On the causative agent of tsutsugamushi disease isolated from field voles, Apodemus speciosus speciosus, inhabiting the foot area of Mt. Fuji in Japan.
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Animals↗
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Analysis of immunity in experimental Tsutsugamushi disease.
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Humans↗
Vectors vs. humans in Australia--who is on top down under? An update on vector-borne disease and research on vectors in Australia.
Australia has a diversity of vectors and vector-borne human diseases. Mosquito-borne arboviruses are of greatest concern, but there are issues with other vector and pathogen systems. Mosquitoes were responsible for more than 35,000 cases of Ross River virus during 1991-1997. Barmah Forest virus is increasing nationwide, and unidentified bunyaviruses suspected of causing illness have been isolated. Cases of Murray Valley encephalitis have occurred in 14 of the past 20 years in northern Australia. Dengue is a continuing problem for northern Queensland, with various serotypes being active. Japanese encephalitis has appeared in the Torres Strait Islands and threatens mainland Australia. Although malaria is eradicated, almost 1,000 cases are imported annually and occasional cases of local transmission occur. With ticks, paralysis in children occurs annually in eastern Australia. Tick typhus (Queensland Tick Typhus--Rickettsia australis) occurs down the east coast, and (Flinders Island Spotted Fever--Rickettsia honei) in Bass Strait and probably Tasmania. Lyme disease is reported but its presence is controversial. Fleas were responsible for a recent outbreak of murine typhus (Rickettsia typhi) in Western Australia. Mites cause scrub typhus (Orientia tsutsugamushi), and there was a recent fatality in the Northern Territory. Overall, resources for investigation and control of vector-borne disease have generally been meager. However, various avenues of basic and applied research have been pursued, and have included investigations into mosquito ecology, vector competence, disease epidemiology, and vector control. Disease surveillance programs vary between states, and mosquito control programs are organized and effective in only a few regions. There are concerns for import of vectors such as Aedes albopictus and export of pathogens such as Ross River virus; the former has occurred but the species has not become established, and the latter has occurred and has resulted in a major outbreak in the South Pacific. The predicted scenarios of increased temperature and rainfall with global warming are also causing concern for increases in vector-borne diseases, particularly the endemic arboviruses. Interest by health authorities is gravitating more towards epidemiological reporting and less towards public health action. In many respects, humans have much to do to get 'on top' of vectors and their pathogens 'down under' in Australia.
Animals↗
Current knowledge of rickettsial diseases in Italy.
Rickettsial diseases continue to be the cause of serious health problems in Italy. From 1998 to 2002, 4,604 clinical cases were reported, with 33 deaths in the period from 1998 to 2001. Almost all the cases reported in Italy are cases of Mediterranean spotted fever (MSF). Other rickettsioses that have been historically documented are murine typhus and epidemic typhus. Since 1950, only sporadic cases of murine typhus have been reported, and Italy currently appears to be free of epidemic typhus. As in other European countries, imported cases of rickettsialpox, African tick-bite fever (ATBF), and scrub typhus have been reported. In 2004, three cases of a mild form of rickettsiosis were serologically attributed to Rickettsia helvetica.
Adolescent↗
Indirect hemagglutination test of Rickettsia orientalis: its specificity for reference strains, Karp, Gilliam and Kato.
Amberlite XE-64 and bovine serum albumin-treated rickettsia suspension, which was prepared from the chicken yolk sacs infected with each of 3 reference strains of Rickettsia orientalis, Karp, Gilliam and Kato, was sonicated at 10 KC for 15 min at 4 degrees C and centrifuged at 10,000 rpm for 40 min at 0 degrees C. The supernatant was used to sensitize the formalinized and tanned sheep red blood cells (SFTSRC). This antigen (2.5%) could be preserved for at least 1 wk at 4-8 degrees C and at least a month, if merthiolate (1:10,000) was added. Each SFTSRCP of 3 reference strains was found to be specific in indirect hemagglutination (IHA) reaction with each homologous immune serum and there was little cross reaction with the heterologous one. This minor cross reaction might be due to the presence of a small amount of soluble antigen in SFTSRC. No cross IHA reaction with the typhus fever immune serum was observed. The IHA test was considered to be useful for the diagnosis of scrub typhus.
Antibody Specificity↗
Rickettsioses and the international traveler.
