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Po TL, Huang CH, Lin CH, Hung HF. Diagnosis of a Rare Rickettsia felis Infection Complicated with Unusual Pericardial Effusion and Cardiac Tamponade Using an mNGS Test. Case Rep Infect Dis 2024; 2024:8877876. [PMID: 39165786 PMCID: PMC11335410 DOI: 10.1155/2024/8877876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/18/2024] [Accepted: 07/31/2024] [Indexed: 08/22/2024] Open
Abstract
The occurrence of sporadic rickettsial infections has been consistently undervalued and overlooked, primarily owing to a limited emphasis on routine examinations for rickettsioses in clinical practice. At present, the immunofluorescence assay is the prevailing diagnostic method for suspected rickettsioses that enables the detection of specific antibodies against rickettsia in human serum. Herein, we present an exceptional instance of rickettsial infection that was characterized by a rare manifestation of extensive pericardial effusion leading to dyspnea and cardiac tamponade. A diagnosis of chronic fibrosing pericarditis was established based on pericardium tissue obtained through pericardiotomy, and a conclusive metagenomic next-generation sequencing test confirmed the presence of Rickettsia felis infection. The cat flea, scientifically known as Ctenocephalides felis, is the predominant carrier of R. felis. An escalating incidence of human R. felis infections has raised concerns, particularly in light of the burgeoning population of domesticated animals in many contemporary societies.
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Affiliation(s)
- Tien-Lung Po
- Division of CardiologyDepartment of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chien-Hsien Huang
- Department of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Division of Infectious DiseaseDepartment of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- College of MedicineFu Jen Catholic University, Hsinchuang, Taipei, Taiwan
| | - Chia-Hsun Lin
- Division of Cardiac SurgeryDepartment of SurgeryShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of SurgeryShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Huei-Fong Hung
- Division of CardiologyDepartment of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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Wang X, Mathias DK. Surveillance of ticks (Acari: Ixodidae) and tick-borne pathogens in Eastern Central Alabama. JOURNAL OF MEDICAL ENTOMOLOGY 2024:tjae096. [PMID: 39102892 DOI: 10.1093/jme/tjae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/28/2024] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
Similar to other states in the southeastern United States, human cases of tick-borne diseases in Alabama have risen steadily over the last 2 decades. Nevertheless, limited data have been published on ticks or tick-borne pathogen (TBP) distributions since the 1990s. To better understand the risk of tick and TBP exposure in eastern central Alabama, ticks were sampled repeatedly across 8 sites associated with recreational use during May and June of 2015 to characterize tick density and diversity. Although habitats were similar across sites, tick density varied among locations. Seven species were collected, but 97.7% of 1,310 samples were the lone star tick, Amblyomma americanum (L.), the primary vector of ehrlichial agents and the tick species most commonly linked to alpha-gal syndrome and southern tick-associated rash illness. To investigate pathogen prevalence among sites, we tested A. americanum by a multiplex qPCR assay for 5 bacterial species, including 3 Ehrlichia spp. and 2 Rickettsia spp. None of the specimens tested positive for Panola Mountain Ehrlichia or Rickettsia parkeri. However, causative agents of human ehrlichiosis, Ehrlichia chaffeensis and Ehrlichia ewingii, occurred at half of the locations with, respectively, 0.27% and 0.45% of A. americanum infected on average. In contrast, Rickettsia amblyommatis, a tick endosymbiont suspected to be nonpathogenic, was found in 54.5% of the 1119 A. americanum tested. Despite low infection rates of Ehrlichia spp. in A. americanum, high encounter rates with this species in recreational deciduous woodlands suggest a moderate risk of tick bite and a low-to-moderate risk of TBP exposure in late spring.
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Affiliation(s)
- Xiaodi Wang
- Department of Entomology and Plant Pathology, 301 Funchess Hall, Auburn University, AL 36849, USA
- Department of Biology, University of Washington, Seattle, WA 98195, USA
| | - Derrick K Mathias
- Department of Entomology and Plant Pathology, 301 Funchess Hall, Auburn University, AL 36849, USA
- Florida Medical Entomology Laboratory, Department of Entomology and Nematology, University of Florida, Vero Beach, FL 32962, USA
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Chisu V, Tanda A, Sechi S, Pinna Parpaglia ML, Masu G, Loi F, Masala G. Clinical Study and Serological Diagnosis of Vector-Borne Pathogens in Sardinian Dogs. Vet Sci 2024; 11:313. [PMID: 39057997 PMCID: PMC11281559 DOI: 10.3390/vetsci11070313] [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: 06/03/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Canine vector-borne diseases (CVBDs) comprise a group of infectious diseases caused by a wide range of pathogens transmitted by arthropod vectors. Clinical signs commonly involve symptoms such as fever, anorexia, weight loss, blood disorders, hepatosplenomegaly, and others that can lead to death in dogs with comorbidities. Some pathogens responsible for CVBDs constitute a serious threat to human health due to their zoonotic transmission. This study aimed to determine the prevalence of zoonotic vector-borne diseases (Rickettsia rickettsii, Anaplasma phagocytophilum, Ehrlichia canis, Bartonella henselae, and Leishmania infantum) in domestic Sardinian dogs with and without clinical signs of these pathogens. Blood serum samples were collected from 142 dogs and examined through serological analysis. Clinical signs suggestive of these pathogens were also evaluated. The results obtained showed that 33 (33/140; 23.6%), 22 (22/134; 16.4%), 14 (14/142; 9.9%), 20 (20/66; 30.3%), and 26 (26/108; 24.1%) dogs were seropositive for Rickettsia sp., Anaplasma sp., Ehrlichia sp., Bartonella sp., and Leishmania sp. antibodies, respectively. Among these dogs, 12 dogs presented with at least one clinical sign (8.5%), while 18 (12.7%) showed more than two symptoms at the same time. Furthermore, among the asymptomatic dogs (93/142; 65.5%), 13% (n = 12) tested positive for A. phagocytophilum, 12% (n = 11) tested positive for B. henselae, 9% (n = 8) tested positive for E. canis, 12% (n = 11) tested positive for L. infantum, and 19% (n = 18) tested positive for R. rickettsii. This survey represents the first study assessing different canine vector-borne pathogens in dogs from North Sardinia. Since the pathogens detected here represent emerging zoonotic diseases, these results highlight the need to undertake further studies to increase the knowledge of these under-reported vector-borne pathogens in Sardinia.
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Affiliation(s)
- Valentina Chisu
- Istituto Zooprofilattico Sperimentale “G. Pegreffi” della Sardegna, Via Duca degli Abruzzi 8, 07100 Sassari, Italy; (V.C.); (A.T.); (G.M.); (G.M.)
| | - Antonio Tanda
- Istituto Zooprofilattico Sperimentale “G. Pegreffi” della Sardegna, Via Duca degli Abruzzi 8, 07100 Sassari, Italy; (V.C.); (A.T.); (G.M.); (G.M.)
| | - Sara Sechi
- Teaching Veterinary Hospital, University of Sassari, Via Vienna 2, 07100 Sassari, Italy; (S.S.); (M.L.P.P.)
| | | | - Gabriella Masu
- Istituto Zooprofilattico Sperimentale “G. Pegreffi” della Sardegna, Via Duca degli Abruzzi 8, 07100 Sassari, Italy; (V.C.); (A.T.); (G.M.); (G.M.)
| | - Federica Loi
- Osservatorio Epidemiologico Veterinario Regionale della Sardegna, Istituto Zooprofilattico Sperimentale della Sardegna, 07100 Sassari, Italy
| | - Giovanna Masala
- Istituto Zooprofilattico Sperimentale “G. Pegreffi” della Sardegna, Via Duca degli Abruzzi 8, 07100 Sassari, Italy; (V.C.); (A.T.); (G.M.); (G.M.)
