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Evidence of rickettsial disease agents in ticks from Ethiopian cattle.

Evidence has recently been accumulating that domestic animals may play an ancillary role in rickettsial zoonoses. In particular, attention has been focused on the activity of Rickettsia prowazekii in Egyptian and Ethiopian livestock and their ticks. An attempt has now been made to confirm previous findings of R. prowazekii in the sera of zebus, sheep and goats in Ethiopia, which brought epidemic typhus into the category of a zoonosis. This attempt was not successful, but tests did indicate that some ticks were infected with R. conori (boutonneuse fever or tick-borne typhus) and Coxiella burneti (Q fever), this being the first evidence for the existence of these agents in Ethiopia.Antibodies against R. conori were found in significant numbers in the sera of sheep and goats from one locality, but Q-fever antibodies were surprisingly rare.

Animals↗

Central nervous system involvement in Rickettsial diseases.

The Rickettsia are obligate intracellular parasites that are usually spread to humans by insects and typically produce vasculitides. The prototypic rickettsial disorder in the United States is Rocky Mountain spotted fever (RMSF). The differential diagnosis of RMSF and related disorders includes other conditions that produce vasculitis, most importantly meningococcemia. The rickettsial disorders are usually treated effectively with tetracycline derivatives.

Central Nervous System Infections↗

Epidemiological, clinical and laboratory characteristics of 19 serologically confirmed rickettsial disease in Singapore.

AIM: To identify epidemiological, clinical and laboratory features of serologically-proven typhus in the local setting. METHOD & RESULTS: Retrospective study looking at rickettsial serologies done over a six-month period and collection of the epidemological, clinical, laboratory and treatment response data from the case notes of the patients with an ordered rickettsial serology. Twenty of the 35 cases had a positive serology. Of these 20 patients, 18 were already clinically diagnosed as having murine typhus. All except one were males and all were migrant workers. Majority of the patients were construction workers staying in containers where rats abound. The most consistent clinical features were high fever (100%) for a median period of seven days, headache (94%) and cough (47%). The white cell count was usually normal (74%) but thrombocytopenia was common (68%). Transaminitis was also common (90%) with the AST component higher than the ALT in half of the cases. Response to doxycycline therapy was rapid and most (88%) were afebrile by 72 hours. CONCLUSION: Typhus (notably murine type) can be confidently diagnosed from consistent clinical features supported by epidemiological and laboratory clues. Early recognition with the prompt treatment response will result in shorter hospital stay with decreased cost. Serological testing may only prove useful in difficult situations when the clinical diagnosis is less clear.

Adult↗