1
|
Fa-ngoen C, Kaewmongkol G, Inthong N, Tanganuchitcharnchai A, Abdad MY, Siengsanan-Lamont J, Blacksell SD, Kaewmongkol S. Serological detection of Rickettsia spp. and evaluation of blood parameters in pet dogs and cats from Bangkok and neighboring provinces. PLoS One 2024; 19:e0297373. [PMID: 38452006 PMCID: PMC10919667 DOI: 10.1371/journal.pone.0297373] [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: 07/04/2023] [Accepted: 01/03/2024] [Indexed: 03/09/2024] Open
Abstract
Rickettsiosis is caused by Orientia spp. and Rickettsia spp., arthropod-borne zoonotic intracellular bacteria. The close relationships between pet dogs, cats and owners increase the risk of rickettsial transmission, with limited studies on the seroprevalence in pets. This study investigated the prevalence of rickettsia exposure among dogs and cats in Bangkok and neighboring provinces. The samples from 367 dogs and 187 cats used in this study were leftover serum samples from routine laboratory testing stored at the Veterinary Teaching Hospital. In-house Enzyme-linked immunosorbent assay (ELISA) tests included IgG against the scrub typhus group (STG), typhus group (TG), and spotted fever group (SFG). The seroprevalence in pet dogs was 30.25% (111/367), including 21.53% for STG, 4.36% for TG, and 1.09% for SFG. Co-seroprevalence consisted of 2.72% for STG and TG, 0.27% for STG and SFG, and 0.27% for pangroup infection. The prevalence in cats was 62.56% (117/187), including 28.34% for STG, 4.28% for TG, and 6.42% for STG. Co-seroprevalence in cats consisted of STG and TG (4.28%), STG and SFG (5.35%), TG and SFG (3.21%), and three-group infection (10.69%). No significant difference in seroprevalence for the three serogroups was observed in any of the 64 districts sampled. The mean hematocrit level significantly decreased in seropositive dogs (P<0.05). Seropositive dogs and cats were detected in significantly greater numbers of anemia cases than nonanemia cases (P<0.05) (odds ratio: 7.93, 0.44, p = 0.00, p = 0.01). A significantly higher number of seropositive cats had decreased hemoglobin levels (P<0.05) (odds ratio: 3.63, p = 0.00). The seropositive samples significantly differed among older cats (P<0.05). These high exposures in pet dogs and cats could constitute important relationship dynamics between companion animals and rickettsial vectors. Significantly decreased hematocrit and hemoglobin levels indicated anemia in the exposed dogs and cats. The study findings will raise awareness of this neglected disease among pet owners and veterinary hospital personnel and aid in future public health preventative planning.
Collapse
Affiliation(s)
- Chanon Fa-ngoen
- Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
- Queen Saovabha Memorial Institute, Thai Red Cross Society, Bangkok, Thailand
| | - Gunn Kaewmongkol
- Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Natnaree Inthong
- Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
| | - Ampai Tanganuchitcharnchai
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Mohammad Yazid Abdad
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Jarunee Siengsanan-Lamont
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Stuart D. Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | | |
Collapse
|
2
|
Konyak BM, Soni M, Saikia S, Chang T, Gogoi I, Khongstid I, Chang CM, Sharma M, Pandey RP. Scrub typhus in Northeast India: epidemiology, clinical presentations, and diagnostic approaches. Trans R Soc Trop Med Hyg 2024; 118:206-222. [PMID: 37972992 DOI: 10.1093/trstmh/trad082] [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: 08/21/2023] [Revised: 09/29/2023] [Indexed: 11/19/2023] Open
Abstract
Scrub typhus is one of the most neglected tropical diseases, a leading cause of acute undifferentiated febrile illness in areas of the 'tsutsugamushi triangle', diagnosed frequently in South Asian countries. The bacteria Orientia tsutsugamushi is the causative agent of the disease, which enters the human body through the bite of trombiculid mites (also known as chiggers) of the genus Leptotrombidium deliense. Diagnosis of the disease is challenging, as its early symptoms mimic other febrile illnesses like dengue, influenza and corona viruses. Lack of rapid, reliable and cost-effective diagnostic methods further complicates the identification process. Northeast India, a mountainous region with a predominantly rural tribal population, has witnessed a resurgence of scrub typhus cases in recent years. Various ecological factors, including rodent populations, habitat characteristics and climatic conditions, influence its prevalence. Entomological investigations have confirmed the abundance of vector mites, highlighting the importance of understanding their distribution and the probability of transmission of scrub typhus in the region. Proper diagnosis, awareness campaigns and behavioural interventions are essential for controlling scrub typhus outbreaks and reducing its impact on public health in Northeast India. Further research and community-based studies are necessary to accurately assess the disease burden and implement effective prevention strategies.
Collapse
Affiliation(s)
- Beyau M Konyak
- Integrated Molecular Diagnostic and Research Laboratory (BSL-2), District Hospital Tuensang, Tuensang-798612, Nagaland, India
- Department of Biosciences, Assam Don Bosco University, Tapesia Garden, Sonapur, Guwahati-782402, Assam, India
| | - Monika Soni
- Department of Biosciences, Assam Don Bosco University, Tapesia Garden, Sonapur, Guwahati-782402, Assam, India
| | - Shyamalima Saikia
- Department of Life Sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Tochi Chang
- Integrated Molecular Diagnostic and Research Laboratory (BSL-2), District Hospital Tuensang, Tuensang-798612, Nagaland, India
| | - Indrani Gogoi
- Department of Life Sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Ibakmensi Khongstid
- Department of Biosciences, Assam Don Bosco University, Tapesia Garden, Sonapur, Guwahati-782402, Assam, India
| | - Chung-Ming Chang
- Master's and PhD Program in Biotechnology Industry, Chang Gung University, No. 259, Wenhua 1st Rd, Guishan District, Taoyuan City-33302, Taiwan (ROC)
- Graduate Institute of Biomedical Sciences, Chang Gung University, No. 259, Wenhua 1st Rd, Guishan District, Taoyuan City-33302, Taiwan (ROC)
| | - Mohan Sharma
- Integrated Molecular Diagnostic and Research Laboratory (BSL-2), District Hospital Tuensang, Tuensang-798612, Nagaland, India
| | - Ramendra Pati Pandey
- School of Health Sciences and Technology, UPES, Dehradun-248007, Uttarakhand, India
| |
Collapse
|
3
|
Dye BV, Coba JA, Dayton CL, Cadena J, Anstead GM. Flea-Borne Typhus as a COVID-19 Mimic: A Report of Four Cases. Case Rep Infect Dis 2024; 2024:9914306. [PMID: 38384261 PMCID: PMC10881251 DOI: 10.1155/2024/9914306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/20/2024] [Accepted: 02/05/2024] [Indexed: 02/23/2024] Open
Abstract
Flea-borne typhus (FBT), due to Rickettsia typhi and R. felis, is an infection causing fever, headache, rash, hepatitis, thrombocytopenia, and diverse organ manifestations. Cough occurs in about 30% of patients with FBT, and chest X-ray abnormalities are seen in 17%. Severe pulmonary manifestations have also been reported in FBT, including adult respiratory distress syndrome and pulmonary embolism. Because of these pulmonary manifestations, FBT can mimic Coronavirus Illness 2019 (COVID-19), a febrile illness with prominent respiratory involvement. Flea-borne typhus and COVID-19 may also have similar laboratory abnormalities, including elevated ferritin, C-reactive protein, and D-dimer. However, elevated transaminase levels, rash, and thrombocytopenia are more common in FBT. Herein, we present four cases of patients with FBT who were initially suspected to have COVID-19. These cases illustrate the problem of availability bias, in which the clinician thinks a particular common condition (COVID-19 in this case) is more prevalent than it actually is.
Collapse
Affiliation(s)
- Bradley V. Dye
- Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Jose Alejandro Coba
- San Antonio Infectious Diseases Consultants, 8042 Wurzbach Road, San Antonio, TX 78229, USA
| | - Christopher L. Dayton
- Division of Pulmonary Diseases and Critical Care, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
- Department of Emergency Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Jose Cadena
- Division of Infectious Diseases, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
- Division of Infectious Diseases, Medical Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
| | - Gregory M. Anstead
- Division of Infectious Diseases, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
- Division of Infectious Diseases, Medical Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA
| |
Collapse
|
4
|
Riswari SF, Prodjosoewojo S, Mony SR, Megantara I, Iskandar S, Mayasari W, Heryaman H, de Mast Q, van der Ven A, Kosasih H, Alisjahbana B. Murine typhus is a common cause of acute febrile illness in Bandung, Indonesia. PLoS One 2023; 18:e0283135. [PMID: 37418452 PMCID: PMC10328256 DOI: 10.1371/journal.pone.0283135] [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: 03/07/2022] [Accepted: 03/02/2023] [Indexed: 07/09/2023] Open
Abstract
Murine typhus (MT), an infection caused by the gram-negative bacteria Rickettsia typhi (R. typhi), is a significant cause of acute febrile illness (AFI) in Southeast Asia but is rarely reported in Indonesia. The current study aimed to describe the clinical characteristics of MT cases in Bandung, West Java. Non-confirmed AFI cases (n = 176) from a prospective cohort study of whom paired serum samples (acute (T1), midterm (T2), or convalescent (T3)) were available were screened using MT serology. IgG against R. typhi was detected in the T2 or T3 samples using an in-house ELISA. Positive IgG samples were further screened for the presence of IgM. If both IgM and IgG were positive, the endpoint titer of T1, T2, or T3 was determined. In cases with a fourfold increase in titer, real-time PCR of T1 samples was performed to detect R. typhi DNA. In total, 71/176 (40.3%) patients tested positive for IgG antibody, and 26 AFI cases were confirmed as MT (23 cases by PCR, 3 cases by fourfold titer increased IgG or IgM titer). The most common clinical symptoms in the confirmed cases were headache (80%), arthralgia (73%), malaise (69%), and myalgia (54%). In these cases, the presumptive clinical diagnoses were typhoid fever (43.2%), dengue (38.5%), and leptospirosis (19.2%). MT was not considered in any of the patients, and no patients received doxycycline. These findings confirmed that MT is an important cause of AFI in Indonesia. MT should be included in the differential diagnosis of AFI, and empirical treatment with doxycycline should be considered.
Collapse
Affiliation(s)
- Silvita Fitri Riswari
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine and the Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Susantina Prodjosoewojo
- Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Siti Rasnawati Mony
- Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia
| | - Imam Megantara
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia
| | - Shelly Iskandar
- Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia
- Department of Psychiatry, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Wulan Mayasari
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Henhen Heryaman
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Quirijn de Mast
- Department of Internal Medicine and the Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andre van der Ven
- Department of Internal Medicine and the Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Herman Kosasih
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Bachti Alisjahbana
- Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| |
Collapse
|
5
|
Chaloemthanetphong A, Ahantarig A, Apanaskevich DA, Hirunkanokpun S, Baimai V, Trinachartvanit W. A novel Rickettsia, Candidatus Rickettsia takensis, and the first record of Candidatus Rickettsia laoensis in Dermacentor from Northwestern Thailand. Sci Rep 2023; 13:10044. [PMID: 37344542 DOI: 10.1038/s41598-023-37206-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/18/2023] [Indexed: 06/23/2023] Open
Abstract
Three hundred and forty-four tick samples were collected from vegetation at Taksin Maharat National Park, Tak province, northwestern Thailand. They were morphologically identified and molecularly confirmed by 16S rRNA and COI genes as Dermacentor laothaiensis (n = 105), D. steini (n = 139), and D. auratus (n = 100). These ticks were examined for the spotted fever group rickettsiae (SFGRs) using PCR and DNA sequencing of six genes; 17-kDa, gltA, 16S rRNA, ompA, ompB, and sca4. Of these ticks, 6.10% (21/344) gave positive results for the presence of SFGRs. Phylogenetic analyses of the SFGRs clearly indicated that a novel genotype assigned as Candidatus Rickettsia takensis was detected in D. laothaiensis (19/105) and at lesser frequency in D. steini (1/139). Furthermore, Candidatus Rickettsia laoensis was also found at a low frequency in D. auratus (1/100), the first record in Thailand. Although, the pathogenicities of these SFGRs remain unknown, our findings suggest potential risks of SFGRs being transmitted via ticks near the border between Thailand and Myanmar, a gateway of daily migrations of local people and visitors both legal and illegal.