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Silva KA, do Prado VB, Silva RR, Rocha MVP, de Oliveira RAR, Falcão TDJR, Serpa CC, Rocha MA, Pereira SP, Silva LS, Machado JM, Machado-de-Ávila RA, Fujiwara RT, Chávez-Fumagalli MA, Coelho EAF, Giunchetti RC, Campos-da-Paz M, Gonçalves AAM, Galdino AS. A Mini-Review of Diagnostic Methods for the Antigen and Antibody Detection of Rocky Mountain and Brazilian Spotted Fever. Biomedicines 2024; 12:1501. [PMID: 39062074 PMCID: PMC11274458 DOI: 10.3390/biomedicines12071501] [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: 04/27/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 07/28/2024] Open
Abstract
Rocky Mountain or Brazilian spotted fever, caused by Rickettsia rickettsii, is a fulminant, seasonal, and neglected disease that occurs in focal points of North America and South America. Its rapid detection is essential for the better prognosis and survival rate of infected individuals. However, disease diagnosis still faces challenges as the accuracy of many of the available laboratory tests fluctuates. This review aimed to analyze methods for antibody or antigen detection, their gaps, and their evolution over time. A search was conducted to find all studies in the Pubmed database that described the antibody or antigen detection of R. rickettsii infections. Initially, a total of 403 articles were screened. Of these articles, only 17 fulfilled the pre-established inclusion criteria and were selected. Among the different methods applied, the IFA technique was the one most frequently found in the studies. However, it presented varied results such as a low specificity when using the indirect method. Other techniques, such as ELISA and immunohistochemistry, were also found, although in smaller numbers and with their own limitations. Although some studies showed promising results, there is a pressing need to find new techniques to develop a rapid and effective diagnosis of R. rickettssi infection.
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Affiliation(s)
- Kamila Alves Silva
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Vanesa Borges do Prado
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Rafael Rodrigues Silva
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Marcelo van Petten Rocha
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Rafael Almeida Ribeiro de Oliveira
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Tarumim de Jesus Rodrigues Falcão
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Clara Cristina Serpa
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Marina Andrade Rocha
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Sabrina Paula Pereira
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Líria Souza Silva
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Juliana Martins Machado
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Ricardo Andrez Machado-de-Ávila
- Laboratório de Fisiopatologia Experimental, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Santa Catarina, Brazil;
| | - Ricardo Toshio Fujiwara
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil;
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru;
| | - Eduardo Antônio Ferraz Coelho
- Postgraduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil;
| | - Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, National Institute of Science and Technology in Tropical Diseases (INCT-DT), Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil;
| | - Mariana Campos-da-Paz
- Laboratório de Bioativos e Nanobiotecnologia, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil;
| | - Ana Alice Maia Gonçalves
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Alexsandro Sobreira Galdino
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
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Rattanakomol P, Khongwichit S, Poovorawan Y. Flea-Borne Rickettsioses and Scrub Typhus in Patients with Suspected Arbovirus Infection in Bangkok, Thailand. Vector Borne Zoonotic Dis 2024. [PMID: 38946645 DOI: 10.1089/vbz.2024.0030] [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: 07/02/2024] Open
Abstract
Background: In urban Thailand, arboviral infections dominate diagnoses of acute undifferentiated fevers (AUFs) owing to their well-defined epidemiology and characteristic clinical presentations. However, rickettsial diseases, also endemic in this setting, remain under-recognized owing to challenges in early detection. Objective: This study aimed to identify potential rickettsial infections among patients with AUF in Bangkok and vicinity utilizing leftover nucleic acid extracted from serum samples from patients initially suspected of but negative for arbovirus infections. Materials and Methods: A total of 609 nucleic acid samples were screened for rickettsial bacteria using real-time PCR, targeting the 17-kDa common antigen gene of Rickettsia spp. and the 47-kDa gene of Orientia tsutsugamushi. Results: Nine samples were positive for Rickettsia spp. and two were positive for O. tsutsugamushi. DNA sequence and phylogenetic analyses based on partial 17-kDa antigen and citrate synthase (gltA) genes identified the Rickettsia-positive samples as R. typhi in eight cases and R. felis in one case. Analysis of the 56-kDa type-specific antigen gene identified the two O. tsutsugamushi isolates as Gilliam-related genotypes. Although rickettsial diseases typically present with mild symptoms, two patients with R. typhi infection (murine typhus) developed respiratory distress syndrome, highlighting the potential for rare but serious complications. Conclusion: This study underscores the critical importance of differential diagnosis and prompt, effective intervention to prevent complications in suspected cases.
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Affiliation(s)
- Patthaya Rattanakomol
- Department of Pediatrics, Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sarawut Khongwichit
- Department of Pediatrics, Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yong Poovorawan
- Department of Pediatrics, Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Pustijanac E, Buršić M, Millotti G, Paliaga P, Iveša N, Cvek M. Tick-Borne Bacterial Diseases in Europe: Threats to public health. Eur J Clin Microbiol Infect Dis 2024; 43:1261-1295. [PMID: 38676855 DOI: 10.1007/s10096-024-04836-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Tick-borne diseases, caused by bacterial pathogens, pose a growing threat to public health in Europe. This paper provides an overview of the historical context of the discovery of the most impactful pathogens transmitted by ticks, including Borrelia burgdorferi sensu lato, Rickettsia spp., Anaplasma spp., Francisella spp., Ehrlichia spp., and Neoehrlichia mikurensis. Understanding the historical context of their discovery provides insight into the evolution of our understanding of these pathogens. METHODS AND RESULTS Systematic investigation of the prevalence and transmission dynamics of these bacterial pathogens is provided, highlighting the intricate relationships among ticks, host organisms, and the environment. Epidemiology is explored, providing an in-depth analysis of clinical features associated with infections. Diagnostic methodologies undergo critical examination, with a spotlight on technological advancements that enhance detection capabilities. Additionally, the paper discusses available treatment options, addressing existing therapeutic strategies and considering future aspects. CONCLUSIONS By integrating various pieces of information on these bacterial species, the paper aims to provide a comprehensive resource for researchers and healthcare professionals addressing the impact of bacterial tick-borne diseases in Europe. This review underscores the importance of understanding the complex details influencing bacterial prevalence and transmission dynamics to better combat these emerging public health threats.
