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PubMed1973

Rickettsiae and rickettsial diseases.

This paper summarizes present knowledge on rickettsiae and rickettsial diseases, and on their epidemiological characteristics, control, and public health significance. There are many natural foci of rickettsial diseases, from where the disease may spread to other areas in the world under changing socioeconomic conditions. Because of rapid long-distance travel, sporadic cases of serious rickettsial diseases may today appear far from endemic areas where the infection occurred. Even in endemic areas the disease may be misdiagnosed and deaths may occur as a result of inadequate treatment. Rapid treatment of rickettsial infections (preferably with tetracyclines) is therefore most important. Epidemic louse-borne typhus, though no longer subject to the International Health Regulations, remains one of the diseases in the WHO epidemiological surveillance programme. This disease continues to be a major cause of morbidity and mortality in some parts of Africa and it is present also in parts of the Americas and of Asia. Scrub typhus remains a continuing and serious public health problem in areas of South-East Asia and in the Western Pacific. The annual number of reported cases of Rocky Mountain spotted fever in the USA showed an increase during the last two decades, which may be due to improved recognition as well as to increased outdoor activities and migration of people from the city centres to the suburbs. Related forms of tick-borne typhus occur in South America, the Mediterranean region, Africa, South-East Asia, the Far East, and the Western Pacific. Increasing in number, though still sporadic, are reports of serious illness from chronic Q fever infection in many parts of the world.

Antigens, Bacterial↗
PubMed1993

Global surveillance of rickettsial diseases: memorandum from a WHO meeting.

Rickettsial diseases are widely distributed throughout the world and are particularly prevalent in developing countries. An indirect immunofluorescence antibody test and standard protocol for its use have been developed and distributed to laboratories in 37 countries. This Memorandum summarizes the results obtained as well as the conclusions and recommendations made by participants at a WHO meeting on the Global Surveillance of Rickettsial Diseases, held in Oslo on 10 September 1991.

Developing Countries↗
PubMed2006

Characterisation of rickettsial diseases in a hospital-based population in Malta.

OBJECTIVE: The aim of the study was to characterise the causative agents of rickettsial disease in Malta. A secondary objective was to study the epidemiology of cases of rickettsial disease. METHODS: Cases admitted to St Luke's Hospital between June 2002 and May 2003 presenting with complaints of fever, headache, rash and/or an eschar were considered possible cases of rickettsial disease. A patient interview was conducted within 24h of admission. Paired sera were taken for serology and blood samples sent for rickettsial PCR and culture. Whenever an eschar was present, biopsies were taken for culture and immunohistochemical analysis. RESULTS: Thirty-three cases of possible rickettsial disease were identified. Although serological tests showed cross reactivities between different species of rickettsiae, one was diagnostic for Rickettsia conorii. None of the sera showed any cross-reactivity with Rickettsia typhi. There was one positive biopsy for R. conorii when tested by PCR and another was positive for spotted fever group Rickettsia by immunohistochemistry. CONCLUSION: Spotted fever rickettsiosis is endemic in Malta. Contrary to previous belief, none of the cases were due to murine typhus. The predominant causative agent of rickettsial disease in Malta is likely to be R. conorii, although the animal reservoir has still not been definitely identified.

Adolescent↗
PubMedDate not supplied

Epidemiology and ecology of rickettsial diseases in the People's Republic of China.

Since 1949, information on rickettsial diseases in the People's Republic of China has been virtually nonexistent in the West. This is the first comprehensive review of the ecology and epidemiology of Chinese rickettsial diseases to be published outside the People's Republic. At least five rickettsioses exist in China: scrub typhus, murine typhus, epidemic typhus, Q fever, and one or more spotted fever-group (SFG) rickettsioses. Although epidemic typhus has been controlled and scrub typhus has abated in many areas, murine typhus, Q fever, and SFG rickettsiosis are important public health problems. Serologic surveys indicate high prevalences of antibodies to Coxiella burnetii, Rickettsia tsutsugamushi, and SFG rickettsiae in some regions; these rickettsiae have been isolated from humans, arthropods, and animals. Doxycycline has emerged as the best treatment for murine typhus, epidemic typhus, and scrub typhus. China offers both opportunities and challenges for the investigation and alleviation of the problems of rickettsial diseases.