The rickettsioses--zoonotic bacterial infections transmitted to humans by arthropods--were for many years considered to be oddities in travel medicine. During the previous 2 decades, however, reports of >450 travel-associated cases have been published worldwide, the vast majority being murine typhus caused by Rickettsia typhi, Mediterranean spotted fever caused by Rickettsia conorii, African tick bite fever caused by Rickettsia africae, and scrub typhus caused by Orientia tsutsugamushi. Most patients present with a benign febrile illness accompanied by headache, myalgia, and cutaneous eruptions, but severe complications and fatalities are occasionally seen. Current microbiological tests include culture, polymerase chain reaction, and serological analysis, of which only the latter method is widely available. Tetracyclines are the drugs of first choice and should be prescribed whenever a case of rickettsiosis is suspected. Preventive measures rely on minimizing the risk of arthropod bites when traveling in areas of endemicity.
Humans↗
Rickettsiae and rickettsial diseases.
This paper summarizes present knowledge on rickettsiae and rickettsial diseases, and on their epidemiological characteristics, control, and public health significance. There are many natural foci of rickettsial diseases, from where the disease may spread to other areas in the world under changing socioeconomic conditions. Because of rapid long-distance travel, sporadic cases of serious rickettsial diseases may today appear far from endemic areas where the infection occurred. Even in endemic areas the disease may be misdiagnosed and deaths may occur as a result of inadequate treatment. Rapid treatment of rickettsial infections (preferably with tetracyclines) is therefore most important. Epidemic louse-borne typhus, though no longer subject to the International Health Regulations, remains one of the diseases in the WHO epidemiological surveillance programme. This disease continues to be a major cause of morbidity and mortality in some parts of Africa and it is present also in parts of the Americas and of Asia. Scrub typhus remains a continuing and serious public health problem in areas of South-East Asia and in the Western Pacific. The annual number of reported cases of Rocky Mountain spotted fever in the USA showed an increase during the last two decades, which may be due to improved recognition as well as to increased outdoor activities and migration of people from the city centres to the suburbs. Related forms of tick-borne typhus occur in South America, the Mediterranean region, Africa, South-East Asia, the Far East, and the Western Pacific. Increasing in number, though still sporadic, are reports of serious illness from chronic Q fever infection in many parts of the world.
Antigens, Bacterial↗
Ectoparasites of commensal rodents in Sulawesi Utara, Indonesia, with notes on species of medical importance.
Ectoparasite records are presented for four species of commensal murid rodents (Rattus rattus palelae Miller & Hollister, R. argentiventer (Robinson & Kloss), R. exulans (Peale) and Mus musculus castaneus Waterhouse) in Sulawesi Utara, with particular reference to the potential for these arthropods to bite and transmit pathogens to humans. The flea, Xenopsylla cheopis (Rothschild), was most common on R.r. palelae and is capable of transmitting plague and other pathogens to humans although no current foci for these diseases are known in Sulawesi. Hoplopleura pacifica Ewing and Polyplax spinulosa (Burmeister) sucking lice parasitized all three Rattus species although H. pacifica was mainly associated with R. exulans and P. spinulosa with R.r. palelae. These lice do not bite humans but may be intramurid vectors of murine typhus and other zoonoses. The mites Laelaps echidnina Berlese and L. nuttalli Hirst were both collected; the latter was recorded from all four murid species, mainly R. exulans. The mite Ornithonyssus bacoti Hirst was rare. Only one chigger mite, Walchiella oudemansi (Walch), was retrieved from murids (from R. exulans) and a single Leptotrombidium deliense (Walch) chigger was taken from a human subject. Although L. deliense is a significant vector of scrub typhus, a disease known from Sulawesi, the L. deliense-R. argentiventer relationship frequently noted in the ecology of this rickettsial disease, was not evident in this survey. Other ectoparasites collected from murids were the ticks, Ixodes granulatus Supino (first record for Sulawesi), Haemaphysalis sp. and Dermacentor sp., the mites Myocoptes musculinus (Koch) and Listrophoroides cucullatus (Trouessart), acarids and a uropodid.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Control of rickettsial diseases.
Prevention of rickettsial infections is aimed at individual control and epidemic measures (especially in epidemic typhus), vector and rodent control, milk pasteurization (in Q fever), chemoprophylaxis and immunoprophylaxis. In vector and rodent control, the main obstacle is the rise in resistance to insecticides and rodenticides. For this reason in vector control, apart from insecticides, enhancement of the natural immunity acquired by animals in response to tick infestation and vaccination with concealed tick antigens as well as the use of hormones, chemosterilants and genetic manipulation can also be considered. For short-term high-risk exposure, doxycycline may be an effective prophylaxis of illness but may not prevent infection with scrub typhus or spotted fever group rickettsiae. At present, for specific prevention by vaccination, only Q fever vaccines are available for common use. However, development of subunit vaccines, namely immunogenic rickettsial proteins, cloned and expressed in Escherichia coli, seems to be very promising.
Animals↗
Spotted fever group and typhus group rickettsioses in humans, South Korea.