Collapse
Affiliation(s)
- Aummarin Chaloemthanetphong
- Department of Biology, Faculty of Science, Biodiversity Research Cluster, Mahidol University, Bangkok, 10400, Thailand
| | - Arunee Ahantarig
- Department of Biology, Faculty of Science, Biodiversity Research Cluster, Mahidol University, Bangkok, 10400, Thailand
- Center of Excellence for Vectors and Vector-Borne Diseases, Faculty of Science, Mahidol University at Salaya, Nakhon Pathom, 73170, Thailand
| | - Dmitry A Apanaskevich
- United States National Tick Collection, The James H. Oliver, Jr. Institute for Coastal Plain Science, Georgia Southern University, Statesboro, GA, 30460-8056, USA
| | - Supanee Hirunkanokpun
- Department of Biology, Faculty of Science, Ramkhamhaeng University, Bangkok, 10240, Thailand
| | - Visut Baimai
- Department of Biology, Faculty of Science, Biodiversity Research Cluster, Mahidol University, Bangkok, 10400, Thailand
| | - Wachareeporn Trinachartvanit
- Department of Biology, Faculty of Science, Biodiversity Research Cluster, Mahidol University, Bangkok, 10400, Thailand.
| |
Collapse
|
6
|
Soh S, Chua CH, Neo ZW, Kong M, Ong BL, Aik J. Rodent activity in municipal waste collection premises in Singapore: an analysis of risk factors using mixed-effects modelling. Sci Rep 2023; 13:3070. [PMID: 36810345 PMCID: PMC9943821 DOI: 10.1038/s41598-023-29405-2] [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: 03/05/2021] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
Refuse storage and collection systems are potential sources of food and harbourage areas for rodents which transmit pathogens. We examined the factors associated with rodent activity in public housing municipal waste collection premises in a highly urbanized city-state. We analysed data from April 2019 to March 2020 in mixed-effects logistic regression models to examine the independent factors associated with rodent activity in central refuse chute rooms (CRCs), individual refuse chute (IRC) bin chambers and bin centres. We accounted for within-year patterns, repeated measures and nested effects. We observed a heterogeneous spatial distribution of rodent activity. Rodent droppings were strongly associated with rodent activity in CRCs (aOR: 6.20, 95% CI: 4.20-9.15), bin centres (aOR: 3.61, 95% CI: 1.70-7.64) and IRC bin chambers (aOR: 90.84, 95% CI: 70.13-117.67). Gnaw marks were positively associated with rodent activity in CRCs (aOR: 5.61, 95% CI: 3.55-8.97) and IRC bin chambers (aOR: 2.05, 95% CI: 1.43-2.95), as were rub marks in CRCs (aOR: 5.04, 95% CI: 3.44-7.37) and IRC bin chambers (aOR: 3.07, 95% CI: 1.74-5.42). Each burrow increased the odds of rodent sightings in bin centres (aOR: 1.03, 95% CI: 1.00-1.06). The odds of rodent sightings in an IRC bin chamber increased with every additional bin chute chamber within the same block (aOR: 1.04, 95% CI: 1.01-1.07). We identified several factors that well predicted rodent activity in waste collection premises. Municipal estate managers with limited resources can adopt a risk-based approach in tailoring the focus of their rodent control interventions.
Collapse
Affiliation(s)
- Stacy Soh
- Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, Singapore, 228231, Singapore.
| | - Chee Heong Chua
- grid.452367.10000 0004 0392 4620Environmental Public Health Operations Group, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, Singapore, 228231 Singapore
| | - Zhi Wei Neo
- grid.452367.10000 0004 0392 4620Environmental Public Health Operations Group, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, Singapore, 228231 Singapore
| | - Marcella Kong
- grid.452367.10000 0004 0392 4620Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, Singapore, 228231 Singapore
| | - Bee Leng Ong
- grid.452367.10000 0004 0392 4620Environmental Public Health Operations Group, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, Singapore, 228231 Singapore
| | - Joel Aik
- Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, Singapore, 228231, Singapore. .,Pre-Hospital & Emergency Research Centre, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| |
Collapse
|
7
|
Kaundinnyayana S, Kamath A. Doxycycline use and adverse pregnancy or neonatal outcomes: A descriptive study using the United States Food and Drug Administration Adverse Event Reporting System database. Health Sci Rep 2022; 5:e931. [PMID: 36381408 PMCID: PMC9662692 DOI: 10.1002/hsr2.931] [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: 08/19/2022] [Revised: 10/11/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aims Doxycycline is recommended for use in rickettsial diseases. The available evidence regarding its safety for rickettsial infection in pregnancy is limited. Our study aimed to describe the adverse events of doxycycline when used during pregnancy for any indication, in terms of adverse maternal and/or neonatal outcomes, using the United States Food and Drug Administration Adverse Event Reporting System (FAERS). Methods We used the OpenVigil software for extracting the safety reports from the United States submitted to the FAERS from 2004 to 2021. We manually reviewed reports of doxycycline use resulting in adverse pregnancy outcomes or congenital anomalies to describe the patient and safety event characteristics. Results From 2004 to 2021, 59 individual case safety reports containing preferred terms indicative of drug exposure during pregnancy or drug-induced adverse fetal outcomes were identified in the FAERS database. Following deduplication and manual review, 20 relevant adverse event reports were obtained. Doxycycline was the suspect medication in 13/20 (65%) reports. The common adverse event terms reported were premature delivery/baby in 6 reports, spontaneous abortion in 6, intrauterine death in 2, and various congenital anomalies in the rest. Fifty percent of the safety reports contained other medications which could have potentially caused the outcome. Conclusions The number of reported events in the FAERS database of adverse pregnancy/neonatal outcomes following doxycycline use is small, similar to the numbers reported from large cohort or surveillance studies. Given the presence of concomitant medications that could have contributed to the outcome, there does not seem to be a strong signal of harm, although this needs to be confirmed by surveillance studies.
Collapse
Affiliation(s)
| | - Ashwin Kamath
- Department of Pharmacology, Kasturba Medical College, MangaloreManipal Academy of Higher EducationManipalIndia
| |
Collapse
|
8
|
Incidence of tick-borne spotted fever group Rickettsia species in rodents in two regions in Kazakhstan. Sci Rep 2022; 12:14872. [PMID: 36050456 PMCID: PMC9437098 DOI: 10.1038/s41598-022-19145-0] [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: 07/06/2022] [Accepted: 08/24/2022] [Indexed: 11/27/2022] Open
Abstract
Records on the distribution of Rickettsia spp. in their natural hosts in Central Asia are incomplete. Rodents and small mammals are potential natural reservoirs for Rickettsiae in their natural lifecycle. Studies about the maintenance of Rickettsia in wild animals are available for Western nations, but—to our knowledge—no studies and data are available in the Republic of Kazakhstan so far. The first case description of Rickettsioses in Kazakhstan was made in the 1950ies in the Almaty region and now Kyzylorda, East Kazakhstan, Pavlodar and North Kazakhstan are endemic areas. The existence of murine and endemic typhus was proven in arthropod vectors in the regions Kyzylorda and Almaty. Here we show for the first time investigations on tick-borne Rickettsia species detected by a pan-rickettsial citrate synthase gene (gltA) real-time PCR in ear lobes of small mammals (n = 624) in Kazakhstan. From all analysed small mammals 2.72% were positive for Rickettsia raoultii, R. slovaca or R. conorii. Sequencing of the rickettsial gene OmpAIV and the 23S–5S interspacer region revealed a similar heritage of identified Rickettsia species that was observed in ticks in previous studies from the region. In summary, this study proves that rodents in Kazakhstan serve as a natural reservoir of Rickettsia spp.
Collapse
|
9
|
Altantogtokh D, Lilak AA, Takhampunya R, Sakolvaree J, Chanarat N, Matulis G, Poole-Smith BK, Boldbaatar B, Davidson S, Hertz J, Bolorchimeg B, Tsogbadrakh N, Fiorenzano JM, Lindroth EJ, von Fricken ME. Metagenomic profiles of Dermacentor tick pathogens from across Mongolia, using next generation sequencing. Front Microbiol 2022; 13:946631. [PMID: 36033893 PMCID: PMC9399792 DOI: 10.3389/fmicb.2022.946631] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
Tick-borne diseases are a major public health concern in Mongolia. Nomadic pastoralists, which make up ~ 26% of Mongolia’s population, are at an increased risk of both tick bite exposure and economic loss associated with clinical disease in herds. This study sought to further characterize tick-borne pathogens present in Dermacentor ticks (n = 1,773) sampled in 2019 from 15 of Mongolia’s 21 aimags (provinces). The ticks were morphologically identified and sorted into 377 pools which were then screened using Next-Generation Sequencing paired with confirmatory PCR and DNA sequence analysis. Rickettsia spp. were detected in 88.33% of pools, while Anaplasma spp. and Bartonella spp. were detected in 3.18 and 0.79% of pools, respectively. Khentii had the highest infection rate for Rickettsia spp. (76.61%; CI: 34.65–94.79%), while Arkhangai had the highest infection rate for Anaplasma spp. (7.79%; CI:4.04–13.72%). The exclusive detection of Anaplasma spp. in tick pools collected from livestock supports previous work in this area that suggests livestock play a significant role in disease maintenance. The detection of Anaplasma, Bartonella, and Rickettsia demonstrates a heightened risk for infection throughout Mongolia, with this study, to our knowledge, documenting the first detection of Bartonella melophagi in ticks collected in Mongolia. Further research deploying NGS methods is needed to characterize tick-borne pathogens in other endemic tick species found in Mongolia, including Hyalomma asiaticum and Ixodes persulcatus.
Collapse
Affiliation(s)
| | - Abigail A. Lilak
- Department of Global and Community Health, George Mason University, Fairfax, VA, United States
| | - Ratree Takhampunya
- Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand
| | - Jira Sakolvaree
- Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand
| | - Nitima Chanarat
- Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand
| | - Graham Matulis
- Department of Global and Community Health, George Mason University, Fairfax, VA, United States
| | - Betty Katherine Poole-Smith
- Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand
| | - Bazartseren Boldbaatar
- School of Veterinary Medicine, Mongolian University of Life Sciences, Ulaanbaatar, Mongolia
| | - Silas Davidson
- Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand
- Department of Chemistry and Life Science, US Military Academy, West Point, NY, United States
| | - Jeffrey Hertz
- Naval Medical Research Unit TWO (NAMRU-2), Sembawang, Singapore
| | | | | | | | - Erica J. Lindroth
- Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand
| | - Michael E. von Fricken
- Department of Global and Community Health, George Mason University, Fairfax, VA, United States
- *Correspondence: Michael E. von Fricken,
| |
Collapse
|
10
|
Saito N, Solante RM, Guzman FD, Telan EO, Umipig DV, Calayo JP, Frayco CH, Lazaro JC, Ribo MR, Dimapilis AQ, Dimapilis VO, Villanueva AM, Mauhay JL, Suzuki M, Yasunami M, Koizumi N, Kitashoji E, Sakashita K, Yasuda I, Nishiyama A, Smith C, Ariyoshi K, Parry CM. A prospective observational study of community-acquired bacterial bloodstream infections in Metro Manila, the Philippines. PLoS Negl Trop Dis 2022; 16:e0010414. [PMID: 35613181 PMCID: PMC9173634 DOI: 10.1371/journal.pntd.0010414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/07/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1st July 2015 and 30th June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including Staphylococcus aureus (n = 20), Salmonella enterica Typhi (n = 18), Escherichia coli (n = 16), Streptococcus pneumoniae (n = 3) and Burkholderia pseudomallei (n = 2). Thirty-four patients had meningococcal disease diagnosed by culture (n = 8) or blood PCR (n = 26). Additional confirmed diagnoses included leptospirosis (n = 177), dengue virus infection (n = 159) and respiratory diphtheria (n = 50). There were 79 (6.0%, 95%CI 4.8%−7.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2% vs 4.4%, P<0.01). Among S. aureus isolates, 11/20 (55%) were methicillin-resistant (MRSA) and ST30: USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in S. enterica Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. S. aureus, including a significant number of MRSA (USA1100 clones), S. enterica Typhi, E.coli and Neisseria meningitidis were frequently identified pathogens.
Collapse
Affiliation(s)
- Nobuo Saito
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Microbiology, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | | | | | | | | | | | | | | | | | | | | | - Annavi M. Villanueva
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- San Lazaro Hospital, Manila, the Philippines
| | - Jaira L. Mauhay
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Motoi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Michio Yasunami
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Emi Kitashoji
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kentaro Sakashita
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ikkoh Yasuda
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Akira Nishiyama
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Koya Ariyoshi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- * E-mail: (KA); (CMP)
| | - Christopher M. Parry
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail: (KA); (CMP)
| |
Collapse
|
11
|
Gonwong S, Mason CJ, Chuenchitra T, Khanijou P, Islam D, Ruamsap N, Kana K, Tabprasit S, Vesely BA, Demons ST, Waters NC, Swierczewski BE, Crawford JM, Jones JW. Nationwide Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever in Young Thai Men. Am J Trop Med Hyg 2022; 106:tpmd201512. [PMID: 35378507 PMCID: PMC9128670 DOI: 10.4269/ajtmh.20-1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/18/2022] [Indexed: 11/07/2022] Open
Abstract
Scrub typhus group (STG), typhus group (TG), and spotted fever group (SFG) rickettsiae are pathogens distributed worldwide and are important causes of febrile illnesses in southeast Asia. The levels of rickettsioses burden and distribution in Thai communities are still unclear. Nonspecific symptoms, limit diagnostic capacity and underdiagnoses contribute to the absence of clarity. The objective of this study was to determine the nationwide IgG seroprevalence of STG, TG, and SFG by ELISA in repository sera from the Royal Thai Army recruits collected during 2007-2008 and 2012 to estimate rickettsiae exposure in young Thai men to better understand rickettsiae exposure distribution in the Thai population. IgG seroprevalence of STG, Orientia tsutsugamushi; TG, Rickettsia typhi; and SFG, R. rickettsii was 12.4%, 6.8%, and 3.3% in 2007-2008 and 31.8%, 4.2%, and 4.5% in 2012, respectively. The STG had the highest seroprevalence of Rickettsia assessed, with the highest regional seroprevalence found in southern Thailand. The STG seroprevalence changed significantly from 2007 to 2008 (P value < 0.05), which corresponds with morbidity rate of scrub typhus from the last decade in Thailand. We were unable to determine the causality for seroprevalence changes between the two periods due to the limitation in sample numbers for intervening years and limited information available for archived specimens. Additional research would be required to determine agency. However, study results do confirm Rickettsia endemicity in Thailand lends weight to reports of increasing STG seroprevalence. It also corroborates the need to raise rickettsial disease awareness and educate the general public in prevention measures.
