1
|
Koutantou M, Drancourt M, Angelakis E. Prevalence of Lyme Disease and Relapsing Fever Borrelia spp. in Vectors, Animals, and Humans within a One Health Approach in Mediterranean Countries. Pathogens 2024; 13:512. [PMID: 38921809 PMCID: PMC11206712 DOI: 10.3390/pathogens13060512] [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: 05/02/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024] Open
Abstract
The genus Borrelia has been divided into Borreliella spp., which can cause Lyme Disease (LD), and Borrelia spp., which can cause Relapsing Fever (RF). The distribution of genus Borrelia has broadened due to factors such as climate change, alterations in land use, and enhanced human and animal mobility. Consequently, there is an increasing necessity for a One Health strategy to identify the key components in the Borrelia transmission cycle by monitoring the human-animal-environment interactions. The aim of this study is to summarize all accessible data to increase our understanding and provide a comprehensive overview of Borrelia distribution in the Mediterranean region. Databases including PubMed, Google Scholar, and Google were searched to determine the presence of Borreliella and Borrelia spp. in vectors, animals, and humans in countries around the Mediterranean Sea. A total of 3026 were identified and screened and after exclusion of papers that did not fulfill the including criteria, 429 were used. After examination of the available literature, it was revealed that various species associated with LD and RF are prevalent in vectors, animals, and humans in Mediterranean countries and should be monitored in order to effectively manage and prevent potential infections.
Collapse
Affiliation(s)
- Myrto Koutantou
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece
| | | | - Emmanouil Angelakis
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece
| |
Collapse
|
2
|
Deng YP, Fu YT, Yao C, Shao R, Zhang XL, Duan DY, Liu GH. Emerging bacterial infectious diseases/pathogens vectored by human lice. Travel Med Infect Dis 2023; 55:102630. [PMID: 37567429 DOI: 10.1016/j.tmaid.2023.102630] [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: 05/12/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.
Collapse
Affiliation(s)
- Yuan-Ping Deng
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Yi-Tian Fu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China; Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Chaoqun Yao
- Department of Biomedical Sciences and One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
| | - Renfu Shao
- Centre for Bioinnovation, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Xue-Ling Zhang
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - De-Yong Duan
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Guo-Hua Liu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China.
| |
Collapse
|
3
|
Ouarti B, Fonkou DMM, Houhamdi L, Mediannikov O, Parola P. Lice and lice-borne diseases in humans in Africa: a narrative review. Acta Trop 2022; 237:106709. [PMID: 36198330 DOI: 10.1016/j.actatropica.2022.106709] [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: 07/27/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 01/18/2023]
Abstract
Lice are host-specific insects. Human lice include Pediculus humanus humanus (body lice) which are known to be vectors of serious human bacterial infectious diseases including epidemic typhus, relapsing fever, trench fever and plague; Pediculus humanus capitis (head lice) that frequently affect children; and Pthirus pubis, commonly known as crab lice. In Africa, human infections transmitted by lice remained poorly known and therefore, underestimated, perhaps due to the lack of diagnostic tools and professional knowledge. In this paper we review current knowledge of the microorganisms identified in human lice in the continent of Africa, in order to alert health professionals to the importance of recognising the risk of lice-related diseases.
Collapse
Affiliation(s)
- Basma Ouarti
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
| | | | - Linda Houhamdi
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, Marseille, France; IRD, AP-HM, MEPHI, Aix Marseille University, Marseille, France.
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
| |
Collapse
|
4
|
A Comparative Study of Body Lice and Bed Bugs Reveals Factors Potentially Involved in Differential Vector Competence for the Relapsing Fever Spirochete Borrelia recurrentis. Infect Immun 2022; 90:e0068321. [PMID: 35384689 DOI: 10.1128/iai.00683-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Borrelia recurrentis is the causative agent of louse-borne relapsing fever and the only Borrelia species transmitted by an insect rather than a tick vector. While bed bugs (Cimex lectularius L.) are not established vectors of any human pathogens, a recent study reported that they may be competent vectors of B. recurrentis. However, many aspects of infection and transmission remain unclear in this possible secondary vector. Here, we carried out several quantitative laboratory studies to gain a better understanding of the host suitability of bed bugs relative to the established body louse vector as well as the factors that may affect the ability of bed bugs to transmit the pathogen. We fed bed bugs B. recurrentis and estimated the level and duration of infection in the hemolymph using live imaging. We performed quantitative PCR (qPCR) to examine whole-body spirochete levels and the occurrence of vertical transmission to progeny. We also developed an assay to compare the amounts of force required to release infectious hemolymph from recently engorged bed bugs and body lice. Finally, we analyzed humoral antibacterial activity in the hemolymph, hemolymph pH, and hemocyte activity in both insect species. Our results confirm that within 24 h of ingestion, B. recurrentis can penetrate the midgut epithelium of bed bugs and enter the hemolymph, overcoming a major host barrier, as in body lice. Once in the hemolymph, spirochetes remain visible for at least 4 days. Moreover, we show that bed bugs are more physically susceptible to crushing than body lice, suggesting that crushing is a feasible route for the natural dissemination of B. recurrentis from the hemolymph of bed bugs, as for body lice. Nonetheless, our data also indicate that bed bugs are suboptimal hosts for B. recurrentis, as the bacterium does not appear to proliferate to high levels or stably colonize the hemolymph and exhibits pleomorphism in this environment. In particular, our data suggest that hemolymph pH and unique cellular immune responses, rather than humoral effectors, may be involved in limiting spirochete survival in bed bugs. Notably, we document the formation of extracellular DNA traps by bed bug hemocytes for the first time. For these reasons, while bed bugs may be capable of limited transmission given their ecology, vector competence is probably minimal relative to body lice. Additional mechanistic studies of human pathogen infection of bed bugs may provide much-needed insight into the biological factors that restrict their ability to act as vectors and may reveal novel mechanisms of immunity.
