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Thomas C, Castillo Valladares H, Berger TG, Chang AY. Scabies, Bedbug, and Body Lice Infestations: A Review. JAMA 2024:2823413. [PMID: 39250129 DOI: 10.1001/jama.2024.13896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Importance Scabies, bedbug, and body lice infestations are caused by organisms that live on or in the skin, on clothing, or in the environment and commonly cause pruritus and rash. In 2021, approximately 622 million incident cases of scabies occurred globally. Data on bedbug infestations are limited. Body lice prevalence ranges from 4.1% to 35% among persons experiencing homelessness worldwide. Observations Scabies is caused by mites (Sarcoptes scabiei) that burrow into the epidermis. Transmission primarily occurs from prolonged skin-to-skin contact with an individual who has an infestation. Common scabies is characterized by excoriated pruritic papules, plaques, and pathognomonic burrows on finger/toe web spaces, volar wrists, ankles, axillae, buttocks, male genitalia, and areolae. Permethrin cream and oral ivermectin are first-line treatments for adults, with similar clearance rates by week 2 (74% with permethrin vs 68% with ivermectin; relative risk, 0.91; 95% CI, 0.76-1.08). Treatment failure can occur with oral ivermectin (11.8%; 95% CI, 8.4%-15.4%) and topical permethrin (10.8%; 95% CI, 7.5%-14.5%). Bedbugs (Cimex lectularius, Cimex hemipterus) are insects that live on mattresses and furniture and feed on blood nocturnally, causing linear pruritic erythematous papules. New skin lesions on waking, cohabitants with similar symptoms, and recently residing in a high-occupancy setting should raise suspicion. Treatment requires eradication with pest management. Body lice (Pediculus humanus humanus) are insects found on clothing that travel to the skin for blood meals. Body lice bites cause pruritic excoriated macules/papules and hyperpigmentation in areas where clothing seams contact skin. Treatment and prevention require at least once-weekly bathing and laundering of clothing and bedding. Conclusions and Relevance Scabies, bedbug, and body lice infestations are common. Accurate diagnosis requires taking a history, including social drivers of health (eg, housing status, living environment), and physical examination. First-line treatments include scabicides for patients with common scabies and their close contacts. Scabies, bedbug, and body lice infestations should be treated with decontamination measures.
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Affiliation(s)
- Cristina Thomas
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Herbert Castillo Valladares
- Department of Dermatology, University of California, San Francisco, School of Medicine, San Francisco
- Department of Dermatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California
| | - Timothy G Berger
- Department of Dermatology, University of California, San Francisco, School of Medicine, San Francisco
| | - Aileen Y Chang
- Department of Dermatology, University of California, San Francisco, School of Medicine, San Francisco
- Department of Dermatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California
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Essa IM, Azzal GY, Thamer NK. First molecular sequencing of Babesia gibsoni in ticks, Iraq. Open Vet J 2024; 14:2029-2039. [PMID: 39308724 PMCID: PMC11415923 DOI: 10.5455/ovj.2024.v14.i8.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/25/2024] [Indexed: 09/25/2024] Open
Abstract
Background Tick is one of the most important ectoparasites distributed worldwide and plays an obvious role in the transmission of different infections to humans and animals as dogs. Aim This study conducted to molecular demonstration of Babesia gibsoni in ticks of stray dogs and phylogenetic analysis of study isolates to detect their identity to global isolates. Prevalence of ticks in dogs, identification of tick species, and their relationship to some risk factors were aimed, also. Methods A total of 97 stray dogs were inspected grossly to detect and collect ticks that existed in different body parts. After collection, all ticks were examined morphologically to identify their species, and then molecularly by the polymerase chain reaction (PCR) assay to detect B. gibsoni in different species of ticks. Local B. gibsoni isolates were sequenced, documented in the National Center For biotechnology information (NCBI) database, analyzed phylogenetically, and compared with the global GenBank-NCBI isolates. Results In the current study, ticks were detected in 43.3% of dogs, and were shown to be varied in number and distribution among different body parts of each dog. Concerning its distribution, ticks were observed significantly on the abdomen, ear, and perineal region. In relation to risk factors, ticks were increased significantly in dogs <6 months old in comparison to older dogs, males more than females; and in rural areas more than dogs of sub-urban and urban areas. Based on morphology, different tick species were seen including Hylaomma anatolicum (86.12%), R. sanguineus (11.99%), and Rhipicephalus turanicus (1.89%). Targeting the 18S rRNA gene, PCR assay reported 3.79% positive ticks to B. gibsoni that were seen in R. sanguineus (13.16%) and H. anatolicum (2.56%). Based on phylogenetic analysis data of five local B. gibsoni isolates, this study demonstrated their close relations to the global NCBI-BLAST B. gibsoni Iraqi isolate (ID: MN385424.1). Conclusion This represents the first Iraqi study that demonstrated molecularly B. gibsoni in different species of ticks that infected stray dogs.
