettsioses in North Africa. Infect Dis Clin North Am 2012; 26:455-78. [DOI: 10.1016/j.idc.2012.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Khaldi M, Socolovschi C, Benyettou M, Barech G, Biche M, Kernif T, Raoult D, Parola P. Rickettsiae in arthropods collected from the North African Hedgehog (Atelerix algirus) and the desert hedgehog (Paraechinus aethiopicus) in Algeria. Comp Immunol Microbiol Infect Dis 2012; 35:117-22. [DOI: 10.1016/j.cimid.2011.11.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 11/15/2011] [Accepted: 11/16/2011] [Indexed: 11/29/2022]
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Beta interferon-mediated activation of signal transducer and activator of transcription protein 1 interferes with Rickettsia conorii replication in human endothelial cells. Infect Immun 2011; 79:3733-43. [PMID: 21690236 DOI: 10.1128/iai.05008-11] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Infection of the endothelial cell lining of blood vessels with Rickettsia conorii, the causative agent of Mediterranean spotted fever, results in endothelial activation. We investigated the effects of R. conorii infection on the status of the Janus kinase (JAK)-signal transducer and activator of transcription protein (STAT) signaling pathway in human microvascular endothelial cells (HMECs), the most relevant host cell type, in light of rickettsial tropism for microvascular endothelium in vivo. R. conorii infection induced phosphorylation of STAT1 on tyrosine 701 and serine 727 at 24, 48, and 72 h postinfection in HMECs. Employing transcription profile analysis and neutralizing antibodies, we further determined that beta interferon (IFN-β) production and secretion are critical for STAT1 activation. Secreted IFN-β further amplified its own expression via a positive-feedback mechanism, while expression of transcription factors interferon regulatory factor 7 (IRF7) and IRF9, implicated in the IFN-β-STAT1 feedback loop, was also induced. Metabolic activity of rickettsiae was essential for the IFN-β-mediated response(s) because tetracycline treatment inhibited R. conorii replication, IFN-β expression, and STAT1 phosphorylation. Inclusion of IFN-β-neutralizing antibody during infection resulted in significantly enhanced R. conorii replication, whereas addition of exogenous IFN-β had the opposite inhibitory effect. Finally, small interfering RNA-mediated knockdown further confirmed a protective role for STAT1 against intracellular R. conorii replication. In concert, these findings implicate an important role for IFN-β-mediated STAT1 activation in innate immune responses of vascular endothelium to R. conorii infection.
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Boudebouch N, Sarih M, Socolovschi C, Fatihi T, Chakib A, Amarouch H, Hassar M, Rolain JM, Parola P, Raoult D. Spotted fever group rickettsioses documented in Morocco. Clin Microbiol Infect 2009; 15 Suppl 2:257-8. [DOI: 10.1111/j.1469-0691.2008.02276.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kaabia N, Letaief A. Characterization of rickettsial diseases in a hospital-based population in central Tunisia. Ann N Y Acad Sci 2009; 1166:167-71. [PMID: 19538277 DOI: 10.1111/j.1749-6632.2009.04521.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In Tunisia, 2 rickettsial groups, spotted fever group and typhus group, have been described since the beginning of the 20th century. Mediterranean spotted fever (MSF), also known as Boutonneuse fever, caused by Rickettsia conorii and transmitted by the dog tick Rhipicephalus sanguineus, is the most frequent rickettsial infection observed. Its seroprevalence in our region is 9% among blood donors and 23% in hospitalized febrile patients. Typhus group rickettsioses, caused by R. typhi and R. prowazekii, are less frequently reported than in the 1970s. Only sporadic cases of typhus were reported in the last decade. However, R. typhi antibodies were present in 3.6% among healthy people and 40% in patients with acute fever of undetermined origin. In the unit of Infectious Diseases at Farhat Hached University Hospital in Sousse, during 2007, 5% of hospitalized patients had eruptive fever, and half of the cases met clinical criteria of MSF and/or were confirmed by rickettsial serology. The majority of cases (90%) were noted in hot seasons, and contact with domestic animals was found in 76%. The most common symptoms were fever (present in all cases), skin rash (in 85% to 98% of cases), and headache (in 69.5% of cases). The clinical triad (fever + rash +"tache noire") was noted in 32 to 61%. Normal blood cells or leukopenia, cytolysis, and thrombopenia were the most frequent biological abnormalities. Complications and malignant forms of rickettsial infections were reported in 3.5 to 6% among hospitalized adult patients. When specific serology was performed, MSF was confirmed in 15%, and we noted an emergence of murine typhus (MT) mistaken for R. conorii or viral infection. Rickettsia felis was identified in 1 patient, whereas 17% of cases remained undetermined. Rickettsia conorii Malish was identified by PCR in skin biopsies. Doxycycline was the antibiotic of choice for rickettsial infections; it was prescribed in the majority of patients, associated with fever defervescence, in a mean of 72 hours. The mean length of stay among hospitalized patients with rickettsial infections was 5.9 days. In conclusion, in our region, MSF and murine typhus are endemic. Doxycycline should be prescribed in patients with acute fever and skin rash, especially in hot seasons. These rickettsioses were characterized by benign prognosis. More skin biopsies are needed to identify other SFG rickettsies.