Collapse
|
5
|
Antinori S, Ridolfo AL, Grande R, Galimberti L, Casalini G, Giacomelli A, Milazzo L. Loop-mediated isothermal amplification (LAMP) assay for the diagnosis of imported malaria: a narrative review. LE INFEZIONI IN MEDICINA 2022; 29:355-365. [PMID: 35146340 DOI: 10.53854/liim-2903-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/09/2021] [Indexed: 11/03/2022]
Abstract
Loop-mediated isothermal amplification (LAMP) is a molecular method to detect malaria recently introduced in the market. LAMP is simple to perform and does not require advanced equipment and training thus satisfying the qualification as a point-of-care diagnostic screening test. In this narrative review, we focus on the role of LAMP for malaria diagnosis in non-endemic settings. We searched PubMed, Embase, Scopus, and Google Scholar, using the following search terms: 'Malaria LAMP' in combination with 'imported malaria' or 'travellers' malaria' or 'non-endemic setting' or 'non-endemic region' or 'malaria screening' or 'malaria diagnosis'. References of each article were also reviewed for possible studies or reports not identified in our search. Overall, 18 studies encompassing 6289 tested samples with 1663 confirmed malaria diagnoses were retrieved. Most of these studies (13/18, 72.2%) were conducted in Europe, and almost half were retrospective. Fourteen studies (77.8%) employed real-time or nested-polymerase chain reaction as the reference method for confirming malaria diagnosis. Sensitivity of LAMP ranged from 93.9 to 100% and specificity from 93.8 to 100% with a negative predictive value of 99.6%-100%. The rate of reported invalid results requiring repeat of the test varied from 0.01% to 5.7%, but they were solved in the majority of cases with a secondary analysis. In non-endemic countries the adoption of LAMP malaria assay as the screening test for malaria diagnosis seems to perform better than conventional methods. However, blood microscopy remains essential to either identify Plasmodium species and quantify parasitaemia and adequately managing malaria cases.
Collapse
Affiliation(s)
- Spinello Antinori
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milano, Italy.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Romualdo Grande
- Clinical Microbiology, Virology and Bioemergency, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Laura Galimberti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Giacomo Casalini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milano, Italy
| | - Andrea Giacomelli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milano, Italy.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| |
Collapse
|
6
|
Giacomelli A, Monti ME, Grande R, Oreni L, Galimberti L, Ridolfo AL, Bonazzetti C, Sabaini F, Cordier L, Zambelli A, Rizzardini G, Galli M, Antinori S. The value of lamp to rule out imported malaria diagnosis: a retrospective observational study in Milan, Italy. Infect Dis (Lond) 2022; 54:410-417. [PMID: 34983306 DOI: 10.1080/23744235.2021.2023754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The diagnosis of malaria in returning travellers could be a challenge in non-endemic settings. We aimed to assess the performance of LAMP in comparison with standard conventional diagnostic methods using real-time-polymerase chain reaction (PCR) in case of discordant results. METHODS All travellers returning from malaria-endemic areas who presented to our Emergency Department (ED) from January 2017 to December 2020 with signs and symptoms suggestive for malaria were included. Blood microscopy was the reference diagnostic method applied at our laboratory with LAMP implemented as an additional method to aid in malaria diagnosis. PCR was employed only in case of between test's discordant results. Sensitivity and specificity of microscopy compared to LAMP were calculated with the confidence interval of 95%. RESULTS Four-hundred and eight patients (55.6% male, median age 42 years) were screened for malaria. The diagnosis was confirmed in 49 cases (12%): 44 cases (90%) caused by Plasmodium falciparum. Peripheral blood smear missed to identify three malaria cases, which tested positive with LAMP and PCR. One case of malaria caused by P. malariae in a naive tourist, one case by P. falciparum in a semi-immune pregnant women and one case by P. falciparum in a previously treated semi-immune patient. All the discordant cases were characterized by a very low parasitaemia. Microscopy when compared to LAMP showed a sensitivity of 93.9% (95% confidence interval (CI) 83.1-98.7%) and a specificity of 100% (95% CI 98.9-100%). CONCLUSIONS In our non-endemic setting LAMP was able to identify malaria cases with low-level parasitaemia otherwise missed by blood microscopy.
Collapse
Affiliation(s)
- Andrea Giacomelli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Maria Elena Monti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Romualdo Grande
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Letizia Oreni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Laura Galimberti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Cecilia Bonazzetti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università degli Studi di Milano, Milan, Italy
| | - Federico Sabaini
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Laura Cordier
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Agostino Zambelli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Massimo Galli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università degli Studi di Milano, Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
7
|
Hashim O, Charvet CL, Toubaté B, Ahmed AAE, Lamassiaude N, Neveu C, Dimier-Poisson I, Debierre-Grockiego F, Dupuy C. Molecular and Functional Characterization of GABA Receptor Subunits GRD and LCCH3 from Human Louse Pediculus Humanus Humanus. Mol Pharmacol 2021; 102:116-127. [PMID: 35858760 PMCID: PMC11037462 DOI: 10.1124/molpharm.122.000499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/21/2022] [Accepted: 05/12/2022] [Indexed: 11/22/2022] Open
Abstract
Human louse Pediculus humanus is a cosmopolitan obligatory blood-feeding ectoparasite causing pediculosis and transmitting many bacterial pathogens. Control of infestation is difficult due to the developed resistance to insecticides that mainly target GABA (γ-aminobutyric acid) receptors. Previous work showed that Pediculus humanus humanus (Phh) GABA receptor subunit resistance to dieldrin (RDL) is the target of lotilaner, a synthetic molecule of the isoxazoline chemical class. To enhance our understanding of how insecticides act on GABA receptors, two other GABA receptor subunits were cloned and characterized: three variants of Phh-grd (glycine-like receptor of Drosophila) and one variant of Phh-lcch3 (ligand-gated chloride channel homolog 3). Relative mRNA expression levels of Phh-rdl, Phh-grd, and Phh-lcch3 revealed that they were expressed throughout the developmental stages (eggs, larvae, adults) and in the different parts of adult lice (head, thorax, and abdomen). When expressed individually in the Xenopus oocyte heterologous expression system, Phh-GRD1, Phh-GRD2, Phh-GRD3, and Phh-LCCH3 were unable to reconstitute functional channels, whereas the subunit combinations Phh-GRD1/Phh-LCCH3, Phh-GRD1/Phh-RDL, and Phh-LCCH3/Phh-RDL responded to GABA in a concentration-dependent manner. The three heteromeric receptors were similarly sensitive to the antagonistic effect of picrotoxin and fipronil, whereas Phh-GRD1/Phh-RDL and Phh-LCCH3/Phh-RDL were respectively about 2.5-fold and 5-fold more sensitive to ivermectin than Phh-GRD1/Phh-LCCH3. Moreover, the heteropentameric receptor constituted by Phh-GRD1/Phh-LCCH3 was found to be permeable and highly sensitive to the extracellular sodium concentration. These findings provided valuable additions to our knowledge of the complex nature of GABA receptors in human louse that could help in understanding the resistance pattern to commonly used pediculicides. SIGNIFICANCE STATEMENT: Human louse is an ectoparasite that causes pediculosis and transmits several bacterial pathogens. Emerging strains developed resistance to the commonly used insecticides, especially those targeting GABA receptors. To understand the molecular mechanisms underlying this resistance, two subunits of GABA receptors were cloned and described: Phh-grd and Phh-lcch3. The heteromeric receptor reconstituted with the two subunits was functional in Xenopus oocytes and sensitive to commercially available insecticides. Moreover, both subunits were transcribed throughout the parasite lifecycle.
