jueves, 19 de marzo de 2015

High Seroprevalence of Antibodies against Spotted Fever and Scrub Typhus Bacteria in Patients with Febrile Illness, Kenya - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC

FULL-TEXT ►

High Seroprevalence of Antibodies against Spotted Fever and Scrub Typhus Bacteria in Patients with Febrile Illness, Kenya - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC



Volume 21, Number 4—April 2015

Dispatch

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

Tables

Technical Appendicies

Jacqueline W. Thiga, Beth K. Mutai, Wurapa K. Eyako, Zipporah Ng’ang’a, Ju Jiang, Allen L. Richards, and John N. WaitumbiComments to Author 
Author affiliations: Walter Reed Project/Kenya Medical Research Institute, Kisumu, Kenya (J.W. Thiga, B.K. Mutai, W.K. Eyako, J.N. Waitumbi)Jomo Kenyatta University of Agriculture and Technology, Itromid, Nairobi, Kenya (J.W. Thiga, Z. Ng’ang’a)Naval Medical Research Center, Silver Spring, Maryland, USA (J. Jiang, A.L. Richards)

Abstract

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.
Rickettsioses are zoonoses that are increasingly being recognized as noteworthy infectious diseases (1). They are caused by bacteria of the genera Rickettsia and Orientia, which are small, gram-negative, obligate intracellular bacteria that are transmitted to humans through bites of infected arthropod vectors, such as fleas, mites, ticks, and lice. These bacteria are able to invade various host cells, including vascular endothelium, causing characteristic symptoms such as rash and petecchial hemorrhages. The genus Rickettsia is divided into 2 main biogroups: spotted fever group (SFG) and typhus group (TG). The scrub typhus group (STG) previously belonged to the genus Rickettsia but now belongs to the genus Orientia (2), which consists of 2 species: O. tsutsugamushiand O. chuto (3).
The past 5 years have seen concerted efforts to understand the etiology of undifferentiated febrile illnesses, a group of diseases that includes rickettsioses. These efforts have confirmed the occurrence of infections with R. felis, transmitted mainly by the cat flea (Ctenocephalides felis felis), as a common cause of fever in rural areas (46). Studies have also shown the preponderance of R. africae, the causative agent of African tick-bite fever, as well as R. conorii and R. aeschlimannii, in different ecoregions of Kenya (7). The study reported here is part of a broader study aimed at identifying pathogens or their surrogates, such as immunoglobulins, in patients with febrile illnesses. It is hoped that these types of reports will help local clinicians expand their list of differential diagnoses for undifferentiated fevers.

At the time of this study, Ms. Thiga was a master of science student at the Jomo Kenyatta University of Agriculture and Technology. Her research interests include rickettsial diagnosis and epidemiology.

Acknowledgments

We are grateful to the patients for taking part in this study. We thank project staff, including medical officers, nurses, and laboratory technicians. This work is published with the permission of the director, Kenya Medical Research Institute.
Financial support for this study was from a grant from the Global Emerging Infection System and Division of the Armed Forces Health Surveillance Center.

References

  1. Raoult DFournier PEFenollar FJensenius MPrioe Tde Pina JJRickettsia africae, a tick-borne pathogen in travelers to sub-Saharan Africa. N Engl J Med2001;344:150410DOIPubMed
  2. La Scola BRaoult DLaboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases. J Clin Microbiol.1997;35:271527.PubMed
  3. Izzard LFuller ABlacksell SDParis DHRichards ALAukkanit NIsolation of a novel Orientia species (O. chuto sp. nov.) from a patient infected in Dubai. J Clin Microbiol2010;48:44049DOIPubMed
  4. Richards ALJiang JOmulo SDare RAbdirahman KAli AHuman infection with Rickettsia felis, Kenya. Emerg Infect Dis2010;16:10816.DOIPubMed
  5. Jiang JMarienau KJMay LABeecham HJ 3rdWilkinson RChing WMLaboratory diagnosis of two scrub typhus outbreaks at Camp Fuji, Japan in 2000 and 2001 by enzyme-linked immunosorbent assay, rapid flow assay, and Western blot assay using outer membrane 56-kD recombinant protiens. Am J Trop Med Hyg2003;69:606.PubMed
  6. Maina ANKnobel DLJiang JHalliday JFeikin DRCleaveland SRickettsia felis infection in febrile patients, western Kenya, 2007–2010. Emerg Infect Dis2012;18:32831DOIPubMed
  7. Mutai BKWainaina JMMagiri CGNganga JKIthondeka PMNjagi ONZoonotic surveillance for rickettsiae in domestic animals in Kenya. Vector Borne Zoonotic Dis2013;13:3606DOIPubMed
  8. Richards ALSoeatmadji DWWidodo MASardjono TWYanuwiadi BHernowati TESeroepidemiologic evidence for murine and scrub typhus in Malang, Indonesia. Am J Trop Med Hyg1997;57:915.PubMed
  9. Graf PCChretien JPUng LGaydos JCRichards ALPrevalence of seropositivity to spotted fever group rickettsiae and Anaplasma phagocytophilum in a large, demographically diverse US sample. Clin Infect Dis2008;46:707DOIPubMed
  10. Prabhu MNicholson WLRoche AJKersh GJFitzpatrick KAOliver LDQ fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania. Clin Infect Dis2011;53:e815DOIPubMed
  11. Reller MEBodinayake CNagahawatte ADevasiri VKodikara-Arachichi WStrouse JJUnsuspected rickettsioses among patients with acute febrile illness, Sri Lanka, 2007. Emerg Infect Dis2012;18:8259DOIPubMed
  12. Bang HALee MJLee WCComparative research on epidemiological aspects of tsutsugamushi disease (scrub typhus) between Korea and Japan. Jpn J Infect Dis2008;61:14850.PubMed
  13. Balcells MERabagliati RGarcia PPoggi HOddo DConcha MEndemic scrub typhus–like illness, Chile. Emerg Infect Dis2011;17:165963.DOIPubMed

Figures

Table

Technical Appendix

Suggested citation for this article: Thiga JW, Mutai BK, Eyako WK, Ng’ang’a Z, Jiang J, Richards AL, et al. High seroprevalence of antibodies against spotted fever and scrub typhus bacteria in patients with febrile illness, Kenya. Emerg Infect Dis [Internet]. 2015 Apr [date cited].http://dx.doi.org/10.3201/eid2104.141387
DOI: 10.3201/eid2104.141387

No hay comentarios:

Publicar un comentario