Collapse
Affiliation(s)
- Siriphan Gonwong
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Carl J. Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Dilara Islam
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Nattaya Ruamsap
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Khunakorn Kana
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Brian A. Vesely
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Norman C. Waters
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - John M. Crawford
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - James W. Jones
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| |
Collapse
|
12
|
First report of Rickettsia asembonensis in small ruminants. Vet Res Commun 2022; 46:979-983. [PMID: 35190932 DOI: 10.1007/s11259-022-09904-9] [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: 12/29/2021] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
Rickettsioses is a group of emerging infectious diseases in Southeast Asia caused by Gram-negative obligate intracellular bacteria in the Rickettsiae tribe. However, there is limited information regarding the vertebrate hosts of Rickettsia spp. in this region. This study aims to detect and identify Rickettsia agents present in wildlife and domesticated animals in Malaysia using Polymerase Chain Reaction (PCR) and sequencing of citrate synthase gene (gltA), followed by genotyping and phylogenetic analysis. Rickettsia sp. was detected in 2 (0.67%) of 300 wildlife and domesticated animal blood samples. The positive samples were derived from a goat (5.56% of 18) and a sheep (2.22% of 45). Both sequences demonstrated 99.64% sequence similarity to Rickettsia asembonensis, a species that is known to infect humans and macaques. This study reported for the first time the detection of R. asembonensis in sheep and goats in Malaysian farms, suggesting this species may be adapting to a wider range of animals, specifically farm animals. Therefore, this bacterium may pose a zoonotic threat to the local community particularly to the farmworkers or animal handlers. The low infection rate of this pathogen across different animals highlighted the need of continuous surveillance of emerging and reemerging pathogens among animal populations.
Collapse
|
13
|
Griffiths J, Yeo HL, Yap G, Mailepessov D, Johansson P, Low HT, Siew CC, Lam P, Ng LC. Survey of rodent-borne pathogens in Singapore reveals the circulation of Leptospira spp., Seoul hantavirus, and Rickettsia typhi. Sci Rep 2022; 12:2692. [PMID: 35177639 PMCID: PMC8854382 DOI: 10.1038/s41598-021-03954-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/10/2021] [Indexed: 11/09/2022] Open
Abstract
Rodents living alongside humans increases the probability of encounter and also the transmission of rodent-borne diseases. Singapore’s cosmopolitan urban landscape provides a perfect setting to study the prevalence of four rodent-borne pathogens: Seoul hantavirus (SEOV), Leptospira species, Rickettsia typhi and Yersinia pestis, and identify the potential risk factors which may influence rodent density and transmission of rodent-borne diseases. A total of 1143 rodents were trapped from 10 unique landscape structures throughout Singapore. Real-time quantitative Polymerase Chain Reactions were used to detect pathogenic and intermediate Leptospira spp. and Yersinia pestis, whereas the seroprevalence of SEOV and R. typhi were analysed by Enzyme-Linked Immunosorbent Assay and Immunofluorescence Assay respectively. Multivariable logistic regression analysis was used to evaluate the association between prevalence of infection in rodent reservoirs and risk factors. Most of the rodents were caught in public residential developments (62.2%). Among the tested rodents, 42.4% were infected with Leptospira spp., while 35.5% and 32.2% were seropositive for SEOV and R. typhi respectively, whereas Yersinia pestis was not detected. Furthermore, risk factors including habitat, species, gender, and weight of rodents, influenced prevalence of infection to a varying extent. This study highlights the presence of Leptospira spp., SEOV and R. typhi in Singapore’s rodent population, suggesting the need for effective rodent management and sanitation strategies to prevent further circulation and transmission to humans.
Collapse
Affiliation(s)
- Jane Griffiths
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Hui Ling Yeo
- Environmental Health Institute, National Environment Agency, Singapore, Singapore.
| | - Grace Yap
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Diyar Mailepessov
- Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Patrik Johansson
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Hwee Teng Low
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Chern-Chiang Siew
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore, Singapore
| | - Patrick Lam
- SAF Biodefence Centre, Force Medical Protection Command, HQ Medical Corps, Singapore Armed Forces, Singapore, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore, Singapore.
| |
Collapse
|
14
|
Ngamprasertchai T, Hanboonkunupakarn B, Piyaphanee W. Rickettsiosis in Southeast Asia: Summary for International Travellers during the COVID-19 Pandemic. Trop Med Infect Dis 2022; 7:tropicalmed7020018. [PMID: 35202213 PMCID: PMC8879928 DOI: 10.3390/tropicalmed7020018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Rickettsiosis is an important cause of febrile illness among travellers visiting Southeast Asia (SEA). The true incidence of rickettsiosis is underestimated; however, murine typhus and scrub typhus are widely distributed across SEA. Among travellers visiting SEA, scrub typhus was mostly reported from Thailand, whereas murine typhus was frequently found in Indonesia. Although most cases are self-limited or present with mild symptoms, a few cases with severe clinical manifestations have been reported. Doxycycline remains the key treatment of rickettsiosis. Some travellers, such as backpackers, trekkers, or cave explorers, are at a higher risk for rickettsiosis than others. Therefore, in resource-limited conditions, empirical treatment should be considered in these travellers. The coronavirus disease 2019 (COVID-19) pandemic has contributed to difficulty in the diagnosis of rickettsiosis because of the clinical similarities between these diseases. In addition, physical distancing mandated by COVID-19 management guidelines limits accurate physical examination, resulting in misdiagnosis and delayed treatment of rickettsiosis. This review summarises the characteristics of murine typhus and scrub typhus, describes travel-associated rickettsiosis, and discusses the impact of the COVID-19 pandemic on rickettsiosis.
Collapse
|
15
|
|
16
|
Chandrasena N, Liyanage A, Gunathilaka N, Sanjeewa R, Premaratna R. Public knowledge, practices and perceptions on typhus fevers in Southern Sri Lanka. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.345942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
17
|
An Update on the Laboratory Diagnosis of Rickettsia spp. Infection. Pathogens 2021; 10:pathogens10101319. [PMID: 34684267 PMCID: PMC8541673 DOI: 10.3390/pathogens10101319] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/25/2021] [Accepted: 10/11/2021] [Indexed: 01/10/2023] Open
Abstract
Rickettsia species causing human illness are present globally and can cause significant disease. Diagnosis and identification of this intracellular bacteria are challenging with many available diagnostic modalities suffering from several shortcomings. Detection of antibodies directed against Rickettsia spp. via serological methods remains widely used with a broad range of sensitivity and specificity values reported depending on the assay. Molecular methods, including polymerase chain reaction (PCR) testing, enables species-specific identification with a fast turnaround time; however, due to resource requirements, use in some endemic settings is limited. Reports on the use of next-generation sequencing (NGS) and metagenomics to diagnose Rickettsia spp. infection have been increasing. Despite offering several potential advantages in the diagnosis and surveillance of disease, genomic approaches are currently only limited to reference and research laboratories. Continued development of Rickettsia spp. diagnostics is required to improve disease detection and epidemiological surveillance, and to better understand transmission dynamics.
Collapse
|
18
|
D E, S P, K G, W R, V P V, Pp AK, Jaj P, Js D. Spotted fever diagnosis: Experience from a South Indian center. Pathog Glob Health 2021; 115:300-306. [PMID: 34493177 DOI: 10.1080/20477724.2021.1934293] [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: 10/20/2022] Open
Abstract
Spotted fever (SF) is an important treatable cause of acute febrile illness (AFI) with rash and has reemerged in India. A prospective AFI with rash study was undertaken at a South Indian hospital to correlate specific clinical findings with laboratory confirmation of spotted fever. During the study period (December 2017 to May 2019), 175 patients with fever and rash were suspected to have spotted fever. Molecular assays for scrub typhus and spotted fever (47 kDa and ompA qPCR) and serology (IgM ELISA) was performed on the 96 individuals recruited. Laboratory confirmed SF cases (ompA qPCR positive) were 21, whereas laboratory supported SF cases (ompA negative but sero-positive by SF IgM ELISA) were 27. Among the 48 spotted fever (SF) cases, 70% of had maculopapular rash, 12.5% had macular rash, purpuric/petechial rash (severe rash) was seen in 8 patients (16.7%). Presence of rash on the palms and soles was associated with a relative risk (RR) of 4.36 (95% CI: 2.67-7.10; p < 0.001). Our study suggests that ompA qPCR though useful for confirming the diagnosis of spotted fever is not always positive. A positive SF IgM ELISA in febrile individuals with palmo-plantar rash supports the diagnosis of spotted fever especially when other causes of febrile rash have been excluded. Multi-centric prospective studies employing the serological reference standard, IFA (immunofluorescence assay) in addition to the assays used in this study are needed to validate these findings.
Collapse
Affiliation(s)
- Elangovan D
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Perumalla S
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Gunasekaran K
- Department of General Medicine, Christian Medical College, Vellore, India
| | - Rose W
- Department of Paediatric Infectious Diseases, Christian Medical College, Vellore, India
| | - Verghese V P
- Department of Paediatric Infectious Diseases, Christian Medical College, Vellore, India
| | - Abhilash K Pp
- Department of Emergency Medicine, Christian Medical College, Vellore, India
| | - Prakash Jaj
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Dumler Js
- Department of Pathology, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| |
Collapse
|
19
|
Das A, Kim K, Park SG, Choi N, Choo J. SERS-based serodiagnosis of acute febrile diseases using plasmonic nanopopcorn microarray platforms. Biosens Bioelectron 2021; 192:113525. [PMID: 34325318 DOI: 10.1016/j.bios.2021.113525] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/14/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
We report a surface-enhanced Raman scattering (SERS)-based immunoassay platform for the rapid diagnosis of scrub typhus and murine typhus, which are the most common acute febrile diseases in South Korea. A microarray device, composed of multiple gold nanopopcorn substrates capable of detecting ultra-sensitive biomarkers, was used as a multiplex SERS-based assay platform. Sequentially diluted titers of Orientia tsutsugamushi and Rickettsia typhi specific human IgG/IgM antibodies, which are biomarkers of two typhus diseases, were analyzed by Raman spectroscopy, and the peak intensity was plotted against the different titer concentration range (0-2048 and 0-1024 for O. tsutsugamushi IgG/IgM and 0-8192 and 0-256 for R. typhi IgG/IgM) to generate calibration curves. The sensitivities and limits of detection (LODs) determined for four different IgG/IgM antibodies were significantly lower than those for the ELISA method. The LODs of titer concentrations for O. tsutsugamushi IgG/IgM and R. typhi IgG/IgM are determined to be 20.4, 7.03, 16.8 and 12.5, respectively. The LOD values were all lower than the cut-off values (256, 16, 128, and 64) used for clinical diagnosis, which means that this assay platform can diagnose two typhus diseases with high sensitivity. When the microarray sensors are combined with portable Raman spectrophotometers, which are commercially available worldwide, it is also possible to directly diagnose a patient in the field without sending their blood sample to a hospital.
Collapse
Affiliation(s)
- Anupam Das
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
| | - Kihyun Kim
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea
| | - Sung-Gyu Park
- Advanced Nano-Surface Department, Korea Institute of Materials Science (KIMS), Changwon, 51508, South Korea
| | - Namhyun Choi
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea.
| | - Jaebum Choo
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea.
| |
Collapse
|
20
|
Jiang D, Ma T, Hao M, Qian Y, Chen S, Meng Z, Wang L, Zheng C, Qi X, Wang Q, Ding F. Spatiotemporal patterns and spatial risk factors for visceral leishmaniasis from 2007 to 2017 in Western and Central China: A modelling analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 764:144275. [PMID: 33385656 DOI: 10.1016/j.scitotenv.2020.144275] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Visceral leishmaniasis (VL) is a neglected disease caused by trypanosomatid protozoa in the genus Leishmania, which is transmitted by phlebotomine sandflies. Although this vector-borne disease has been eliminated in several regions of China during the last century, the reported human VL cases have rebounded in Western and Central China in recent decades. However, understanding of the spatial epidemiology of the disease remains vague, as the spatial risk factors driving the spatial heterogeneity of VL. In this study, we analyzed the spatiotemporal patterns of annual human VL cases in Western and Central China from 2007 to 2017. Based on the related spatial maps, the boosted regression tree (BRT) model was adopted to explore the relationships between VL and spatial correlates as well as predicting both the existing and potential infection risk zones of VL in Western and Central China. The mined links reveal that elevation, minimum temperature, relative humidity, and annual accumulated precipitation make great contributions to the spatial heterogeneity of VL. The maps show that Xinjiang Uygur Autonomous Region, Gansu, western Inner Mongolia Autonomous Region, and Sichuan are predicted to fall in the highest infection risk zones of VL. Approximately 61.60 million resident populations lived in the high-risk regions of VL in Western and Central China. Our results provide a better understanding of how spatial risk factors driving VL spread as well as identifying the potential endemic risk region of VL, thereby enhancing the biosurveillance capacity of public health authorities.