Collapse
Affiliation(s)
- Omar Hashim
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Claude L Charvet
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Berthine Toubaté
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Aimun A E Ahmed
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Nicolas Lamassiaude
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Cédric Neveu
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Isabelle Dimier-Poisson
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Françoise Debierre-Grockiego
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Catherine Dupuy
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| |
Collapse
|
8
|
The First Immunocompetent Mouse Model of Strictly Human Pathogen, Borrelia recurrentis. Infect Immun 2021; 89:e0004821. [PMID: 33875475 DOI: 10.1128/iai.00048-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The spirochetal bacterium Borrelia recurrentis causes louse-borne relapsing fever (LBRF). B. recurrentis is unique because, as opposed to other Borrelia spirochetes, this strictly human pathogen is transmitted by lice. Despite the high mortality and historically proven epidemic potential and current outbreaks in African countries and Western Europe, research on LBRF has been obstructed by the lack of suitable animal models. The previously used grivet monkey model is associated with ethical concerns, among other issues. An existing immunodeficient mouse model does not limit bacteremia due to its impaired immune system. In this study, we used genetically diverse Collaborative Cross (CC) lines to develop the first LBRF immunocompetent mouse model. Out of 12 CC lines tested, CC046 mice consistently developed B. recurrentis-induced spirochetemia during the first 3 days postchallenge as concordantly detected by dark-field microscopy, culture, and quantitative PCR. However, spirochetemia was not detected from day 4 through day 10 postchallenge. The high-level spirochetemia (>107 cells/ml of blood) observed in CC046 mice was similar to that recorded in LBRF patients as well as immunocompetent mouse strains experimentally infected by tick-borne relapsing fever (RF) spirochetes, Borrelia hermsii and Borrelia persica. In contrast to the Old World and New World RF spirochetes, which develop multiple relapses (n = 3 to 9), B. recurrentis produced only single culture-detectable spirochetemia in CC046 mice. The lack of relapses may not be surprising, as LBRF patients and the grivet monkey model usually develop no or only 1 to 2 spirochetemic relapses. The novel model will now allow scientists to study B. recurrentis in the context of intact immunity.
Collapse
|
9
|
Kahlig P, Neumayr A, Paris DH. Louse-borne relapsing fever-A systematic review and analysis of the literature: Part 2-Mortality, Jarisch-Herxheimer reaction, impact on pregnancy. PLoS Negl Trop Dis 2021; 15:e0008656. [PMID: 33705387 PMCID: PMC7951929 DOI: 10.1371/journal.pntd.0008656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Louse-borne relapsing fever (LBRF) is a classical epidemic disease, which in the past was associated with war, famine, poverty, forced migration, and crowding under poor hygienic conditions around the world. The disease's causative pathogen, the spirochete bacterium Borrelia recurrentis, is confined to humans and transmitted by a single vector, the human body louse Pediculus humanus corporis. Since the disease was at its peak before the days of modern medicine, many of its aspects have never been formally studied and to date remain incompletely understood. In order to shed light on some of these aspects, we have systematically reviewed the accessible literature on LBRF since the recognition of its mode of transmission in 1907, and summarized the existing data on mortality, Jarisch-Herxheimer reaction (JHR), and impact on pregnancy. Publications were identified by using a predefined search strategy of electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of LBRF published in English, French, German, and Spanish since 1907 were included. Data extraction followed a predefined protocol and included a grading system to judge the certainty of the diagnosis of reported cases. The high mortality rates often found in literature are confined to extreme scenarios. The case fatality rate (CFR) of untreated cases is on average significantly lower than frequently assumed. In recent years, a rise in the overall CFRs is documented, for which reasons remain unknown. Lacking standardized criteria, a clear diagnostic threshold defining antibiotic treatment-induced JHR does not exist. This explains the wide range of occurrence rates found in literature. Pre-antibiotic era data suggest the existence of a JHR-like reaction also in cases treated with arsenicals and even in untreated cases. LBRF-related adverse outcomes are observed in 3 out of 4 pregnancies.
Collapse
Affiliation(s)
- Pascal Kahlig
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| |
Collapse
|
10
|
Kahlig P, Paris DH, Neumayr A. Louse-borne relapsing fever-A systematic review and analysis of the literature: Part 1-Epidemiology and diagnostic aspects. PLoS Negl Trop Dis 2021; 15:e0008564. [PMID: 33705384 PMCID: PMC7951878 DOI: 10.1371/journal.pntd.0008564] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Louse-borne relapsing fever (LBRF) is a classical epidemic disease, which in the past was associated with war, famine, poverty, forced migration, and crowding under poor hygienic conditions around the world. The disease's causative pathogen, the spirochete bacterium Borrelia recurrentis, is confined to humans and transmitted by a single vector, the human body louse Pediculus humanus. Since the disease has had its heyday before the days of modern medicine, many of its aspects have never been formally studied and to date, remain incompletely understood. In order to shed light on some of these aspects, we have systematically reviewed the accessible literature on LBRF, since the recognition of its mode of transmission in 1907, and summarized the existing data on epidemiology and diagnostic aspects of the disease. Publications were identified by using a predefined search strategy on electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of LBRF published in English, French, German, and Spanish since 1907 were included. Data extraction followed a predefined protocol and included a grading system to judge the certainty of the diagnosis of reported cases. Historically, Ethiopia is considered a stronghold of LBRF. The recognition of LBRF among East African migrants (originating from Somalia, Eritrea, and Ethiopia) arriving to Europe in the course of the recent migration flow from this region suggests that this epidemiological focus ostensibly persists. Currently, there is neither evidence to support or refute active transmission foci of LBRF elsewhere on the African continent, in Latin America, or in Asia. Microscopy remains the most commonly used method to diagnose LBRF. Data are lacking on sensitivity and specificity of most diagnostic methods.
