Rickettsioses in Colombia during the 20th century: A historical review

Rickettsioses are vector-borne zoonotic diseases whose etiological agents are bacteria of the genera Rickettsia and Orientia. In Colombia, literature published on rickettsioses during the 20th century is limited and disperse; to date, there are no detailed publications that compile the affected regions or the involved Rickettsia species in each outbreak. Since early works of Luis Patiño-Camargo, the study of rickettsioses gained major importance with the subsequent description of significant outbreaks in some departments of the country. During the 1940s, many articles were published reporting outbreaks probably caused by Rickettsia rickettsii, Rickettsia typhi, and Rickettsia prowazekii, as well as studies on their diagnosis, vaccination, and prophylaxis. One of the most notorious works was published by Patiño-Camargo where he named the R. rickettsii rickettsiosis as "Tobia fever". However, in the subsequent decades, these entities entered a prolonged period of neglected research and surveillance, and just gained importance until the 21st century, when new fatal cases began to be reported in the country; thus, many questions remained unanswered during this overlooked period. The present work reviewed online databases, repositories, and libraries to compile literature related to rickettsioses in Colombia published during the 20th century. Gathered data show that typhus group rickettsioses (including infections by R. typhi and R. prowazekii) were broadly distributed in departments from the Andean and Caribbean regions, and that spotted fever group rickettsioses cases (including infections by R. rickettsii) were registered in other locations different from Tobia (Cundinamarca), like Atlántico, Bolivar, and Santander departments. These findings contribute to the knowledge of these diseases, their historical distribution, public health burden, and set new horizons for rickettsioses research in different Colombian locations.

Frequency of antibodies and seroconversion against Rickettsia spp in patients consulting health institutions in the department of Caldas, Colombia, 2016-2019

Introduction: Rickettsioses are zoonotic diseases transmitted by arthropods acting as vectors and reservoirs. Disease symptoms are nonspecific and, therefore, their clinical diagnosis is difficult. Indirect immunofluorescence (IFA) is the gold standard assay for diagnosis. The interest for conducting studies on these pathologies has resurfaced in Colombia since 2001; besides, previous studies have evidenced cases of rickettsiosis in the north of the department of Caldas. Objective: To establish the frequency of antibodies and seroconversion against Rickettsia spp. In patients consulting health institutions in Caldas, Colombia, from 2016 to 2019. Materials and methods: We conducted a quantitative, observational, and descriptive study on a non-probabilistic sample of 175 patients with symptoms compatible with rickettsiosis who consulted in different municipalities of Caldas, Colombia; IFA was performed to detect antibodies in the acute and convalescent phases against Rickettsia rickettsii, Rickettsia typhi, and Rickettsia felis. Results: The average age of the patients was 31 years. The municipalities with the highest proportion of seropositive cases were Belalcázar, Chinchiná, Filadelfia, La Dorada, La Merced, and Manizales; 66% of patients owned pets and 12% reported arthropod bites. The most frequent signs and symptoms were headache (69.7%), arthromyalgia (60%), and fever (58.2%). IgG seroprevalence was 60% for R. rickettsii, 47.9% for R. typhi, and, and 24% for R. felis. Eight patients presented seroconversion. Conclusion: We found evidence of the circulation of Rickettsia species from the spotted fever group and the typhus group associated with human cases in Caldas.