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PubMed1955

Viral and rickettsial diseases; laboratory methods in diagnosis.

FACTORS CONTRIBUTING TO THE DEVELOPMENT OF VIRAL DIAGNOSTIC SERVICES HAVE BEEN: (1) technical advances, and (2) increasing demand for services due to relative and actual increases in the prevalence of these illnesses. This increase has been both relative, as in the case of diphtheria, etc., and actual as in the cases of poliomyelitis. Technical advances have been numerous and frequent. One of the most spectacular has been the development of methods for the culture of living cells for the propagation of viruses. Emphasis must be placed on the fact that the diagnosis of many viral diseases requires close teamwork between local, state, federal, and privately supported agencies. Laboratory procedures remain expensive but are frequently the only way to determine the exact nature of a particular illness. The available or practical procedures are emphasized in this discussion.

Diphtheria↗
PubMed1988

Imported rickettsial disease: clinical and epidemiologic features.

PURPOSE AND METHODS: The rickettsioses continue to constitute major health problems in many parts of the world. With increasing international travel, recognition of rickettsial diseases by physicians is becoming more important. The clinical features of four cases of rickettsial disease imported into Canada over a five-year period are presented; two patients with tick typhus (Rickettsia conorii), one patient with scrub typhus (R. tsutsugamushi), and one patient with murine typhus (R. typhi). We also present the North American data over the past 10 years from the Centers for Disease Control (CDC) (Atlanta). RESULTS: Since 1983 in the United States, three cases of imported scrub typhus, all after travel to India, were confirmed, as well as six cases of murine typhus after travel to southeast Asia. At the CDC, 67 imported cases of tick typhus have been confirmed by indirect fluorescent antibody test since 1976; most illnesses occurred after travel to Africa. CONCLUSION: Rickettsial diseases are underrecognized by physicians, who should consider these diagnoses in travelers returning from endemic areas. Since effective treatment is available, prompt diagnosis and treatment are important. In all cases, specific serologic confirmation should be obtained.

Adult↗
PubMed1991

Control of rickettsial diseases.

Prevention of rickettsial infections is aimed at individual control and epidemic measures (especially in epidemic typhus), vector and rodent control, milk pasteurization (in Q fever), chemoprophylaxis and immunoprophylaxis. In vector and rodent control, the main obstacle is the rise in resistance to insecticides and rodenticides. For this reason in vector control, apart from insecticides, enhancement of the natural immunity acquired by animals in response to tick infestation and vaccination with concealed tick antigens as well as the use of hormones, chemosterilants and genetic manipulation can also be considered. For short-term high-risk exposure, doxycycline may be an effective prophylaxis of illness but may not prevent infection with scrub typhus or spotted fever group rickettsiae. At present, for specific prevention by vaccination, only Q fever vaccines are available for common use. However, development of subunit vaccines, namely immunogenic rickettsial proteins, cloned and expressed in Escherichia coli, seems to be very promising.

Animals↗
PubMed1949

Chemotherapy in viral and rickettsial disease.

Aureomycin and chloromycetin have now been used in a number of viral and rickettsial diseases and have gone far toward fulfilling their original promise. In local trials aureomycin has been shown to be a very effective drug in primary atypical pneumonia, and a valuable drug in Q fever. A small number of cases of psittacosis appear to have responded favorably to aureomycin. The search for chemotherapeutic compounds which may be effective in other viral diseases has been sharply stimulated by these developments.

Chloramphenicol↗
PubMed1984

Rickettsial diseases of the Far East: new perspectives.

The rickettsial disease of man found only in Asia is mite-borne (scrub) typhus, caused by Rickettsia tsutsugamushi. Unique to southern Japan is a little-known human mononucleosis-like disease caused by Rickettsia sennetsu. In 1981 and 1982, there was a remarkable resurgence in the number of reported cases of mite-borne typhus in Japan after some years of virtual absence. Recent studies of R sennetsu have resulted in its reclassification to the genus Ehrlichia, members of which until now have been exclusively pathogens of animals. The historical background of ecologic investigations, in Malaysia and elsewhere, of these two developments suggest directions for future research.

Animals↗
PubMed1983

Arthropod- and rodent-borne viral and rickettsial diseases in the WHO South-East Asia and Western Pacific regions: memorandum from a WHO meeting.