The presence of the nucleic acid of the spotted fever group (SPG) and typhus group (TG) rickettsiae was investigated in 200 serum specimens seropositive for SFG rickettsiae by multiplex-nested polymerase chain reaction with primers derived from the rickettsial outer membrane protein B gene. The DNA of SFG, TG, or both rickettsiae was amplified in the 24 serum specimens, and sequence analysis showed Rickettsia conorii, R. japonica, and R. felis in the specimens. R. conorii and R. typhi were found in 7 serum specimens, which indicated the possibility of dual infection in these patients. These findings suggest that several kinds of rickettsial diseases, including boutonneuse fever, rickettsialpox, R. felis infection, and Japanese spotted fever, as well as scrub typhus and murine typhus, are occurring in Korea.
Antigens, Bacterial↗
Survey of rickettsial antibodies at two local sites and review of rickettsiosis in Papua New Guinea.
The status of rickettsial infection in Papua New Guinea (PNG) is unknown although several reports of typhus-like illnesses infecting predominantly white settlers and the Allied troops during World War 2 were published between 1930 and 1945. We performed a serological survey for evidence of rickettsial infection by measuring rickettsia-specific antibody levels in the blood of 191 non-randomly selected Papua New Guineans living in Port Moresby (n=93) and in the highland villages of Samberigi (n=98). Antibodies were measured by a microimmunofluorescence method using a panel of rickettsial antigens of a number of species and strains. In addition, we have reviewed the current status of rickettsiosis in PNG. Overall, we were able to demonstrate significant titres of antibodies to two groups of rickettsiae, the scrub typhus group (STG) and the spotted fever group (SFG). All positive individuals (7/191) were residents of Port Moresby. None from the highlands showed any significant levels of antibodies to rickettsiae. The strains detected within each group were Gilliam and Karp for STG and, for SFG, Rickettsia honei, R. conorii, R. sibirica, R. rickettsii, R. australis and R. akari. No significant antibody titres to typhus group infection were detected in either Port Moresby or highland volunteers. These findings were not surprising given previous reports of typhus-like illnesses and favourable environmental characteristics for rickettsiae in some parts of PNG. Until a definite status of this disease is known, we suggest that rickettsial infection be included as a differential diagnosis for patients presenting with acute febrile illness in Port Moresby and surrounding areas.
Humans↗
Tropical rickettsioses.
In recent years, a bewildering array of emerging rickettsial pathogens have been described throughout the world, including in the tropics. Here we present an updated overview of scrub typhus, murine typhus, and epidemic typhus. We also present an update on the emerging spotted fever group rickettsioses described in the tropics through 2005, focusing on epidemiologic and clinical data and management.
Humans↗
Orientia tsutsugamushi inhibits tumor necrosis factor alpha production by inducing interleukin 10 secretion in murine macrophages.
Orientia tsutsugamushi (OT) is the causative agent of scrub typhus or Tsutsugamushi disease. We have previously reported that OT suppresses the production of inflammatory cytokines in murine macrophages. In this study, we examined the mechanism of OT to suppress the tumor necrosis factor alpha (TNF-alpha) production. J774 macrophages were preinfected with OT for various times and then treated with lipopolysaccharide (LPS) for 24 h. Preinfection by OT inhibited LPS-induced production of TNF-alpha, but did not affect the activation of NF-kappaB. This suppression was also induced by the conditioned medium (CM) from OT-infected macrophages. Interestingly, the CM contained a potent interleukin-10 (IL-10)-inducing factor that is active on activated macrophages. Therefore, the IL-10-inducing factor might enhance the negative-feedback mechanism ascribed to IL-10, to allow bacterial survival in the hostile environment of macrophages.
Animals↗
Comparison of PanBio Dengue Duo IgM and IgG capture ELISA and venture technologies dengue IgM and IgG dot blot.
BACKGROUND: A number of commercial ELISA for dengue diagnosis have recently become available, though direct comparison between these assays have not been published. OBJECTIVES: The Venture Technologies Dengue IgM and IgG Dot Blot assays and the PanBio Dengue Duo IgM and IgG Capture ELISA were compared. STUDY DESIGN: Paired sera from patients with dengue (n=20) and Japanese encephalitis (JE, n=10), and single sera from patients with typhoid (n=10), leptospirosis (n=10) and scrub typhus (n=10) were assayed according to the manufacturer's instructions. RESULTS: The Dot Blot IgM ELISA showed higher sensitivity than the PanBio IgM ELISA (100 vs. 95%), while the PanBio IgM ELISA showed higher specificity in JE (100 vs. 20%) and non-flavivirus infections (100 vs. 97%). Defining elevation of either IgM or IgG as a positive result, the Dot Blot and ELISA tests both showed 100% sensitivity in dengue infection, while the PanBio test showed superior specificity in JE (70 vs. 0%) and non-flavivirus infections (100 vs. 67%). CONCLUSIONS: Both assays are useful aids to the serological diagnosis of dengue infection. The clinical setting, user preference and local conditions will be important in determining which test is more appropriate.
