Detection of Rickettsia montanensis in Dermacentor variabilis in Northern Wisconsin.

Background: Spotted fever rickettsiosis is caused by a group of closely related bacteria that includes Rickettsia rickettsii, the etiological agent of Rocky Mountain spotted fever. Recently, Rickettsia montanensis has been reported to cause clinical and subclinical symptoms in both humans and animal models. Materials and Methods: In this study, we collected ticks in Ashland County, located in northern Wisconsin, and tested 16 ticks identified as Dermacentor variabilis for the presence of rickettsial bacteria using PCR techniques. Results: Four positive results identified using gel electrophoresis were then sequenced to determine the rickettsiae species. Of the samples sequenced, three matched for R. montanensis (∼19% of the 16 ticks tested). Conclusion: In this study, we report the presence and prevalence of R. montanensis in northern Wisconsin.

Mapping Brazilian spotted fever: Linking etiological agent, vectors, and hosts.

Brazilian spotted fever (BSF) is a highly lethal disease in southeastern Brazil. BSF is caused by the bacterium Rickettsia rickettsii and is transmitted by the bites of the tick of the genus Amblyomma. The spatial distribution of BSF risk areas is not well known in the country given the complexity of the transmission cycle. This study used the ecological niche modeling (ENM) approach to anticipate the potential distribution of the etiological agent (Rickettsia rickettsii), vectors (Amblyomma sculptum and A. dubitatum), and hosts (Hydrochoerus hydrochaeris, Didelphis aurita, and D. marsupialis) of BSF in Brazil. We compiled occurrence records for all vectors, hosts, and BSF from our own field surveillance, online repositories, and literature. ENM identified BSF risk areas in southeastern and southern Brazil, and anticipated other dispersed suitable areas in the western, central, and northeastern coast regions of Brazil. Tick vectors and mammalian hosts were confined to these same areas; however, host species showed broader suitability in northern Brazil. All species ENMs performed significantly better than random expectations. We also tested the BSF prediction based on 253 additional independent cases identified in our surveillance; the model anticipated 251 out of 253 of these independent cases. Background similarity tests comparing the ENMs of R. rickettsii, tick vectors, and mammalian hosts were unable to reject null hypotheses of niche similarity. Finally, we observed close coincidence between independent BSF cases, and areas suitable for combinations of vectors and hosts, reflecting the ability of these model pairs to anticipate the distribution of BSF cases across Brazil.

A human case of spotted fever caused by Rickettsia parkeri strain Atlantic rainforest and its association to the tick Amblyomma ovale.

BACKGROUND: Rickettsia parkeri strain Atlantic rainforest has emerged in Brazil during the last 10 years, with three laboratory-confirmed human cases. While these cases were epidemiologically associated with the tick Amblyomma ovale, in none of them the tick specimens that bit the patients could be identified. RESULTS: We report a clinical case of spotted fever rickettsiosis that was acquired in an Atlantic forest area in Bahia state, northeast Brazil. The case was determined to be caused by R. parkeri strain Atlantic rainforest, based on molecular analysis of the crust removed from the tick bite site (inoculation eschar) of the patients' skin. DNA extracted from the crust yielded partial sequences of three rickettsial genes (gltA, ompA and ompB), which were 99-100% identical to R. parkeri strain Atlantic rainforest. The tick specimen that was attached to patient skin was identified as a female of A. ovale. CONCLUSIONS: We report the fourth confirmed case of spotted fever rickettsiosis caused by R. parkeri strain Atlantic rainforest, providing to our knowledge for the first time, direct evidence of R. parkeri strain Atlantic rainforest transmission by A. ovale.

Tick Talk: Tick-borne Diseases of South Dakota.

In addition to being a nuisance, ticks can carry disease. This article presents a brief review of ticks and associated tick-borne disease relevant to South Dakota and surrounding regions. Tick-borne diseases of special relevance in South Dakota include tularemia, Rocky Mountain spotted fever, and Lyme disease. A number of others may also be encountered in the state as well. Prompt treatment of suspected cases is important to ensure a successful recovery, and tick-avoidance measures can reduce the risks of acquiring them. Most of these conditions are nationally reportable infectious diseases.

Rickettsia sp. Strain Atlantic Rainforest Infection in a Patient from a Spotted Fever-Endemic Area in Southern Brazil.