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Affiliation(s)
- Emina Pustijanac
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia.
| | - Moira Buršić
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Gioconda Millotti
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Paolo Paliaga
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Neven Iveša
- Faculty of Natural Sciences, Juraj Dobrila University of Pula, Zagrebačka 30, 52100, Pula, Croatia
| | - Maja Cvek
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000, Rijeka, Croatia
- Teaching Institute of Public Health of the Region of Istria, Nazorova 23, 52100, Pula, Croatia
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Gual-Gonzalez L, Cantillo-Barraza O, Torres ME, Quintero-Vélez JC, Medina M, Self SCW, Nolan MS. Antibody Seroprevalence to Spotted Fever Group Rickettsiae in Miraflores, Colombia: A Cross-Sectional Study in Humans and Dogs. Am J Trop Med Hyg 2024; 110:1245-1252. [PMID: 38593790 PMCID: PMC11154037 DOI: 10.4269/ajtmh.23-0593] [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: 08/28/2023] [Accepted: 01/25/2024] [Indexed: 04/11/2024] Open
Abstract
Tick-borne disease burdens are increasing globally, impacting mostly rural and vulnerable communities. Among the most important emerging tick-borne pathogens are the Rickettsia species within the spotted fever group (SFGR) because of their genetic diversity and high lethality rate. Colombia is highly affected by SFGR despite not being reportable diseases; thus, research and clinical management are neglected. Although some departments have demonstrated high seroprevalence rates, in others, such as Boyacá Department, seroprevalence is unknown. Rickettsioses have not been described in Boyacá since 1943, and conversations with local physicians raised suspicions of recent undiagnosed disease compatible with rickettsiosis in some rural areas of the department, warranting epidemiological investigation. Using biobanked human and canine samples from a previous 2021 vector-borne disease study in Miraflores municipality, Boyacá, we had an opportunity to unearth SFGR's exposure in the region. Samples were evaluated using IgG indirect fluorescent assays against SFGR and complemented by survey questionnaires evaluating associated factors. Findings yielded first-time SFGR serological evidence in Boyacá with a 26.5% seroprevalence among dogs and a 20.4% among humans. Human and dog seroprevalences were positively associated, suggesting the presence of domestic transmission. Owning a greater number of domestic animals (prevalence ratio adjusted for all measured factors [aPR], 1.52) and living near crop fields (aPR, 7.77) were associated with an increased likelihood of household seropositivity. Our findings are consistent with the literature in Colombia, uncovering a suspected region where the disease is endemic. Future studies are warranted to continue defining high-risk areas to determine public health intervention plans.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - Omar Cantillo-Barraza
- Grupo Biología y Control Enfermedades Infecciosas, Universidad de Antioquia, Medellín, Colombia
| | - Myriam E. Torres
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | | | - Manuel Medina
- Unidad de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Stella C. W. Self
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - Melissa S. Nolan
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
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Lehner L, Thurau S, Pusl K, Tiedt S, Schöberl F, Forbrig R, Höglinger G, Strupp M. Meningoencephalitis and retinal vasculitis due to rickettsial infection. J Neurol 2024; 271:1469-1472. [PMID: 38001378 PMCID: PMC10896935 DOI: 10.1007/s00415-023-12097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023]
Affiliation(s)
- Louisa Lehner
- Department of Neurology, LMU University Hospital, Ludwig Maximilians University Munich Marchioninistr, 15, 81377, Munich, Germany.
| | - Stephan Thurau
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Konstantin Pusl
- Department of Neurology, LMU University Hospital, Ludwig Maximilians University Munich Marchioninistr, 15, 81377, Munich, Germany
| | - Steffen Tiedt
- Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich, Munich, Germany
| | - Florian Schöberl
- Department of Neurology, LMU University Hospital, Ludwig Maximilians University Munich Marchioninistr, 15, 81377, Munich, Germany
| | - Robert Forbrig
- Institute of Neuroradiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Günter Höglinger
- Department of Neurology, LMU University Hospital, Ludwig Maximilians University Munich Marchioninistr, 15, 81377, Munich, Germany
| | - Michael Strupp
- Department of Neurology, LMU University Hospital, Ludwig Maximilians University Munich Marchioninistr, 15, 81377, Munich, Germany
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9
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Eikeland R, Henningsson AJ, Lebech AM, Kerlefsen Y, Mavin S, Vrijlandt A, Hovius JW, Lernout T, Lim C, Dobler G, Fingerle V, Gynthersen RM, Lindgren PE, Reiso H. Tick-borne diseases in the North Sea region-A comprehensive overview and recommendations for diagnostics and treatment. Ticks Tick Borne Dis 2024; 15:102306. [PMID: 38183851 DOI: 10.1016/j.ttbdis.2023.102306] [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: 08/14/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/08/2024]
Abstract
As part of the NorthTick project, co-funded by the European Union through the European Regional Development Fund and the North Sea Region Programme, specialists in the field of tick-borne diseases from seven North Sea countries co-operated with patient organisations and governmental health care institutions to provide this comprehensive overview of diagnostics and treatment recommendations in the region for Lyme borreliosis, Borrelia miyamotoi infection, tick-borne encephalitis, human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis and babesiosis. The main conclusion is that the recommendations in these northern countries are essentially the same, with very few differences. This overview presents the current diagnostics and provides useful clinical guidance.
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Affiliation(s)
- Randi Eikeland
- Norwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital, Kristiansand, Norway; Faculty of Health and Sport science, University of Agder, Grimstad, Norway.
| | - Anna J Henningsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; National Reference Laboratory for Borreliosis and Other Tick-Borne Bacteria, Clinical Microbiology, Laboratory Medicine, Region Jönköping County, Sweden
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Yvonne Kerlefsen
- Norwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital, Kristiansand, Norway
| | - Sally Mavin
- Scottish Lyme Disease and Tick-borne Infections Reference Laboratory, Raigmore Hospital, Inverness, UK
| | - Amber Vrijlandt
- Amsterdam UMC, location AMC, Department of Internal Medicine, Section of Infectious Diseases, Amsterdam UMC Multidisciplinary Lyme borreliosis Center, Amsterdam, The Netherlands
| | - Joppe W Hovius
- Amsterdam UMC, location AMC, Department of Internal Medicine, Section of Infectious Diseases, Amsterdam UMC Multidisciplinary Lyme borreliosis Center, Amsterdam, The Netherlands
| | - Tinne Lernout
- Sciensano Epidemiology of infectious diseases, Brussels, Belgium
| | - Chin Lim
- Scottish Lyme Disease and Tick-borne Infections Reference Laboratory, Raigmore Hospital, Inverness, UK
| | - Gerhard Dobler
- Nationales Konsiliarlabor FSME, Institut für Mikrobiologie der Bundeswehr, Munich, Germany
| | - Volker Fingerle
- German National Reference Center for Borreliae, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Rosa M Gynthersen
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Harald Reiso
- Norwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital, Kristiansand, Norway
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10
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Polsomboon Nelson S, Ergunay K, Bourke BP, Reinbold-Wasson DD, Caicedo-Quiroga L, Kirkitadze G, Chunashvili T, Tucker CL, Linton YM. Nanopore-based metagenomics reveal a new Rickettsia in Europe. Ticks Tick Borne Dis 2024; 15:102305. [PMID: 38150911 DOI: 10.1016/j.ttbdis.2023.102305] [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: 04/18/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 12/29/2023]
Abstract
Accurate identification of tick-borne bacteria, including those associated with rickettsioses, pose significant challenges due to the polymicrobial and polyvectoral nature of the infections. We aimed to carry out a comparative evaluation of a non-targeted metagenomic approach by nanopore sequencing (NS) and commonly used PCR assays amplifying Rickettsia genes in field-collected ticks. The study included a total of 310 ticks, originating from Poland (44.2 %) and Bulgaria (55.8 %). Samples comprised 7 species, the majority of which were Ixodes ricinus (62.9 %), followed by Dermacentor reticulatus (21.2 %). Screening was carried out in 55 pools, using total nucleic acid extractions from individual ticks. NS and ompA/gltA PCRs identified Rickettsia species in 47.3 % and 54.5 % of the pools, respectively. The most frequently detected species were Rickettsia asiatica (27.2 %) and Rickettsia raoultii (21.8 %), followed by Rickettsia monacensis (3.6 %), Rickettsia helvetica (1.8 %), Rickettsia massiliae (1.8 %) and Rickettsia tillamookensis (1.8 %). Phylogeny construction on mutS, uvrD, argS and virB4 sequences and a follow-up deep sequencing further supported R. asiatica identification, documented in Europe for the first time. NS further enabled detection of Anaplasma phagocytophilum (9.1 %), Coxiella burnetii (5.4 %) and Neoehrlichia mikurensis (1.8 %), as well as various endosymbionts of Rickettsia and Coxiella. Co-detection of multiple rickettsial and non-rickettsial bacteria were observed in 16.4 % of the pools with chromosome and plasmid-based contigs. In conclusion, non-targeted metagenomic sequencing was documented as a robust strategy capable of providing a broader view of the tick-borne bacterial pathogen spectrum.
