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PubMed1979

Changing risk of scrub typhus in relation to socioeconomic development in the Pescadores islands of Taiwan.

Long term changes in risk of Rickettsia tsutsugamushi infection among civilian residents of the Pescadores Islands of Taiwan were associated with changing social conditions. Age specific incidence rates of scrub typhus in the Pescadores before 1940 were highest among children under 5 years of age. Rickettsiae can be demonstrated in vectors, wild animals continue to be infected and scrub typhus occurs in military personnel. A serologic survey for antibody to R. tsutsugamushi was conducted during 1975 and 1977 and failed to show evidence of previous infection among children. Two events appear to be associated with the decreased incidence of rickettsial infection in the young: increased urbanization and increased enrollment in schools. Both changes accompanied socioeconomic development which took place in the islands during the past 50 years. Prevalence of antibody to R. tsutsugamushi continues to be equal in the sexes and is undoubtedly due to similar occupational exposure of both sexes in fields and farms where vectors are numerous. The absence of apparent morbidity due to scrub typhus among the civilian populace was attributed to the mild nature of the disease caused by Pescadores strains, misdiagnosis and a lack of obligatory reporting.

Adolescent↗
PubMed1984

Rocky Mountain spotted fever vaccine: a regional need.

Because the killed Rickettsia vaccines have failed to provide protection against Rocky Mountain spotted fever, we approached the problem of protective immunity to Rickettsia rickettsii with a closely related, live, less pathogenic spotted fever Rickettsia. Guinea pigs vaccinated with R conorii produced antibodies to spotted fever group rickettsiae and did not have fever or other signs of illness after challenge with R rickettsii. A vaccine against Rocky Mountain spotted fever would be useful in some medical practices in the southeastern United States because of the life-threatening nature of the disease, including the possibility of a fulminant course and the frequent difficulty in diagnosis. Further studies should be pursued toward the goal of developing an effective vaccine against Rocky Mountain spotted fever.

Animals↗
PubMed2005

Presence of Rickettsia conorii subsp. israelensis, the causative agent of Israeli spotted fever, in Sicily, Italy, ascertained in a retrospective study.

A retrospective analysis by molecular-sequence-based techniques was performed to correctly identify the etiological agent of 24 Mediterranean spotted fever cases occurring in Western Sicily, Italy, from 1987 to 2001. Restriction analysis of a 632-bp PCR-amplified portion of the ompA gene allowed presumptive identification of five clinical isolates as belonging to Rickettsia conorii subsp. israelensis, the etiological agent of Israeli spotted fever (ISF). The remaining 19 rickettsial isolates were Rickettsia conorii subsp. conorii, the only pathogenic rickettsia of the spotted fever group reported in Italy until the present. Sequence analysis of the ompA gene confirmed the identification of all the R. conorii subsp. israelensis isolates and demonstrated that rickettsiosis caused by R. conorii subsp. israelensis can be traced back to 1991 in Sicily. The recorded clinical data of the five ISF patients support the idea that these strains could correlate to more-severe forms of human disease. Three of five patients experienced severe disease, and one of them died.

Adult↗
PubMed1995

In vitro effectiveness of azithromycin against doxycycline-resistant and -susceptible strains of Rickettsia tsutsugamushi, etiologic agent of scrub typhus.

