Novel Spotted Fever Group Rickettsiosis,Brazil

We report a clinical case of spotted fever group rickettsiosis acquired in São Paulo, Brazil. Definitive diagnosis was supported by seroconversion between acute-phase and convalescent-phase serum samples. Molecular analysis of skin samples indicated the agent was a novel spotted fever group strain closely related to Rickettsia africae, R. parkeri, and R. sibirica.     

Novel Rickettsia Species Infecting Dogs,United States

In 2018 and 2019, spotted fever was suspected in 3 dogs in 3 US states. The dogs had fever and hematological abnormalities; blood samples were Rickettsia seroreactive. Identical Rickettsia DNA sequences were amplified from the samples. Multilocus phylogenetic analysis showed the dogs were infected with a novel Rickettsia species related to human Rickettsia pathogens.     

Prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs from an endemic area of mediterranean spotted fever in Catalonia, Spain

We assessed the prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs by indirect immunofluorescence in the region of 'Vallés Occidental', Barcelona (Spain). In the group of 150 serum samples from patients without former history of Mediterranean spotted fever, 12 had antibodies to Rickettsia conori. The overall seroprevalence was 8% (95% confidence interval, 4.6% to 13.5%). There were no statistically significant differences between the mean ages of patients with positive and negative antibodies to R. conorii. However, seropositivity was significantly more common among patients living in semi-rural areas. In the group of 138 dog serum samples, 36 (26.1%) sera had antibodies to R. conorii. When the present results were compared with those obtained in a previous seroepidemiological survey carried out in the same geographical region in 1987, no significant differences were found. Therefore, although the epidemiological markers have dropped, this does not absolutely confirm the decrease of the presence of R. conorii in this area.     

Relationships between the Rhipicephalus sanguineus complex ecology and mediterranean spotted fever epidemiology in France

The authors examine the epidemiologic features of Meditteranean spotted fever in France in light of the bioecological pecularities of each of the three known member of the Rhipicephalus sanguineus tick group (R. sanguineus, R. turanicus, R. pusillus). The results show that R. sanguineus is the main vector. Certain aspects of this tick species are of interest: affinity for man, close contact with humans for a long periods, peak of tick population (preimaginal stages) at the same time as the peak of the disease. The largest populations of R. sanguineus are noted in the endemic zone of human rickettsiosis. The fact that immature stages are more prevalent during the hot season and these forms' ability to bite humans is important and may suggest a role for them in the epidemiology of the disease. The sporadic isolation of this species outside the endemic zone may explain the occurrence of isolated cases of the disease in these areas. We cannot currently exclude vector roles for the two other species, which can parasitize humans, though none of our data supports this hypothesis.     

Rickettsia honei infection in human, Nepal, 2009

We report a case of Rickettsia honei infection in a human in Nepal. The patient had severe illness and many clinical features typical of Flinders Island spotted fever. Diagnosis was confirmed by indirect immunofluorescent assay with serum and molecular biological techniques. Flinders Island spotted fever may be an endemic rickettsiosis in Nepal.     

Rickettsia parkeri in Amblyomma maculatum ticks, North Carolina, USA, 2009-2010

We detected Rickettsia parkeri in 20%-33% of Amblyomma maculatum ticks sampled in North Carolina. Results highlight the high frequencies of R. parkeri-infected ticks in the state with the highest annual incidence of Rocky Mountain spotted fever. Epidemiologic studies are needed to definitively link R. parkeri to cases of spotted fever rickettsiosis.     

Rickettsia parkeri strain Atlantic rainforest infecting Amblyomma ovale (Acari: Ixodidae) in the Amazon Biome (Acre state,Brazil)

There is a lack of studies regarding tick-associated Rickettsia in the Amazon biome. Aiming to contribute to this knowledge, our research group collected ticks in the Western Amazon to better understand the tick fauna and their associated Rickettsia. In this study, we detected Rickettsia parkeri strain Atlantic rainforest DNA in the tick Amblyomma ovale Koch, 1844 in Rio Branco municipality, Acre state, northern Brazil. This is the first time that the R. parkeri strain Atlantic rainforest has been reported in the Amazon biome and is the first evidence of the circulation of a pathogenic spotted fever group (SFG) Rickettsia in this biome. This finding provides substantial information to help public health authorities understand which species of Rickettsia may be related to Amazon spotted fever cases.     

Amblyomma imitator Ticks as Vectors of Rickettsia rickettsii, Mexico

Real-time PCR of Amblyomma imitator tick egg masses obtained in Nuevo Leon State, Mexico, identified a Rickettsia species. Sequence analyses of 17-kD common antigen and outer membrane protein A and B gene fragments showed to it to be R. rickettsii, which suggested a potential new vector for this bacterium.     

