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PubMedDate not supplied

Murine typhus in Greece: epidemiological, clinical, and therapeutic data from 83 cases.

Over a period of 5 years (1993-97), 83 cases of murine typhus were identified and studied in the city of Chania, on the island of Crete. Of these cases, 4.8% were registered in 1993, 19.3% in 1994, 47.0% in 1995, 10.8% in 1996, and 18.1% in 1997. The greatest incidence of the disease occurred during the third trimester of the year. Direct contact with rats was noted in 45 (54.2%) of 83 patients. Two strains of Rickettsia typhi were isolated in cell cultures. The predominant clinical manifestations were: fever (100%), headache (88%), chills (86.7%), and rash (79.5%). In 4 of the patients (4.8%), the disease was complicated by acute renal failure, and in 4 other patients (4.8%), by pulmonary consolidations. The outcome under appropriate treatment was favourable for all patients.

Adult↗
PubMed1989

Relapse of rickettsial Mediterranean spotted fever and murine typhus after treatment with chloramphenicol.

In the years 1975-1984, 132 patients with rickettsial Mediterranean spotted fever and murine typhus were treated with chloramphenicol or tetracycline. Among the 24 patients who received chloramphenicol ten relapsed and one failed to respond at all. None of the 108 recipients of tetracycline suffered a relapse. It appears that tetracycline should serve as first-line therapy in several rickettsial diseases.

Chloramphenicol↗
PubMed1999

An unusual site of chigger bite in a patient with scrub typhus.

A 70-year-old female farmer was admitted to the hospital because of fever, headache, and diarrhea for 7 days. Hypotension, right-sided pleural effusion with respiratory distress and leukocytosis were noted. She was initially treated as systemic bacterial infection by i.v. administration of ampicillin/sulbactam and amikacin. Because fever persisted in spite of aggressive treatment, a repeat thorough physical examination was done. An eschar was found over the left-sided labium majus and an enlarged lymph node was noted over the left inguinal region. Under the impression of scrub typhus, minocycline was administered. The patient's clinical condition improved dramatically within 3 days. The diagnosis was later confirmed by a serologic test for Rickettsia tsutsugamushi.

Aged↗
PubMed2004

The cause of the plague of Athens: plague, typhoid, typhus, smallpox, or measles?

The plague of Athens raged for 4 years and resulted in the defeat of Athens. The cause of the plague of Athens continues to be debated. Infectious diseases most often cited as causes of the plague include influenza, epidemic typhus, typhoid fever, bubonic plague, smallpox, and measles. Thucydides provides the only available description of the plague of Athens. Given the nuances of the translation, bubonic plague, smallpox, and measles are the most likely causes of the plague. In my view, measles is the most likely cause of the plague of Athens.

Communicable Diseases↗
PubMed2000

A century of typhus, lice and Rickettsia.

At the beginning of the 20th century, it was discovered at the Pasteur Institute in Tunis that epidemic typhus is transmitted by the human body louse. The complete genome sequence of its causative agent, Rickettsia prowazekii, was determined at Uppsala University in Sweden at the end of the century. In this mini-review, we discuss insights gained from the genome sequence of this fascinating and deadly organism.

Animals↗
PubMed2000

Transmission of Orientia tsutsugamushi, the aetiological agent for scrub typhus, to co-feeding mites.

Experiments were conducted to investigate the potential for transmission of Orientia tsutsugamushi, the aetiological agent for scrub typhus, when naturally infected mite larvae were co-feeding with uninfected larvae. Larvae from colonies of Leptotrombidium deliense and L. imphalum infected with O. tsutsugamushi were used. Transmission of O. tsutsugamushi to previously uninfected L. deliense and Blankaartia acuscutellaris co-fed with infected L. deliense was shown to occur. The overall minimum rate of acquisition was 1.6% (4/258) for L. deliense and 2.5% (3/119) for B. acuscutellaris. When individual infected L. deliense were co-fed with B. acuscutellaris acquisition of O. tsutsugamushi was not detected. However, when 4 and 8 infected larvae were co-fed with B. acuscutellaris acquisition of O. tsutsugamushi was detected. Transmission of O. tsutsugamushi was not observed when uninfected L. deliense were co-fed with infected L. imphalum. This novel transmission route may explain the occurrence of rickettsiae in genera other than Leptotrombidium spp, which are considered to be the main vectors of O. tsutsugamushi.

Animals↗
PubMed1997

Domestic cats as indicators of the presence of spotted fever and typhus group rickettsiae.

Using indirect immunofluorescence assays, sera from cats in Zimbabwe (n = 119) and South Africa (n = 52) were found to contain antibodies reactive with Rickettsia conorii (34% and 19% respectively) and R. typhi (7% and 10% respectively). These results indicate that cats may become infected with members of the spotted fever and typhus groups of rickettsiae and that cats can, therefore, be used as indicators of the presence of these organisms.

Animals↗
PubMed2002

Cytokins in the pathogenesis of astrakhan spotted Fever and North Asian scrub typhus: problems of immunocorrection.