In an effort to find a potential alternative treatment for scrub typhus, we evaluated the effectiveness of the standard drug doxycycline and the new macrolide azithromycin against a doxycycline-susceptible strain (Karp) and a doxycycline-resistant strain (AFSC-4) of Rickettsia tsutsugamushi. The antibiotics were tested in an in vitro assay system in which infected mouse fibroblast cells (L929) were incubated for 3 days in various concentrations of the drugs. Rickettsial growth was evaluated by direct visual counts of rickettsiae in Giemsastained cells or by flow cytometry. Initial tests were conducted at the concentration of each antibiotic considered to be the upper breakpoint for susceptibility (16 micrograms/ml for doxycycline and 8 micrograms/ml for azithromycin). Growth of both Karp and AFSC-4 was strongly inhibited with both antibiotics, as measured by visual counts, although the percentage of cells infected with AFSC-4 in the presence of doxycycline was three times greater than the percentage of cells infected with Karp but was only 60% as great as the percentage of cells infected with Karp in the presence of azithromycin. Flow cytometry confirmed that rickettsial growth occurred in the absence of antibiotics, but it failed to detect it in the presence of high concentrations of either drug. Visual counts of rickettsial growth at lower concentrations of the antibiotics (0.25 to 0.0078 microgram/ml) showed that the Karp strain was 16 times more susceptible that the AFSC-4 strain to doxycycline. Azithromycin was much more effective than doxycycline against AFSC-4, inhibiting rickettsial growth at 0.0156 microgram/ml to levels below that achieved by 0.25 microgram of doxycycline per ml. Azithromycin was also more effective than doxycycline against the Karp strain, causing greater reductions in the number of rickettsiae per cell at lower concentrations. If in vivo testing confirms the in vitro effectiveness of azithromycin, it may prove to be the drug of choice for the treatment of scrub typhus in children and pregnant women, who should not take doxycycline, and in patients with refractory disease from locations where doxycycline-resistant strains of R. tsutsugamushi have been found. When tested in an in vitro assay system, azithromycin was more effective than doxycycline against doxycycline-susceptible and -resistant strains of R. tsutsugamushi.

Animals↗
PubMed1992

Spotted fever in Hong Kong.

A previously healthy 7-year-old Hong Kong-born Caucasian child developed sudden onset fever, followed by a generalized rash and systemic symptoms of rigor and prostration, mucous membrane involvement (conjunctivitis) and arthralgia. He lives in a rural area of Hong Kong and has been in contact with various domestic animals--rodents, dogs and cows. Chloramphenicol 50 mg/kg/day was given on day 4 with rapid response. Subsequent Weil-Felix test and specific serology suggested the diagnosis of rickettsial infection of the spotted fever group. To our knowledge, this is the first confirmed case of spotted fever reported in Hong Kong.

Child↗
PubMed1990

Haemoparasites of equines: impact on international trade of horses.

The geographical distribution of Babesia equi and Babesia caballi and their tick vectors is discussed. Control of infections with these protozoa is hampered by the lack of a suitable antiprotozoal drug and a reliable serological test. No vaccine is available. Ehrlichia risticii (the causal agent of Potomac horse fever) and E. equi are rickettsial parasites which are difficult to control. Little is known of their geographical distribution and vectors. Early diagnosis is required for tetracycline therapy to be effective and there is a need for a rapid test to provide an early diagnosis.

Animals↗
PubMed1993

Feline hemobartonellosis.

H. felis is a rickettsial parasite that causes hemolysis and sequestration of feline erythrocytes. It should be considered as a potential primary pathogen or opportunist in any cat presented with signs ranging from episodic malaise to acute anemic collapse. Diagnosis requires visualization of the organism in properly prepared blood smears. Treatment uses antirickettsial drugs, corticosteroids, and supportive measures. Clinical recovery requires immune containment of the organism. Treatment does not eliminate the organism from the host. Carrier cats may relapse when their immunity is severely compromised by other diseases such as FeLV. Transmission is presumed to be by blood-sucking parasites and possibly bite wounds between cats. Prevention requires prudent health management of cats. Future advances in the knowledge of the disease will relate mainly to the development of a diagnostic technique that will allow identification of all infected cats.

Anaplasmataceae Infections↗
PubMed1984

[A severe form of Mediterranean boutonneuse fever].

A severe case of boutonneuse fever was reported which was only diagnosed after death. The infectious syndrome and cutaneous eruption were associated with meningitis, encephalitis, hypoxaemia and thrombocytopaenia. The absence of an initial lesion ("tache noire") and the notion of recent German measles contamination explained the late diagnosis. Serious cases of boutonneuse fever were usually rare; they were better known as Rocky Mountain spotted fever, a rickettsial infection of the same group, the clinical symptoms of which were very similar and which gave the same proteus agglutination reactions as with boutonneuse fever. An earlier diagnosis, now possible thanks to immunofluorescent techniques using skin biopsies, should enable earlier treatment.

Acute Disease↗
PubMed1996

Abortion in a heifer associated with the intra-uterine transmission of Cowdria ruminantium-like organisms following heartwater vaccination.