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Affiliation(s)
- Israa M. Essa
- Department of Parasitology, College of Veterinary Medicine, University of Basrah, Basra, Iraq
| | - Ghazi Y. Azzal
- Department of Parasitology, College of Veterinary Medicine, University of Basrah, Basra, Iraq
| | - Nadia K. Thamer
- Department of Parasitology, College of Veterinary Medicine, University of Basrah, Basra, Iraq
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Jackson-Litteken CD, Guo W, Hogland BA, Ratliff CT, McFadden L, Fullerton MS, Voth DE, Rego ROM, Blevins JS. Development and validation of systems for genetic manipulation of the Old World tick-borne relapsing fever spirochete, Borrelia duttonii. PLoS Negl Trop Dis 2024; 18:e0012348. [PMID: 39038047 PMCID: PMC11293673 DOI: 10.1371/journal.pntd.0012348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/01/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
Relapsing fever (RF), a vector-borne disease caused by Borrelia spp., is characterized by recurring febrile episodes due to repeated bouts of bacteremia. RF spirochetes can be geographically and phylogenetically divided into two distinct groups; Old World RF Borrelia (found in Africa, Asia, and Europe) and New World RF Borrelia (found in the Americas). While RF is a rarely reported disease in the Americas, RF is prevalent in endemic parts of Africa. Despite phylogenetic differences between Old World and New World RF Borrelia and higher incidence of disease associated with Old World RF spirochete infection, genetic manipulation has only been described in New World RF bacteria. Herein, we report the generation of genetic tools for use in the Old World RF spirochete, Borrelia duttonii. We describe methods for transformation and establish shuttle vector- and integration-based approaches for genetic complementation, creating green fluorescent protein (gfp)-expressing B. duttonii strains as a proof of principle. Allelic exchange mutagenesis was also used to inactivate a homolog of the Borrelia burgdorferi p66 gene, which encodes an important virulence factor, in B. duttonii and demonstrate that this mutant was attenuated in a murine model of RF. Finally, the B. duttonii p66 mutant was complemented using shuttle vector- and cis integration-based approaches. As expected, complemented p66 mutant strains were fully infectious, confirming that P66 is required for optimal mammalian infection. The genetic tools and techniques reported herein represent an important advancement in the study of RF Borrelia that allows for future characterization of virulence determinants and colonization factors important for the enzootic cycle of Old World RF spirochetes.
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Affiliation(s)
- Clay D. Jackson-Litteken
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Wanfeng Guo
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Brandon A. Hogland
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - C. Tyler Ratliff
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - LeAnn McFadden
- Department of Biology, University of Arkansas at Little Rock, Little Rock, Arkansas, United States of America
| | - Marissa S. Fullerton
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Daniel E. Voth
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Ryan O. M. Rego
- Institute of Parasitology, Biology Centre CAS, České Budějovice, Czech Republic
- Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
| | - Jon S. Blevins
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
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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.