Collapse
Affiliation(s)
- Dong Jiang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tian Ma
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Mengmeng Hao
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yushu Qian
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Shuai Chen
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ze Meng
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Liping Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
| | - Canjun Zheng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
| | - Xiao Qi
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China.
| | - Qian Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Fangyu Ding
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| |
Collapse
|
21
|
Tanabe MB, Blanton LS, La Rosa M, Webb CM. Murine Typhus Infection in Pregnancy: Case Series and Literature Review. Pathogens 2021; 10:pathogens10020219. [PMID: 33670581 PMCID: PMC7922808 DOI: 10.3390/pathogens10020219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/06/2021] [Accepted: 02/10/2021] [Indexed: 12/25/2022] Open
Abstract
Murine typhus is a flea-borne disease of worldwide distribution with a recent reemergence in the United States of America. There are limited data about the presentation, treatment, and outcomes in the pregnant population. We report on two cases of murine typhus during pregnancy and review the literature to compile previously reported cases. A comprehensive search was performed via the PubMed database for published articles between 1990 and 2020. Seven articles met the criteria of symptomatic pregnant murine typhus infection. A total of 37 patients were identified. Patients frequently presented with a prolonged duration of fevers prior to presentation, headache, and elevated hepatic transaminases. The diagnosis was predominantly based on serology. Treatment varied. Overall, the pregnancy outcome was favorable. Murine typhus can mimic other pregnancy-related pathologies. More exclusive and large-scale studies are needed to learn more of murine typhus during pregnancy.
Collapse
Affiliation(s)
- Melinda B. Tanabe
- Department of Medicine, Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX 77555, USA; (L.S.B.); (C.M.W.)
- Correspondence:
| | - Lucas S. Blanton
- Department of Medicine, Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX 77555, USA; (L.S.B.); (C.M.W.)
| | - Mauricio La Rosa
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Camille M. Webb
- Department of Medicine, Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX 77555, USA; (L.S.B.); (C.M.W.)
| |
Collapse
|
22
|
Caravedo Martinez MA, Ramírez-Hernández A, Blanton LS. Manifestations and Management of Flea-Borne Rickettsioses. Res Rep Trop Med 2021; 12:1-14. [PMID: 33574726 PMCID: PMC7873028 DOI: 10.2147/rrtm.s274724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/26/2021] [Indexed: 12/16/2022] Open
Abstract
Murine typhus and flea-borne spotted fever are undifferentiated febrile illnesses caused by Rickettsia typhi and Rickettsia felis, respectively. These organisms are small obligately intracellular bacteria and are transmitted to humans by fleas. Murine typhus is endemic to coastal areas of the tropics and subtropics (especially port cities), where rats are the primary mammalian host and rat fleas (Xenopsylla cheopis) are the vector. In the United States, a cycle of transmission involving opossums and cat fleas (Ctenocephalides felis) are the presumed reservoir and vector, respectively. The incidence and distribution of murine typhus appear to be increasing in endemic areas of the US. Rickettsia felis has also been reported throughout the world and is found within the ubiquitous cat flea. Flea-borne rickettsioses manifest as an undifferentiated febrile illness. Headache, malaise, and myalgia are frequent symptoms that accompany fever. The incidence of rash is variable, so its absence should not dissuade the clinician to consider a rickettsial illness as part of the differential diagnosis. When present, the rash is usually macular or papular. Although not a feature of murine typhus, eschar has been found in 12% of those with flea-borne spotted fever. Confirmatory laboratory diagnosis is usually obtained by serology; the indirect immunofluorescence assay is the serologic test of choice. Antibodies are seldom present during the first few days of illness. Thus, the diagnosis requires acute- and convalescent-phase specimens to document seroconversion or a four-fold increase in antibody titer. Since laboratory diagnosis is usually retrospective, when a flea-borne rickettsiosis is considered, empiric treatment should be initiated. The treatment of choice for both children and adults is doxycycline, which results in a swift and effective response. The following review is aimed to summarize the key clinical, epidemiological, ecological, diagnostic, and treatment aspects of flea-borne rickettsioses.
Collapse
Affiliation(s)
- Maria A Caravedo Martinez
- Department of Internal Medicine – Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Lucas S Blanton
- Department of Internal Medicine – Division of Infectious Diseases, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
23
|
Abstract
Scrub typhus and other rickettsial infections contribute to 25 - 50% of acute undifferentiated febrile illnesses in endemic regions. Delayed recognition and therapy increase the morbidity and mortality. The constellation of fever with eschar or rash and multisystem involvement should facilitate the diagnosis and initiation of appropriate therapy. The pathological hallmark of rickettsial infections is endothelial infection and inflammation causing vasculitis. Endothelial inflammation results in microvascular dysfunction and increased vascular permeability. Immune and endothelial activation may worsen microvascular dysfunction, predisposing to multi-organ failure. Serology is the mainstay of diagnosis, although false negatives occur early in the disease. Point-of-care rapid diagnostic tests and molecular techniques, such as quantitative polymerase chain reaction (qPCR), can hasten diagnostic processes. Intravenous doxycycline with a loading dose is the most widely used antibiotic in critically ill patients, with azithromycin as a suitable alternative. Early appropriate treatment and organ support can decrease the duration of illness and be life-saving. How to cite this article: Gunasekaran K, Bal D, Varghese GM, et al. Scrub Typhus and Other Rickettsial Infections. Indian J Crit Care Med 2021;25(Suppl 2):S138-S143.
Collapse
Affiliation(s)
- Karthik Gunasekaran
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Deepti Bal
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - George M Varghese
- Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
24
|
Elders PND, Swe MMM, Phyo AP, McLean ARD, Lin HN, Soe K, Htay WYA, Tanganuchitcharnchai A, Hla TK, Tun NN, Nwe TT, Moe MM, Thein WM, Zaw NN, Kyaw WM, Linn H, Htwe YY, Smithuis FM, Blacksell SD, Ashley EA. Serological evidence indicates widespread distribution of rickettsioses in Myanmar. Int J Infect Dis 2020; 103:494-501. [PMID: 33310022 PMCID: PMC7862081 DOI: 10.1016/j.ijid.2020.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022] Open
Abstract
Diagnosis of rickettsial infections is difficult in low-resource settings; this leads to delays in receiving appropriate treatment. Before this study, the distribution of rickettsioses in Myanmar was not known. This serosurvey shows that rickettsioses are widespread in Myanmar. Particularly high prevalence of scrub typhus was found in central and northern regions.
Background Little research has been published on the prevalence of rickettsial infections in Myanmar. This study determined the seroprevalence of immunoglobulin G (IgG) antibodies to rickettsial species in different regions of Myanmar. Methods Seven hundred leftover blood samples from patients of all ages in primary care clinics and hospitals in seven regions of Myanmar were collected. Samples were screened for scrub typhus group (STG), typhus group (TG) and spotted fever group (SFG) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Immunofluorescence assays were performed for the same rickettsial groups to confirm seropositivity if ELISA optical density ≥0.5. Results Overall IgG seroprevalence was 19% [95% confidence interval (CI) 16–22%] for STG, 5% (95% CI 3–7%) for TG and 3% (95% CI: 2–5%) for SFG. The seroprevalence of STG was particularly high in northern and central Myanmar (59% and 19–33%, respectively). Increasing age was associated with higher odds of STG and TG seropositivity [per 10-year increase, adjusted odds ratio estimate 1.68 (p < 0.01) and 1.24 (p = 0.03), respectively]. Conclusion Rickettsial infections are widespread in Myanmar, with particularly high seroprevalence of STG IgG antibodies in central and northern regions. Healthcare workers should consider rickettsial infections as common causes of fever in Myanmar.
Collapse
Affiliation(s)
| | | | | | - Alistair R D McLean
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Kyaw Soe
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | | | - Ampai Tanganuchitcharnchai
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thel K Hla
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Medical Action Myanmar, Yangon, Myanmar
| | - Ni Ni Tun
- Medical Action Myanmar, Yangon, Myanmar
| | - Thin Thin Nwe
- Magway General Hospital and University of Medicine, Magway, Myanmar; University of Medicine 2, Yangon, Myanmar
| | - Myat Myat Moe
- Magway General Hospital and University of Medicine, Magway, Myanmar
| | - Win May Thein
- Mandalay General Hospital and University of Medicine, Mandalay, Myanmar
| | - Ni Ni Zaw
- Mandalay General Hospital and University of Medicine, Mandalay, Myanmar
| | | | - Htun Linn
- Monywa General Hospital, Monywa, Myanmar
| | | | - Frank M Smithuis
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Medical Action Myanmar, Yangon, Myanmar
| | - Stuart D Blacksell
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Elizabeth A Ashley
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic.
| |
Collapse
|
25
|
Diagnostic accuracy of an in-house Scrub Typhus enzyme linked immunoassay for the detection of IgM and IgG antibodies in Laos. PLoS Negl Trop Dis 2020; 14:e0008858. [PMID: 33284807 PMCID: PMC7746293 DOI: 10.1371/journal.pntd.0008858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/17/2020] [Accepted: 10/06/2020] [Indexed: 01/30/2023] Open
Abstract
Scrub typhus is a major cause of morbidity and mortality in Southeast Asia. Diagnosis of scrub typhus is difficult due to a lack of accessible validated diagnostic tools. Despite its objectivity, the diagnostic accuracy of ELISA tests is influenced by methodological and patient factors. This study aims to evaluate the performance of a novel in-house ELISA developed in the Mahidol Oxford Tropical Medicine Research Unit (MORU) for anti-scrub typhus group IgM and IgG compared to the “gold standard” reference IFA and PCR, and to determine whether the in-house ELISA can be used as a seroepidemiological screening tool and/or stand-alone test for scrub typhus. A total of 1,976 admission and 1,438 participant follow-up sera collected in the Lao PDR (Laos) were tested with ELISA for IgM and IgG. Samples with an ELISA OD≥0.50 were tested with IFA for IgM and/or IgG. A strong positive relationship was present between ELISA ODs and IFA titers for admission IgM (r2: 0.70, p <0.005) and IgG (r2: 0.76, p<0.005), and for follow-up IgM and IgG (both r2: 0.76, p<0.005) samples. The best compromise between sensitivity and specificity for the ELISA OD cut-off is likely to be between 0.8–1.0 for IgM antibodies and 1.2–1.8 for IgG antibodies. These results demonstrate that the diagnostic accuracy of the MORU in-house scrub typhus group ELISA is comparable to that of IFA, with similar results as reported for the commonly used InBios Scrub Typhus Detect ELISA, validating the use of the in-house ELISA. The optimal ELISA cut-off would depend on the use of the test, and the desired sensitivity and specificity. Further studies are required to authenticate the use of these cut-offs in other endemic regions. This in-house ELISA has the potential to replace the imperfect IFA, which could ultimately reduce the burden of scrub typhus by improving the rate of scrub typhus diagnoses in endemic low-resource areas. Scrub typhus is a mite-borne infectious disease, caused by the Orientia tsutsugamushi bacterium, resulting in considerable morbidity and mortality in the Asia-Pacific region. Diagnosis is difficult since it does not present with any distinctive clinical signs compared to other febrile illnesses in this region, except for a necrotic skin lesion (eschar) in some patients. Laboratory tests are therefore crucial to identify scrub typhus. Reliable laboratory tests need significant infrastructure and experienced staff, making access to accurate tests very limited in the low-resource endemic regions. This study aimed to evaluate the accuracy of less expensive and easier-to-use in-house Enzyme Linked Immunoassays (ELISAs) detecting immunoglobulin IgM and IgG antibodies against scrub typhus infection compared to the “gold-standard” Immunofluorescence Assays (IFAs). There was a strong positive relationship between ELISA and IFA antibody levels for both IgM and IgG. If the ELISA would be used as a stand-alone test for scrub typhus diagnosis in Laos, an ideal balance between sensitivity and specificity would likely be around an ELISA optical density (OD) of 0.8–1.0 for IgM and 1.2–1.8 for IgG. There is a need to investigate the use of these cut-offs in other endemic regions, which could improve the rate of scrub typhus diagnosis in low-resource settings.