Collapse
Affiliation(s)
- Pascal Kahlig
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| |
Collapse
|
11
|
Oumarou Hama H, Barbieri R, Guirou J, Chenal T, Mayer A, Ardagna Y, Signoli M, Aboudharam G, Raoult D, Drancourt M. An outbreak of relapsing fever unmasked by microbial paleoserology, 16th century, France. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 173:784-789. [PMID: 32959380 DOI: 10.1002/ajpa.24138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/10/2020] [Accepted: 08/04/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Depicting past epidemics currently relies on DNA-based detection of pathogens, an approach limited to pathogens with well-preserved DNA sequences. We used paleoserology as a complementary approach detecting specific antibodies under a mini line-blot format including positive and negative control antigens. METHODS Mini line blot assay incorporated skim milk as negative control, Staphylococcus aureus as positive control, and antigens prepared from lice-borne pathogens Rickettsia prowazekii, Borrelia recurrentis, Bartonella quintana, and Yersinia pestis. Paleoserums were extracted from rehydrated dental pulp recovered from buried individuals. Mini line blots observed with the naked eye, were quantified using a scanner and appropriate software. Paleoserology was applied to the indirect detection of lice-borne pathogens in seven skeletons exhumed from a 16th-17th century suspected military burial site (Auxi-le-Château); and 14 civils exhumed from a 5th-13th century burial site (Saint-Mont). Direct detection of pathogens was performed using quantitative real-time PCR. RESULTS In Auxi-le-Château, paleoserology yielded 7/7 interpretable paleoserums including 7/7 positives for B. recurrentis including one also positive for B. quintana. In Saint-Mont, paleoserology yielded 8/14 interpretable paleoserums and none reacted against any of the four pathogens. Antibodies against R. prowazekii and Y. pestis were not detected. The seroprevalence was significantly higher in the military burial site of Auxi-le-Château than in the civil burial site of Saint-Mont. Real-time PCR detection of B. quintana yielded 5/21 positive (3 at Saint-Mont and 2 at Auxi-le-Château) whereas B. recurrentis was not detected. CONCLUSIONS Paleoserology unmasked an outbreak of relapsing B. recurrentis fever in one 16th - 17th century military garrison, missed by real-time PCR. Paleoserology offers a new tool for investigating past epidemics, in complement to DNA sequence-based approaches.
Collapse
Affiliation(s)
- Hamadou Oumarou Hama
- IHU Méditerranée Infection, Marseille, France.,Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Rémi Barbieri
- IHU Méditerranée Infection, Marseille, France.,Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.,Aix-Marseille-Univ., CNRS, EFS, ADES, Marseille, France
| | - Jacqueline Guirou
- IHU Méditerranée Infection, Marseille, France.,Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | | | - Aurélie Mayer
- Bureau d'études Éveha, Limoges/Ivry-sur-Seine, France
| | - Yann Ardagna
- Aix-Marseille-Univ., CNRS, EFS, ADES, Marseille, France
| | | | - Gérard Aboudharam
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.,UFR Odontologie, Aix-Marseille-Univ., Marseille, France
| | - Didier Raoult
- IHU Méditerranée Infection, Marseille, France.,Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France.,Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| |
Collapse
|
12
|
El Hamzaoui B, Laroche M, Bechah Y, Bérenger JM, Parola P. Testing the Competence of Cimex lectularius Bed Bugs for the Transmission of Borrelia recurrentis, the Agent of Relapsing Fever. Am J Trop Med Hyg 2020; 100:1407-1412. [PMID: 30938280 DOI: 10.4269/ajtmh.18-0804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In recent years, bed bugs have reappeared in greater numbers, more frequently, and are biting humans in many new geographic areas. Infestations by these hematophagous insects are rapidly increasing worldwide. Borrelia recurrentis, a spirochete bacterium, is the etiologic agent of louse-borne relapsing fever. The known vectors are body lice, Pediculus humanus humanus. However, previous studies have suggested that bed bugs might also be able to transmit this bacterium. Adult Cimex lectularius were artificially infected with a blood meal mixed with bacterial suspension of B. recurrentis. They were subsequently fed with pathogen-free human blood until the end of the experiment. Bed bugs and feces were collected every 5 days to evaluate the capacity of bed bugs to acquire and excrete viable B. recurrentis using molecular biology, cultures, fluorescein diacetate and immunofluorescence assays. The feces collected on the day 5 and 10 postinfection contained viable bacteria. Immunofluorescence analysis of exposed bed bugs showed the presence of B. recurrentis in the digestive tract, even in bed bugs collected on day 20 after infection. Like human body lice, bed bugs can acquire, maintain, and excrete viable B. recurrentis that might infect humans through skin lesions. This preliminary work suggests that bed bugs might be competent vectors of B. recurrentis. Because bed bugs and body lice may share the same ecological niches, the role of bed bugs in transmitting recurrent fevers deserves further study.
Collapse
Affiliation(s)
- Basma El Hamzaoui
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Maureen Laroche
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Yassina Bechah
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean Michel Bérenger
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| |
Collapse
|
13
|
Amanzougaghene N, Fenollar F, Raoult D, Mediannikov O. Where Are We With Human Lice? A Review of the Current State of Knowledge. Front Cell Infect Microbiol 2020; 9:474. [PMID: 32039050 PMCID: PMC6990135 DOI: 10.3389/fcimb.2019.00474] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 12/24/2019] [Indexed: 12/20/2022] Open
Abstract
Pediculus humanus is an obligate bloodsucking ectoparasite of human that includes two ecotypes, head louse and body louse, which differ slightly in morphology and biology, but have distinct ecologies. Phylogenetically, they are classified on six mitochondrial clades (A, B, C, D, E, and F), head louse encompasses the full genetic diversity of clades, while body louse belongs to clades A and D. Recent studies suggested that not only body louse, but also head louse can transmit disease, which warrants greater attention as a serious public health problem. The recent sequencing of body louse genome confirmed that P. humanus has the smallest genome of any hemimetabolous insect reported to date, and also revealed numerous interesting characteristics in the nuclear and mitochondrial genomes. The transcriptome analyses showed that body and head lice were almost genetically identical. Indeed, the phenotypic flexibility associated with the emergence of body lice, is probably a result of regulatory changes, perhaps epigenetic in origin, triggered by environmental signals. Current lice control strategies have proven unsuccessful. For instance, ivermectin represents a relatively new and very promising pediculicide. However, ivermectin resistance in the field has begun to be reported. Therefore, novel opportunities for pest control strategies are needed. Our objective here is to review the current state of knowledge on the biology, epidemiology, phylogeny, disease-vector and control of this fascinating and very intimate human parasite.