Comparative study of interleukin-1 and tumor necrosis factor production under conditions of experimental rickettsial infection caused by agents of Astrakhan spotted fever and North Asian scrub typhus showed that therapy with galavit reduced manifestations of the disease, decreased mortality of experimental animals, and decreased the concentrations of interleukin-1 and tumor necrosis factor to normal values.

Animals↗
PubMed2002

Astrakhan scrub typhus: time course of infectious process according to electron microscopy findings.

Structural changes in the liver and spleen of albino mice with Astrakhan scrub typhus were studied by electron microscopy. Rickettsia invasion and formation of granulomas induced structural (destructive) and metabolic changes in hepatocytes. Rickettsia were degraded in cytophagosomes and cytolysophagosomes of hepatic macrophages (Kupffer cells) and blood capillary endotheliocytes. In the spleen rickettsia were seen in the extracellular spaces and in various cell populations.

Animals↗
PubMed1989

Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus.

An 81-year-old woman had chills, fever, nausea, vomiting, and epigastric pain. On day 3 she had hematuria and was treated with trimethoprim-sulfamethoxazole. On day 5 she had a cough, hypotension, anemia, azotemia, and elevated hepatic enzyme levels. Her condition deteriorated with thrombocytopenia, anuria requiring dialysis, edema, and hypoalbuminemia. Treatment with chloramphenicol and doxycycline was started on day 10. By day 11, she was in hypotensive shock; on day 12 she had seizures and died. Murine typhus was diagnosed by demonstration of antibodies to Rickettsia typhi by indirect immunofluorescence. Necropsy revealed interstitial pneumonia, pulmonary edema, hyaline membranes, alveolar hemorrhages, petechiae and vasculitis in the central nervous system, interstitial myocarditis, multifocal interstitial nephritis and hemorrhages, splenomegaly, portal triaditis, and mucosal hemorrhages in urinary tract. Immunofluorescent R. typhi were demonstrated in the lungs, brain, kidneys, liver, and heart. This unusual death occurred in an elderly patient without rash who was treated too late with antirickettsial drugs.

Aged↗
PubMed1977

Typhus fever: report of an epidemic in New York City in 1847.

An epidemic of thyphus fever in New York City in 1847 that was associated with massive immigrations from Ireland is described by review of the records of 138 cases admitted to The New York Hospital during a seven-week period. Medical understanding of epidemic diseases, of typhus, and of therapeutics is examined. Most patients (80%) acquired the disease during passage, but 20% of the cases resulted from secondary spread in New York. The illness was characterized by high fever, headache, myalgias, and loss of appetite. Complications, most commonly central nervous system dysfunction and secondary bacterial infections, occurred in 29% of the cases. The mortality rate was 11%. Therapy was directed at cleansing the bowel and diaphoresis. Bleeding was not employed. In spite of mistaken concepts about epidemic diseases, measures were employed that controlled spread of the disease.

Disease Outbreaks↗
PubMed1990

Diagnosis of acute typhus infection using the polymerase chain reaction.

The first use of the polymerase chain reaction (PCR) for the diagnosis of an acute rickettsial infection is described. A primer pair derived from the 17-kDa antigen sequence of Rickettsia rickettsii gave specific amplification of a 434-base pair DNA fragment from the genome of Rocky Mountain spotted fever and endemic and epidemic typhus. The assay could detect as few as 30 rickettsiae. Detection of PCR-amplified DNA with a nonradioactive DNA probe confirmed an acute infection with Rickettsia prowazekii.

Acute Disease↗
PubMed1994

Trombiculid fauna and seasonal abundance of Leptotrombidium scutellare (Acari: Trombiculidae) in an endemic area of scrub typhus (Tsutsugamushi disease) in Yamakita Town, Kanagawa Prefecture, Japan.

Using the Tullgren funnel method, we surveyed for trombiculid larvae around dwellings and in mandarin orange groves on the slopes of Sengenyama and Maruyama, Yamakita Town, Kanagawa Prefecture, Japan, during the period between 8 October 1992 and 8 January 1993. In total, 6,690 trombiculid larvae, consisting of 6,669 Leptotrombidium scutellare (Nagayo, Mitamura, Tamiya & Tenjin), 13 L. fuji Kuwata, Berge & Philip, two L. himizu (Sasa, Kumada, Hayashi, Enomoto, Fukuzumi & Obata), two Neotrombicula japonica (Tanaka, Kaiwa, Teramura & Kagaya), one Gahrliepia saduski Womersley, and three Walchia ogatai Sasa & Teramura, were taken from 240 soil samples (40 samples, six times at intervals of 2-4 wk). From the above species composition, L. scutellare is suspected to be the sole vector of scrub typhus in the survey area, where the disease is known to be caused by two serotypic strains of Rickettsia tsutsugamushi Ogata, Kawasaki and Kuroki. L. scutellare larvae rapidly increased in number in late October to form an acuminate peak of abundance in early November, followed by a gradual wane.