A Nguni heifer aborted a 6-month-old foetus 35 days after intravenous inoculation with Onderstepoort heartwater vaccine. Histopathological examination of the brain revealed numerous suspected Cowdria ruminantium organisms in the endothelial cells of the blood vessels. The organisms were ultrastructurally and immunohistochemically compatible with Cowdria ruminantium, although, owing to autolysis and cross-reactions, the possibility that they represent another rickettsial or related organism could not be completely excluded. As far as we could ascertain this is the first recorded case of suspected intra-uterine transmission of Cowdria ruminantium in ruminants.

Abortion, Veterinary↗
PubMed2003

Emerging rickettsial infections in Sri Lanka: the pattern in the hilly Central Province.

OBJECTIVES: To identify different rickettsial infections using a specific immunofluorescent technique in patients clinically diagnosed as 'typhus fever' in the Central Province of Sri Lanka, and to define the clinical picture, assess the severity of infection and to determine the pattern of geographical distribution of the infections of the hospital-based patients. METHODS: A specific indirect immunofluorescent antibody technique was used on the sera of two groups of patients in laboratories in Japan and Thailand. RESULTS: We serodiagnosed infections with Orientia tsutsugamushi, Rickettsia typhi and spotted fever group in 56 of 118 clinically investigated patients. There were eight infections with O. tsutsugamushi, two with R. typhi and 10 spotted fever group patients with IgM antibodies suggestive of acute infection. Nineteen patients had antibodies against these three rickettsial species, suggestive of past exposure, co-infection or cross-reactivity of antigens. Discrete, erythematous maculopapular rash was common to all three types of infection except for five patients who had no rash. Five patients positive for spotted fever antibodies developed fern-leaf type skin necrosis with severe illness. Duration of the febrile period ranged from 4 to 23 days with defervescence occurring after specific antibiotic treatment. CONCLUSIONS: The study has shown the presence of different types of rickettsial infections in the Central Province of Sri Lanka. The characterization of the clinical picture and the severity of infection provide useful information for the proper management of the patients in the future.

Adult↗
PubMedDate not supplied

[Spotted fever: isolation of Rickettsia from a skin biopsy sample].

A 2 years old child living in an area of the State of São Paulo, known in the past as endemic for rickettsiosis developed clinical evidences of spotted fever after a tick bite. Rickettsiae were isolated from guinea pigs inoculated with a skin homogenate. In sera tested by indirect immunofluorescence with Rickettsia rickettsii standard antigen, IgG specific antibody titers raised from 1:512 in the first sample to 1:2048 in the third one; IgM specific antibody titer was 1:128 in the three samples. Also positive were sera obtained from the inoculated guinea pigs. In the last 20 years no other case of rickettsial spotted fever has been confirmed by isolation of the agent in Brasil. To our knowledge, there are no previous reports of isolation of Rickettsiae through inoculation of skin biopsy homogenates.

Animals↗
PubMed1995

Immunohistochemical identification of Cowdria ruminantium in formalin-fixed tissue sections from mice, sheep, cattle and goats.

An immunohistochemical staining technique in which a monospecific serum was used against the major antigenic protein -1 (MAP-1) of Cowdria ruminantium, was evaluated for the detection of C. ruminantium in formalin-fixed tissues of experimentally infected mice and field cases of heartwater in sheep, cattle and goats. Mice were infected with the mouse-pathogenic stocks: Mara, Kwanyanga, Welgevonden, Nonile, Vosloo, Kümm, Mali and Omatjenne. In all these cases and in the naturally infected cattle, sheep and goats, Cowdria colonies were identified as clearly-defined, brown-staining rickettsial colonies within the cytoplasm of endothelial cells. No positive staining was observed in the control group. This technique was shown to be reliable for detecting infection with C. ruminantium in the formalin-fixed tissues of mice and domestic ruminants.

Animals↗
PubMed1989

Rocky Mountain spotted fever: a disease in need of microbiological concern.

Rocky Mountain spotted fever, a life-threatening tick-transmitted infection, is the most prevalent rickettsiosis in the United States. This zoonosis is firmly entrenched in the tick host, which maintains the rickettsiae in nature by transovarian transmission. Although the incidence of disease fluctuates in various regions and nationwide, the problems of a deceptively difficult clinical diagnosis and little microbiologic diagnostic effort persist. Many empiric antibiotic regimens lack antirickettsial activity. There is neither an effective vaccine nor a generally available assay that is diagnostic during the early stages of illness, when treatment is most effective. Microbiology laboratories that offer only the archaic retrospective Weil-Felix serologic tests should review the needs of their patients. Research microbiologists who tackle these challenging organisms have an array of questions to address regarding rickettsial surface composition, structure-function analysis, and pathogenic and immune mechanisms, as well as laboratory diagnosis.