Santa Catarina State in southern Brazil is the state with the second highest number of laboratory-confirmed cases of spotted fever illness in Brazil. However, all these cases were confirmed solely by serological analysis (seroconversion to spotted fever group rickettsiae), which has not allowed identification of the rickettsial agent. Here, a clinical case of spotted fever illness from Santa Catarina is shown by seroconversion and molecular analysis to be caused by Rickettsia sp. strain Atlantic rainforest. This is the third confirmed clinical case due to this emerging rickettsial agent in Brazil. Like the previous two cases, the patient presented an inoculation eschar at the tick bite site. Our molecular diagnosis was performed on DNA extracted from the crust removed from the eschar. These results are supported by previous epidemiological studies in Santa Catarina, which showed that nearly 10% of the most common human-biting ticks were infected by Rickettsia sp. strain Atlantic rainforest.

Imaging of rickettsial, spirochetal, and parasitic infections.

This article is an update and literature review of the clinical and neuroimaging findings of the commonly known rickettsial, spirochetal, and eukaryotic parasitic infections. Being familiar with clinical presentation and imaging findings of these infections is crucial for early diagnosis and treatment especially in patients who live in or have a travel history to endemic regions or are immunocompromised.

Tick-borne infections.

Ticks, obligate, blood-sucking members of the order Acarina and class Arachnida, are the most common agents of vector-borne diseases in the United States. Ticks play an important role in transmitting viruses, bacteria, spirochetes, parasites, and rickettsia. This article reviews the epidemiology, microbiology, diagnosis, and treatment of the major tick-borne diseases in the United States.

Fiebre maculosa de las Montañas Rocosas

Las rickettsiosis son un grupo de enfermedades producidas por bacterias pleomorfas que se comportan como parásitos intracelulares. Aunque estas enfermedades son raras en nuestro medio, la proliferación de viajes internacionales a zonas endémicas suponen un riesgo de aparición en nuestro país1. Las características generales de estas enfermedades, así como las rickettsiosis más importantes transmitidas por piojos, pulgas y ácaros, han sido descritas en un trabajo anterior. En esta revisión se exponen las características más importantes, en especial aspectos epidemiológicos y clínicos, tanto en adultos como en niños, de las rickettsiosis más frecuentes transmitidas por garrapatas, como son la fiebre de las Montañas Rocosas, la fiebre botonosa mediterránea, la fiebre Q y la ehrlichiosis (AU)

Protection of guinea-pigs from experimental Rocky Mountain spotted fever by immunization with baculovirus-expressed Rickettsia rickettsii rOmpA protein.

Baculovirus recombinants that express the Rickettsia rickettsii rOmpA protein were constructed. Monoclonal antibodies (mAbs) against the rOmpA protein reacted with recombinant-infected Spodoptera frugiperda (Sf9) cells in indirect immunofluorescence assays. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting of infected Sf9 cell lysates with a mAb against rOmpA showed that the recombinant-expressed rOmpA protein migrated slightly below rOmpA extracted from R. rickettsii. Guinea-pigs immunized with lysates of recombinant-infected Sf9 cells developed antibodies reactive with R. rickettsii and were protected against challenge, indicating that the baculovirus-expressed rOmpA protein could be useful in subunit vaccines and for studies of the immune response to R. rickettsii infection.

A protective protein antigen of Rickettsia rickettsii has tandemly repeated, near-identical sequences.

The nucleotide sequence of a Rickettsia rickettsii gene that encodes a high-molecular-mass surface antigen (190 kilodaltons), which elicits protective immunity, was determined. The 6,747-nucleotide gene coded for a 2,249-amino-acid protein with a calculated molecular weight of 224,321. A 3.8-kilobase PstI fragment proximal to the 5' end of the gene was found to consist of 13 highly related tandem repeats which constituted over 40% of the coding region. The repeated sequences could be divided into either a 225-nucleotide, 75-amino-acid unit (type I) or a 216-nucleotide, 72-amino-acid unit (type II), with extensive homology between the two types of repeating units. The deduced amino acid sequence for these repeat units, overall, was slightly hydrophobic with short hydrophilic domains. The carboxy-terminal (nonrepetitive) portion of the deduced protein sequence was hydrophilic, with potential surface-exposed epitopes. The full-length reading frame was reconstructed in Escherichia coli, and transient expression of the 190-kilodalton antigen was demonstrated; however, the protein appeared to be severely degraded by proteases and was apparently toxic to E. coli. The conservation of this unique repetitive gene structure, coupled with results from previous reports showing the protective properties of the 190-kilodalton antigen, suggests that this protein plays an important role in the pathogenesis of and immunity to Rocky Mountain spotted fever.

Causative agent of spotted fever group rickettsiosis in Japan.