Agriculture↗
PubMed1998

A new ecology for scrub typhus associated with a focus of antibiotic resistance in rice farmers in Thailand.

Following the documentation of chloramphenicol-resistant and doxycycline-resistant strains of Orientia tsutsugamushi (Hyashi) in northern Thailand, we conducted ecological and epidemiological studies near the houses of patients hospitalized with antibiotic-resistant infections. New associations between chiggers, rodents, and O. tsutsugamushi in active rice agriculture areas, an ecological habitat not described previously, are reported. Rattus rattus (L.) was the most common species (representing 85.8% of the 1,433 rodents processed), followed by Rattus losea (Swinhoe) (9.4%), Bandicota indica (Bechstein) (3.6%), and Rattus argentiventer (Robinson and Kloss) (1.3%). O. tsutsugamushi was isolated from 30% of the R. rattus and R. losea, 29% of the B. indica, and 33% of the R. argentiventer collected. Mean minimum infection rates were 0.03 in Leptotrombidium chiangraiensis Tanskul & Linthicum, a new species of chigger, and 0.002 in Leptotrombidium imphalum (Vercammen-Grandjean & Langston), a chigger species not previously associated with scrub typhus transmission. Efficient vertical and horizontal transmission of O. tsutsugamushi by L. chiangraiensis and L. imphalum was demonstrated. During a 19-mo period from October 1993 to April 1995, the overall prevalence of human IgM and IgG antibody to O. tsutsugamushi was 25.5 and 47.3%, respectively. L. chiangraiensis and L. imphalum are incriminated as vectors of O. tsutsugamushi in a rice field habitat associated with a focus of antibiotic resistance.

Animals↗
PubMed1993

Serological reactivity of sera from scrub typhus patients against Weil-Felix test antigens.

Sera from 17 patients of scrub typhus in the acute and convalescent phases were tested by indirect immunoperoxidase test, Weil-Felix (WF) test, enzyme-linked immunosorbent assay (ELISA), and immunoblotting. In the comparison of antibody titers between acute- and convalescent-phase sera, we recognized a parallelism of increment between the titers in WF test and titers of immunoglobulin M (IgM) in ELISA against Proteus mirabilis strain OXK-whole cells and OXK-lipopolysaccharides (Proteus OXK-LPS). Furthermore, IgM antibodies from almost all of WF test-positive sera recognized LPS from Proteus OXK in immunoblotting. Based on these results, it was concluded that IgM antibody rather than IgG may participate in WF test, and that Proteus OXK-LPS may have one of antigenic epitopes common to the components of R. tsutsugamushi.

Agglutination Tests↗
PubMed1997

Prevalence of genotypes of Orientia tsutsugamushi in patients with scrub typhus in Miyazaki Prefecture.

The genotypes of Orientia tsutsugamushi in patients with scrub typhus in Miyazaki Prefecture were examined by polymerase chain reaction (PCR) and the restriction fragment length polymorphism method. Specific patterns for genotypes Irie, Hirano, Tazume and Yoshimura were detected in 26, 6, 5 and 2 of 39 DNA samples obtained from peripheral blood mononuclear cells, respectively. DNA sequences of the PCR products from the Tazume strain were genetically very close to the Hirano strain and the Yoshimura strain was also very close to the Karp strain. Furthermore, the DNA sequences from the Irie and Tazume strains were completely homologous to the reported sequences of the Kawasaki and Kuroki strains, respectively.

Base Sequence↗
PubMed1990

Possible typhus-group infection in New York State: presentation of four suspect cases.

Epidemiologic investigations were recently conducted on four cases which were reported in New York State in 1986 and 1987, three of which were within one family. These included hospital chart reviews, case or family interviews, animal trappings, and ectoparasite surveys. Serologic tests and immunoblots were performed on blood samples obtained from these patients. All four patients had acute febrile illnesses; two required hospitalization and one died. Microimmunofluorescence test results using Rickettsia typhi and R. prowazekii antigens showed a greater than or equal to 4-fold increase in titer with paired sera from three patients. The remaining patient had a single serum titer of 4096 with both antigens. In addition, sera from all patients reacted with R. typhi in the immunoblot test and, from the three patients for whom sera were available, also with R. prowazekii. Results suggest that the four patients were exposed to the typhus-group rickettsiae or to an organism which shares a common epitope(s).

Adult↗
PubMed1990

Diagnosis of acute typhus infection using the polymerase chain reaction.

We used the polymerase chain reaction (PCR) for the diagnosis of an acute rickettsial infection. A primer pair derived from the 17-kDa antigen sequence of Rickettsia rickettsii amplified specifically a 434-bp DNA fragment from the genome of Rocky Mountain spotted fever and endemic and epidemic typhus. The assay was able to detect as few as 30 rickettsiae. Detection of PCR-amplified DNA with a digoxigenin-labeled DNA probe confirmed an acute human infection with Rickettsia prowazekii.

Acute Disease↗