Collapse
Affiliation(s)
- Nadia Amanzougaghene
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Florence Fenollar
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Didier Raoult
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Oleg Mediannikov
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| |
Collapse
|
14
|
Looking Backward To Move Forward: the Utility of Sequencing Historical Bacterial Genomes. J Clin Microbiol 2019; 57:JCM.00100-19. [PMID: 31092597 DOI: 10.1128/jcm.00100-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Many pathogens that caused devastating disease throughout human history, such as Yersinia pestis, Mycobacterium tuberculosis, and Mycobacterium leprae, remain problematic today. Historical bacterial genomes represent a unique source of genetic information and advancements in sequencing technologies have allowed unprecedented insights from this previously understudied resource. This minireview brings together example studies which have utilized ancient DNA, individual historical isolates (both extant and dead) and collections of historical isolates. The studies span human history and highlight the contribution that sequencing and analysis of historical bacterial genomes have made to a wide variety of fields. From providing retrospective diagnosis, to uncovering epidemiological pathways and characterizing genetic diversity, there is clear evidence for the utility of historical isolate studies in understanding disease today. Studies utilizing historical isolate collections, such as those from the National Collection of Type Cultures, the American Type Culture Collection, and the Institut Pasteur, offer enhanced insight since they typically span a wide time period encompassing important historical events and are useful for the investigating the phylodynamics of pathogens. Furthermore, historical sequencing studies are particularly useful for looking into the evolution of antimicrobial resistance, a major public health concern. In summary, although there are limitations to working with historical bacterial isolates, especially when utilizing ancient DNA, continued improvement in molecular and sequencing technologies and the resourcefulness of investigators mean this area of study will continue to expand and contribute to the understanding of pathogens.
Collapse
|
15
|
Di Meco E, Di Napoli A, Amato LM, Fortino A, Costanzo G, Rossi A, Mirisola C, Petrelli A. Infectious and dermatological diseases among arriving migrants on the Italian coasts. Eur J Public Health 2019; 28:910-916. [PMID: 30010744 DOI: 10.1093/eurpub/cky126] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Since 2008 Italy has been the destination of the 'central Mediterranean route', used by migrants to reach Europe. The aim of this study is to describe demographic characteristics and health problems of migrants at the time of arrival on the Italian coasts, focussing on dermatological and infectious diseases. Methods Cross-sectional study of data routinely collected (n = 6, 188) by the National Institute for Health Migration and Poverty (INMP) in the centres for migrants of Lampedusa and Trapani-Milo (2015-16). Logistic models were performed to identify factors associated with scabies, varicella and the occurrence of two or more not related diagnosis. Results The average age was 21.6 years; 83.5% of the patients were males. The most frequent countries of origin were Eritrea, Nigeria, and Somalia. The most frequent diagnosis was scabies (58% of patients), skin infections, pediculosis and dermatitis; respiratory infections and varicella were the most represented infectious diseases. The diagnosis of scabies was more probable among Somalis (OR: 11.60) and Eritreans (OR: 10.05); the diagnosis of varicella was more probable among Ghanaians (OR: 13.58) and Nigerians (OR: 9.79). Somalis (OR: 4.10) and Eritreans (OR: 3.32) were the patients more likely to receive two or more diagnosis. Conclusions The majority of the diseases affecting migrants is in most cases, related to the migration experience and is likely not to represent a major threat for public health. Up-to-date information regarding the burden of diseases is needed in order to identify the health needs of incoming migrants and to arrange the appropriate response in terms of health services provision.
Collapse
Affiliation(s)
- Eugenia Di Meco
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | - Anteo Di Napoli
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | | | - Antonio Fortino
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | | | - Alessandra Rossi
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | - Concetta Mirisola
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | - Alessio Petrelli
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | | |
Collapse
|
16
|
De Liberato C, Magliano A, Romiti F, Menegon M, Mancini F, Ciervo A, Di Luca M, Toma L. Report of the human body louse (Pediculus humanus) from clothes sold in a market in central Italy. Parasit Vectors 2019; 12:201. [PMID: 31053177 PMCID: PMC6500014 DOI: 10.1186/s13071-019-3458-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediculus humanus, the human body louse, is widespread where overcrowding and lack of hygiene are present, in areas of the world affected by poverty, war, famine and presence of refugees. It has recently been considered re-emerging among homeless populations in developed countries. In Italy, it was last reported in 1945. Pediculus humanus is a vector of highly relevant human pathogens. METHODS In October 2018, a woman found small insects on a T-shirt bought second-hand in a local street market in a village 35 km south of Rome (central Italy). Insects were identified both morphologically and by molecular analysis. Moreover, they were analyzed molecularly for the presence of Rickettsia prowazekii, Borrelia recurrentis, Bartonella quintana, Coxiella burnetii and Yersinia pestis. RESULTS Morphological and molecular analyses of the insects identified them as 26 lice (12 females, 10 males and 4 nymphs) of the species P. humanus. Many nits were found on the T-shirt seams. DNA of the investigated pathogens was not detected in any of the lice. CONCLUSIONS The exceptionality of the described case lies both in the report of P. humanus from a country where it had not been reported since 1945, and in its finding from second-hand clothes for sale in a market, constituting a potential source of infection for people buying this type of goods. The question arises, how did adults and nits of P. humanus infest clothes for sale on a market stall in a country where it had not been reported for decades. Given that the body louse requires frequent blood meals to survive and develop, its arrival on clothes imported from abroad is highly improbable. Hence, it must be presumed that people infected with the human body louse are present in Italy. This report points out a serious regulatory problem regarding the management of second-hand clothes prior to sale and, more generally, of controls in street markets.
Collapse
Affiliation(s)
- Claudio De Liberato
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Rome, Italy.
| | - Adele Magliano
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Rome, Italy
| | - Federico Romiti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Rome, Italy
| | - Michela Menegon
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Fabiola Mancini
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Alessandra Ciervo
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Marco Di Luca
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luciano Toma
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| |
Collapse
|
17
|
(Re-) conceptualising vulnerability as a part of risk in global health emergency response: updating the pressure and release model for global health emergencies. Emerg Themes Epidemiol 2019; 16:2. [PMID: 31007703 PMCID: PMC6454779 DOI: 10.1186/s12982-019-0084-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/03/2019] [Indexed: 12/31/2022] Open
Abstract
Vulnerability has become a key concept in emergency response research and is being critically discussed across several disciplines. While the concept has been adopted into global health, its conceptualisation and especially its role in the conceptualisation of risk and therefore in risk assessments is still lacking. This paper uses the risk concept pioneered in hazard research that assumes that risk is a function of the interaction between hazard and vulnerability rather than the neo-liberal conceptualisation of vulnerability and vulnerable groups and communities. By seeking to modify the original pressure and release model, the paper unpacks the representation or lack of representation of vulnerability in risk assessments in global health emergency response and discusses what benefits can be gained from making the underlying assumptions about vulnerability, which are present whether vulnerability is sufficiently conceptualised and consciously included or not, explicit. The paper argues that discussions about risk in global health emergencies should be better grounded in a theoretical understanding of the concept of vulnerability and that this theoretical understanding needs to inform risk assessments which implicitly used the concept of vulnerability. By using the hazard research approach to vulnerability, it offers an alternative narrative with new perspectives on the value and limits of vulnerability as a concept and a tool.