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Affiliation(s)
- Naoufel Kaabia
- Infectious Diseases Unit, Farhat Hached, University Hospital Sousse - Tunisia, Tunisia
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Johnston V, Stockley JM, Dockrell D, Warrell D, Bailey R, Pasvol G, Klein J, Ustianowski A, Jones M, Beeching NJ, Brown M, Chapman ALN, Sanderson F, Whitty CJM. Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management. J Infect 2009; 59:1-18. [PMID: 19595360 DOI: 10.1016/j.jinf.2009.05.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Accepted: 05/20/2009] [Indexed: 01/23/2023]
Abstract
International travel is increasing. Most physicians and general practitioners will encounter returned travellers with fever and the majority of travel-related infection is associated with travel to the tropics. In those returning from the tropics malaria must always be excluded, and HIV considered, from all settings. Common causes of non-malarial fever include from Africa rickettsial diseases, amoebic liver abscess and Katayama syndrome; from South and South East Asia, enteric fever and arboviral infection; from the Middle East, brucellosis and from the Horn of Africa visceral leishmaniasis. Other rare but important diseases from particular geographical areas include leptospirosis, trypanosomiasis and viral haemorrhagic fever. North and South America, Europe and Australia also have infections which are geographically concentrated. Empirical treatment may have to be started based on epidemiological probability of infection whilst waiting for results to return. The evidence base for much of the management of tropical infections is limited. These recommendations provide a pragmatic approach to the initial diagnosis and management of fever in returned travellers, based on evidence where it is available and on consensus of expert opinion where it is not. With early diagnosis and treatment the majority of patients with a potentially fatal infection related to travel will make a rapid and full recovery.
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Affiliation(s)
- Victoria Johnston
- Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London, UK.
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Uspensky I. Attachment of nymphal Rhipicephalus sanguineus (Acari: Ixodidae) to a human in an urban area followed by severe adverse reaction shortly before drop-off. Folia Parasitol (Praha) 2009; 56:67-9. [PMID: 19391333 DOI: 10.14411/fp.2009.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A case of attachment and complete engorgement of a Rhipicephalus sanguineus (Latreille, 1806) nymph on a woman with severe pain shortly before nymphal drop-off is described. The pain continued for about 2 weeks after tick removal. Apparently, this is the first documented case of human adverse reaction developed at the very last stage of engorgement of nymphal R. sanguineus. The infestation most likely took place inside the enclosed household garden in the southern area of Jerusalem where the woman took care of the plants. The importance of immature R. sanguineus ticks in attacking humans is discussed.
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Affiliation(s)
- Igor Uspensky
- Department of Biological Chemistry, A. Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Givat-Ram Campus, Jerusalem 91904, Israel.