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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
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Chala TK, Abera EG, Tukeni KN, Didu GH, Abbagidi FA, Yesuf EA, Yilma D, Gudina EK. The Need to Establish and Sustain Public Health Emergency Operation Centers for Managing Infectious Disease Outbreaks: Lesson From Response to Louse-Borne Relapsing Fever Outbreak in Jimma, Ethiopia. Disaster Med Public Health Prep 2023; 17:e535. [PMID: 37985925 DOI: 10.1017/dmp.2023.192] [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] [Indexed: 11/22/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has provided a great lesson for the globe about the necessity and significance of pandemics-related preparedness in all settings. Public health emergency operation centers play critical roles in preparing for and responding to public health events and emergencies by coordinating and pooling resources. In this article, we aimed to share lessons learnt from the public health response to the louse-borne relapsing fever (LBRF) outbreak coordinated by the emergency operation center established to respond to the COVID-19 pandemic in Jimma, Ethiopia.After the major waves of COVID-19 outbreaks in Ethiopia were over, Jimma University Medical Center (JUMC) reported clusters of louse-borne relapsing fever cases from Jimma Main Prison. Accordingly, Jimma Emergency Operation Center (JEOC) established for the COVID-19 pandemic was immediately alerted and effectively coordinated the overall response.As a result, the outbreak was contained within the prison without spreading to the community and the outbreak ended within a shorter period compared to previous LBRF outbreaks in Ethiopia. This indicates the necessity of establishing and sustaining public health emergency operation centers to prepare for and combat potential future public health emergencies.
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Affiliation(s)
- Temesgen K Chala
- Department of Health Policy and Management, Jimma University, Jimma, Oromia, Ethiopia
- Jimma Emergency Operation Center, Jimma University, Jimma, Oromia, Ethiopia
| | - Eyob G Abera
- Clinical Trial Unit, Jimma University, Oromia, Ethiopia
- Department of Public Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Kedir N Tukeni
- Department of Internal Medicine, Jimma University, Jimma, Oromia, Ethiopia
- Jimma Emergency Operation Center, Jimma University, Jimma, Oromia, Ethiopia
| | - Gelaw H Didu
- Jimma Emergency Operation Center, Jimma University, Jimma, Oromia, Ethiopia
- Department of Emergency Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Fetiya A Abbagidi
- Department of Gynecology and Obstetrics. Jimma University, Jimma, Oromia, Ethiopia
| | - Elias A Yesuf
- Department of Health Policy and Management, Jimma University, Jimma, Oromia, Ethiopia
- Jimma Emergency Operation Center, Jimma University, Jimma, Oromia, Ethiopia
| | - Daniel Yilma
- Clinical Trial Unit, Jimma University, Oromia, Ethiopia
- Department of Internal Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Esayas K Gudina
- Clinical Trial Unit, Jimma University, Oromia, Ethiopia
- Department of Internal Medicine, Jimma University, Jimma, Oromia, Ethiopia
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6
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Mitchell PG, Natsios C, Haag MB, Qin X, Vaz LE. Relapsing Fever: A Rare Cause of Pediatric Fever of Unknown Origin. Clin Pediatr (Phila) 2023; 62:1285-1289. [PMID: 36797991 DOI: 10.1177/00099228231154129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Paul G Mitchell
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Claire Natsios
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Meredith B Haag
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
| | - Xuan Qin
- Clinical Microbiology, Oregon Health & Science University, Portland, OR, USA
| | - Louise E Vaz
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA
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Basu S, Debroy R, Kumar H, Singh H, Ramaiah S, Anbarasu A. Bioactive phytocompounds against specific target proteins of Borrelia recurrentis responsible for louse-borne relapsing fever: Genomics and structural bioinformatics evidence. MEDICAL AND VETERINARY ENTOMOLOGY 2023; 37:213-218. [PMID: 36377635 DOI: 10.1111/mve.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/20/2022] [Indexed: 05/18/2023]
Abstract
Louse-borne relapsing fever (LBRF) with high untreated mortality caused by spirochete Borrelia recurrentis is predominantly endemic to Sub-Saharan Africa and has re-emerged in parts of Eastern Europe, Asia and Latin America due to population migrations. Despite subtractive evolution of lice-borne pathogenic Borrelia spp. from tick-borne species, there has been no comprehensive report on conservation of protein targets across tick and lice-borne pathogenic Borrelia nor exploration of phytocompounds that are toxic to tick against lice. From the 19 available whole genomes including B. recurrentis, B. burgdorferi, B. hermsii, B. parkeri and B. miyamotoi, conservation of seven drug targets (>80% domain identity) viz. 30 S ribosomal subunit proteins (RSP) S3, S7, S8, S14, S19, penicillin-binding protein-2 and 50 S RSP L16 were deciphered through multiple sequence alignments. Twelve phytocompounds (hydroxy-tyrosol, baicalein, cis-2-decanoic acid, morin, oenin, rosemarinic acid, kaempferol, piceatannol, rottlerin, luteolin, fisetin and monolaurin) previously explored against Lyme disease spirochete B. burgdorferi when targeted against LBRF-causing B. recurrentis protein targets revealed high multi-target affinity (2%-20% higher than conventional antibiotics) through molecular docking. However, based on high binding affinity against all target proteins, stable coarse-grained dynamics (fluctuations <1 Å) and safe pharmacological profile, luteolin was prioritized. The study encourages experimental evaluation of the potent phytocompounds and similar protocols for investigating other emerging vector-borne diseases.