Collapse
|
18
|
Killing Clothes Lice by Holding Infested Clothes Away from Hosts for 10 Days to Control Louseborne Relapsing Fever, Bahir Dah, Ethiopia. Emerg Infect Dis 2019. [PMCID: PMC6346454 DOI: 10.3201/eid2502.181226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Louseborne relapsing fever (LBRF) was once a cosmopolitan disease, but it now occurs only in the Horn of Africa. Recent cases in refugees to Europe made LBRF topical again. Crowded boarding houses and church dwellings in Ethiopia are analogous to the crowded air-raid shelters of World War II. Thus, we might learn from experiments the London School of Tropical Hygiene and Medicine conducted during World War II. When the vector of Borrelia recurrentis (Pediculus humanus lice) was held away from the host for 10 days, 100% of nymphal and adult lice starved to death and 100% of eggs did not hatch. We hypothesize that holding infested clothes away from hosts in plastic shopping bags will kill enough lice to control LBRF in Ethiopia. Owning 2 sets of clothes might be useful; 1 set might be held in a plastic shopping bag for 10 days to kill lice and their eggs.
Collapse
|
19
|
Detection of bacterial pathogens in clade E head lice collected from Niger's refugees in Algeria. Parasit Vectors 2018; 11:348. [PMID: 29907122 PMCID: PMC6003154 DOI: 10.1186/s13071-018-2930-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/01/2018] [Indexed: 12/18/2022] Open
Abstract
Background Head lice, Pediculus humanus capitis, are obligate blood-sucking parasites. Phylogenetically, they occur in five divergent mitochondrial clades (A, D, B, C and E), each having a particular geographical distribution. Recent studies have revealed that head lice, as is the case of body lice, can act as a vector for louse-borne diseases. Here, we aimed to study the genetic diversity of head lice collected from Niger’s refugees (migrant population) arriving in Algeria, northern Africa, and to look for louse-borne pathogens. Comparative head lice samples collected from indigenous population of schoolchildren (non-immigrant) were also analyzed to frame the study. Results In this study, 37 head lice samples were collected from 31 Nigerien refugees, as well as 45 head lice from 27 schoolchildren. The collection was established in three localities of eastern Algiers, north Algeria. Quantitative real-time PCR screening of pathogens bacteria and the genetic characterisation of the head lice satut were performed. Through amplification and sequencing of the cytb gene, results showed that all head lice of Nigerien refugees 37/82 (45.12%) belonged to clade E with the presence of four new haplotypes, while, of the 45 head lice of schoolchildren, 34/82 lice (41.46%) belonged to clade A and 11/82 (13.41%) belonged to clade B. Our study is the first to report the existence of clade E haplogroup in Nigerien head lice. DNA of Coxiella burnetii was detected in 3/37 (8.10%) of the head lice collected from 3 of the 31 (9.67%) migrant population. We also revealed the presence of Acinetobacter DNA in 20/37 (54.05%) of head lice collected from 25/31 (80.64%) of the Nigerien refugees, and in 25/45 (55.55%) head lice collected from 15/27 (55.55%) schoolchildren. All positive Nigerien-head lice for Acinetobacter spp. were identified as A. baumannii, while positive schoolchildren-head lice were identified as A. johnsonii 15/25 (60%), A. variabilis 8/25 (32%) and A. baumannii 2/25 (8%). Conclusions Based on these findings from head lice collected on migrant and non-migrant population, our results show, for the first time, that head lice from Niger belong to haplogroup E, and confirm that the clade E had a west African distribution. We also detected, for the first time, the presence of C. burnetii and A. baumannii in these Nigerien head lice. Nevertheless, further studies are needed to determine whether the head lice can transmit these pathogenic bacteria from one person to another.
Collapse
|
20
|
Luo Z, Kelleher AJ, Darwiche R, Hudspeth EM, Shittu OK, Krishnavajhala A, Schneiter R, Lopez JE, Asojo OA. Crystal Structure of Borrelia turicatae protein, BTA121, a differentially regulated gene in the tick-mammalian transmission cycle of relapsing fever spirochetes. Sci Rep 2017; 7:15310. [PMID: 29127407 PMCID: PMC5681642 DOI: 10.1038/s41598-017-14959-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/19/2017] [Indexed: 12/28/2022] Open
Abstract
Tick-borne relapsing fever (RF) borreliosis is a neglected disease that is often misdiagnosed. RF species circulating in the United States include Borrelia turicatae, which is transmitted by argasid ticks. Environmental adaptation by RF Borrelia is poorly understood, however our previous studies indicated differential regulation of B. turicatae genes localized on the 150 kb linear megaplasmid during the tick-mammalian transmission cycle, including bta121. This gene is up-regulated by B. turicatae in the tick versus the mammal, and the encoded protein (BTA121) is predicted to be surface localized. The structure of BTA121 was solved by single-wavelength anomalous dispersion (SAD) using selenomethionine-derivative protein. The topology of BTA121 is unique with four helical domains organized into two helical bundles. Due to the sequence similarity of several genes on the megaplasmid, BTA121 can serve as a model for their tertiary structures. BTA121 has large interconnected tunnels and cavities that can accommodate ligands, notably long parallel helices, which have a large hydrophobic central pocket. Preliminary in-vitro studies suggest that BTA121 binds lipids, notably palmitate with a similar order of binding affinity as tablysin-15, a known palmitate-binding protein. The reported data will guide mechanistic studies to determine the role of BTA121 in the tick-mammalian transmission cycle of B. turicatae.