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Affiliation(s)
- Suppaluck Polsomboon Nelson
- Walter Reed Biosystematics Unit (WRBU), Smithsonian Institution, Museum Support Center, Suitland, MD, USA; Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, USA; Smithsonian Institution, Department of Entomology, National Museum of Natural History (NMNH), Washington, DC, USA
| | - Koray Ergunay
- Walter Reed Biosystematics Unit (WRBU), Smithsonian Institution, Museum Support Center, Suitland, MD, USA; Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, USA; Smithsonian Institution, Department of Entomology, National Museum of Natural History (NMNH), Washington, DC, USA; Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Brian P Bourke
- Walter Reed Biosystematics Unit (WRBU), Smithsonian Institution, Museum Support Center, Suitland, MD, USA; Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, USA; Smithsonian Institution, Department of Entomology, National Museum of Natural History (NMNH), Washington, DC, USA
| | | | - Laura Caicedo-Quiroga
- Walter Reed Biosystematics Unit (WRBU), Smithsonian Institution, Museum Support Center, Suitland, MD, USA; Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, USA; Smithsonian Institution, Department of Entomology, National Museum of Natural History (NMNH), Washington, DC, USA
| | - Giorgi Kirkitadze
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Tbilisi, Georgia
| | - Tamar Chunashvili
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Tbilisi, Georgia
| | - Cynthia L Tucker
- Walter Reed Biosystematics Unit (WRBU), Smithsonian Institution, Museum Support Center, Suitland, MD, USA; Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, USA
| | - Yvonne-Marie Linton
- Walter Reed Biosystematics Unit (WRBU), Smithsonian Institution, Museum Support Center, Suitland, MD, USA; Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, USA; Smithsonian Institution, Department of Entomology, National Museum of Natural History (NMNH), Washington, DC, USA
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11
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Blacksell SD, Le KK, Rungrojn A, Wongsantichon J, Stenos J, Graves SR, Day NPJ. Gaps and inconsistencies in the current knowledge and implementation of biosafety and biosecurity practices for rickettsial pathogens. BMC Infect Dis 2024; 24:268. [PMID: 38424500 PMCID: PMC10905923 DOI: 10.1186/s12879-024-09151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Rickettsia spp. and Orientia spp. are the causes of neglected infections that can lead to severe febrile and systemic illnesses in humans. Implementing proper biosafety practices when handling these pathogens is crucial to ensure a safe and sustainable work environment. It is essential to assess the current knowledge and identify any potential gaps to develop effective measures that minimise the risk of exposure to these pathogens. By doing so, we can establish a comprehensive framework that promotes safety, mitigates hazards, and safeguards the well-being of personnel and the surrounding community. METHODS AND RESULTS This review aimed to synthesise and determine the evidence base for biosafety precautions for Rickettsia spp. and Orientia spp. pathogens. Enhancing our understanding of the relative infectious risk associated with different strains of Rickettsia and Orientia spp. requires identifying the infectious dose of these pathogens that can cause human disease. The application of risk groups for Rickettsia and Orientia spp. is inconsistent across jurisdictions. There is also incomplete evidence regarding decontamination methods for these pathogens. With regards to Orientia spp. most of the available information is derived from experiments conducted with Rickettsia spp. CONCLUSIONS Rickettsia and Orientia spp. are neglected diseases, as demonstrated by the lack of evidence-based and specific biosafety information about these pathogens. In the case of Orientia spp., most of the available information is derived from Rickettsia spp., which may not be appropriate and overstate the risks of working with this pathogen. The advent of effective antibiotic therapy and a better understanding of the true hazards and risks associated with pathogen manipulation should inform decisions, allowing a sustainable and safe work environment.
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Affiliation(s)
- Stuart D Blacksell
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, 10400, Bangkok, Thailand.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Department of Medicine Research Building, University of Oxford, Nuffield, Oxford, UK.
| | - Khanh Kim Le
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, 10400, Bangkok, Thailand
| | - Artharee Rungrojn
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, 10400, Bangkok, Thailand
| | - Jantana Wongsantichon
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, 10400, Bangkok, Thailand
| | - John Stenos
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC, Australia
| | - Stephen R Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC, Australia
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Research Medicine Unit, Faculty of Tropical Medicine, Mahidol University, 10400, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Department of Medicine Research Building, University of Oxford, Nuffield, Oxford, UK
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12
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Dantas-Torres F. Diagnosis of spotted fever group rickettsioses in new transmission areas. Travel Med Infect Dis 2024; 57:102680. [PMID: 38113998 DOI: 10.1016/j.tmaid.2023.102680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Filipe Dantas-Torres
- Laboratory of Immunoparasitology, Department of Immunology, Aggeu Magalhães Institute, Fiocruz, Recife, PE, Brazil.
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13
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Pradeep J, Anitharaj V, Sangeetha B. Human rickettsial infections in India - A review. J Vector Borne Dis 2024; 61:5-22. [PMID: 38648402 DOI: 10.4103/0972-9062.392255] [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: 06/29/2023] [Accepted: 10/27/2023] [Indexed: 04/25/2024] Open
Abstract
Rickettsial infections are emerging and/or re-emerging disease that poses a serious global threat to humans and animals. Transmission to humans and animals is through the bite of the ectoparasites including ticks, fleas and chigger mites. Most of the rickettsial diseases are endemic in India, but underdiagnosed. This review is aimed at analyzing the prevalence of rickettsiosis in India and the advancement of rickettsial diagnosis. We have conducted a systematic review on the prevalence of rickettsial disease in India ranging from 1.3% to 46.6% for spotted fever, 2.4% to 77.8% for scrub typhus and 1% to 46.4% for Q fever, based on the literature published with the evidence of isolation, serological, and molecular diagnostics. Search engines Medline/PubMed, Science Direct, ProQuest, and EBSCO were used to retrieve the articles from electronic databases by using appropriate keywords to track the emergence of these rickettsial diseases in India for the period of 1865 to till date. We retrieved 153 published rickettsial articles on hospital-based studies from India that were purely made on the basis of prevalence and the laboratory parameters viz., Weil-Felix test (WF) and Rapid Immunochromatographic tests (RICT) with reference to the gold standard IFA and ELISA. More epidemiological studies are required for epidemic typhus to know the exact prevalence status of this louse-borne rickettsiosis in India. Currently, there is no confirmed specific inflammatory marker for rickettsial diseases. Moreover, serological cross-reactivity is an important aspect, and it should be investigated in endemic areas, there is also a need to include molecular diagnostic techniques for further confirmation in healthcare settings.