Adult↗
PubMed2000

Doxycycline use for rickettsial disease in pediatric patients.

BACKGROUND: Recent evidence suggests that despite potential side effects, doxycycline should be considered the drug of choice for children of all ages in whom a rickettsial disease is considered in the differential diagnosis of the illness. We hypothesized that doxycycline would be used infrequently for the treatment of suspected rickettsial disease. The objective of the investigation was to determine the initial antibiotic administered to children for whom rickettsial infection was considered likely. METHODS: The study population consisted of 35 children evaluated at Texas Children's Hospital between 1987 and 1999 in whom rickettsial disease was a diagnostic consideration. Demographic information and clinical manifestations were assessed through a retrospective chart review. RESULTS: Thirty children (86%) presented with fever, 21 (60%) with rash and 14 (40%) with headache, which are typical presenting symptoms for rickettsial diseases. Only 1 of 35 children (3%) was prescribed a tetracycline class antibiotic as initial empiric therapy. Eleven (31%) children received doxycycline during the hospital course. A total of 19 patients, or 54%, received an antimicrobial known to have efficacy in the treatment of rickettsial infection, usually at the suggestion of an infectious diseases consultant. CONCLUSIONS: Even among children for whom rickettsial infection is a diagnostic consideration, doxycycline is not prescribed with the frequency that is indicated. Pediatric caregivers should have heightened awareness regarding the appropriate indications for doxycycline use in childhood.

Adolescent↗
PubMed2006

Epidemiological characteristics of rickettsial diseases in Croatia.

OBJECTIVE: To show the presence and prevalence of rickettsial diseases and the geographic distribution in Croatia. METHODS: The pattern of these diseases was monitored during the 1992-2003 period. RESULTS: The rickettsial diseases that occur sporadically in the littoral of Croatia (Adriatic islands and the coastal area) include Mediterranean spotted fever, murine typhus, Brill-Zinsser disease, and a clinical entity known as rickettsioses. Mediterranean spotted fever and murine typhus are considered to be endemic exclusively in Dalmatia. CONCLUSION: The term rickettsioses has been used because of inadequate laboratory differentiation of causative agents; therefore, the species of rickettsiae responsible for this clinical entity remains unknown. Highly efficient, military, infectious disease research should be continued, to shed more light on this important issue.

Croatia↗
PubMed1983

The WHO programme for prevention and control of viral, chlamydial, and rickettsial diseases. Brief review.

Through the advancement of biological and medical sciences and the application of modern technology, the disease burden imposed by viral, chlamydial and rickettsial disease has steadily decreased. Smallpox has been eradicated, poliomyelitis is under control in many countries, and measles, mumps and rubella viruses may eventually be eliminated in many developed countries. New and improved vaccines have also recently become available for rabies and hepatitis. These are major advancements. Not to be overshadowed however, are the developments which may lead to the prevention or control of other infectious diseases. For many agents, recently acquired knowledge relating to virology, replication, structural and genetic characteristics, and host responses to infection pave the way for disease intervention in numerous ways. For other agents, recent advances in molecular biology make possible new classes of effective vaccines. It is crucial that these advances be incorporated as soon as possible into effective public health programmes for developing as well as developed nations. Much work yet remains, particularly in the prevention and control of respiratory diseases, diarrhoeal diseases, vector-borne diseases and hepatitis. The WHO Viral Diseases Programme has a major role in supporting laboratory and field research on new technologies and intervention strategies, in disseminating technological advances through teaching and training, and in translating the newer knowledge into action programmes for the prevention and control of viral, chlamydial and rickettsial diseases.

Adolescent↗
PubMed2005

[Rickettsial diseases in Brazil and Portugal: occurrence, distribution and diagnosis].

The present study is an update review on the occurrence and diagnosis of rickettsial diseases in Brazil and Portugal, aiming at promoting their epidemiological surveillance in both countries. A literature review was carried out and unpublished data of laboratories and surveillance systems were presented. The results described the occurrence of rickettsial diseases and infections in Brazil and Portugal, including other new and still poorly understood rickettsial infections. Current diagnostic methods were discussed. As in many other countries, rickettsial diseases and infections seem to be an emerging public health problem. Treated as a minor problem for many decades, the interest in these infections has increased in both countries but further studies are needed to establish their role as a public health problem.

Animals↗