Collapse
|
26
|
Paris DH, Kelly DJ, Fuerst PA, Day NPJ, Richards AL. A Brief History of the Major Rickettsioses in the Asia-Australia-Pacific Region: A Capstone Review for the Special Issue of TMID. Trop Med Infect Dis 2020; 5:tropicalmed5040165. [PMID: 33121158 PMCID: PMC7709643 DOI: 10.3390/tropicalmed5040165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/19/2022] Open
Abstract
The rickettsioses of the "Far East" or Asia-Australia-Pacific region include but are not limited to endemic typhus, scrub typhus, and more recently, tick typhus or spotted fever. These diseases embody the diversity of rickettsial disease worldwide and allow us to interconnect the various contributions to this special issue of Tropical Medicine and Infectious Disease. The impact of rickettsial diseases-particularly of scrub typhus-was substantial during the wars and "police actions" of the last 80 years. However, the post-World War II arrival of effective antibiotics reduced their impact, when recognized and adequately treated (chloramphenicol and tetracyclines). Presently, however, scrub typhus appears to be emerging and spreading into regions not previously reported. Better diagnostics, or higher population mobility, change in antimicrobial policies, even global warming, have been proposed as possible culprits of this phenomenon. Further, sporadic reports of possible antibiotic resistance have received the attention of clinicians and epidemiologists, raising interest in developing and testing novel diagnostics to facilitate medical diagnosis. We present a brief history of rickettsial diseases, their relative importance within the region, focusing on the so-called "tsutsugamushi triangle", the past and present impact of these diseases within the region, and indicate how historically, these often-confused diseases were ingeniously distinguished from each another. Moreover, we will discuss the importance of DNA-sequencing efforts for Orientia tsutsugamushi, obtained from patient blood, vector chiggers, and rodent reservoirs, particularly for the dominant 56-kD type-specific antigen gene (tsa56), and whole-genome sequences, which are increasing our knowledge of the diversity of this unique agent. We explore and discuss the potential of sequencing and other effective tools to geographically trace rickettsial disease agents, and develop control strategies to better mitigate the rickettsioses.
Collapse
Affiliation(s)
- Daniel H. Paris
- Department of Medicine, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
- Department of Clinical Research, University of Basel, 4051 Basel, Switzerland
- Correspondence: ; Tel.: +41-61-284-8111
| | - Daryl J. Kelly
- Department of Evolution, Ecology and Organismal Biology, The Ohio State University, Columbus, OH 43210, USA; (D.J.K.); (P.A.F.)
| | - Paul A. Fuerst
- Department of Evolution, Ecology and Organismal Biology, The Ohio State University, Columbus, OH 43210, USA; (D.J.K.); (P.A.F.)
| | - Nicholas P. J. Day
- Mahidol-Oxford Tropical Medicine Research Programme, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok 10400, Thailand;
- Center for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, Old Road, Headington, Oxford OX3 7LJ, UK
| | - Allen L. Richards
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA;
| |
Collapse
|
27
|
Lee KH, Heo ST, Jeong SU, Kim MY, Jeong WS, Hyun CL, Kim YK, Yoo JR. Acute Cholangitis Caused by Boryong Strain of Orientia tsutsugamushi. Infect Chemother 2020; 52:621-625. [PMID: 32869554 PMCID: PMC7779989 DOI: 10.3947/ic.2020.52.4.621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/06/2020] [Indexed: 11/24/2022] Open
Abstract
Scrub typhus present with a variety clinical manifestations caused by Orientia tsutsugamushi, it is sometimes accompanied by severe complications. The clinical course of this complication is not well clear. Herein, we first report a case with acute cholangitis and acalculous cholecystitis caused by the Boryong genotype of O. tsutsugamushi. A 82-year-old woman presented with fever and acute abdominal pain on the right upper quadrant. Initially, the patient showed an abnormality of liver enzymes of cholestatic pattern. An acute cholangitis and cholecystitis were suspected on the enhanced computed tomography (CT), and emergent endoscopic retrograde cholangiopancreatography (ERCP) performed. However, neither ERCP nor CT detected common bile duct stones or sludge. The patient's illness progressed despite bile drainage and antibiotic therapy. On the fifth day in hospital, an immunofluorescence IgG assay for O. tsutsugamushi was positive, and the patient newly developed a skin rash and an eschar lesion on the right abdomen. The polymerase chain reaction amplification of Orientia genes from blood and bile was positive, genotype of both samples was identified the Boryong type. The presentation of scrub typhus as an acute cholangitis is not reported till now. In endemic areas, scrub typhus would be considered a rare etiology of acute cholangitis.
Collapse
Affiliation(s)
- Keun Hwa Lee
- Department of Microbiology, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Seung Uk Jeong
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Mi Yeon Kim
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Woo Seong Jeong
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Chang Lim Hyun
- Department of Pathology, Jeju National University School of Medicine, Jeju, Korea
| | - Young Kyu Kim
- Department of Surgery, Jeju National University School of Medicine, Jeju, Korea
| | - Jeong Rae Yoo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
| |
Collapse
|
28
|
Rozo M, Schully KL, Philipson C, Fitkariwala A, Nhim D, Som T, Sieng D, Huot B, Dul S, Gregory MJ, Heang V, Vaughn A, Vantha T, Prouty AM, Chao CC, Zhang Z, Belinskaya T, Voegtly LJ, Cer RZ, Bishop-Lilly KA, Duplessis C, Lawler JV, Clark DV. An Observational Study of Sepsis in Takeo Province Cambodia: An in-depth examination of pathogens causing severe infections. PLoS Negl Trop Dis 2020; 14:e0008381. [PMID: 32804954 PMCID: PMC7430706 DOI: 10.1371/journal.pntd.0008381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 05/11/2020] [Indexed: 01/20/2023] Open
Abstract
The world's most consequential pathogens occur in regions with the fewest diagnostic resources, leaving the true burden of these diseases largely under-represented. During a prospective observational study of sepsis in Takeo Province Cambodia, we enrolled 200 patients over an 18-month period. By coupling traditional diagnostic methods such as culture, serology, and PCR to Next Generation Sequencing (NGS) and advanced statistical analyses, we successfully identified a pathogenic cause in 46.5% of our cohort. In all, we detected 25 infectious agents in 93 patients, including severe threat pathogens such as Burkholderia pseudomallei and viral pathogens such as Dengue virus. Approximately half of our cohort remained undiagnosed; however, an independent panel of clinical adjudicators determined that 81% of those patients had infectious causes of their hospitalization, further underscoring the difficulty of diagnosing severe infections in resource-limited settings. We garnered greater insight as to the clinical features of severe infection in Cambodia through analysis of a robust set of clinical data.
Collapse
Affiliation(s)
- Michelle Rozo
- Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Ft. Detrick, Maryland, United States of America
- The Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Kevin L. Schully
- Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Ft. Detrick, Maryland, United States of America
| | - Casandra Philipson
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Fort Detrick, Maryland, United States of America
- Defense Threat Reduction Agency, Fort Belvoir, Virginia, United States of America
| | | | | | - Tin Som
- Chenda Polyclinic, Phnom Penh, Cambodia
| | - Darith Sieng
- Lucerent Clinical Solutions, Phnom Penh, Cambodia
| | - Bora Huot
- Chenda Polyclinic, Phnom Penh, Cambodia
| | - Sokha Dul
- Chenda Polyclinic, Phnom Penh, Cambodia
| | | | - Vireak Heang
- U.S. Naval Medical Research Unit TWO (NAMRU-2), Phnom Penh, Cambodia
| | - Andrew Vaughn
- U.S. Naval Medical Research Unit TWO (NAMRU-2), Phnom Penh, Cambodia
| | - Te Vantha
- Takeo Provincial Referral Hospital, Takeo, Cambodia
| | - Angela M. Prouty
- U.S. Naval Medical Research Unit TWO (NAMRU-2), Phnom Penh, Cambodia
| | - Chien-Chung Chao
- Viral and Rickettsial Diseases Department, Naval Medical Research Center-Silver Spring, Silver Spring, Maryland, United States of America
| | - Zhiwen Zhang
- Viral and Rickettsial Diseases Department, Naval Medical Research Center-Silver Spring, Silver Spring, Maryland, United States of America
| | - Tatyana Belinskaya
- Viral and Rickettsial Diseases Department, Naval Medical Research Center-Silver Spring, Silver Spring, Maryland, United States of America
| | - Logan J. Voegtly
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Fort Detrick, Maryland, United States of America
- Leidos, Reston, Virginia, United States of America
| | - Regina Z. Cer
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Fort Detrick, Maryland, United States of America
- Leidos, Reston, Virginia, United States of America
| | - Kimberly A. Bishop-Lilly
- Genomics and Bioinformatics Department, Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Fort Detrick, Maryland, United States of America
| | - Chris Duplessis
- Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Ft. Detrick, Maryland, United States of America
| | - James V. Lawler
- Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Ft. Detrick, Maryland, United States of America
- Global Center for Health Security at Nebraska and Division of Infectious Disease, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Danielle V. Clark
- Austere environments Consortium for Enhanced Sepsis Outcomes (ACESO), Biological Defense Research Directorate, Naval Medical Research Center-Frederick, Ft. Detrick, Maryland, United States of America
- The Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| |
Collapse
|
29
|
Aman AT, Wibawa T, Kosasih H, Asdie RH, Safitri I, Intansari US, Mawarti Y, Sudarmono P, Arif M, Puspitasari D, Alisjahbana B, Parwati KTM, Gasem MH, Lokida D, Lukman N, Hartono TS, Mardian Y, Liang CJ, Siddiqui S, Karyana M, Lau CY. Etiologies of severe acute respiratory infection (SARI) and misdiagnosis of influenza in Indonesia, 2013-2016. Influenza Other Respir Viruses 2020; 15:34-44. [PMID: 32666619 PMCID: PMC7405185 DOI: 10.1111/irv.12781] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 03/02/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. However, epidemiology of SARI in tertiary hospitals in Indonesia is unknown. This study sought to assess the burden, clinical characteristics, and etiologies of SARI and concordance of clinical diagnosis with confirmed etiology. Methods Data and samples were collected from subjects presenting with SARI as part of the acute febrile Illness requiring hospitalization study (AFIRE). In tertiary hospitals, clinical diagnosis was ascertained from chart review. Samples were analyzed to determine the “true” etiology of SARI at hospitals and Indonesia Research Partnership on Infectious Diseases (INA‐RESPOND) laboratory. Distribution and characteristics of SARI by true etiology and accuracy of clinical diagnosis were assessed. Results Four hundred and twenty of 1464 AFIRE subjects presented with SARI; etiology was identified in 242 (57.6%), including 121 (28.8%) viruses and bacteria associated with systemic infections, 70 (16.7%) respiratory bacteria and viruses other than influenza virus, and 51 (12.1%) influenza virus cases. None of these influenza patients were accurately diagnosed as having influenza during hospitalization. Conclusions Influenza was misdiagnosed among all patients presenting with SARI to Indonesian tertiary hospitals in the AFIRE study. Diagnostic approaches and empiric management should be guided by known epidemiology. Public health strategies to address the high burden of influenza should include broad implementation of SARI screening, vaccination programs, clinician education and awareness campaigns, improved diagnostic capacity, and support for effective point‐of‐care tests.
Collapse
Affiliation(s)
- Abu Tholib Aman
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia.,Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Tri Wibawa
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia.,Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Herman Kosasih
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Rizka Humardewayanti Asdie
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Ida Safitri
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Department of Pediatric, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Umi Solekhah Intansari
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Department of Clinical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Yuli Mawarti
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia.,Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Pratiwi Sudarmono
- Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mansyur Arif
- Faculty of Medicine, Universitas Hasanudin / Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Dwiyanti Puspitasari
- Dr. Soetomo Academic General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Bachti Alisjahbana
- Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin Hospital, Sumedang, Indonesia
| | | | | | - Dewi Lokida
- Tangerang District Hospital, Tangerang, Indonesia
| | - Nurhayati Lukman
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Teguh Sarry Hartono
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Sulianti Saroso Hospital, Jakarta, Indonesia
| | - Yan Mardian
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - C Jason Liang
- National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
| | - Sophia Siddiqui
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
| | - Muhammad Karyana
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta, Indonesia
| | - Chuen-Yen Lau
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
30
|
Grigg MJ, William T, Clemens EG, Patel K, Chandna A, Wilkes CS, Barber BE, Anstey NM, Dumler JS, Yeo TW, Reller ME. Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia. Emerg Infect Dis 2020; 26. [PMID: 32568664 PMCID: PMC7323546 DOI: 10.3201/eid2607.191722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Orientia tsutsugamushi, spotted fever group rickettsioses, and typhus group rickettsioses (TGR) are reemerging causes of acute febrile illness (AFI) in Southeast Asia. To further delineate extent, we enrolled patients >4 weeks of age with nonmalarial AFI in Sabah, Malaysia, during 2013-2015. We confirmed rickettsioses (past or acute, IgG titer >160) in 126/354 (36%) patients. We confirmed acute rickettsioses (paired 4-fold IgG titer rise to >160) in 38/145 (26%) patients: 23 O. tsutsugamushi, 9 spotted fever group, 4 TGR, 1 O. tsutsugamushi/spotted fever group, and 1 O. tsutsugamushi/TGR. PCR results were positive in 11/319 (3%) patients. Confirmed rickettsioses were more common in male adults; agricultural/plantation work and recent forest exposure were risk factors. Dizziness and acute hearing loss but not eschars were reported more often with acute rickettsioses. Only 2 patients were treated with doxycycline. Acute rickettsioses are common (>26%), underrecognized, and untreated etiologies of AFI in East Malaysia; empirical doxycycline treatment should be considered.