Animals↗
PubMedDate not supplied

Viral and rickettsial etiology of an outbreak of acute respiratory tract infection.

An outbreak of 111 cases of acute respiratory tract infection was recorded in a community of the town "T" in April-May 1984. The clinical picture was severer than usual; 28% of the cases had to be hospitalized, average absenteeism being as high as 26 days per case. Serological investigations demonstrated the previous circulation of influenza virus B/Singapore/222/79 and the simultaneous circulation during the outbreak of influenza virus A/England/333/80 (H1N1) and of Rickettsia burneti (as also ascertained by isolation in the chick embryo of the former and by visualization by immunofluorescence in exfoliated cells of the latter pathogen). The association of the two etiological agents appears to account for the severe and protracted course of the disease.

Acute Disease↗
PubMed1993

Bacillary angiomatosis of the spleen.

Bacillary angiomatosis is a recently described vasoproliferative lesion associated with infection by a newly characterized rickettsial organism, Rochalimaea henselae. Most previous reports have described skin lesions in immunocompromised patients infected with human immunodeficiency virus. This is the first case report detailing the features of bacillary angiomatosis of the spleen occurring in a patient undergoing cytotoxic chemotherapy for disseminated ovarian carcinoma.

Angiomatosis, Bacillary↗
PubMed1988

The identification of Eperythrozoon ovis in anemic sheep.

Eperythrozoon ovis, a rickettsial parasite of erythrocytes, was found in anemic lambs maintained for reproductive endocrinology research. The parasite was identified in the blood films of 13 animals in the flock of 30. The sexes were infected equally (7/16 males versus 6/14 females). The relationship between the severity of the anemia and the presence of organisms in blood was statistically significant. One animal died with severe anemia. Light, scanning electron, and transmission electron microscopy of peripheral erythrocytes revealed an extracellular organism identified as E. ovis. These findings indicate that this parasite can cause disease in sheep and therefore may interfere with biomedical research.

Anaplasmataceae Infections↗
PubMed2002

Characterization of spotted fever group rickettsiae detected in dogs and ticks in Okinawa, Japan.

Spotted fever group (SFG) rickettsial DNAs were detected in 2.4% of 340 canine blood samples and a pool of 84 tick pool samples (229 ticks) collected in Okinawa, Japan by PCR using a citrate synthase and an SFG rickettsial 190-kDa surface antigen gene primer pair. The sequences of both genes from canine blood and tick samples showed high levels of similarity with those of Rickettsiajaponica and several SFG rickettsiae (R. aeschlimannii, R. massiliae, R. rhipicephali and Bar-29 strain). Phylogenesis of canine blood and tick samples was closely related to that of reference SFG rickettsiae. Serological evidence of SFG rickettsial infection in dogs and humans in Okinawa, where no clinical human cases have been reported, has been obtained. In this study, genetical characterization of SFG rickettsia in Okinawa was investigated phylogenetically.

Animals↗
PubMed1989

Mediterranean spotted fever in Salamanca, Spain. Epidemiological study in patients and serosurvey in animals and healthy human population.

Mediterranean spotted fever is a spotted fever group rickettsiosis caused by Rickettsia conorii. The fever has a recognized incidence in large geographic areas, and its presence in Salamanca Province (Spain) has been well documented since 1981. This work presents the results of the centralized prospective survey carried out in this area and was designed to study the epidemiological behavior of the disease and the prevalence of antibodies against R. conorii among animals and healthy human population. In 110 patients with confirmed diagnosis by an immunofluorescent antibody test we have observed a bimodal temporal curve of incidence of Mediterranean spotted fever in our zone and their predominant origin in villages under 2000 inhabitants. The serosurvey in a statistically representative sample of the human population of Salamanca shows a rate of 73.5% of reactive sera and percentages as high as 82% in samples from small villages. The seroepidemiological study of 300 animals reveals a widespread response to rickettsial antigens throughout the province. Immunofluorescent antibody titers of greater than or equal to 1:40 are present in 93% of dogs and high rates and titers are detected in other domestic mammals, suggesting their feasible epidemiological role in Mediterranean spotted fever.

Adolescent↗