Antibodies, Viral↗
Occurrence of high ratio of males after introduction of minocycline in a colony of Leptotrombidium fletcheri infected with Orientia tsutsugamushi.
In colonies of Leptotrombidium fletcheri mites infected with Orientia tsutsugamushi (Ot), the agent of scrub typhus, males rarely appear. In the present study, the development of a high ratio of males was observed after introduction of minocycline (MC). A high dose of MC was injected subcutaneously into a mouse, and by feeding unfed larvae from an infected mite colony on this mouse, the Ot in the mites were successfully killed. Of a total of 130 unfed larvae attached to the mouse, 29 developed into females; of these, 9 laid an average of 112.4 eggs/female. Unfed larvae in the succeeding generations were attached to untreated mice. All adults in the P and F1 generation were females, and males started to appear at the F2 generation. The ratio of males to females was 332:7, 108:13, 263:61 and 71:9 at the F2, F3, F4 and F5 generations, respectively. These data suggest that Ot in the ovary or gonad may suppress the development of males.
Animals↗
Clinical deterioration in community acquired infections associated with lymphocyte upsurge in immunocompetent hosts.
Clinical deterioration during the course of community-acquired infections can occur as a result of an exaggerated immune response of the host towards the inciting pathogens, leading to immune-mediated tissue damage. Whether a surge in the peripheral lymphocyte count can be used as a surrogate marker indicating the onset of immunopathological tissue damage is not known. In this study, we report the clinical presentations and outcomes of a cohort of immunocompetent patients with non-tuberculous community acquired infections who experienced clinical deterioration during hospital stay (n=85). 12 (14.1%) patients had a surge in lymphocyte count preceding their clinical deteriorations, and their diagnoses included viral pneumonitis , viral encephalitis , scrub typhus , leptospirosis , brucellosis , and dengue haemorrhagic fever . The clinical manifestations during deterioration ranged from interstitial pneumonitis , airway obstruction , CNS disturbances , and systemic capillary leak syndrome , all of which were thought to represent immunopathological tissue damages. When compared with patients without lymphocyte surge, these patients were more likely to be infected with fastidious/viral pathogens (0 vs 12; p<0.05), in addition to having lower mean baseline lymphocyte counts (403+/-181 vs 1143+/-686 cells/microl; p<0.05). We postulate that the peripheral lymphocyte count may be a useful surrogate marker indicating the presence of immunopathological damage during clinical deterioration in certain infectious diseases.
Adult↗
Renal failure in vibrio vulnificus infection.
Vibrio vulnificus infection with septicemia is a life threatening disease in the immunocompromised hosts. Renal involvement has not been documented. We reported herein 8 patients with V. vulnificus septicemia. All were immunocompromised hosts. Four patients had cirrhosis of the liver, 3 were heavy alcohol drinkers and one had systemic lupus erythematosis. Presenting symptomatology included fever, chills, leg pain and skin rash. Renal failure was observed in 6 patients. Four patients died shortly after admission. Two survived with clinical course of tubular necrosis. Renal failure is therefore common in V. vulnificus infection. This should be brought to attention, and vigorous antibiotic treatment is required. The disease may be confused with leptospirosis, scrub typhus, malaria and other forms of sepsis which also present with renal failure.
Acute Kidney Injury↗
Structural and functional studies of the early T lymphocyte activation 1 (Eta-1) gene. Definition of a novel T cell-dependent response associated with genetic resistance to bacterial infection.
We describe a murine cDNA, designated Early T lymphocyte activation 1 (ETA-1) which is abundantly expressed after activation of T cells. Eta-1 encodes a highly acidic secreted product having structural features of proteins that bind to cellular adhesion receptors. The Eta-1 gene maps to a locus on murine chromosome 5 termed Ric that confers resistance to infection by Rickettsia tsutsugamushi (RT), an obligate intracellular bacterium that is the etiological agent for human scrub typhus. With one exception, inbred mouse strains that expressed the Eta-1a allele were resistant to RT infection (RicR), and inbred strains expressing the Eta-1b allele were susceptible (RicS). These findings suggest that Eta-1 is the gene inferred from previous studies of the Ric locus (5). Genetic resistance to RT infection is associated with a strong Eta-1 response in vivo and inhibition of early bacterial replication. Eta-1 gene expression appears to be part of a surprisingly rapid T cell-dependent response to bacterial infection that may precede classical forms of T cell-dependent immunity.
Amino Acid Sequence↗