Collapse
Affiliation(s)
- Zhipu Luo
- Synchrotron Radiation Research Section, Macromolecular Crystallography Laboratory, National Cancer Institute, Argonne, Illinois, 60439, USA
| | - Alan J Kelleher
- National School of Tropical Medicine, Baylor College of Medicine, Houston Texas, United States of America
| | - Rabih Darwiche
- Division of Biochemistry, Department of Biology, University of Fribourg Chemin du Musée 10, CH 1700, Fribourg, Switzerland
| | - Elissa M Hudspeth
- National School of Tropical Medicine, Baylor College of Medicine, Houston Texas, United States of America
| | - Oluwatosin K Shittu
- National School of Tropical Medicine, Baylor College of Medicine, Houston Texas, United States of America
| | - Aparna Krishnavajhala
- National School of Tropical Medicine, Baylor College of Medicine, Houston Texas, United States of America
| | - Roger Schneiter
- Division of Biochemistry, Department of Biology, University of Fribourg Chemin du Musée 10, CH 1700, Fribourg, Switzerland
| | - Job E Lopez
- National School of Tropical Medicine, Baylor College of Medicine, Houston Texas, United States of America.
| | - Oluwatoyin A Asojo
- National School of Tropical Medicine, Baylor College of Medicine, Houston Texas, United States of America.
| |
Collapse
|
21
|
Antinori S, Tonello C, Edouard S, Parravicini C, Gastaldi D, Grande R, Milazzo L, Ricaboni D, Fenollar F, Raoult D, Corbellino M, Mediannikov O. Diagnosis of Louse-Borne Relapsing Fever despite Negative Microscopy in Two Asylum Seekers from Eastern Africa. Am J Trop Med Hyg 2017; 97:1669-1672. [PMID: 29016302 DOI: 10.4269/ajtmh.17-0320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We report two cases of louse-borne relapsing fever observed at our Institution in June 2016. Both patients were young asylum seekers from Africa who had recently arrived in Milan, Italy. Notably, direct microscopic examination of peripheral blood smears was repeatedly negative for the presence of spirochetes and the diagnosis, supported by clinical and epidemiologic evidence, required molecular confirmation by polymerase chain reaction amplification of DNA extracted from blood and sequencing of the amplified products.
Collapse
Affiliation(s)
- Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy.,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Cristina Tonello
- Pathology Unit, Ospedale L. Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Sophie Edouard
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Carlo Parravicini
- Pathology Unit, Ospedale L. Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | - Romualdo Grande
- Clinical Microbiology, Virology and Bioemergence Diagnostics, Ospedale L Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Davide Ricaboni
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Florence Fenollar
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Oleg Mediannikov
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| |
Collapse
|
22
|
Ehounoud C, Fenollar F, Dahmani M, N’Guessan J, Raoult D, Mediannikov O. Bacterial arthropod-borne diseases in West Africa. Acta Trop 2017; 171:124-137. [PMID: 28365316 DOI: 10.1016/j.actatropica.2017.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Indexed: 01/18/2023]
Abstract
Arthropods such as ticks, lice, fleas and mites are excellent vectors for many pathogenic agents including bacteria, protozoa and viruses to animals. Moreover, many of these pathogens can also be accidentally transmitted to humans throughout the world. Bacterial vector-borne diseases seem to be numerous and very important in human pathology, however, they are often ignored and are not well known. Yet they are in a phase of geographic expansion and play an important role in the etiology of febrile episodes in regions of Africa. Since the introduction of molecular techniques, the presence of these pathogens has been confirmed in various samples from arthropods and animals, and more rarely from human samples in West Africa. In this review, the aim is to summarize the latest information about vector-borne bacteria, focusing on West Africa from 2000 until today in order to better understand the epidemiological risks associated with these arthropods. This will allow health and veterinary authorities to develop a strategy for surveillance of arthropods and bacterial disease in order to protect people and animals.
Collapse
|
23
|
Grecchi C, Zanotti P, Pontarelli A, Chiari E, Tomasoni LR, Gulletta M, Barbui A, Caligaris S, Matteelli A, Castelli F. Louse-borne relapsing fever in a refugee from Mali. Infection 2017; 45:373-376. [PMID: 28161771 DOI: 10.1007/s15010-017-0987-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/25/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Due to the increasing number of refugees from East Africa, louse-borne relapsing fever (LBRF) has become an emergent disease in Europe. No single case of LBRF has been reported in Europe in refugees from other parts of Africa. CASE REPORT We report a case of LBRF in a refugee from Mali, likely acquired in Libya, where several migration routes into Europe meet. The disease must be considered in any febrile refugee regardless the country of origin.
Collapse
Affiliation(s)
- Cecilia Grecchi
- University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy.
| | - Paola Zanotti
- University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy
| | - Agostina Pontarelli
- Infectious Diseases and Viral Hepatitis Unit, Department of Internal and Specialistic Medicine, Second University of Naples, Naples, Italy
| | - Erika Chiari
- University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy
| | - Lina Rachele Tomasoni
- SSVD of Infectious and Tropical Diseases, Spedali Civili General Hospital, Brescia, Italy
| | - Maurizio Gulletta
- SSVD of Infectious and Tropical Diseases, Spedali Civili General Hospital, Brescia, Italy
| | - Anna Barbui
- SC Microbiology and Virology U, AOU CDSS Molinette Hospital, Turin, Italy
| | - Silvio Caligaris
- SSVD of Infectious and Tropical Diseases, Spedali Civili General Hospital, Brescia, Italy
| | - Alberto Matteelli
- University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy
| | - Francesco Castelli
- University Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy
| |
Collapse
|
24
|
Amanzougaghene N, Akiana J, Mongo Ndombe G, Davoust B, Nsana NS, Parra HJ, Fenollar F, Raoult D, Mediannikov O. Head Lice of Pygmies Reveal the Presence of Relapsing Fever Borreliae in the Republic of Congo. PLoS Negl Trop Dis 2016; 10:e0005142. [PMID: 27911894 PMCID: PMC5135033 DOI: 10.1371/journal.pntd.0005142] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/27/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Head lice, Pediculus humanus capitis, occur in four divergent mitochondrial clades (A, B, C and D), each having particular geographical distributions. Recent studies suggest that head lice, as is the case of body lice, can act as a vector for louse-borne diseases. Therefore, understanding the genetic diversity of lice worldwide is of critical importance to our understanding of the risk of louse-borne diseases. METHODOLOGY/PRINCIPAL FINDINGS Here, we report the results of the first molecular screening of pygmies' head lice in the Republic of Congo for seven pathogens and an analysis of lice mitochondrial clades. We developed two duplex clade-specific real-time PCRs and identified three major mitochondrial clades: A, C, and D indicating high diversity among the head lice studied. We identified the presence of a dangerous human pathogen, Borrelia recurrentis, the causative agent of relapsing fever, in ten clade A head lice, which was not reported in the Republic of Congo, and B. theileri in one head louse. The results also show widespread infection among head lice with several species of Acinetobacter. A. junii was the most prevalent, followed by A. ursingii, A. baumannii, A. johnsonii, A. schindleri, A. lwoffii, A. nosocomialis and A. towneri. CONCLUSIONS/SIGNIFICANCE Our study is the first to show the presence of B. recurrentis in African pygmies' head lice in the Republic of Congo. This study is also the first to report the presence of DNAs of B. theileri and several species of Acinetobacter in human head lice. Further studies are needed to determine whether the head lice can transmit these pathogenic bacteria from person to another.