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Socolovschi C, Raoult D, Parola P. Influence of temperature on the attachment of Rhipicephalus sanguineus ticks on rabbits. Clin Microbiol Infect 2009; 15 Suppl 2:326-7. [PMID: 19438617 DOI: 10.1111/j.1469-0691.2008.02260.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Socolovschi
- Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine, UMR CNRS-IRD 6236, WHO Collaborative Center for Rickettsial Diseases and Other Arthropod-borne Bacterial Diseases, Marseille, France
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Kaabia N, Bellazreg F, Hachfi W, Khalifa M, Ghanouchi N, Bahri F, Letaief A. Rickettsial infection in hospitalised patients in central Tunisia: report of 119 cases. Clin Microbiol Infect 2009; 15 Suppl 2:216-7. [PMID: 19374646 DOI: 10.1111/j.1469-0691.2008.02139.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- N Kaabia
- Infectious Diseases Unit, Farhat Hached Hospital, Sousse, Tunisia.
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Mouffok N, Parola P, Lepidi H, Raoult D. Mediterranean spotted fever in Algeria — new trends. Int J Infect Dis 2009; 13:227-35. [DOI: 10.1016/j.ijid.2008.06.035] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 06/11/2008] [Accepted: 06/12/2008] [Indexed: 11/29/2022] Open
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Mokrani N, Parola P, Tebbal S, Dalichaouche M, Aouati A, Raoult D. Rickettsia aeschlimannii infection, Algeria. Emerg Infect Dis 2009; 14:1814-5. [PMID: 18976583 PMCID: PMC2630723 DOI: 10.3201/eid1411.071221] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Warmer weather linked to tick attack and emergence of severe rickettsioses. PLoS Negl Trop Dis 2008; 2:e338. [PMID: 19015724 PMCID: PMC2581602 DOI: 10.1371/journal.pntd.0000338] [Citation(s) in RCA: 186] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Accepted: 10/27/2008] [Indexed: 11/20/2022] Open
Abstract
The impact of climate on the vector behaviour of the worldwide dog tick Rhipicephalus sanguineus is a cause of concern. This tick is a vector for life-threatening organisms including Rickettsia rickettsii, the agent of Rocky Mountain spotted fever, R. conorii, the agent of Mediterranean spotted fever, and the ubiquitous emerging pathogen R. massiliae. A focus of spotted fever was investigated in France in May 2007. Blood and tissue samples from two patients were tested. An entomological survey was organised with the study of climatic conditions. An experimental model was designed to test the affinity of Rh. sanguineus for biting humans in variable temperature conditions. Serological and/or molecular tools confirmed that one patient was infected by R. conorii, whereas the other was infected by R. massiliae. Dense populations of Rh. sanguineus were found. They were infected with new genotypes of clonal populations of either R. conorii (24/133; 18%) or R. massiliae (13/133; 10%). April 2007 was the warmest since 1950, with summer-like temperatures. We show herein that the human affinity of Rh. sanguineus was increased in warmer temperatures. In addition to the originality of theses cases (ophthalmic involvements, the second reported case of R. massiliae infection), we provide evidence that this cluster of cases was related to a warming-mediated increase in the aggressiveness of Rh. sanguineus, leading to increased human attacks. From a global perspective, we predict that as a result of globalisation and warming, more pathogens transmitted by the brown dog tick may emerge in the future. The impact of climate on the behaviour of the worldwide dog tick Rhipicephalus sanguineus is a cause of concern. This tick is a vector for life-threatening organisms including Rickettsia rickettsii, the agent of Rocky Mountain spotted fever, R. conorii, the agent of Mediterranean spotted fever, and the ubiquitous emerging pathogen R. massiliae. A focus of spotted fever was investigated in France in May 2007. One patient was found to be infected by R. conorii, whereas the other was infected by R. massiliae. Theses cases were original because of ophthalmic involvements, and the report of the second case of R. massiliae infection in the scientific literature. During an entomological survey, dense populations of Rh. sanguineus were found in the house where the patient had been bitten by ticks. Ticks were infected with either R. conorii or R. massiliae. Interestingly, April 2007 was the warmest since 1950, with summer-like temperatures. In this work, we show that the human affinity of Rh. sanguineus is increased in warmer temperatures, and provide evidence that this cluster of cases was related to a warming-mediated increase in the aggressiveness of Rh. sanguineus, leading to increased human attacks. From a global perspective, we predict that as a result of globalisation and warming, more pathogens transmitted by the brown dog tick may emerge in the future.