Since 1984, it has been known that spotted fever group rickettsiosis exists in Japan. We isolated three strains of the causative rickettsiae, designated Katayama, Misaka, and Abe, from patients with the disease and studied the characteristics of the isolates. Nude mice and cyclophosphamide-treated mice died after infection with the isolates. However, infected normal mice recovered and acquired immunity. Infected adult male guinea pigs had fever, a scrotal reaction, and seroconversion. The isolates propagated well in tissue-cultured Vero cells. Analysis by the cross-immunofluorescence antibody method showed that these isolates were closely related serologically. To reveal their immunological properties in detail, we produced 21 anti-Katayama monoclonal antibodies. Seven of these antibodies reacted with all representative strains of spotted fever group rickettsiae used in this study, and five others reacted only with the homologous strain, revealing that the Katayama strain has a strain-specific antigen(s) different from those of other spotted fever group rickettsiae. Moreover, these strain-specific antibodies also reacted with the Misaka and Abe strains. These results demonstrate that the causative agent of spotted fever group rickettsiosis in Japan is a new serotype of spotted fever group rickettsiae.

Tick-borne dermatologic diseases.

Inquiries regarding tick exposure can be important in dermatologic diagnosis and treatment since ticks can be vectors of a diversity of infectious diseases. The classic teaching is that ticks are best removed with nail polish, solvents, petrolatum, mineral oil, or a hot match. However, a recent evaluation of tick removal revealed that mechanical removal with forceps preceded and followed by disinfection is the most effective method. In most cases, should the characteristic dermatologic lesion or systemic symptoms appear, appropriate treatment should be initiated for presumptive diseases.

Rocky Mountain spotted fever in Georgia, 1961-75: analysis of social and environmental factors affecting occurrence.

For the period of 1961 through 1975, 10 geographic and sociologic variables in each of the 159 counties of Georgia were analyzed to determine how they were correlated with the occurrence of Rocky Mountain spotted fever (RMSF). Combinations of variables were transformed into a smaller number of factors using principal-component analysis. Based upon the relative values of these factors, geographic areas of similarity were delineated by cluster analysis. It was found by use of these analyses that the counties of the State formed four similarity clusters, which we called south, central, lower north and upper north. When the incidence of RMSF was subsequently calculated for each of these regions of similarity, the regions had differing RMSF incidence; low in the south and upper north, moderate in the central, and high in the lower north. The four similarity clusters agreed closely with the incidence of RMSF when both were plotted on a map. Thus, when analyzed simultaneously, the 10 variables selected could be used to predict the occurrence of RMSF. The most important variables were those of climate and geography. Of secondary, but still major importance, were the changes over the 15-year period in variables associated with humans and their environmental alterations. Detailed examination of these factors has permitted quantitative evaluation of the simultaneous impacts of the geographic and sociologic variables on the occurrence of RMSF in Georgia. These analyses could be updated to reflect changes in the relevant variables and tested as a means of identifying new high risk areas for RMSF in the State. More generally, this method might be adapted to clarify our understanding of the relative importance of individual variables in the ecology of other diseases or environmental health problems.

Canine Rocky Mountain spotted fever: a kennel epizootic.

Within a period of 5 consecutive days after the initial observation of illness was made, 7 of 12 Siberian Husky dogs developed clinical signs of Rickettsia rickettsii infection. One dog died and was necropsied. Clinical signs of infection consisted of lethargy, anorexia, ocular and nasal discharges, and neurologic disorder (incoordination and rolling). Scleral blood vessel injection, fever, lymphadenomegaly, splenomegaly, and increased bronchovesicular lung sounds were prominent findings. Clinical laboratory test results identified decreased platelet numbers, variable neutrophil counts, increased serum alkaline phosphatase activity, hyponatremia, hypokalemia, and bilirubinuria. Diagnosis of Rocky Mountain spotted fever was confirmed by serologic evaluation of acute and convalescent sera, using the micro-immunofluorescence technique, and R rickettsii antigen was determined by demonstration of intracellular rickettsial organisms in vascular endothelial cells of brain and lung (stained with carbol-basic fuchsin and aqueous malachite green) and by demonstration of spotted fever-group rickettsiae in tissues by direct fluorescent antibody technique. Near-simultaneous naturally occurring tick-borne infection of 7 dogs with R rickettsii documents an unreported occurrence.

Rocky Mountain spotted fever: a warm weather problem.

Rocky Mountain spotted fever occurs primarily in the warm weather months of April through September in the southeastern and south central United States. It is transmitted by the bite of ticks infected with the etiologic Rickettsia. This article reviews the epidemiology, clinical manifestations, diagnosis and therapy of Rocky Mountain spotted fever. Emphasis is placed on the dilemmas of early diagnosis and the necessity of early and often empirical antibiotic treatment of suspected cases.