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Affiliation(s)
- Soumya Basu
- Medical and Biological Computing Laboratory, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
- Department of Biotechnology, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
| | - Reetika Debroy
- Medical and Biological Computing Laboratory, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
- Department of Bio Sciences, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
| | - Hithesh Kumar
- Department of Bio Sciences, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
| | - Harpreet Singh
- Division of Biomedical Informatics, Indian Council of Medical Research (ICMR), New Delhi, India
| | - Sudha Ramaiah
- Medical and Biological Computing Laboratory, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
- Department of Bio Sciences, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
| | - Anand Anbarasu
- Medical and Biological Computing Laboratory, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
- Department of Biotechnology, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore, India
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Qiu Y, Chambaro HM, Sato K, Squarre D, Simulundu E, Kajihara M, Changula K, Simbotwe M, Harima H, Ndebe J, Moonga L, Nakao R, Takada A, Hang’ombe BM, Sawa H, Kawabata H. Detection of Old and New World Relapsing Fever Borreliae in Ornithodoros Ticks Collected from Warthog Burrows in Zambia. Microorganisms 2023; 11:microorganisms11010200. [PMID: 36677492 PMCID: PMC9865017 DOI: 10.3390/microorganisms11010200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
Relapsing fever (RF) is an arthropod-borne disease caused by Borrelia spirochete, which is one of the major public health concerns in endemic regions including Africa. However, information on Borrelia spirochetes is limited in Zambia. Here, we investigate the Borrelia spirochetes harbored by Ornithodoros ticks in Zambian National Parks. We analyzed 182 DNA samples pooled from 886 Ornithodoros ticks. Of these, 43 tested positive, and their sequence revealed that the ticks harbored both Old and New World RF borreliae. This research presents the first evidence of Old-World RF borreliae in Zambia. The New World RF borreliae detected herein differed from the Candidatus Borrelia fainii previously reported in Zambia and were closely related to the pathogenic Borrelia sp. VS4 identified in Tanzania. Additionally, Borrelia theileri was recently reported in Zambia. Hence, at least four different Borrelia species occur in Zambia, and the organisms causing relapsing fever there might be more complex than previously thought. We empirically confirmed that real-time PCR with TaqMan minor groove binder probes accurately and simultaneously detected both Old and New World RF. In this manner, they could facilitate quantitative analyses of both types of RF borreliae. Subsequent investigations should endeavor to isolate the aforementioned Borrelia spp. and perform serosurveys on patients with RF.