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Abstract
Mediterranean spotted fever (MSF) was first described in 1910. Twenty years later, it was recognized as a rickettsial disease transmitted by the brown dog tick. In contrast to Rocky Mountain spotted fever (RMSF), MSF was thought to be a benign disease; however, the first severe case that resulted in death was reported in France in the 1980s. We have noted important changes in the epidemiology of MSF in the last 10 years, with emergence and reemergence of MSF in several countries. Advanced molecular tools have allowed Rickettsia conorii conorii to be classified as a subspecies of R. conorii. New clinical features, such as multiple eschars, have been recently reported. Moreover, MSF has become more severe than RMSF; the mortality rate was as high as 32% in Portugal in 1997. Whether Rhipicephalus sanguineus is the only vector and reservoir for R. conorii conorii is a question not yet answered.
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Affiliation(s)
- Nadjet Mouffok
- Service des Maladies Infectieuses CHU’Oran, Oran, Algeria
| | - Philippe Parola
- World Health Organization Collaborative Centre for Rickettsial and Arthropod-borne Bacterial Diseases, Marseilles, France
| | - Didier Raoult
- World Health Organization Collaborative Centre for Rickettsial and Arthropod-borne Bacterial Diseases, Marseilles, France
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Fièvre boutonneuse méditerranéenne : nouveaux aspects et nouvelles questions. Med Mal Infect 2008; 38 Suppl 2:S39-40. [DOI: 10.1016/s0399-077x(08)72984-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Benabdellah A, Mouffok N, Bensaad M, Belkadi Kouied A, Razik F, Raoult D. Mediterranean-spotted fever: clinical and laboratory characteristics of 34 children in Oran (Algeria). ACTA ACUST UNITED AC 2007; 55:539-42. [PMID: 17913393 DOI: 10.1016/j.patbio.2007.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Accepted: 07/16/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Mediterranean-spotted fever (MSF) is endemic in the Mediterranean basin. The aim of our study is to describe clinical and laboratory characteristics of MSF in Algeria. METHODS Retrospective study of 34 children suffering from MSF hospitalized from 2002 to 2005. Diagnosis and outcome data were abstracted from patient medical reports. The serological confirmation was obtained by immunofluorescent antibody. RESULTS All the children were hospitalized during summer time. The median age was 4.5 years. The sex ratio in the children was 0.76. Clinical features were high fever, maculopapulous rash and black eschar. Among analytical findings, leucocyte count was decreased in 50% of children during the first week of illness. The indirect immunofluorescence for Rickettsia conorii was positive in 70% of cases in the second determination. All received antimicrobial therapy. All children cured without complications. CONCLUSION MSF is a mild rickettsial disease in Algeria.
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Affiliation(s)
- A Benabdellah
- Service des Maladies Infectieuses, CHU d'Oran, 72, Boulevard Benzerdjeb, 31000, Oran, Algeria.
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Brouqui P, Parola P, Fournier PE, Raoult D. Spotted fever rickettsioses in southern and eastern Europe. ACTA ACUST UNITED AC 2007; 49:2-12. [PMID: 17266709 DOI: 10.1111/j.1574-695x.2006.00138.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mediterranean spotted fever due to Rickettsia conorii conorii was thought, for many years, to be the only tick-borne rickettsial disease prevalent in southern and eastern Europe. However, in recent years, six more species or subspecies within the spotted fever group of the genus Rickettsia have been described as emerging pathogens in this part of the world. Tick-borne agents include Rickettsia conorii israelensis, Rickettsia conorii caspia, Rickettsia aeschlimannii, Rickettsia slovaca, Rickettsia sibirica mongolitimonae and Rickettsia massiliae. Many Rickettsia of unknown pathogenicity have also been detected from ticks and could represent potential emerging pathogens to be discovered in the future. Furthermore, a new spotted fever rickettsia, Rickettsia felis, was found to be associated with cat fleas and is an emerging human pathogen. Finally, the mite-transmitted Rickettsia akari, the agent of rickettsialpox, is also known to be prevalent in Europe. We present here an overview of these rickettsioses, focusing on emerging diseases.
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Affiliation(s)
- Philippe Brouqui
- Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
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