Serosurvey among Mediterranean spotted fever patients of a new spotted fever group rickettsial strain (Bar29)

Mediterranean spotted fever is an endemic disease in Catalonia, Spain. A new spotted fever group (SFG) rickettsial strain (Bar29) of unknown pathogenicity for humans was isolated by our group, in 1996, from the dog brown tick, Rhipicephalus sanguineus. Interestingly, Rickettsia conorii was not isolated in this study. The aim of the present study was to assess the possible pathogenic role of the Bar29 strain. To this purpose, serum samples from 15 patients with Mediterranean spotted fever were obtained and tested by immunofluorescence for antibodies against four related rickettsial strains (R. conorii, R. africae, R. massiliae, and Bar29). Eight of the studied sera reacted at high titers with only R. conorii and Bar29 antigens. For five of the eight sera, the titers against Bar29 were clearly higher than for R. conorii. Four of these sera were also studied by Western blot immunoassay to confirm a specific response. Two of these sera reacted with the high-molecular-mass specific proteins of Bar29 as well as with the low-molecular-mass region (LPS antigen) whereas their reactions with R. conorii were located only on bands of the LPS. This specific response would support the possible pathogenic role of the Bar29 strain for humans. According to this finding, spotted fever caused by R. conorii and rickettsial strain Bar29 may be present in our area. The epidemiological implications of spotted fever caused by R. conorii and by rickettsial strain Bar29 in the Catalonia deserve further studies with isolation and characterization of more rickettsial strains.     

Rickettsial infections and fever, Vientiane, Laos

Rickettsial diseases have not been described previously from Laos, but in a prospective study, acute rickettsial infection was identified as the cause of fever in 115 (27%) of 427 adults with negative blood cultures admitted to Mahosot Hospital in Vientiane, Laos. The organisms identified by serologic analysis were Orientia tsutsugamushi (14.8%), Rickettsia typhi (9.6%), and spotted fever group rickettsia (2.6% [8 R. helvetica, 1 R. felis, 1 R. conorii subsp. indica, and 1 Rickettsia "AT1"]). Patients with murine typhus had a lower frequency of peripheral lymphadenopathy than those with scrub typhus (3% vs. 46%, p<0.001). Rickettsioses are an underrecognized cause of undifferentiated febrile illnesses among adults in Laos. This finding has implications for the local empiric treatment of fever.     

Novel PCR exclusion assay to detect spotted fever group rickettsiae in the lone star tick (Amblyomma americanum)

The lone star tick (Amblyomma americanum) is the most common and abundant human-biting tick in the southeastern United States where spotted fever rickettsioses frequently occur. However, the role of this tick in transmitting and maintaining pathogenic and non-pathogenic spotted fever group rickettsiae (SFGR) remains poorly defined. This is partially due to the high prevalence and abundance of Rickettsia amblyommatis in most populations of A. americanum. Many molecular assays commonly employed to detect rickettsiae use PCR primers that target highly conserved regions in the SFGR so low abundance rickettsia may not be detected when R. amblyommatis is present. It is costly and inefficient to test for low abundance rickettsial agents with multiple individual specific assays even when they are multiplexed, as most samples will be negative. Real time PCR assays may also be hampered by inadequate limits of detection (LODs) for low abundance agents. We exploited the absence of an otherwise relatively SFGR-conserved genome region in R. amblyommatis to design a hemi-nested PCR-assay which has a sensitivity of 10 copies in detecting the presence of most SFGR, but not R. amblyommatis in DNA of infected lone star ticks. This deletion is conserved in 21 isolates of R. amblyommatis obtained from multiple states. We demonstrated the assay’s utility by detecting a pathogenic SFGR, Rickettsia parkeri, in 15/50 (30 %) of field collected A. americanum ticks that were previously screened with conventional assays and found to be positive for R. amblyommatis. These co-infected ticks included 1 questing female, 6 questing nymphs, and 8 attached males. The high prevalence of R. parkeri among host-attached ticks may be due to several variables and does not necessarily reflect the risk of disease transmission from attached ticks to vertebrate hosts. This novel assay can provide accurate estimates of the prevalence of less common SFGR in A. americanum and thus improve our understanding of the role of this tick in the maintenance and transmission of the SFGR commonly responsible for human rickettsioses.     