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Affiliation(s)
- J Pradeep
- Department of Microbiology, Mahatma Gandhi Medical Advanced Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Puducherry, India
| | - V Anitharaj
- Department of Microbiology, Panimalar Medical College and Hospital, Chennai, India
| | - B Sangeetha
- Block Technology Manager, Department of Agriculture, Government of Puducherry, Karaikal, Puducherry, India
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14
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Silva-Ramos CR, Gil-Mora J, Serna-Rivera CC, Martínez Díaz HC, Restrepo-López N, Agudelo-Flórez P, Arboleda M, Díaz FJ, Faccini-Martínez ÁA, Hidalgo M, Melby PC, Aguilar PV, Cabada MM, Tobón-Castaño A, Rodas JD. Etiological characterization of acute undifferentiated febrile illness in Apartadó and Villeta municipalities, Colombia, during COVID-19 pandemic. LE INFEZIONI IN MEDICINA 2023; 31:517-532. [PMID: 38075419 PMCID: PMC10705856 DOI: 10.53854/liim-3104-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/02/2023] [Indexed: 03/28/2024]
Abstract
Background Acute undifferentiated febrile illness (AUFI) is one of the leading causes of illness in tropical regions. Although malaria is the most important cause, other pathogens such as Dengue (DENV), Leptospira and recently, Coronavirus Disease 2019 (COVID-19) have gained importance. In Colombia, few studies aimed to identify the etiology of AUFI. Most of them performed in Apartadó and Villeta municipalities, identifying the active circulation of several pathogens. Thus, we conducted a cross-sectional study in these municipalities to characterize the etiologies of AUFI during COVID-19 pandemic. Methods An active surveillance was conducted between September and December 2021 in local hospitals of Apartadó and Villeta municipalities. Febrile patients were enrolled after voluntarily agreeing to participate in the study. Ten different etiologies were evaluated through direct, serological, molecular and rapid diagnostic methods. Results In Apartadó a confirmed etiology was found in 60% of subjects, DENV (25%) being the most frequent, followed by leptospirosis (16.7%), malaria (10%), COVID-19 (8.3%), spotted fever group (SFG) rickettsiosis (6.7%) and Chikungunya (1.7%). In Villeta, a specific etiology was confirmed in 55.4% of patients, of which SFG rickettsiosis (39.3%) was the most frequent, followed by leptospirosis (21.4%), DENV (3.6%) and malaria (1.8%). No cases due to Mayaro, Yellow Fever, Oropouche and Venezuelan Equine Encephalitis viruses were detected. Conclusion We confirm the relevance of dengue fever, leptospirosis, SFG rickettsiosis, COVID-19 and malaria as causes of AUFI in the municipality of Apartadó, and highlight the great importance of SFG rickettsiosis as the main cause of AUFI in the municipality of Villeta.
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Affiliation(s)
- Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juliana Gil-Mora
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Cristian C. Serna-Rivera
- Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín, Colombia
| | - Heidy-C. Martínez Díaz
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Nicaela Restrepo-López
- Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín, Colombia
| | - Piedad Agudelo-Flórez
- Grupo de Investigación en Ciencias Básicas, Escuela de Graduados, Universidad CES, Medellín, Colombia
| | - Margarita Arboleda
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, Colombia
| | - Francisco J. Díaz
- Grupo de Inmunovirología, Universidad de Antioquia, Medellin,Colombia
| | - Álvaro A. Faccini-Martínez
- Servicio de Infectología, Hospital Militar Central, Bogotá, Colombia
- Servicios y Asesorías en Infectología - SAI, Bogotá, Colombia
- Facultad de Medicina, Universidad Militar Nueva Granada, Bogotà, Colombia
| | - Marylin Hidalgo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Peter C. Melby
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA
| | - Patricia V. Aguilar
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Miguel M. Cabada
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas, USA
| | | | - Juan David Rodas
- Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín, Colombia
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Sanchez-Vicente S, Tokarz R. Tick-Borne Co-Infections: Challenges in Molecular and Serologic Diagnoses. Pathogens 2023; 12:1371. [PMID: 38003835 PMCID: PMC10674443 DOI: 10.3390/pathogens12111371] [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: 11/01/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023] Open
Abstract
Co-infections are a poorly understood aspect of tick-borne diseases. In the United States alone, nineteen different tick-borne pathogens have been identified. The majority of these agents are transmitted by only two tick species, Ixodes scapularis and Amblyomma americanum. Surveillance studies have demonstrated the presence of multiple pathogens in individual ticks suggesting a risk of polymicrobial transmission to humans. However, relatively few studies have explored this relationship and its impact on human disease. One of the key factors for this deficiency are the intrinsic limitations associated with molecular and serologic assays employed for the diagnosis of tick-borne diseases. Limitations in the sensitivity, specificity and most importantly, the capacity for inclusion of multiple agents within a single assay represent the primary challenges for the accurate detection of polymicrobial tick-borne infections. This review will focus on outlining these limitations and discuss potential solutions for the enhanced diagnosis of tick-borne co-infections.
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Affiliation(s)
- Santiago Sanchez-Vicente
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Rafal Tokarz
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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16
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Cambrea SC, Badiu D, Ionescu C, Penciu R, Pazara L, Mihai CM, Cambrea MA, Mihai L. Boutonneuse Fever in Southeastern Romania. Microorganisms 2023; 11:2734. [PMID: 38004746 PMCID: PMC10673018 DOI: 10.3390/microorganisms11112734] [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: 09/21/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Boutonneuse fever (BF) is an eruptive disease and is classified as a spotted fever, which is endemic in the Mediterranean basin (i.e., Marseille fever or Mediterranean spotted fever) and the Black Sea, caused by Rickettsia conorii, with dog ticks being a vector (i.e., Rhipicephalus sanguineus). In Romania, although the first reported outbreak of BF occurred during the summer of 1931 in Constanta, the disease was discovered in 1910. Although the disease has occurred most frequently in the two counties of the Dobruja region (Constanta and Tulcea), a region of the Balkan Peninsula, during the last few years, other counties in southeastern Romania have started to report BF cases. In a period of 9 years, 533 cases were registered in Constanta county, while in a period of 11 years, 339 cases were registered in Bucharest county. In this review, we describe the bacterial tick-borne disease caused by R. conorii in southeastern Romania, focusing on its history and epidemiology, pathophysiology, clinical aspects, diagnosis, treatment and preventive measures in the context of climate changes. Although R. conorii is the principal etiologic agent of BF in southeastern Romania, we should take into consideration that other Rickettsia spp. could be present and involved in disease transmission.
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Affiliation(s)
- Simona Claudia Cambrea
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
- Clinical Hospital of Infectious Diseases, 900178 Constanta, Romania
| | - Diana Badiu
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Constantin Ionescu
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Roxana Penciu
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Loredana Pazara
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Cristina Maria Mihai
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Mara Andreea Cambrea
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
| | - Larisia Mihai
- Faculty of Medicine, “Ovidius” University from Constanta, 900470 Constanta, Romania; (S.C.C.); (R.P.); (L.P.); (C.M.M.); (M.A.C.); (L.M.)
