scholarly journals Leptospirosis and Rickettsial Diseases Sero-Conversion Surveillance Among U.S. Military Personnel in Honduras

2021 ◽  
Author(s):  
Chien-Chung Chao ◽  
Zhiwen Zhang ◽  
Tatyana Belinskaya ◽  
Hua-Wei Chen ◽  
Wei-Mei Ching

ABSTRACT Introduction Leptospirosis and rickettsial diseases are global zoonotic diseases. In severe infection cases, mortality can range from 10% to 30%. Currently most epidemiological data available are based on outbreak investigations and hospital-based studies from endemic countries. The U.S. soldiers at military bases in these countries are highly vulnerable due to the fact that most of them are immunologically naïve to these pathogens. No risk assessment of leptospirosis and rickettsial diseases among U.S. military personnel in Honduras is currently available. This study was aimed at determining the prevalence of leptospirosis and rickettsial diseases in U.S. military personnel deployed to Honduras using serological assays. Materials and Methods A cohort of pre- and post-deployment sera from the most recent 1,000 military personnel stationed in Honduras for at least 6 months between 2000 and 2016 was identified for this study. Serum specimens from these eligible subjects were retrieved. All post-deployment serum specimens were screened at a dilution of 1:100 for the presence of IgG antibodies to Leptospira and Rickettsia pathogens. The pre-deployment sera from those individuals with post-deployment IgG antibodies above cutoff (i.e., seropositive) were tested to determine seroconversion. Seroconversion was defined as conversion of an optical density value from below the cutoff (i.e., negative) in a pre-deployed specimen to above the cutoff (i.e., positive) in a post-deployed specimen at a titer of 100. Results The seropositive post-deployment specimens for antibodies against Leptospira (causing leptospirosis), Rickettsia typhi (causing murine typhus [MT]), spotted fever group rickettsioses (SFGR, causing SFG Rickettsia), Orientia tsutsugamushi (causing scrub typhus [ST]), and Coxiella burnetii (causing Q fever [QF]) were 11.6%, 11.3%, 6%, 5.6%, and 8.0%, respectively. The seroconverted rate in those assigned to Honduras from 2000 to 2016 was 7.3%, 1.9%, 3.9%, 4.3%, and 2.7% for leptospirosis, MT, SFGR, ST, and QF, respectively. Among the seroconverted specimens, 27 showed seroconversion of at least two antibodies. These seroconverted individuals accounted for 8.8% (3 out of 34) of the personnel who looked for medical attention during their deployment. Conclusions Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-related pathogens. Testing of vectors for rickettsial pathogens in the areas could inform effective vector control countermeasures to prevent exposure. Proper precaution and protective measures are needed to better protect military personnel deployed to Honduras.

Author(s):  
David Ndeereh ◽  
Gerald Muchemi ◽  
Andrew Thaiyah

Many factors contribute to misdiagnosis and underreporting of infectious zoonotic diseases in most sub-Saharan Africa including limited diagnostic capacity and poor knowledge. We assessed the knowledge, practices and attitudes towards spotted fever group rickettsioses (SFGR) and Q fever amongst local residents in Laikipia and Maasai Mara in Kenya. A semistructured questionnaire was administered to a total of 101 respondents including 51 pastoralists, 17 human health providers, 28 wildlife sector personnel and 5 veterinarians. The pastoralists expressed no knowledge about SFGR and Q fever. About 26.7% of the wildlife sector personnel in Laikipia expressed some knowledge about SFGR and none in Maasai Mara. None of these respondents had knowledge about Q fever. About 45.5 and 33.3% of the health providers in Laikipia and Maasai Mara respectively expressed knowledge about SFGR and 9.1% in Laikipia expressed good knowledge on Q fever and none in Maasai Mara. The diseases are not considered amongst potential causes of febrile illnesses in most medical facilities except in one facility in Laikipia. Majority of pastoralists practiced at least one predisposing activity for transmission of the diseases including consumption of raw milk, attending to parturition and sharing living accommodations with livestock. Education efforts to update knowledge on medical personnel and One-Health collaborations should be undertaken for more effective mitigation of zoonotic disease threats. The local communities should be sensitized through a multidisciplinary approach to avoid practices that can predispose them to the diseases.