Collapse
Affiliation(s)
- Nadia Amanzougaghene
- Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Aix-Marseille Université, Marseille, France
| | - Jean Akiana
- Laboratoire national de santé publique, Brazzaville, République du Congo
| | - Géor Mongo Ndombe
- Laboratoire national de santé publique, Brazzaville, République du Congo
| | - Bernard Davoust
- Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Aix-Marseille Université, Marseille, France
| | | | - Henri-Joseph Parra
- Laboratoire national de santé publique, Brazzaville, République du Congo
| | - Florence Fenollar
- Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Aix-Marseille Université, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Aix-Marseille Université, Marseille, France
- Campus International UCAD-IRD, Dakar, Senegal
- * E-mail: (OM); (DR)
| | - Oleg Mediannikov
- Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Aix-Marseille Université, Marseille, France
- Campus International UCAD-IRD, Dakar, Senegal
- * E-mail: (OM); (DR)
| |
Collapse
|
25
|
Hytönen J, Khawaja T, Grönroos JO, Jalava A, Meri S, Oksi J. Louse-borne relapsing fever in Finland in two asylum seekers from Somalia. APMIS 2016; 125:59-62. [PMID: 27859692 DOI: 10.1111/apm.12635] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/21/2016] [Indexed: 11/25/2022]
Abstract
We report two cases of louse-borne relapsing fever (LBRF) in young Somali asylum seekers having recently arrived to Finland. They had sought medical attention for a febrile illness. Blood smears were examined for suspected malaria, but instead, spirochete shaped bacteria were observed. The bacteria were confirmed as Borrelia recurrentis by PCR and sequencing. The patients survived, but their treatment was complicated by Jarisch-Herxheimer reaction. We conclude that LBRF must be considered as a diagnostic option in febrile refugees also in the northernmost parts of Europe.
Collapse
Affiliation(s)
- Jukka Hytönen
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland.,Microbiology and Genetics Department, Turku University Hospital, Turku, Finland
| | - Tamim Khawaja
- Helsinki University Central Hospital, Helsinki, Finland
| | - Juha O Grönroos
- Microbiology and Genetics Department, Turku University Hospital, Turku, Finland
| | - Anna Jalava
- Department of Bacteriology and Immunology, Haartman Institute, Helsinki, Finland
| | - Seppo Meri
- Department of Bacteriology and Immunology, Haartman Institute, Helsinki, Finland.,Immunobiology Research Program, University of Helsinki, Helsinki, Finland.,HUSLAB, Helsinki, Finland
| | - Jarmo Oksi
- University of Turku and Turku University Hospital, Turku, Finland
| |
Collapse
|
26
|
Dzelalija B, Punda-Polic V, Medic A, Dobec M. Rickettsiae and rickettsial diseases in Croatia: Implications for travel medicine. Travel Med Infect Dis 2016; 14:436-443. [PMID: 27404664 DOI: 10.1016/j.tmaid.2016.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/30/2016] [Accepted: 06/30/2016] [Indexed: 11/28/2022]
Abstract
AIM To review the current state of knowledge concerning rickettsiae and rickettsioses in Croatia and to discuss their implications for travellers. METHODS The PubMed database was searched from 1991 to 2015 by combining the words "rickettsia," "rickettsiosis", "travellers" and "Croatia". RESULTS Since 1969, Croatia appears to be free of epidemic typhus (ET) caused by Rickettsia prowazekii and the last case of Brill-Zinsser disease was recorded in 2008. Mediterranean spotted fever (MSF) caused by Rickettsia conorii is the most frequent human rickettsial infection in Croatia, followed by murine typhus caused by Rickettsia typhi. Human cases of MSF and murine typhus have been predominantly observed along the eastern Adriatic coast from Zadar to Dubrovnik and between Zadar and Split, respectively. Rickettsia akari, etiologic agent of rickettsialpox, was isolated from blood of a patient diagnosed with MSF in Zadar, but no cases of rickettsialpox were reported. Several species of pathogenic (Rickettsia slovaca, Rickettsia aeschlimannii, Ricketsia helvetica, and Ricketsia raoultii) and species of undetermined pathogenicity (Ricketsia hoogstraalii sp. nov.) rickettsiae were identified in ticks collected in different ecological regions of Croatia. A search of the literature revealed no evidence of rickettsial infection in travellers visiting Croatia. Three imported cases of Rickettsia africae were observed in travellers returning from South Africa. CONCLUSION Rickettsiae and rickettsial diseases continue to be present in Croatia. As they can be acquired while travelling, physicians should consider rickettsial infection in the differential diagnosis of patients returning from Croatia and presenting with febrile illness.
Collapse
Affiliation(s)
- Boris Dzelalija
- Department of Infectious Diseases, Zadar General Hospital, Zadar, Croatia; School of Medicine, University of Split, Split, Croatia
| | | | - Alan Medic
- Institute of Public Health, Zadar, Croatia
| | - Marinko Dobec
- Medica, Medizinische Laboratorien Dr. F. Kaeppeli, Wolfbachstrasse 17, CH-8024 Zurich, Switzerland.
| |
Collapse
|
27
|
Antinori S, Mediannikov O, Corbellino M, Raoult D. Louse-borne relapsing fever among East African refugees in Europe. Travel Med Infect Dis 2016; 14:110-4. [PMID: 26872415 DOI: 10.1016/j.tmaid.2016.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
Louse-borne relapsing fever a neglected and forgotten disease by western physicians has recently re-emerged among East African migrants seeking asylum in Europe. We review here the cases observed so far together with a critical reappraisal of several issues regarding clinical presentation, diagnosis and treatment.
Collapse
Affiliation(s)
- Spinello Antinori
- Department of Clinical and Biomedical Sciences Luigi Sacco, University of Milano, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, Milano, Italy.
| | - Oleg Mediannikov
- Aix-Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm U1095, Faculté de Médecine, Marseille, France.
| | - Mario Corbellino
- Department of Clinical and Biomedical Sciences Luigi Sacco, University of Milano, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, Milano, Italy.
| | - Didier Raoult
- Aix-Marseille Université, URMITE, UM63, CNRS 7278, IRD 198, Inserm U1095, Faculté de Médecine, Marseille, France.
| |
Collapse
|