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Dixit R, Gopalan N, Behera SK. Isothermal amplification technology (IAT) for rapid diagnosis of Rickettsioses: scope, overview, existing evidence, and the way forward. Diagn Microbiol Infect Dis 2023; 107:116046. [PMID: 37625171 DOI: 10.1016/j.diagmicrobio.2023.116046] [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: 04/24/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
Rickettsioses, a category of zoonosis primarily caused by Rickettsia and Orientia, is a huge cause of public health concern worldwide. Diseases like murine typhus, scrub typhus, Mediterranean spotted fever and rocky mountain spotted fever are major contributors of Rickettsioses globally, with peculiar distributions in south-east Asia, Africa, Arabia and the Americas. With the innovations in molecular diagnostics, Isothermal Amplification Technology is gaining popularity for its fidelity, rapidity and cost-effectiveness. Compared to commercial assays, they are easily adaptable for point-of-care (PoC) settings. Due to nonspecific presentation as an acute undifferentiated febrile illness, diagnosis of Rickettsioses poses a great challenge. Certain isothermal amplification assays have proven to be highly efficient in diagnosing vector borne diseases like dengue, malaria, and chikungunya. The purpose of this review is to provide readers the current advancements, scope, challenges, and future prospects of isothermal amplification technologies in the detection of zoonotic pathogens like Rickettsia and Orientia.
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Affiliation(s)
- Rashi Dixit
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - Natarajan Gopalan
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India.
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18
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Raele DA, Cafiero MA. Rickettsial Infection in the COVID-19 Era: The Correlation between the Detection of Rickettsia aeschlimannii in Ticks and Storytelling Photography of a Presumable Human Rickettsiosis Case. Microorganisms 2023; 11:2645. [PMID: 38004657 PMCID: PMC10673559 DOI: 10.3390/microorganisms11112645] [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: 09/13/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
Rickettsia aeschlimannii infection is an emerging human tick-borne disease with only a few recorded cases. We reported a presumable autochthonous case of rickettsiosis in an Italian cattle breeder associated with a Hyalomma marginatum bite. Rickettsia aeschlimannii DNA was detected in both the tick specimen from the patient and the grazing cattle close to his farm.
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Affiliation(s)
- Donato Antonio Raele
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy;
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Dutta Majumder P, Mochizuki M, González-López JJ, Gonzales J, Sharma M, Sharma K, Biswas J. Laboratory Investigations in Infectious Uveitis. Ocul Immunol Inflamm 2023; 31:1405-1415. [PMID: 36698066 DOI: 10.1080/09273948.2022.2164728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 01/27/2023]
Abstract
Laboratory investigations can play a significant role in the diagnosis and decision-making of infectious uveitis. Though direct demonstration of the infective organism remains the gold standard of diagnosis, it is not always possible with ocular tissues. Recent advancements in molecular techniques have made it possible to overcome these limitations and to identify the genomic DNA of pathogens associated with infectious uveitis. Techniques such as next-generation sequencing can analyze all DNA-based lifeforms, regardless of whether they are bacteria, fungi, viruses, or parasites and have been used in the laboratory diagnosis of intraocular inflammation. On the other hand, serological tests, though they dominate the diagnostic landscape of various infectious etiologies in uveitis in routine clinical practice, have varied specificities and sensitivities in different infectious uveitis. In this review, we focus on various methods of laboratory diagnosis of infectious uveitis and discuss the recent advances in molecular diagnosis and their role in various infectious clinical entities.
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Affiliation(s)
| | - Manabu Mochizuki
- Miyata Eye Hospital, Miyakonojo, Japan
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Julio J González-López
- Ophthalmology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Surgery Department, Universidad de Alcalá, Madrid, Spain
| | - John Gonzales
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Megha Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Bilaspur, India
| | - Kusum Sharma
- Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh (PGIMER), Chandigarh, India
| | - Jyotirmay Biswas
- Director of Uveitis & Ocular Pathology, Sankara Nethralaya, Chennai, India
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Silva-Ramos CR, Faccini-Martínez ÁA, Serna-Rivera CC, Mattar S, Hidalgo M. Etiologies of Zoonotic Tropical Febrile Illnesses That Are Not Part of the Notifiable Diseases in Colombia. Microorganisms 2023; 11:2154. [PMID: 37763998 PMCID: PMC10535066 DOI: 10.3390/microorganisms11092154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 09/29/2023] Open
Abstract
In Colombia, tropical febrile illnesses represent one of the most important causes of clinical attention. Febrile illnesses in the tropics are mainly zoonotic and have a broad etiology. The Colombian surveillance system monitors some notifiable diseases. However, several etiologies are not monitored by this system. In the present review, we describe eleven different etiologies of zoonotic tropical febrile illnesses that are not monitored by the Colombian surveillance system but have scientific, historical, and contemporary data that confirm or suggest their presence in different regions of the country: Anaplasma, Arenavirus, Bartonella, relapsing fever group Borrelia, Coxiella burnetii, Ehrlichia, Hantavirus, Mayaro virus, Orientia, Oropouche virus, and Rickettsia. These could generate a risk for the local population, travelers, and immigrants, due to which they should be included in the mandatory notification system, considering their importance for Colombian public health.
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Affiliation(s)
- Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | - Álvaro A. Faccini-Martínez
- Servicio de Infectología, Hospital Militar Central, Bogotá 110110, Colombia;
- Servicios y Asesorías en Infectología—SAI, Bogotá 110110, Colombia
| | - Cristian C. Serna-Rivera
- Grupo de Investigación en Ciencias Veterinarias (CENTAURO), Línea de Investigación Zoonosis Emergentes y Re-Emergentes, Facultad de Ciencias Agrarias, Universidad de Antioquia, Medellín 050034, Colombia;
- Grupo de Investigación en Genética, Biodiversidad y Manejo de Ecosistemas (GEBIOME), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Universidad de Caldas, Manizales 170004, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería 230001, Colombia;
| | - Marylin Hidalgo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
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Cao Y, Liu P, Song Q, Wang J. Case report: A case of sepsis caused by rickettsial infection-induced hemophagocytic syndrome. Front Med (Lausanne) 2023; 10:1209174. [PMID: 37608831 PMCID: PMC10440429 DOI: 10.3389/fmed.2023.1209174] [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: 04/20/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare histiocytic disorder characterized by reactive hyperplasia of the mononuclear phagocytic system, which is primarily caused by dysfunction of cytotoxic killer cells and natural killer cells, leading to antigen clearance barriers and the overactivation of the mononuclear phagocytic system due to continuous antigen stimulation. HLH encompasses a group of clinical syndromes marked by the overproduction of inflammatory cytokines. A 68-year-old Chinese man presented with persistent fever, chills, nausea, and vomiting; the patient had no history of any underlying conditions. Laboratory investigations revealed decreased levels of red blood cells, white blood cells, and platelets, along with reduced natural killer cell activity, increased CD25, hyperferritinemia, and the detection of Rickettsia DNA in his blood, meeting the diagnostic criteria of the Histiocyte Society HLH-2004 guidelines. The patient was treated with antibiotics, improving anemia, glucocorticoid therapy, and continuous renal replacement therapy (CRRT), temporarily improving his condition. However, the patient died after 2 years from chronic renal failure caused by septic shock.
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Affiliation(s)
| | | | | | - Jing Wang
- Department of Respiratory and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
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Aita T, Sando E, Katoh S, Hamaguchi S, Fujita H, Kurita N. Nonnegligible Seroprevalence and Predictors of Murine Typhus, Japan. Emerg Infect Dis 2023; 29:1438-1442. [PMID: 37347821 PMCID: PMC10310371 DOI: 10.3201/eid2907.230037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
To elucidate the epidemiology of murine typhus, which is infrequently reported in Japan, we conducted a cross-sectional study involving 2,382 residents of rickettsiosis-endemic areas in Honshu Island during August-November 2020. Rickettsia typhi seroprevalence rate was higher than that of Orientia tsutsugamushi, indicating that murine typhus is a neglected disease.