2003 ◽  
Vol 36 (4) ◽  
pp. 479-481 ◽  
Author(s):  
Márcio Antônio Moreira Galvão ◽  
Simone Berger Calic ◽  
Chequer Buffe Chamone ◽  
Cláudio Lísias Mafra S. ◽  
Gracco Cesarino Filho ◽  
...  

We report cases of spotted fever rickettsiosis in Coronel Fabriciano Municipality of Minas Gerais State, Brazil. The cases occurred in May and June of 2000. During this period there were two deaths among children from an area named Pedreira in a periurban area of this municipality. In a boy who died with clinical manifestations of Brazilian spotted fever, a necropsy revealed the presence of a spotted fever group Rickettsia. The serological results confirm the difficulty in the differential diagnosis of patients with symptoms of rickettsial diseases.


2005 ◽  
Vol 9 (2) ◽  
pp. 54-62
Author(s):  
Jashin J. Wu ◽  
David B. Huang ◽  
Katie R. Pang ◽  
Stephen K. Tyring

Background: The rickettsial diseases are an important group of infectious agents that have dermatological manifestations. These diseases are important to consider in endemic areas, but in certain suspicious cases, possible acts of bioterrorism should warrant prompt notification of the appropriate authorities. Objective: In this two part review article, we review these diverse diseases by examining established and up-to-date information about the pathophysiology, epidemiology, clinical manifestations, and treatment of the ricksettsiae. Methods: Using PubMed to search for relevant articles, we browsed over 500 articles to compose a clinically based review article. Results: Part one focuses on pathophysiology of the rickettsial diseases and the clinical aspects of the spotted fever group. Conclusions: At the completion of part one of this learning activity, participants should be able to discuss all of the clinical manifestations and treatments of the sported fever group. Participants should also be familiar with the pathophysiology of the rickettsial diseases.


Author(s):  
Lisa Sun ◽  
Michael V. Johnston

Tick-borne rickettsioses are emerging as more important health problems throughout the world. The spotted fever group including Rickettsia rickettsia can cause encephalopathy, meningitis and brain damage by selectively targeting capillary endothelial cells in the brain, and stimulating inflammation, capillary leakage, hemorrhage, and intravascular coagulation. Rickettsia are are arthropod-borne gram-negative coccobacilli bacteria and are obligate intracellular organisms that do not survive in artificial medium. In North and South America, the most common rickettsial disorder is rocky mountain spotted fever (RMSF) transmitted by the dog tick Dermacentor variabilis or the wood tick Dermacentor andersoni. A characteristic “starry sky” pattern can be seen on MRI imaging of the brain in some patients with RMSF encephalopathy and is thought to reflect the organisms targeting of brain endothelial cells in capillaries the white matter. Early treatment with doxycycline is curative and reverses signs of encephalopathy if given within a few day of onset, but delayed treatment can be associated with permanent neurological disability. The typhus group of rickettsia bacteria include R. prowazekii, which causes epidemic typhus and R. typhi, which causes murine typhus (endemic) typhus in tropical and subtropical parts of the world. Flying squirrels and humans carry R prowazekii and rats are carry R. typhi. Q fever caused by the rickettsia organism Coxiella burnetti is transmitted from farm animals including sheep and is seen throughout the world including the United States.


1990 ◽  
Vol 22 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Pablo Yagupsky ◽  
Batia Sarov ◽  
Lechaim Naggan ◽  
Israel Sarov ◽  
Keysary Avy ◽  
...  

2007 ◽  
Vol 136 (7) ◽  
pp. 972-979 ◽  
Author(s):  
V. PUNDA-POLIĆ ◽  
B. LUKŠIĆ ◽  
V. ČAPKUN

SUMMARYWe determined the epidemiological features of three zoonoses in hospitalized patients in southern Croatia. Patients were diagnosed by serological testing. Clinical and epidemiological data were also collected. Between 1982 and 2002, Mediterranean spotted fever (MSF) was diagnosed in 126 (incidence rate 1·27/100 000 per year), murine typhus (MT), in 57 (incidence rate 0·57/100 000 per year), and Q fever in 170 (incidence rate 1·7/100 000 per year) patients. MSF and Q fever were characterized by a marked seasonality. Incidences of Q fever and of MSF were higher for males than for females (P<0·0001 andP=0·0024, respectively). The most frequent of the three zoonoses in children was MSF. Q fever and MT cases were mostly seen in the 21–50 years age group. We found no statistically significant differences between season- and gender-specific incidence rates of MT. Whereas infections due to rickettsiae decreased, the incidence of Q fever increased over the last 12 years of the study.