Collapse
|
31
|
Prevalence of scrub typhus in a tertiary care centre in Telangana, south India. IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:204-208. [PMID: 32685116 PMCID: PMC7340608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Scrub typhus is re-emerging as an important cause of acute undifferentiated fever in the last decade from various parts of India. Complexity in performing the "gold standard" immunofluorescent assay and the unreliable nature of Weil Felix test often results in delayed or misdiagnosis in a majority of cases. The present study seeks to integrate the results of rapid diagnostic tests, clinical and laboratory features to aid the diagnosis and management of scrub typhus patients. MATERIALS AND METHODS A total of 645 serum samples with suspected scrub typhus sent to the Department of Microbiology were included in the study. Scrub typhus was tested by rapid immunochromatographic test (SD Diagnostics) and IgM ELISA (Inbios International, USA). Clinical features, laboratory parameters and final outcome were analysed from the clinical records of positive patients. RESULTS Scrub typhus was diagnosed in 13.7% of patients and majority of them were observed in the month of August. 58.6% of scrub typhus patients presented with fever of one to two weeks duration. Eschar was documented in 13.7% of patients and 24% of patients gave a history of working outdoors or exposure to vegetation. All the patients responded to Doxycycline treatment and there was no mortality. CONCLUSION High index of suspicion for scrub typhus is necessary in febrile patients not responding to conventional antibiotics especially during outbreak situations. Rapid immunochromatographic tests with excellent specificity and acceptable sensitivity can be used as potential point of care tests for quick diagnosis of scrub typhus especially in delayed presentation.
Collapse
|
32
|
Devamani CS, Schmidt WP, Ariyoshi K, Anitha A, Kalaimani S, Prakash JAJ. Risk Factors for Scrub Typhus, Murine Typhus, and Spotted Fever Seropositivity in Urban Areas, Rural Plains, and Peri-Forest Hill Villages in South India: A Cross-Sectional Study. Am J Trop Med Hyg 2020; 103:238-248. [PMID: 32458785 PMCID: PMC7356468 DOI: 10.4269/ajtmh.19-0642] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Scrub typhus and spotted fever group rickettsioses are thought to be common causes of febrile illness in India, whereas they rarely test for murine typhus. This cross-sectional study explored the risk factors associated with scrub typhus, tick-borne spotted fever, and murine typhus seropositivity in three different geographical settings, urban, rural, and hill villages in Tamil Nadu, South India. We enrolled 1,353 participants living in 48 clusters. The study included a questionnaire survey and blood sampling. Blood was tested for Orientia tsutsugamushi (scrub typhus), Rickettsia typhi (murine typhus), and spotted fever group Rickettsia IgG using ELISA. The seroprevalence of scrub typhus, spotted fever, and murine typhus were 20.4%, 10.4%, and 5.4%, respectively. Scrub typhus had the highest prevalence in rural areas (28.1%), and spotted fever was most common in peri-forested areas (14.9%). Murine typhus was more common in rural (8.7%) than urban areas (5.4%) and absent in peri-forested hill areas. Agricultural workers had a higher relative risk for scrub typhus, especially in urban areas. For murine typhus, proximity to a waterbody and owning a dog were found to be major risk factors. The main risk factors for spotted fever were agricultural work and living in proximity to a forest. Urban, rural plains, and hill settings display distinct epidemiological pattern of Orientia and rickettsial infections. Although scrub typhus and spotted fever were associated with known risk factors in this study, the findings suggest a different ecology of murine typhus transmission compared with other studies conducted in Asia.
Collapse
Affiliation(s)
| | - Wolf-Peter Schmidt
- Department for Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Arumugam Anitha
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Saravanan Kalaimani
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - John A J Prakash
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| |
Collapse
|
33
|
Galay RL, Talactac MR, Ambita-Salem BV, Chu DMM, Costa LMOD, Salangsang CMA, Caracas DKB, Generoso FH, Babelonia JA, Vergano JL, Berana LC, Sandalo KAC, Divina BP, Alvarez CR, Mago ER, Andoh M, Tanaka T. Molecular Detection of Rickettsia Spp. and Coxiella Burnetii in Cattle, Water Buffalo, and Rhipicephalus ( Boophilus) Microplus Ticks in Luzon Island of the Philippines. Trop Med Infect Dis 2020; 5:tropicalmed5020054. [PMID: 32260468 PMCID: PMC7345074 DOI: 10.3390/tropicalmed5020054] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/30/2020] [Accepted: 04/02/2020] [Indexed: 12/25/2022] Open
Abstract
Rickettsia and Coxiella burnetii are zoonotic, tick-borne pathogens that can cause febrile illnesses with or without other symptoms in humans, but may cause subclinical infections in animals. There are only a few reports on the occurrence of these pathogens in cattle and water buffalo in Southeast Asia, including the Philippines. In this study, molecular detection of Rickettsia and C. burnetii in the blood and in the Rhipicephalus (Boophilus) microplus ticks of cattle and water buffalo from five provinces in Luzon Island of the Philippines was done. A total of 620 blood samples of cattle and water buffalo and 206 tick samples were collected and subjected to DNA extraction. After successful amplification of control genes, nested PCR was performed to detect gltA of Rickettsia and com1 of C. burnetii. No samples were positive for Rickettsia, while 10 (cattle = 7, water buffaloes = 3), or 1.6% of blood, and five, or 1.8% of tick samples, were C. burnetii-positive. Sequence analysis of the positive amplicons showed 99-100% similarity to reported C. burnetii isolates. This molecular evidence on the occurrence of C. burnetii in Philippine ruminants and cattle ticks and its zoonotic nature should prompt further investigation and surveillance to facilitate its effective control.
Collapse
Affiliation(s)
- Remil L. Galay
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
- Correspondence: (R.L.G.); (T.T.); Tel.: +63-049-536-2728 (R.L.G.); +81-99-285-3570 (T.T.)
| | - Melbourne R. Talactac
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Bea V. Ambita-Salem
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Dawn Maureen M. Chu
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Lali Marie O. dela Costa
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Cinnamon Mae A. Salangsang
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Darwin Kyle B. Caracas
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Florante H. Generoso
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Jonathan A. Babelonia
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Joeneil L. Vergano
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Lena C. Berana
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Kristina Andrea C. Sandalo
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Billy P. Divina
- Department of Veterinary Paraclinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, College, Laguna 4031, Philippines; (B.V.A.-S.); (D.M.M.C.); (L.M.O.d.C.); (C.M.A.S.); (D.K.B.C.); (K.A.C.S.); (B.P.D.)
| | - Cherry R. Alvarez
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Emmanuel R. Mago
- Department of Clinical and Population Health, College of Veterinary Medicine and Biomedical Sciences, Cavite State University, Indang, Cavite 4122, Philippines; (M.R.T.); (F.H.G.); (J.A.B.); (J.L.V.); (L.C.B.); (C.R.A.); (E.R.M.)
| | - Masako Andoh
- Laboratory of Public Health, Joint Faculty of Veterinary Medicine, Kagoshima University, Korimoto 1-21-24, Kagoshima 890-0065, Japan;
| | - Tetsuya Tanaka
- Laboratory of Infectious Diseases, Joint Faculty of Veterinary Medicine, Kagoshima University, Korimoto 1-21-24, Kagoshima 890-0065, Japan
- Correspondence: (R.L.G.); (T.T.); Tel.: +63-049-536-2728 (R.L.G.); +81-99-285-3570 (T.T.)
| |
Collapse
|
34
|
Low VL, Tan TK, Khoo JJ, Lim FS, AbuBakar S. An overview of rickettsiae in Southeast Asia: Vector-animal-human interface. Acta Trop 2020; 202:105282. [PMID: 31778642 DOI: 10.1016/j.actatropica.2019.105282] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/24/2019] [Accepted: 11/24/2019] [Indexed: 02/07/2023]
Abstract
Rickettsioses are emerging, and re-emerging diseases caused by obligate intracellular arthropod-borne bacteria that infect humans and animals worldwide. Various rickettsiae such as Orientia, Rickettsia, Anaplasma and Ehrlichia have been circulated in companion, domesticated and wild animals through bites of infected ticks, fleas, lice or mites. This review summarizes the infections of rickettsiae, including the newly discovered regional species Rickettsia thailandii, Candidatus Rickettsia sepangensis, Candidatus Rickettsia johorensis, Candidatus Rickettsia laoensis, Candidatus Rickettsia mahosotii, Candidatus Rickettsia khammouanensis, Candidatus Anaplasma pangolinii, and other novel genotypes in vectors, humans and animals in Southeast Asia. Issues on some unidentified rickettsiae that elicit immune responses and production of antibodies that are cross-reactive with the antigens used are discussed. Knowledge gaps which required attention are also identified in this review.
Collapse
Affiliation(s)
- Van Lun Low
- Higher Institution Centre of Excellence (HICoE), Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Tiong Kai Tan
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jing Jing Khoo
- Higher Institution Centre of Excellence (HICoE), Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia
| | - Fang Shiang Lim
- Higher Institution Centre of Excellence (HICoE), Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia
| | - Sazaly AbuBakar
- Higher Institution Centre of Excellence (HICoE), Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia; Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
35
|
Lokida D, Sudarmono P, Kosasih H, Butar-butar DP, Salim G, Antonjaya U, Sari RA, Aman AT, Parwati I, Arif M, Lau CY, Karyana M. Comparison of Commercial Enzyme-Linked Immunosorbent Assay and Immunofluorescence Assay for Diagnosis of Acute Rickettsia typhi Infections. Vector Borne Zoonotic Dis 2020; 20:93-99. [PMID: 31448989 PMCID: PMC7041318 DOI: 10.1089/vbz.2019.2451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Murine typhus is a tropical disease caused by Rickettsia typhi and is endemic in resource-limited settings such as Southeast Asian countries. Early diagnosis of R. typhi infection facilitates appropriate management and reduces the risk of severe disease. However, molecular detection of R. typhi in blood is insensitive due to low rickettsemia. Furthermore, the gold standard of sero-diagnosis by immunofluorescence assay (IFA) is cumbersome, subjective, impractical, and unavailable in many endemic areas. In an attempt to identify a practical diagnostic approach that can be applied in Indonesia, we evaluated the performance of commercial R. typhi IgM and IgG enzyme-linked immunosorbent assay (ELISA) and IFA using paired plasma from previously studied R. typhi PCR-positive cases and controls with other known infections. Sensitivity and specificity of combined ELISA IgM and IgG anti-R. typhi using paired specimens were excellent (95.0% and 98.3%, respectively), comparable to combined IFA IgM and IgG (97.5% and 100%, respectively); sensitivity of ELISA IgM from acute specimens only was poor (45.0%), but specificity was excellent (98.3%). IFA IgM was more sensitive (77.5%), but less specific (89.7%) for single specimens.
Collapse
Affiliation(s)
- Dewi Lokida
- Department of Clinical Pathology, Tangerang District Hospital, Tangerang, Indonesia
| | | | - Herman Kosasih
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Deni Pepy Butar-butar
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Gustiani Salim
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | | | - Rizky Amalia Sari
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Abu Tholib Aman
- Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ida Parwati
- Department of Clinical Pathology, Universitas Padjadjaran/Hasan Sadikin Hospital, Bandung, Indonesia
| | - Mansyur Arif
- Faculty of Medicine, Universitas Hasanudin/Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Chuen-Yen Lau
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Muhammad Karyana
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| |
Collapse
|
36
|
Rogozin E, Lazarovitch T, Weinberger M. High Morbidity Due to Murine Typhus Upsurge in Urban Neighborhoods in Central Israel. Am J Trop Med Hyg 2020; 100:952-956. [PMID: 30761983 DOI: 10.4269/ajtmh.18-0076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The incidence of murine typhus in Israel has decreased substantially since 1950 to a low of 0.04/100,000 population in 2010. We present the experience of a single university medical center in central Israel. Hospitalized patients serologically positive for Rickettsia typhi by indirect immunofluorescence antibody assay during 2006-2016 were retrospectively identified. Clinical and laboratory data from patients' charts were used to analyze disease trends and distribution. Seventy-eight patients were studied (mean age: 27.9 years), mostly of Arab ethnicity (68, 87.2%). Seventy-one (91%) patients resided in two large mixed Jewish-Arab cities-Lod and Ramla. The incidence of murine typhus among the Arab population in Lod increased 8.4-fold from 6.4/100,000 in 2006 to a peak of 53.4/100,000 in 2013. The average annual incidence among Arabs in Ramla was 10.1/100,000. Among Jews, incidences were 0.8/100,000 in Lod and 0.4/100,000 in Ramla. The classical triad of fever, headache, and rash was noted in 20.8% patients. Substantial morbidity included prolonged fever before hospitalization and hospital stay (mean of 8.4 and 5.1 days, respectively), and severe complications in six patients, including pneumonitis in three patients, and splenic infarctions, pericardial effusion, and retinitis, each in one. One previously healthy patient died of multiorgan failure. The study describes a high incidence of murine typhus with a recent upsurge in an urban setting in central Israel. High morbidity and a single fatal outcome challenge the concept of murine typhus being a mild disease. The study calls for better rodent control and sanitation measures in the affected neighborhoods.