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Eneku W, Erima B, Byaruhanga AM, Atim G, Tugume T, Ukuli QA, Kibuuka H, Mworozi E, Douglas C, Koehler JW, Cleary NG, von Fricken ME, Tweyongyere R, Wabwire-Mangen F, Byarugaba DK. Wide distribution of Mediterranean and African spotted fever agents and the first identification of Israeli spotted fever agent in ticks in Uganda. PLoS Negl Trop Dis 2023; 17:e0011273. [PMID: 37498943 PMCID: PMC10409254 DOI: 10.1371/journal.pntd.0011273] [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: 04/04/2023] [Revised: 08/08/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
Rickettsia microorganisms are causative agents of several neglected emerging infectious diseases in humans transmitted by arthropods including ticks. In this study, ticks were collected from four geographical regions of Uganda and pooled in sizes of 1-179 ticks based on location, tick species, life stage, host, and time of collection. Then, they were tested by real-time PCR for Rickettsia species with primers targeting gltA, 17kDa and ompA genes, followed by Sanger sequencing of the 17kDa and ompA genes. Of the 471 tick pools tested, 116 (24.6%) were positive for Rickettsia spp. by the gltA primers. The prevalence of Rickettsia varied by district with Gulu recording the highest (30.1%) followed by Luwero (28.1%) and Kasese had the lowest (14%). Tick pools from livestock (cattle, goats, sheep, and pigs) had the highest positivity rate, 26.9%, followed by vegetation, 23.1%, and pets (dogs and cats), 19.7%. Of 116 gltA-positive tick pools, 86 pools were positive using 17kDa primers of which 48 purified PCR products were successfully sequenced. The predominant Rickettsia spp. identified was R. africae (n = 15) in four tick species, followed by R. conorii (n = 5) in three tick species (Haemaphysalis elliptica, Rhipicephalus appendiculatus, and Rh. decoloratus). Rickettsia conorii subsp. israelensis was detected in one tick pool. These findings indicate that multiple Rickettsia spp. capable of causing human illness are circulating in the four diverse geographical regions of Uganda including new strains previously known to occur in the Mediterranean region. Physicians should be informed about Rickettsia spp. as potential causes of acute febrile illnesses in these regions. Continued and expanded surveillance is essential to further identify and locate potential hotspots with Rickettsia spp. of concern.
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Affiliation(s)
- Wilfred Eneku
- Makerere University, College of Veterinary Medicine, Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Bernard Erima
- Makerere University Walter Reed Project, Kampala, Uganda
| | | | - Gladys Atim
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Titus Tugume
- Makerere University Walter Reed Project, Kampala, Uganda
| | | | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Edison Mworozi
- Makerere University, College of Health Sciences, Kampala, Uganda
| | - Christina Douglas
- Diagnostic Systems Division, USAMRIID, Fort Detrick, Maryland, United States of America
| | - Jeffrey W. Koehler
- Diagnostic Systems Division, USAMRIID, Fort Detrick, Maryland, United States of America
| | - Nora G. Cleary
- Global and Community Health, George Mason University, Fairfax, Virginia, United States of America
| | - Michael E. von Fricken
- Global and Community Health, George Mason University, Fairfax, Virginia, United States of America
| | | | - Fred Wabwire-Mangen
- Makerere University Walter Reed Project, Kampala, Uganda
- Makerere University, School of Public Health, Kampala, Uganda
| | - Denis Karuhize Byarugaba
- Makerere University, College of Veterinary Medicine, Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
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Krishnamoorthi S, Goel S, Kaur J, Bisht K, Biswal M. A Review of Rickettsial Diseases Other Than Scrub Typhus in India. Trop Med Infect Dis 2023; 8:tropicalmed8050280. [PMID: 37235328 DOI: 10.3390/tropicalmed8050280] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Rickettsial diseases (RD) are widely reported all over the world. Scrub typhus (ST) is a major tropical infection which is well documented all over India. Therefore, the index of suspicion of scrub typhus is high among physicians with regard to patients presenting with acute febrile illness (AFI) and acute undifferentiated febrile illness (AUFI) in India. Rickettsial diseases other than ST (non-ST RDs), which include spotted fever group (SFG) rickettsioses and typhus group (TG) rickettsioses are not uncommon in India, but the index of suspicion is not as high as ST unless there is a history of the presence of fever with rashes and/or recent arthropod bites. This review aims to look into the Indian scenario on the epidemiology of non-ST RDs, especially the SFG and TG rickettsioses based on various investigations, spectrum of clinical presentation, challenges and gaps in knowledge to suspect and diagnose these infections.
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Affiliation(s)
| | - Shriya Goel
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Jasleen Kaur
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Kamlesh Bisht
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Manisha Biswal
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Baharani A, Reddy P RR. Treatment Outcomes of Presumed Rickettsial Retinitis: Evidence from OCTA Based Quantitative Analysis. Ocul Immunol Inflamm 2023:1-8. [PMID: 37141535 DOI: 10.1080/09273948.2023.2206490] [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: 05/06/2023]
Abstract
AIM To quantify retinal ischemia following presumed rickettsial retinitis (RR). To compare outcomes between initial treatment with Doxycycline (Group 1) versus steroids (Group 2). METHODS Retrospective analysis of patients with presumed RR was done. ImageJ software was used to obtain %area of ischemia on swept-source optical coherence tomography angiography (SS-OCTA). RESULTS Eleven eyes of 8 patients belonged to Group1 and 6 eyes of 3 patients belonged to Group 2. The BCVA improved from logMAR 0.8 ∓ 0.7 to logMAR 0.06 ∓ 0.08 (p < 0.002) and central foveal thickness (CFT) changed from 479μ ∓ 341.3μ to 163.5μ ∓ 20.5μ (p < 0.005) after a median of 5 weeks in Group 1. In Group 2, BCVA improved from logMAR 1.03 ∓ 0.05 to logMAR 0.23 ∓ 0.23 (p < 0.004) and CFT changed from 286.5μ ∓ 158.8μ to 177.5μ ∓ 25.9μ (>0.05) following a mean of 11 weeks. Mean %area of ischemia was 4.6 ∓ 1.5 in Group 1 and 13.9 ∓ 4.1 in Group 2. CONCLUSION Analysis of flow deficit on SS-OCTA confirms that treatment with Doxycycline in presumed RR results in less ischemia and quicker recovery than initial treatment with steroids.
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Al Bshabshe A, Mousa WF, Nor El-Dein N. An Overview of Clinical Manifestations of Dermatological Disorders in Intensive Care Units: What Should Intensivists Be Aware of? Diagnostics (Basel) 2023; 13:diagnostics13071290. [PMID: 37046508 PMCID: PMC10093365 DOI: 10.3390/diagnostics13071290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
Acute skin failure is rarely the primary diagnosis that necessitates admission to an intensive care unit. Dermatological manifestations in critically ill patients, on the other hand, are relatively common and can be used to make a key diagnosis of an adverse drug reaction or an underlying systemic illness, or they may be caused by factors related to a prolonged stay or invasive procedures. In intensive care units, their classification is based on the aetiopathogenesis of the cutaneous lesion and, in the meantime, distinguishes critical patients. When evaluating dermatological manifestations, several factors must be considered: onset, morphology, distribution, and associated symptoms and signs. This review depicts dermatological signs in critical patients in order to lay out better recognition.