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Affiliation(s)
- Yongjin Qiu
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- Correspondence: ; Tel.: +81-3-4582-2749
| | - Herman M. Chambaro
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- Virology Unit, Central Veterinary Research Institute, Ministry of Fisheries and Livestock, P.O. Box 33980, Lusaka 10101, Zambia
| | - Kozue Sato
- Department of Bacteriology-I, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku, Tokyo 162-8640, Japan
| | - David Squarre
- FQM Trident Wildlife and Forestry Programs, P.O. Box 230022, Kalumbila 10101, Zambia
- Royal (Dick) School of Veterinary Studies, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH25 9RG, UK
| | - Edgar Simulundu
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
- Macha Research Trust, Macha 10101, Zambia
| | - Masahiro Kajihara
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
| | - Katendi Changula
- Department of Paraclinical Studies, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
| | - Manyando Simbotwe
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
| | - Hayato Harima
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
| | - Joseph Ndebe
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
| | - Ladslav Moonga
- Department of Paraclinical Studies, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
| | - Ryo Nakao
- Laboratory of Parasitology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, North 18 West 9, Kita-ku, Sapporo 060-0818, Japan
| | - Ayato Takada
- Department of Diseases Control, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- One Health Research Center, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
| | - Bernard Mudenda Hang’ombe
- Department of Paraclinical Studies, School of Veterinary Medicine, The University of Zambia, P.O. Box 32379, Lusaka 10101, Zambia
| | - Hirofumi Sawa
- Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- One Health Research Center, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, North 20 West 10, Kita-ku, Sapporo 001-0020, Japan
- Global Virus Network, 725 West Lombard St, Room S413, Baltimore, MD 21201, USA
- Institute for Vaccine Research and Development, Hokkaido University, North 21 West 11, Kita-Ku, Sapporo 001-0021, Japan
| | - Hiroki Kawabata
- Department of Bacteriology-I, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku, Tokyo 162-8640, Japan
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Abera EG, Tukeni KN, Didu GH, Chala TK, Yilma D, Gudina EK. Epistaxis and thrombocytopenia as major presentations of louse borne relapsing fever: Hospital-based study. PLoS One 2022; 17:e0279721. [PMID: 36584095 PMCID: PMC9803200 DOI: 10.1371/journal.pone.0279721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Louse-borne relapsing fever (LBRF) remains a cause of sporadic illness and occasional outbreaks in Ethiopia and other east African countries in overcrowded and unhygienic settings. In this article, we present clinical profiles and treatment outcome of patients treated as confirmed or probable cases of LBRF at Jimma Medical Center (JMC) in southwest Ethiopia. METHODS Patients treated as confirmed or probable cases of LBRF at JMC during a period of May-July 2022 were prospectively followed during their course of hospital stay. All patients were evaluated with blood film for hemoparasites, complete blood count, and liver enzymes on hospital presentation. They were followed with daily clinical evaluation during their hospital stay. RESULT Thirty-six patients were treated as cases of LBRF. All patients except one were from Jimma Main Prison in Jimma Town, Ethiopia. All the patients were male with mean age of 28.7 years (SD = 12.7). The diagnosis of LBRF was confirmed by detection of B. recurrentis in blood film of 14 (38.9%) of the patients; the rest were treated as presumptive case of LBRF. Fever, reported by all patients, and an acute onset epistaxis, 30 (83.3%), were the major reasons for healthcare visits. Twenty-two (61.1%) patients were having thrombocytopenia with a platelet count < 150,000/μL; nine (25%) of which had severe forms (<50,000/μL). All patients were treated with oral doxycycline and discharged with improvement after a mean length of hospital stay of 4.25 days (SD = 0.77), range 2-6 days. Public health emergency was activated within two days of the first cases and helped in delousing all the cases and their contacts. CONCLUSION LBRF remains a public health problem in Ethiopia in settings with poor personal hygiene. Patients with LBRF may present with severe thrombocytopenia and life-threatening bleeding. Early detection and treatment initiation prevents outbreak propagation and improves treatment outcome.