Collapse
Affiliation(s)
- Evgeny Rogozin
- Department of Medicine B, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Tsilia Lazarovitch
- The Microbiology Laboratory, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Miriam Weinberger
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Infectious Diseases Unit, Assaf Harofeh Medical Center, Zerifin, Israel
| |
Collapse
|
37
|
Phuklia W, Panyanivong P, Sengdetka D, Sonthayanon P, Newton PN, Paris DH, Day NPJ, Dittrich S. Novel high-throughput screening method using quantitative PCR to determine the antimicrobial susceptibility of Orientia tsutsugamushi clinical isolates. J Antimicrob Chemother 2020; 74:74-81. [PMID: 30295746 PMCID: PMC6293087 DOI: 10.1093/jac/dky402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/05/2018] [Indexed: 01/08/2023] Open
Abstract
Objectives To develop a method to enable the large-scale antimicrobial susceptibility screening of Orientia tsutsugamushi clinical isolates, using one timepoint and one concentration of antibiotics to considerably speed up the time to result. Methods Growth, harvesting, multiplicity of infection (moi) and the day to determine the MICs were optimized using five O. tsutsugamushi reference strains [susceptible (Karp, Kato and Gilliam) and putatively resistant (AFC-3 and AFSC-4)], one clinical isolate (UT76) and one rodent isolate (TA763). Subsequently, the MICs of azithromycin, chloramphenicol and doxycycline for these strains and 51 clinical isolates including AFSC-7 were determined. An optimal concentration was calculated using the epidemiological cut-off value. Results The conditions for O. tsutsugamushi infection, growth and harvesting were determined to be an moi of 100:1 and trypsinization with the peak growth on day 10. The resulting MICs were in line with previously published susceptibility data for all reference strains, except for Karp and AFSC-4, which showed azithromycin MICs of 0.0156 and 0.0313 mg/L, compared with 0.0078 and 0.0156 mg/L, respectively, in previous reports. The MIC of doxycycline for AFC-3 was 0.125 mg/L compared with >4 mg/L in earlier reports. The final single screening concentrations were identified as: azithromycin, 0.125 mg/L; chloramphenicol, 8 mg/L; and doxycycline, 1 mg/L. Conclusions This simplified procedure facilitates the simultaneous screening of 48 isolates for actively monitoring potential resistance of this important fever pathogen, with an 8-fold throughput improvement over early methods. The data do not support the existence of doxycycline- and chloramphenicol-resistant scrub typhus.
Collapse
Affiliation(s)
- Weerawat Phuklia
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Phonepasith Panyanivong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Davanh Sengdetka
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Piengchan Sonthayanon
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Daniel H Paris
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sabine Dittrich
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,FIND, Malaria & Fever Program, Geneva, Switzerland
| |
Collapse
|
38
|
Gasem MH, Kosasih H, Tjitra E, Alisjahbana B, Karyana M, Lokida D, Neal A, Liang CJ, Aman AT, Arif M, Sudarmono P, Suharto, Merati TP, Lisdawati V, Siswanto, Siddiqui S, Lane HC. An observational prospective cohort study of the epidemiology of hospitalized patients with acute febrile illness in Indonesia. PLoS Negl Trop Dis 2020; 14:e0007927. [PMID: 31923174 PMCID: PMC6977771 DOI: 10.1371/journal.pntd.0007927] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/23/2020] [Accepted: 11/14/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The epidemiology of acute febrile illness, a common cause of hospitalization in Indonesia, has not been systematically studied. METHODOLOGY/PRINCIPAL FINDINGS This prospective observational study enrolled febrile patients (temperature ≥38°C) aged ≥1 year from July 2013 until June 2016 at eight government referral teaching hospitals in seven provincial capitals in Indonesia. Patients were managed according to the hospital standard-of-care (SOC), and blood samples were drawn for molecular and serological assays. Clinical data, laboratory results, and specimens for additional tests were collected at enrollment, days 14-28, and at three months. Regular follow-up visits were then scheduled for every three months either until symptoms resolved or until one year. In total, this study included 1,486 adult and pediatric patients presenting with multi-organ (768, 51.7%), gastrointestinal (497, 33.0%), respiratory (114, 7.7%), constitutional (62, 4.2%), skin and soft-tissue (24, 1.6%), central nervous system (17, 1.1%), or genitourinary (4, 0.3%) manifestations. Microbiological diagnoses were found in 1,003/1,486 (67.5%) participants, of which 351/1,003 (35.0%) were not diagnosed during hospitalization using SOC diagnostic tests. Missed diagnoses included all cases caused by Rickettsia spp., chikungunya, influenza, and Seoul virus. The most common etiologic agents identified were dengue virus (467, 46.6%), Salmonella spp. (103, 10.3%), and Rickettsia spp. (103, 10.3%). The overall mortality was 89 (5.9%). CONCLUSIONS/SIGNIFICANCE Febrile illness in Indonesia has various microbiologic etiologies and substantial overall mortality. Diagnostic limitations and lack of epidemiologic data resulted in potentially treatable, and at times fatal, diseases being missed.
Collapse
Affiliation(s)
| | - Herman Kosasih
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta, Indonesia
| | - Emiliana Tjitra
- National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | | | - Muhammad Karyana
- National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | - Dewi Lokida
- Department of Clinical Pathology, Tangerang District Hospital, Tangerang, Indonesia
| | - Aaron Neal
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - C. Jason Liang
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Abu Tholib Aman
- Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mansyur Arif
- Faculty of Medicine, Universitas Hasanudin, Makassar, Indonesia
| | | | - Suharto
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Vivi Lisdawati
- Sulianti Saroso, Infectious Disease Hospital, Jakarta, Indonesia
| | - Siswanto
- National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | - Sophia Siddiqui
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - H. Clifford Lane
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | | |
Collapse
|
39
|
Trung NV, Hoi LT, Dien VM, Huong DT, Hoa TM, Lien VN, Van Luan P, Lewycka SO, Choisy M, Bryant JE, Nadjm B, Rogier van Doorn H, Richards AL, Van Kinh N. Clinical Manifestations and Molecular Diagnosis of Scrub Typhus and Murine Typhus, Vietnam, 2015-2017. Emerg Infect Dis 2019; 25. [PMID: 30882318 PMCID: PMC6433017 DOI: 10.3201/eid2504.180691] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Scrub typhus was the predominant rickettsial disease diagnosed among hospitalized patients with acute undifferentiated fever in northern Vietnam. Rickettsioses are endemic to Vietnam; however, only a limited number of clinical studies have been performed on these vectorborne bacteria. We conducted a prospective hospital-based study at 2 national referral hospitals in Hanoi to describe the clinical characteristics of scrub typhus and murine typhus in northern Vietnam and to assess the diagnostic applicability of quantitative real-time PCR assays to diagnose rickettsial diseases. We enrolled 302 patients with acute undifferentiated fever and clinically suspected rickettsiosis during March 2015–March 2017. We used a standardized case report form to collect clinical information and laboratory results at the time of admission and during treatment. We confirmed scrub typhus in 103 (34.1%) patients and murine typhus in 12 (3.3%) patients. These results highlight the need for increased emphasis on training for healthcare providers for earlier recognition, prevention, and treatment of rickettsial diseases in Vietnam.
Collapse
|
40
|
Satjanadumrong J, Robinson MT, Hughes T, Blacksell SD. Distribution and Ecological Drivers of Spotted Fever Group Rickettsia in Asia. ECOHEALTH 2019; 16:611-626. [PMID: 30993545 PMCID: PMC6910891 DOI: 10.1007/s10393-019-01409-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/30/2023]
Abstract
Spotted fever group and related rickettsia (SFGR) are a neglected group of pathogens that belong to the genus Rickettsia. SFGR are zoonotic and are transmitted by arthropod vectors, primarily ticks, fleas and mites to accidental hosts. These emerging and re-emerging infections are widely distributed throughout the world. Land-use change and increasing human-wildlife conflict compound the risk of SFGR infection to local people in endemic areas and travelers to these regions. In this article, we discuss the rickettsial organisms causing spotted fever and related diseases, their arthropod vectors in Asia and the impact of land-use change on their spread.
Collapse
Affiliation(s)
- Jaruwan Satjanadumrong
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand
| | - Matthew T Robinson
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7FZ, UK
| | - Tom Hughes
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand
- EcoHealth Alliance, 460 West 34th Street, 17th Floor, New York, NY, USA
| | - Stuart D Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok, 10400, Thailand.
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, OX3 7FZ, UK.
| |
Collapse
|
41
|
Ding F, Wang Q, Fu J, Chen S, Hao M, Ma T, Zheng C, Jiang D. Risk factors and predicted distribution of visceral leishmaniasis in the Xinjiang Uygur Autonomous Region, China, 2005-2015. Parasit Vectors 2019; 12:528. [PMID: 31703720 PMCID: PMC6839266 DOI: 10.1186/s13071-019-3778-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/30/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a neglected disease that is spread to humans by the bites of infected female phlebotomine sand flies. Although this vector-borne disease has been eliminated in most parts of China, it still poses a significant public health burden in the Xinjiang Uygur Autonomous Region. Understanding of the spatial epidemiology of the disease remains vague in the local community. In the present study, we investigated the spatiotemporal distribution of VL in the region in order to assess the potential threat of the disease. METHODS Based on comprehensive infection records, the spatiotemporal patterns of new cases of VL in the region between 2005 and 2015 were analysed. By combining maps of environmental and socioeconomic correlates, the boosted regression tree (BRT) model was adopted to identify the environmental niche of VL. RESULTS The fitted BRT models were used to map potential infection risk zones of VL in the Xinjiang Uygur Autonomous Region, revealing that the predicted high infection risk zones were mainly concentrated in central and northern Kashgar Prefecture, south of Atushi City bordering Kashgar Prefecture and regions of the northern Bayingolin Mongol Autonomous Prefecture. The final result revealed that approximately 16.64 million people inhabited the predicted potential infection risk areas in the region. CONCLUSIONS Our results provide a better understanding of the potential endemic foci of VL in the Xinjiang Uygur Autonomous Region with a 1 km spatial resolution, thereby enhancing our capacity to target the potential risk areas, to develop disease control strategies and to allocate medical supplies.
Collapse
Affiliation(s)
- Fangyu Ding
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qian Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jingying Fu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Shuai Chen
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Mengmeng Hao
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Tian Ma
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Canjun Zheng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing, 102206, China.
| | - Dong Jiang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China.
- Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Land & Resources, Beijing, 100101, China.
| |
Collapse
|
42
|
Abstract
Spotted fever group rickettsiae (SFG) are a neglected group of bacteria, belonging to the genus Rickettsia, that represent a large number of new and emerging infectious diseases with a worldwide distribution. The diseases are zoonotic and are transmitted by arthropod vectors, mainly ticks, fleas and mites, to hosts such as wild animals. Domesticated animals and humans are accidental hosts. In Asia, local people in endemic areas as well as travellers to these regions are at high risk of infection. In this review we compare SFG molecular and serological diagnostic methods and discuss their limitations. While there is a large range of molecular diagnostics and serological assays, both approaches have limitations and a positive result is dependent on the timing of sample collection. There is an increasing need for less expensive and easy-to-use diagnostic tests. However, despite many tests being available, their lack of suitability for use in resource-limited regions is of concern, as many require technical expertise, expensive equipment and reagents. In addition, many existing diagnostic tests still require rigorous validation in the regions and populations where these tests may be used, in particular to establish coherent and worthwhile cut-offs. It is likely that the best strategy is to use a real-time quantitative polymerase chain reaction (qPCR) and immunofluorescence assay in tandem. If the specimen is collected early enough in the infection there will be no antibodies but there will be a greater chance of a PCR positive result. Conversely, when there are detectable antibodies it is less likely that there will be a positive PCR result. It is therefore extremely important that a complete medical history is provided especially the number of days of fever prior to sample collection. More effort is required to develop and validate SFG diagnostics and those of other rickettsial infections.
Collapse
|
43
|
Shah HA, Huxley P, Elmes J, Murray KA. Agricultural land-uses consistently exacerbate infectious disease risks in Southeast Asia. Nat Commun 2019; 10:4299. [PMID: 31541099 PMCID: PMC6754503 DOI: 10.1038/s41467-019-12333-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/31/2019] [Indexed: 12/14/2022] Open
Abstract
Agriculture has been implicated as a potential driver of human infectious diseases. However, the generality of disease-agriculture relationships has not been systematically assessed, hindering efforts to incorporate human health considerations into land-use and development policies. Here we perform a meta-analysis with 34 eligible studies and show that people who live or work in agricultural land in Southeast Asia are on average 1.74 (CI 1.47-2.07) times as likely to be infected with a pathogen than those unexposed. Effect sizes are greatest for exposure to oil palm, rubber, and non-poultry based livestock farming and for hookworm (OR 2.42, CI 1.56-3.75), malaria (OR 2.00, CI 1.46-2.73), scrub typhus (OR 2.37, CI 1.41-3.96) and spotted fever group diseases (OR 3.91, CI 2.61-5.85). In contrast, no change in infection risk is detected for faecal-oral route diseases. Although responses vary by land-use and disease types, results suggest that agricultural land-uses exacerbate many infectious diseases in Southeast Asia.