Ticks and tick-borne rickettsiae from dogs in El Salvador,with report of the human pathogen Rickettsia parkeri

Twelve tick species have been reported in El Salvador; however, information regarding ticks infesting domestic dogs is lacking, and pathogenic tick-borne Rickettsia species have never been reported in El Salvador. This work evaluated ticks infesting 230 dogs from ten municipalities in El Salvador from July 2019 to August 2020. A total of 1,264 ticks were collected and identified into five species: Rhipicephalus sanguineus sensu lato (s.l.), Rhipicephalus microplus, Amblyomma mixtum, Amblyomma ovale, and Amblyoma cf. parvum. The tick R. sanguineus s.l. was the most frequent species in all localities (81.3% of sampled dogs), followed by Amblyomma mixtum (13.0%), Amblyomma ovale (10.9%) and Amblyomma cf. parvum (10.4%). The overall mean intensity of tick infestation was 5.5 ticks/dog. The highest specific mean intensity value was for R. sanguineus s.l. (4.8 ticks/dog), varying from 1.6 to 2.7 ticks/dog for the three Amblyomma species. From a random sample of 288 tick specimens tested molecularly for the presence of rickettsial agents, three spotted fever group Rickettsia were detected: Rickettsia amblyommatis in 90% (36/40) A. mixtum, 46% (11/24) A. cf. parvum, 4% (7/186) R. sanguineus s.l., and 17% Amblyomma spp.; Rickettsia parkeri strain Atlantic rainforest in 4% (1/25) A. ovale; and an unnamed rickettsia agent, designated as ‘Rickettsia sp. ES-A.cf.parvum’, in 4% (1/24) A. cf. parvum. Our finding of R. parkeri strain Atlantic rainforest in A. ovale is highly relevant because this agent has been associated to spotted fever illness in other Latin American countries, where A. ovale is implicated as its main vector. These findings suggest that spotted fever cases caused by R. parkeri strain Atlantic rainforest could be occurring in El Salvador.     

Severe Case of Rickettsiosis Identified by Metagenomic Sequencing,China

A case of Rickettsia sibirica subspecies sibirica BJ-90 infection in China was identified by metagenomic analysis of an eschar biopsy specimen and confirmed by nested PCR. Seroprevalence of spotted fever group Rickettsia was ≈17.4% among the local population. This report highlights the threat of rickettsioses to public health in the Qinghai–Tibet Plateau.     

Isolation of Rickettsia rickettsii in Rocky Mountain Spotted Fever Outbreak,Panama

We report new cases of Rocky Mountain spotted fever in patients from Kinkantu, Ngäbe-Bugle indigenous comarca, Panama. We isolated Rickettsia rickettsii in cell culture after intraperitoneal inoculation of guinea pigs with tissues from a deceased patient. Our results indicate that Rocky Mountain spotted fever is emerging in this region.     

Immature hard ticks infected with Rickettsia amblyommatis on breeding birds from Pantanal

Immature hard ticks from the genus Amblyomma feed on blood from a wide range of Neotropical avian hosts. They serve as vectors for pathogens of medical and veterinary importance, such as Rickettsia agents of the spotted fever group (SFG). Hence, determining ecological factors that increase encounter rates between immature ticks and their avian hosts may contribute to the understanding of tick-borne diseases transmission. Here, we used 720 individual birds from 96 species surveyed in the Brazilian Pantanal to test whether host breeding season influenced tick infestation probabilities. Additionally, collected ticks were screened for Rickettsia agents to describe new avian-tick-bacteria associations. Our models revealed that the probability of an individual bird being infested with immature ticks was similar during the breeding and pre-breeding season, but higher loads of immature tick stages were found during the breeding season. Host sex did not predict infestation probability, but Rickettsia agents recovered from ticks were more prevalent during the pre-breeding season. The new records of host usage by larvae and nymphs of Amblyomma in Pantanal and the growing body of tick surveys in Neotropical avian communities, suggest that immature ticks may benefit from avian blood sources during their annual cycle. The low number of infected ticks with Rickettsia agents on Pantanal birds suggest that this vertebrate group are likely not acting as reservoirs for these microorganisms. However, long-term surveys at the same site are imperative to determine which tick species are acting as reservoirs for Rickettsia agents in Pantanal and determine whether birds are playing a role in dispersing ticks and tick-borne pathogens.     