Author(s):  
Emmanouil Angelakis ◽  
Didier Raoult

Bacteria of the genus Rickettsia belong to the family Rickettsiaceae in the order Rickettsiales and have for long been described simply as short, Gram-negative, strict intracellular rods that retain basic fuchsin when stained by the method of Gimenez (Raoult and Roux 1997). These bacteria are associated with ticks, lice, fleas or mites. To date the Rickettsia genus contains 24 recognized species classified into three groups based on their antigenic, morphological, and ecologic patterns: 1) the typhus group, 2) the spotted fever group and 3) Rickettsia bellii (Fournier and Raoult 2007). Most spotted fever group (SFG) rickettsiae are closely associated with ticks belonging to the family Ixodidae (also called “hard” ticks) (Parola et al. 2005). Ticks can act as vectors, reservoirs, and/or amplifiers of SFG rickettsiae and require optimal environmental conditions which determine the geographic distribution of the vectors and consequently the risk areas for rickettsioses. Many Rickettsia species are strictly associated with one genus of ticks and the transmittion to people is made through the tick bite, which generally implies that the Rickettsia can localize to their salivary glands. Therefore, since larvae, nymphs, and adults may all be infective for susceptible vertebrate hosts, the ticks must be regarded as the main reservoir host of rickettsiae. Humans are not considered as good reservoirs for Rickettsiae, as they are seldom infested with ticks for long periods and rickettsiaemia has normally short duration, especially with antibiotic intervention.


Author(s):  
Sruti Pisharody ◽  
Matthew P. Rubach ◽  
Manuela Carugati ◽  
William L. Nicholson ◽  
Jamie L. Perniciaro ◽  
...  

Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance—coupling case-finding at two referral hospitals and healthcare utilization data—we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunofluorescence assay of Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007–2008) or Rickettsia africae (2012–2014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20–454) and 147 (uncertainty range, 52–645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24–163) and 75 (uncertainty range, 34–176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence estimates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration.


PEDIATRICS ◽  
1958 ◽  
Vol 22 (2) ◽  
pp. 384-387
Author(s):  
Lauri Luoto

BECAUSE rickettsial infections occur sporadically, pediatricians may not be as thoroughly familiar with them as they are with common diseases of children that are characterized by rash. Hence, the rickettsias are infrequently considered in the etiology of febrile exanthemas or fevers of undertermined origin. Rickettsial diseases of primary interest in this country are Rocky Mountain spotted fever, murine typhus, rickcttsialpox and Q fever. The agents causing these diseases exist as latent infections in arthropods and animals, and they are transmitted accidentally to man through well-defined channels of spread. An awareness of the epizootiology of rickettsial diseases in nature and of the means by which these agents are transmitted to man is helpful in establishing a diagnosis of a rickettsial disease. Therefore, salient features of the natural cycles of infection which may suggest a clinical diagnosis will be stressed, and characteristics of these diseases in children will be reviewed briefly. Rocky Mountain spotted fever is usually contracted during the spring or summer through the bite of an infected tick although infection also may be acquired by dermal contact with tissues of a crushed or improperly removed tick. The wood tick, Dermacentor andersoni, the dog tick, D. variabilis, and the lone-star tick, Amblyomma americanum, which are found, respectively, in the western, eastern, and southern United States are responsible for transmitting the organism to man. Natural infection with Rickettsia rickettsii in these species is maintained by transovarial passage of the agent and by the feeding of immature stages on infected small mammals. Environmental factors such as rainfall, temperature, food supply of small mammals, and prevalence of predators indirectly affect the abundance of ticks.


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