Collapse
Affiliation(s)
- Hiral A Shah
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
- Grantham Institute-Climate Change and the Environment-Imperial College London, London, UK.
| | - Paul Huxley
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Grantham Institute-Climate Change and the Environment-Imperial College London, London, UK
| | - Jocelyn Elmes
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Grantham Institute-Climate Change and the Environment-Imperial College London, London, UK
| |
Collapse
|
44
|
Chang YC, Kuo KC, Sun W, Lin JN, Lai CH, Lee CH. Clinicoepidemiologic characteristics of scrub typhus and murine typhus: A multi-center study in southern Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2019; 52:769-778. [PMID: 31088776 DOI: 10.1016/j.jmii.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/14/2019] [Accepted: 04/24/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to offer key features to differentiate scrub typhus (ST) and murine typhus (MT) at the early stage of the diseases and provide clinicoepidemiologic characteristics of ST and MT in southern Taiwan, a region where both diseases are endemic. Comparison of doxycycline treatment efficacy between the two diseases by matching disease severity and delayed treatment had never been investigated. METHODS We reviewed the medical records of cases of ST and MT in four hospitals in southern Taiwan. Propensity-score matching was used to analyze the defervescence curves between patients with doxycycline-treated ST and MT by log-rank test. RESULTS Between 2004 and 2016, 265 ST and 63 MT cases were diagnosed. The number of cases of ST was significantly related to temperature (Rs = 0.77) and rainfall (Rs = 0.63). Island area exposure, arthropod bite, eschar, and lymphadenopathy were only recorded in ST patients. Multivariate analysis revealed that mountainous area exposure (odds ratio [OR], 11.0; 95% confidence interval [CI], 4.4-27.2) was an independent predictor for ST, while contact with rats (OR, 8.4; 95% CI, 3.3-21.3) was that for MT. After propensity-score matching, there was no difference in defervescence curves between these two rickettsioses treated with doxycycline (p = 0.24). CONCLUSION In the present study, island area exposure, arthropod bite, eschar, and lymphadenopathy were unique manifestations of ST. Mountainous area exposure is a predictive factor for ST, while contact with rats predicted MT. There was no difference in defervescence time between these two rickettsioses after doxycycline treatment.
Collapse
Affiliation(s)
- Yi-Chin Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Kuang-Che Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Wu Sun
- Infection Control Department, Pao-Chien Hospital, Pingtung County, Taiwan
| | - Jiun-Nong Lin
- Division of Infectious Diseases, Department of Internal Medicine and Department of Critical Care Medicine, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chung-Hsu Lai
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine and Division of Infection Control Laboratory, E-Da Hospital, Kaohsiung, Taiwan
| | - Chen-Hsiang Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
| |
Collapse
|
45
|
Bilateral Sensorineural Deafness in a Young Pregnant Female Presenting with a Fever: A Rare Complication of a Reemerging Disease-Spotted Fever Group Rickettsioses. Case Rep Infect Dis 2019; 2019:5923146. [PMID: 31019815 PMCID: PMC6452535 DOI: 10.1155/2019/5923146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/14/2019] [Accepted: 03/03/2019] [Indexed: 11/18/2022] Open
Abstract
Background Rickettsial illnesses are a group of arthropod-borne remerging diseases. They are subdivided into three groups as typhus, spotted fever, and scrub typhus group. Complications such as reversible bilateral deafness due to spotted fever rickettsioses are infrequently reported in the literature. Case Presentation We present a young pregnant female who developed bilateral sensorineural deafness on the fifth day of an acute febrile illness with a maculopapular rash. Rickettsia conorii IgG (>1/450) became highly positive, and she received oral azithromycin for ten days with complete resolution of fever and rash. The sensorineural deafness slowly improved over several months. Conclusion Sensorineural deafness is a rare complication of spotted fever group rickettsioses. Since usage of doxycycline is controversial in pregnancy, azithromycin gave a favourable recovery of fever. Sensorineural deafness took several months to resolve after completion of antibiotics.
Collapse
|
46
|
Prodjosoewojo S, Riswari SF, Djauhari H, Kosasih H, van Pelt LJ, Alisjahbana B, van der Ven AJ, de Mast Q. A novel diagnostic algorithm equipped on an automated hematology analyzer to differentiate between common causes of febrile illness in Southeast Asia. PLoS Negl Trop Dis 2019; 13:e0007183. [PMID: 30870415 PMCID: PMC6435198 DOI: 10.1371/journal.pntd.0007183] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/26/2019] [Accepted: 01/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Distinguishing arboviral infections from bacterial causes of febrile illness is of great importance for clinical management. The Infection Manager System (IMS) is a novel diagnostic algorithm equipped on a Sysmex hematology analyzer that evaluates the host response using novel techniques that quantify cellular activation and cell membrane composition. The aim of this study was to train and validate the IMS to differentiate between arboviral and common bacterial infections in Southeast Asia and compare its performance against C-reactive protein (CRP) and procalcitonin (PCT). METHODOLOGY/PRINCIPAL FINDINGS 600 adult Indonesian patients with acute febrile illness were enrolled in a prospective cohort study and analyzed using a structured diagnostic protocol. The IMS was first trained on the first 200 patients and subsequently validated using the complete cohort. A definite infectious etiology could be determined in 190 of 463 evaluable patients (41%), including 89 arboviral infections (81 dengue and 8 chikungunya), 94 bacterial infections (26 murine typhus, 16 salmonellosis, 6 leptospirosis and 46 cosmopolitan bacterial infections), 3 concomitant arboviral-bacterial infections, and 4 malaria infections. The IMS detected inflammation in all but two participants. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the IMS for arboviral infections were 69.7%, 97.9%, 96.9%, and 77.3%, respectively, and for bacterial infections 77.7%, 93.3%, 92.4%, and 79.8%. Inflammation remained unclassified in 19.1% and 22.5% of patients with a proven bacterial or arboviral infection. When cases of unclassified inflammation were grouped in the bacterial etiology group, the NPV for bacterial infection was 95.5%. IMS performed comparable to CRP and outperformed PCT in this cohort. CONCLUSIONS/SIGNIFICANCE The IMS is an automated, easy to use, novel diagnostic tool that allows rapid differentiation between common causes of febrile illness in Southeast Asia.
Collapse
Affiliation(s)
- Susantina Prodjosoewojo
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Silvita F. Riswari
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Hofiya Djauhari
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Herman Kosasih
- Indonesia Research Partnership of Infectious Disease (INA-RESPOND), Jakarta, Indonesia
| | - L. Joost van Pelt
- Department of Laboratory Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Bachti Alisjahbana
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Andre J. van der Ven
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Quirijn de Mast
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands
- * E-mail:
| |
Collapse
|
47
|
Bora T, Khan SA, Jampa L, Laskar B. Genetic diversity of Orientia tsutsugamushi strains circulating in Northeast India. Trans R Soc Trop Med Hyg 2019; 112:22-30. [PMID: 29584919 DOI: 10.1093/trstmh/try019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 02/08/2018] [Indexed: 01/30/2023] Open
Abstract
Background Scrub typhus, caused by the intracellular bacteria Orientia tsutsugamushi is widely distributed in Southeast Asian countries with antigenically divergent strains reported across the Asia-Pacific belt. The present study was conducted to characterize the circulating strains of Orientia tsutsugamushi prevailing in two Northeastern states of India-the gateway to most Southeast Asian countries. Methods A total of 278 (98 clinical and 180 field collected) scrub typhus positive blood samples collected from December 2014 to December 2016 were subjected for amplification of partial 56 KDa, 47 KDa and 16SrRNA genes of Orientia. Results Highest number of PCR positives were obtained for 56 KDa gene (17.3%); followed by 11.2% for 47 KDa gene and 5.1% for 16S rRNA gene. High degree of genetic diversity was identified among the identified strains, especially within the 56 KDa gene. Different strains of Orientia circulate in the northeastern part of India, with a pre-dominance of Karp-like strains. Independently branched isolates formed distinct clades, suggesting the possibility of a new strain type of Orientia. Conclusion This study provides insight into the genetic and evolutionary relationship of Orientia strains prevalent in this part of the country. Understanding the regional genetic diversity is crucial for its implications in vaccine developments strategies as well as sero-diagnostics. Accession numbers KU163366, KY594249, KY594248, KY594251, KU163359, KU163361, KU163363, KU163369, KY594250, KP067915, KU163373, KU163372, KU163370, KU163364, KU163362, KY594247, KY594252, KU163360, KU163365, KU163367, KU163368, KU163371, KX1555826, KY594257, KY594255, KY594256, KX155825, KX155829, KX155827, KX155828, KY594254, KY594253, KY594258, KY583503, KY583499, KY583501, KY583500, KY583502.
Collapse
Affiliation(s)
- Trishna Bora
- Arbovirology and Rickettsial Disease group, Entomology Division, Regional Medical Research Centre [ICMR], N.E. Region, Post box no. 105, Dibrugarh-786001, Assam
| | - Siraj Ahmed Khan
- Arbovirology and Rickettsial Disease group, Entomology Division, Regional Medical Research Centre [ICMR], N.E. Region, Post box no. 105, Dibrugarh-786001, Assam
| | - Lobsang Jampa
- State Epidemiologist, Directorate of Health Services, Arunachal Pradesh
| | - Basanta Laskar
- Department of Medicine, Assam Medical College & Hospital, Dibrugarh-786002, Assam, India
| |
Collapse
|
48
|
Sánchez-Montes S, Colunga-Salas P, Fernández-Figueroa EA, Medel MLH, Benítez CR, Becker I. Murine typhus in Mexico City: report of an imported case. Rev Inst Med Trop Sao Paulo 2019; 61:e16. [PMID: 30864621 PMCID: PMC6413773 DOI: 10.1590/s1678-9946201961016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/08/2018] [Indexed: 11/22/2022] Open
Abstract
Murine typhus is endemic in several countries. We herein report an imported case of murine typhus caused by Rickettsia typhi in Mexico City. This is the first report of a case after almost 20 years since the last report. The species was confirmed by DNA sequencing and phylogenetic reconstruction.
Collapse
Affiliation(s)
- Sokani Sánchez-Montes
- Universidad Nacional Autónoma de México, Facultad de Medicina,
Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental,
Ciudad de México, México
| | - Pablo Colunga-Salas
- Universidad Nacional Autónoma de México, Facultad de Medicina,
Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental,
Ciudad de México, México
| | - Edith A. Fernández-Figueroa
- Universidad Nacional Autónoma de México, Facultad de Medicina,
Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental,
Ciudad de México, México
- Instituto Nacional de Medicina Genómica, Computational Genomics
Laboratory, Ciudad de México, México
| | | | | | - Ingeborg Becker
- Universidad Nacional Autónoma de México, Facultad de Medicina,
Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental,
Ciudad de México, México
| |
Collapse
|
49
|
Kho KL, Tan PE, Tay ST. Diversity of Rickettsiae in Feeding and Questing Ticks Collected From a Malaysian Forest Reserve Area. JOURNAL OF MEDICAL ENTOMOLOGY 2019; 56:547-552. [PMID: 30304529 DOI: 10.1093/jme/tjy168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Indexed: 06/08/2023]
Abstract
High seropositivity to Rickettsia conorii and Rickettsia felis has been reported in Malaysian indigenous community living in settlements adjacent to forest areas. The current study was conducted to determine the type and distribution of rickettsiae in feeding and questing ticks that were collected from a forest reserve area at Kuala Lompat in Pahang, Malaysia. Using PCR assays targeting citrate synthase (gltA), outer membrane protein A (ompA) and B (ompB) genes, rickettsiae were detected from approximately one-third of 98 ticks (mainly Dermacentor and Haemaphysalis spp.) collected from the forest reserve. BLAST analysis reveals the predominance of Rickettsia sp. RF2125 in both feeding and questing ticks and Rickettsia sp. TCM1 in the questing ticks. Sequences exhibiting close genetic relationship with Rickettsia raoultii, Rickettsia tamurae, Rickettsia heilongjiangensis, and Rickettsia asiatica were also detected from the ticks. This study highlights the diversity of rickettsial species and potential tick vectors which may contribute to the high seropositivity observed among the local communities.
Collapse
Affiliation(s)
- Kai Ling Kho
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Poai Ean Tan
- Department of Wildlife and National Parks Peninsular Malaysia, Kuala Lumpur, Malaysia
| | - Sun Tee Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
50
|
Carroll C, Sarkisian S, Brillhart D. An Unusual Presentation of Murine Typhus and Mononucleosis. Mil Med 2018; 183:e756-e757. [DOI: 10.1093/milmed/usy106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/27/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christine Carroll
- Emergency Medicine Residency, Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave, Fort Hood, TX
| | - Simon Sarkisian
- Emergency Medicine Residency, Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave, Fort Hood, TX
| | - Daniel Brillhart
- Emergency Medicine Residency, Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave, Fort Hood, TX
| |
Collapse
|