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Affiliation(s)
- Eyob Girma Abera
- Department of Public Health, Jimma University, Jimma, Oromia, Ethiopia
- Clinical Trial Unit, Jimma University, Jimma, Oromia, Ethiopia
- * E-mail:
| | | | | | - Temesgen Kabeta Chala
- Department of Health Policy and Management, Jimma University, Jimma, Oromia, Ethiopia
| | - Daniel Yilma
- Clinical Trial Unit, Jimma University, Jimma, Oromia, Ethiopia
- Department of Internal Medicine, Jimma University, Jimma, Oromia, Ethiopia
| | - Esayas Kebede Gudina
- Clinical Trial Unit, Jimma University, Jimma, Oromia, Ethiopia
- Department of Internal Medicine, Jimma University, Jimma, Oromia, Ethiopia
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Zhang XA, Tian F, Li Y, Zhang XL, Jiang BG, Liu BC, Zhang JT, Tian S, Ding H, Li S, Li H, Fang LQ, Liu W. Molecular detection and identification of relapsing fever Borrelia in ticks and wild small mammals in China. Emerg Microbes Infect 2022; 11:2632-2635. [PMID: 36214427 DOI: 10.1080/22221751.2022.2134054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We identified relapsing fever (RF) Borrelia in 1.45% (145/10426) of the ticks and 1.40% (40/2850) of the wild mammals in a field investigation in China. Three RF Borrelia species, including human-pathogenic Borrelia miyamotoi, Borrelia persica and unclassified Babesia sp. were determined. Main species determined from ticks was B. miyamotoi (44.14%), followed by the unclassified Borrelia sp. (42.76%), and Borrelia theileri (13.10%). In wild mammals, main species found was B. persica (57.50%), followed by the unclassified Borrelia sp. (40.00%), and B. miyamotoi (2.50%). We determined B. theileri and B. persica in China for the first time. The coexistence of RF Borrelia species in one tick species in a given region was observed, with the most frequent coexistence seen for B. miyamotoi and the unclassified Borrelia sp. in Dermacentor silvarum, Haemaphysalis japonica, Haemaphysalis longicornis, and Ixodes persulcatuss respectively. The wide distribution and high variety of RF Borrelia in China pose a potential threat to public health.
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Affiliation(s)
- Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Feng Tian
- Urumqi Customs Port Outpatient Department, Xinjiang International Travel Health Care Center, Urumqi, 830011, P. R. China
| | - Yue Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Xiao-Long Zhang
- Science and Technology Research Center of China Customs (STRC), 100026, Beijing, P. R. China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Bao-Cheng Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Jing-Tao Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Shen Tian
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, P. R. China
| | - Heng Ding
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Shuang Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China.,School of Public Health, Peking University, Beijing, P. R. China
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11
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Röttgerding F, Njeru J, Schlüfter E, Latz A, Mahdavi R, Steinhoff U, Cutler SJ, Besier S, Kempf VAJ, Fingerle V, Kraiczy P. Novel approaches for the serodiagnosis of louse-borne relapsing fever. Front Cell Infect Microbiol 2022; 12:983770. [PMID: 36204641 PMCID: PMC9530196 DOI: 10.3389/fcimb.2022.983770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Louse-borne relapsing fever (LBRF) caused by B. recurrentis is a poverty-related and neglected infectious disease with an endemic focus in the Horn of Africa. Re-emergence of the disease occurred in Europe during the refugee crisis in 2015 and sporadic outbreaks were frequently reported in Eastern Africa where poor settings lack affordable diagnostics. Currently, there are no validated in vitro assays available for the serodiagnosis of LBRF. The aim of this study was to develop novel and reliable immunoassays by investigating clinically suspected and culture-confirmed serum samples from LBRF patients and a broad panel of serum samples from patients with other spirochetal, bacterial, and parasitic diseases. We identified two immunoreactive antigens (complement-inhibiting protein CihC and the glycerophosphodiester phosphodiesterase GlpQ of B. recurrentis) as the most promising target candidates leading to the evaluation of two immunoassays (line immunoblot and ELISA) for IgM and IgG. To optimize the IgM immunoassay, we conducted a bioinformatic approach to localize the relevant immunogenic regions within CihC. By utilizing a N-terminal CihC fragment, the sensitivity and specificity of both immunoassays (CihC and GlpQ) were high (IgM: sensitivity 100%, specificity of 89.9%, IgG: sensitivity 100%, specificity 99.2%). In conclusion, our findings indicate the diagnostic potential of CihC and GlpQ as valuable markers for the serodiagnosis of LBRF even at early time points of infection. Here, we provide strong evidence for the utilization of these immunoassays as reliable tools in clinical practice.