Arthropod- and rodent-borne viral and rickettsial diseases continue to be one of the most important causes of morbidity and mortality in the WHO South-East Asia and Western Pacific Regions. Both epidemics and sporadic cases occur. In some years, outbreaks of dengue haemorrhagic fever and Japanese encephalitis reached alarming proportions. The significance of other arthropod- and rodent-borne viral and rickettsial diseases has still to be determined. Therefore, continuous epidemiological surveillance, diagnosis, and control of these groups of diseases remains an urgent task.The objectives, targets, priority areas, and strategies for future plans of action have been identified and recommendations formulated.

Animals↗
PubMed2006

No serological evidence for rickettsial diseases among Danish elite orienteerers.

A series of sudden unexpected cardiac deaths among Swedish elite orienteerers in the 1980s have resulted from the combination of infectious diseases and physical exercise. Studies in the late 1990s have pointed to Chlamydia and Barontella, which both had a high seroprevalence among Swedish elite orienteerers. We conducted a case-control study aimed to elucidate the serologic prevalence of rickettsial diseases among Danish elite orienteerers. Ticks are known as vectors for some rickettsial diseases. None of the orienteerers had a positive antibody titer against any of the tested Rickettsia despite a very high frequency of tick bites in this group.

Animals↗
PubMed2004

Tick-borne rickettsial diseases: emerging risks in Europe.

Ticks are currently considered the main vectors of human infectious diseases in Europe, particularly since their role in the transmission of the agent of Lyme borreliosis was demonstrated in the 1980s. In the recent years, ticks have also been shown to be the vectors of numerous emerging rickettsial diseases. Although Mediterranean spotted fever (MSF) due to Rickettsia conorii was thought for a long time to be the only tick-borne rickettsial disease prevalent in Europe, five more spotted fever rickettsiae have been described as emerging pathogens in the last decade. Further, cases of infection due to Anaplasma phagocytophilum, the agent of human anaplasmosis (previously known as human granulocytic ehrlichiosis), have been reported throughout Europe. We present here these emerging diseases and discuss other potential threat for the future.

Anaplasma phagocytophilum↗
PubMed1991

Human ehrlichiosis: a rickettsial disease associated with severe cholestasis and multisystemic disease.

We report an unusual case of a typically canine rickettsial disease, ehrlichiosis, in a 56-year-old man. Although only occasionally affecting humans with a mild illness, exposure to a tick bite in our patient led to severe multisystemic disease with intense cholestasis. Coma, acute renal failure and respiratory failure requiring mechanical ventilation ensued. Imaging procedures showed no biliary obstruction. A liver biopsy demonstrated bile stasis and sinusoidal lymphoid infiltrates. The diagnosis was confirmed serologically. Only partial improvement occurred with tetracycline therapy, but total resolution of all abnormalities eventually followed therapy with chloramphenicol.

Acute Kidney Injury↗
PubMed2006

Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis--United States: a practical guide for physicians and other health-care and public health professionals.

Tickborne rickettsial diseases (TBRD) continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low cost, effective antimicrobial therapy. The greatest challenge to clinicians is the difficult diagnostic dilemma posed by these infections early in their clinical course, when antibiotic therapy is most effective. Early signs and symptoms of these illnesses are notoriously nonspecific or mimic benign viral illnesses, making diagnosis difficult. In October 2004, CDC's Viral and Rickettsial Zoonoses Branch, in consultation with 11 clinical and academic specialists of Rocky Mountain spotted fever, human granulocytotropic anaplasmosis, and human monocytotropic ehrlichiosis, developed guidelines to address the need for a consolidated source for the diagnosis and management of TBRD. The preparers focused on the practical aspects of epidemiology, clinical assessment, treatment, and laboratory diagnosis of TBRD. This report will assist clinicians and other health-care and public health professionals to 1) recognize epidemiologic features and clinical manifestations of TBRD, 2) develop a differential diagnosis that includes and ranks TBRD, 3) understand that the recommendations for doxycycline are the treatment of choice for both adults and children, 4) understand that early empiric antibiotic therapy can prevent severe morbidity and death, and 5) report suspect or confirmed cases of TBRD to local public health authorities to assist them with control measures and public health education efforts.

Anaplasmosis↗