Feeding Period Required by Amblyomma aureolatum Ticks for Transmission of Rickettsia rickettsii to Vertebrate Hosts

Rocky Mountain spotted fever is endemic to the São Paulo metropolitan area, Brazil, where the etiologic agent, Rickettsia rickettsii, is transmitted to humans by adult Amblyomma aureolatum ticks. We determined the minimal feeding period required by A. aureolatum nymphs and adults to transmit R. rickettsii to guinea pigs. Unfed nymphs and unfed adult ticks had to be attached to the host for >10 hours to transmit R. rickettsii. In contrast, fed ticks needed a minimum of 10 minutes of attachment to transmit R. rickettsii to hosts. Most confirmed infections of Rocky Mountain spotted fever in humans in the São Paulo metropolitan area have been associated with contact with domestic dogs, the main host of A. aureolatum adult ticks. The typical expectation that transmission of tickborne bacteria to humans as well as to dogs requires ≥2 hours of tick attachment may discourage persons from immediately removing them and result in transmission of this lethal bacterium.     

Antibodies to spotted fever group rickettsiae in dogs in Croatia

The prevalence of IgG antibodies to spotted fever group rickettsiae was studied by the indirect immunofluorescent antibody assay in a sample of 194 canine sera from different parts of Croatia. Dogs (n=141) from urban and suburban-semirural environs from the middle part of the eastern coast of Adriatic sea, and dogs (n=53) from Zagreb, the capital of Croatia located in the northern continental part of Croatia, were tested. The total of 88 (62.4%) dogs from southern coastal Croatia had antibodies toRickettsia conorii, with a significantly higher prevalence (69.9%) in suburban-semirural areas. The prevalence rate of antibodies toRickettsia conorii in canine sera from urban environment in the north of Croatia was 20.7%. The results show that the members of spotted fever group rickettsiae are present in both coastal and continental Croatia.Abbreviations IFA indirect immunofluorescence - IgG immunoglobulin G - MSF Mediterranean spotted fever - SFG spotted fever group     

Use of an exclusion assay to detect novel rickettsiae in field collected Amblyomma americanum

In the south-central United States, several tick-borne diseases (TbDs) occur at or near their highest levels of incidence of anywhere in the U.S. The diversity of Rickettsia species found in Amblyomma americanum continues to be under-characterized in this region and throughout the U.S. and Canada where this tick species is expanding. One reason for this lack of knowledge about Rickettsia diversity is the high prevalence of the endosymbiont Rickettsia amblyommatis that obscures detection of other bacteria in this genus. Focusing on unknown rickettsial agents, we used a recently described R. amblyommatis exclusion assay to screen 1909 A. americanum collected in Oklahoma City, Oklahoma, which resulted in eight ticks that had unique rickettsial sequences. Through the process of characterizing primary and secondary rickettsiae, we identified ticks primarily infected with Rickettsia rhipicephali and a Rickettsia species (2019-CO-FNY) previously linked with a canine rickettsiosis case in Tulsa, Oklahoma. We also identified a Rickettsia agent that was 97% identical with an endosymbiont of Amblyomma tonelliae and which aligned with archaic rickettsial species. Through this study, we further demonstrate the usefulness of this exclusion assay for rapid screening in large cohort A. americanum studies to identify a small number of ticks that contain poorly described and previously undocumented rickettsiae.     

High Seroprevalence of Antibodies against Spotted Fever and Scrub Typhus Bacteria in Patients with Febrile Illness,Kenya

Serum samples from patients in Kenya with febrile illnesses were screened for antibodies against bacteria that cause spotted fever, typhus, and scrub typhus. Seroprevalence was 10% for spotted fever group, <1% for typhus group, and 5% for scrub typhus group. Results should help clinicians expand their list of differential diagnoses for undifferentiated fevers.     

海南岛斑点热疫源地的调查研究

本文报告在海南岛发现了斑点热疫源地，其人群北亚斑点热抗体的阳性率３８．３％，鼠类抗体阳性率５３．０％。从７种鼠检出抗体，其中优势种黄毛鼠（Ｒａｔｔｕｓｌｏｓｅａ）、黄胸鼠（Ｒ．ｆｌａｖｉｐｅｃｔｕｓ）和海南屋顶鼠（Ｒ．ｒａｔｔｕｓｈａｉｎａｎｉｃｕｓ）阳性率＞５０．０％，应用ＰＣＲ技术从该３种鼠检出斑点热群立克次体特异ＤＮＡ。小兽类寄生蜱３种、革螨５种，优势种分别为粒形硬蜱（Ｉｘｏｄｅｓｇｒａｎｕｌａｔｕｓ）和毒棘厉螨（Ｌａｅｌａｐｓｅｃｈｉｄｎｉｎｕｓ）；牛羊寄生蜱为微小牛蜱（Ｂｏｏｐｈｉｌｕｓｍｉｃｒｏｐｌｕｓ）。从粒形硬蜱和微小牛蜱检出斑点热群立克次体特异ＤＮＡ。