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Affiliation(s)
- Florian Röttgerding
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Goethe-University Frankfurt, Frankfurt, Germany
| | - John Njeru
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Andreas Latz
- NovaTec Immundiagnostica GmbH, Dietzenbach, Germany
| | - Rouzbeh Mahdavi
- Institute for Medical Microbiology and Hygiene, Philipps-University Marburg, Marburg, Germany
| | - Ulrich Steinhoff
- Institute for Medical Microbiology and Hygiene, Philipps-University Marburg, Marburg, Germany
| | - Sally J. Cutler
- School of Health, Sports & Bioscience, University of East London, London, United Kingdom
| | - Silke Besier
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Goethe-University Frankfurt, Frankfurt, Germany
| | - Volkhard A. J. Kempf
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Goethe-University Frankfurt, Frankfurt, Germany
| | - Volker Fingerle
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany
| | - Peter Kraiczy
- Institute of Medical Microbiology and Infection Control, University Hospital of Frankfurt, Goethe-University Frankfurt, Frankfurt, Germany
- *Correspondence: Peter Kraiczy,
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12
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Faccini-Martínez ÁA, Silva-Ramos CR, Santodomingo AM, Ramírez-Hernández A, Costa FB, Labruna MB, Muñoz-Leal S. Historical overview and update on relapsing fever group Borrelia in Latin America. Parasit Vectors 2022; 15:196. [PMID: 35676728 PMCID: PMC9175325 DOI: 10.1186/s13071-022-05289-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/16/2022] [Indexed: 12/04/2022] Open
Abstract
Relapsing fever group Borrelia (RFGB) are motile spirochetes transmitted to mammalian or avian hosts through the bite of hematophagous arthropods, such as soft ticks (Argasidae), hard ticks (Ixodidae) and the human clothing lice. RFGB can infect pets such as dogs and cats, as well as birds, cattle and humans. Borrelia recurrentis, B. anserina and B. theileri are considered to have worldwide distribution, affecting humans, domestic birds and ruminants, respectively. Borrelia spp. associated with soft ticks are transmitted mainly by Ornithodoros ticks and thrive in endemic foci in tropical and subtropical latitudes. Nowadays, human cases of soft tick-borne relapsing fever remain neglected diseases in several countries, and the impact these spirochetes have on the health of wild and domestic animals is largely understudied. Human infection with RFGB is difficult to diagnose, given the lack of distinguishing clinical features (undifferentiated febrile illness). Clinically, soft tick or louse-borne relapsing fever is often confused with other etiologies, such as malaria, typhoid or dengue. In Latin America, during the first half of the twentieth century historical documents elaborated by enlightened physicians were seminal, and resulted in the identification of RFGB and their associated vectors in countries such as Mexico, Panama, Colombia, Venezuela, Peru and Argentina. Almost 80 years later, research on relapsing fever spirochetes is emerging once again in Latin America, with molecular characterizations and isolations of novel RFGB members in Panama, Bolivia, Brazil and Chile. In this review we summarize historical aspects of RFGB in Latin America and provide an update on the current scenario regarding these pathogens in the region. To accomplish this, we conducted an exhaustive search of all the published literature for the region, including old medical theses deposited in libraries of medical academies. RFGB were once common pathogens in Latin America, and although unnoticed for many years, they are currently the focus of interest among the scientific community. A One Health perspective should be adopted to tackle the diseases caused by RFGB, since these spirochetes have never disappeared and the maladies they cause may be confused with etiologies with similar symptoms that prevail in the region.