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Warrell CE, Osborne J, Mrcp LN, Gibney B, Carter DP, Warner J, Houlihan CF, Brooks TJG, Rampling T. Imported Rickettsial Infections to the United Kingdom, 2015-2020. J Infect 2023; 86:446-452. [PMID: 36948252 DOI: 10.1016/j.jinf.2023.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The burden of imported rickettsial infection in the UK is not previously described. This retrospective review identifies rickettsial cases diagnosed at the national reference laboratory between 2015-2022. METHODS Samples testing positive for spotted fever group, typhus group and scrub typhus IgG/IgM on acute and convalescent blood samples, and/or PCR on tissue/blood were categorised as suspected, confirmed or past infection. RESULTS 220 patients had rickettsioses, the commonest import was acute spotted fever group infection (61%, 125/205), 54% (62/114) from South Africa. Acute typhus group cases, 60% (40/67) from Southeast Asia. One patient with Rickettsia typhi bacteremia died. Scrub typhus group infections (5%, 10/205) were exclusively from Asia and the Western Pacific regions. Overall, 43% of confirmed cases (39/91) had not received doxycycline prior to results. CONCLUSIONS Rickettsial infections are important and under-recognised causes of imported fever in the UK. Thorough history, examination and timely treatment with doxycycline should be considered if there is suspicion of Rickettsia infection before testing.
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Affiliation(s)
- Clare E Warrell
- Rare and Imported Pathogens Laboratory, Salisbury, UK; London School of Hygiene and Tropical Medicine, London, UK.
| | - Jane Osborne
- Rare and Imported Pathogens Laboratory, Salisbury, UK
| | | | - Barry Gibney
- Rare and Imported Pathogens Laboratory, Salisbury, UK
| | | | | | - Catherine F Houlihan
- Rare and Imported Pathogens Laboratory, Salisbury, UK; Hospital for Tropical Diseaess, London, UCLH, UK; Department of Clinical Virology UCLH, UK; Infection and Immunity, University College London, United Kingdom
| | | | - Tommy Rampling
- Rare and Imported Pathogens Laboratory, Salisbury, UK; Hospital for Tropical Diseaess, London, UCLH, UK; Infection and Immunity, University College London, United Kingdom
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Kjemtrup AM, Padgett K, Paddock CD, Messenger S, Hacker JK, Feiszli T, Melgar M, Metzger ME, Hu R, Kramer VL. A forty-year review of Rocky Mountain spotted fever cases in California shows clinical and epidemiologic changes. PLoS Negl Trop Dis 2022; 16:e0010738. [PMID: 36108065 PMCID: PMC9514610 DOI: 10.1371/journal.pntd.0010738] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 09/27/2022] [Accepted: 08/12/2022] [Indexed: 01/05/2023] Open
Abstract
Rocky Mountain spotted fever (RMSF) is a life-threatening tick-borne disease documented in North, Central, and South America. In California, RMSF is rare; nonetheless, recent fatal cases highlight ecological cycles of the two genera of ticks, Dermacentor and Rhipicephalus, known to transmit the disease. These ticks occur in completely different habitats (sylvatic and peridomestic, respectively) resulting in different exposure risks for humans. This study summarizes the demographic, exposure, and clinical aspects associated with the last 40 years of reported RMSF cases to the California Department of Public Health (CDPH). Seventy-eight RMSF cases with onsets from 1980 to 2019 were reviewed. The incidence of RMSF has risen in the last 20 years from 0.04 cases per million to 0.07 cases per million (a two-fold increase in reports), though the percentage of cases that were confirmed dropped significantly from 72% to 25% of all reported cases. Notably, Hispanic/Latino populations saw the greatest rise in incidence. Cases of RMSF in California result from autochthonous and out-of-state exposures. During the last 20 years, more cases reported exposure in Southern California or Mexico than in the previous 20 years. The driver of these epidemiologic changes is likely the establishment and expansion of Rhipicephalus sanguineus sensu lato ticks in Southern California and on-going outbreaks of RMSF in northern Mexico. Analysis of available electronically reported clinical data from 2011 to 2019 showed that 57% of reported cases presented with serious illness requiring hospitalization with a 7% mortality. The difficulty in recognizing RMSF is due to a non-specific clinical presentation; however, querying patients on the potential of tick exposure in both sylvatic and peridomestic environments may facilitate appropriate testing and treatment.
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Affiliation(s)
- Anne M. Kjemtrup
- California Department of Public Health, Sacramento, California, United States of America
- * E-mail:
| | - Kerry Padgett
- California Department of Public Health, Richmond, California, United States of America
| | | | - Sharon Messenger
- California Department of Public Health, Richmond, California, United States of America
| | - Jill K. Hacker
- California Department of Public Health, Richmond, California, United States of America
| | - Tina Feiszli
- California Department of Public Health, Richmond, California, United States of America
| | - Michael Melgar
- School of Medicine, University of California, San Francisco, California, United States of America
| | - Marco E. Metzger
- California Department of Public Health, Ontario, California, United States of America
| | - Renjie Hu
- California Department of Public Health, Ontario, California, United States of America
| | - Vicki L. Kramer
- California Department of Public Health, Sacramento, California, United States of America
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Pollio AR, Jiang J, Lee SS, Gandhi JS, Knott BD, Chunashvili T, Conte MA, Walls SD, Hulseberg CE, Farris CM, Reinbold-Wasson DD, Hang J. Discovery of Rickettsia spp. in mosquitoes collected in Georgia by metagenomics analysis and molecular characterization. Front Microbiol 2022; 13:961090. [PMID: 36160204 PMCID: PMC9493313 DOI: 10.3389/fmicb.2022.961090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
Arthropods have a broad and expanding worldwide presence and can transmit a variety of viral, bacterial, and parasite pathogens. A number of Rickettsia and Orientia species associated with ticks, fleas, lice, and mites have been detected in, or isolated from, patients with febrile illness and/or animal reservoirs throughout the world. Mosquitoes are not currently considered vectors for Rickettsia spp. pathogens to humans or to animals. In this study, we conducted a random metagenome next-generation sequencing (NGS) of 475 pools of Aedes, Culex, and Culiseta species of mosquitoes collected in Georgia from 2018 to 2019, identifying rickettsial gene sequences in 33 pools of mosquitoes. We further confirmed the findings of the Rickettsia by genus-specific quantitative PCR (qPCR) and multi-locus sequence typing (MLST). The NGS and MLST results indicate that Rickettsia spp. are closely related to Rickettsia bellii, which is not known to be pathogenic in humans. The results, together with other reports of Rickettsia spp. in mosquitoes and the susceptibility and transmissibility experiments, suggest that mosquitoes may play a role in the transmission cycle of Rickettsia spp.
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Affiliation(s)
- Adam R. Pollio
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Ju Jiang
- Naval Medical Research Center, Silver Spring, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Sam S. Lee
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Jaykumar S. Gandhi
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Brian D. Knott
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Walter Reed Army Institute of Research, Tbilisi, Georgia
| | - Tamar Chunashvili
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Walter Reed Army Institute of Research, Tbilisi, Georgia
| | - Matthew A. Conte
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Shannon D. Walls
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Walter Reed Army Institute of Research, Tbilisi, Georgia
| | - Christine E. Hulseberg
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Walter Reed Army Institute of Research, Tbilisi, Georgia
| | | | - Drew D. Reinbold-Wasson
- U.S. Army Medical Research Directorate - Georgia (USAMRD-G), Walter Reed Army Institute of Research, Tbilisi, Georgia
| | - Jun Hang
- Walter Reed Army Institute of Research, Silver Spring, MD, United States
- *Correspondence: Jun Hang,
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