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Affiliation(s)
- Álvaro A Faccini-Martínez
- Research Institute, Fundación Universitaria de Ciencias de la Salud - FUCS, Bogotá, Colombia.,Servicios y Asesorías en Infectología - SAI, Bogotá, Colombia.,Latin American Group for the Study of Ornithodoros-borne Borrelioses (Grupo Latinoamericano Para el Estudio de Borreliosis Transmitidas Por Ornithodoros [GLEBTO]), Bogotá, Colombia
| | - Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Adriana M Santodomingo
- Department of Animal Science, Faculty of Veterinary Sciences, University of Concepción, Chillán, Ñuble, Chile
| | - Alejandro Ramírez-Hernández
- Latin American Group for the Study of Ornithodoros-borne Borrelioses (Grupo Latinoamericano Para el Estudio de Borreliosis Transmitidas Por Ornithodoros [GLEBTO]), Bogotá, Colombia.,Grupo Parasitología Veterinaria, Departamento de Salud Animal, Facultad de Medicina Veterinaria y de Zootecnia, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Francisco B Costa
- Latin American Group for the Study of Ornithodoros-borne Borrelioses (Grupo Latinoamericano Para el Estudio de Borreliosis Transmitidas Por Ornithodoros [GLEBTO]), Bogotá, Colombia.,Faculdade de Medicina Veterinária, Universidade Estadual Do Maranhão, São Luís, MA, Brazil
| | - Marcelo B Labruna
- Latin American Group for the Study of Ornithodoros-borne Borrelioses (Grupo Latinoamericano Para el Estudio de Borreliosis Transmitidas Por Ornithodoros [GLEBTO]), Bogotá, Colombia.,Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Sebastián Muñoz-Leal
- Latin American Group for the Study of Ornithodoros-borne Borrelioses (Grupo Latinoamericano Para el Estudio de Borreliosis Transmitidas Por Ornithodoros [GLEBTO]), Bogotá, Colombia. .,Department of Animal Science, Faculty of Veterinary Sciences, University of Concepción, Chillán, Ñuble, Chile.
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13
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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.
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14
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Jakab Á, Kahlig P, Kuenzli E, Neumayr A. Tick borne relapsing fever - a systematic review and analysis of the literature. PLoS Negl Trop Dis 2022; 16:e0010212. [PMID: 35171908 PMCID: PMC8887751 DOI: 10.1371/journal.pntd.0010212] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/01/2022] [Accepted: 01/27/2022] [Indexed: 02/07/2023] Open
Abstract
Tick borne relapsing fever (TBRF) is a zoonosis caused by various Borrelia species transmitted to humans by both soft-bodied and (more recently recognized) hard-bodied ticks. In recent years, molecular diagnostic techniques have allowed to extend our knowledge on the global epidemiological picture of this neglected disease. Nevertheless, due to the patchy occurrence of the disease and the lack of large clinical studies, the knowledge on several clinical aspects of the disease remains limited. In order to shed light on some of these aspects, we have systematically reviewed the literature on TBRF and summarized the existing data on epidemiology and clinical 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 TBRF published in English, French, Italian, German, and Hungarian were included. Maps showing the epidemiogeographic mosaic of the different TBRF Borrelia species were compiled and data on clinical aspects of TBRF were analysed. The epidemiogeographic mosaic of TBRF is complex and still continues to evolve. Ticks harbouring TBRF Borrelia have been reported worldwide, with the exception of Antarctica and Australia. Although only molecular diagnostic methods allow for species identification, microscopy remains the diagnostic gold standard in most clinical settings. The most suggestive symptom in TBRF is the eponymous relapsing fever (present in 100% of the cases). Thrombocytopenia is the most suggestive laboratory finding in TBRF. Neurological complications are frequent in TBRF. Treatment is with beta-lactams, tetracyclines or macrolids. The risk of Jarisch-Herxheimer reaction (JHR) appears to be lower in TBRF (19.3%) compared to louse-borne relapsing fever (LBRF) (55.8%). The overall case fatality rate of TBRF (6.5%) and LBRF (4-10.2%) appears to not differ. Unlike LBRF, where perinatal fatalities are primarily attributable to abortion, TBRF-related perinatal fatalities appear to primarily affect newborns.
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Affiliation(s)
- Ákos Jakab
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Pascal Kahlig
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Esther Kuenzli
- 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
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