Rickettsial Disease in the Peruvian Amazon Basin

Overview

Journal PLoS Negl Trop Dis

Specialties Infectious Diseases
Tropical Medicine

Date 2016 Jul 15

PMID 27416029

Citations 17

Authors

Claudine Kocher

Amy C Morrison

Mariana Leguia

Steev Loyola

Roger M Castillo

Hugo A Galvez

Helvio Astete

Carmen Flores-Mendoza

Julia S Ampuero

Daniel G Bausch

Eric S Halsey

Manuel Cespedes

Karine Zevallos

Ju Jiang

Allen L Richards

Affiliations

Soon will be listed here.

Abstract

Using a large, passive, clinic-based surveillance program in Iquitos, Peru, we characterized the prevalence of rickettsial infections among undifferentiated febrile cases and obtained evidence of pathogen transmission in potential domestic reservoir contacts and their ectoparasites. Blood specimens from humans and animals were assayed for spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR) by ELISA and/or PCR; ectoparasites were screened by PCR. Logistic regression was used to determine associations between patient history, demographic characteristics of participants and symptoms, clinical findings and outcome of rickettsial infection. Of the 2,054 enrolled participants, almost 2% showed evidence of seroconversion or a 4-fold rise in antibody titers specific for rickettsiae between acute and convalescent blood samples. Of 190 fleas (Ctenocephalides felis) and 60 ticks (Rhipicephalus sanguineus) tested, 185 (97.4%) and 3 (5%), respectively, were positive for Rickettsia spp. Candidatus Rickettsia asemboensis was identified in 100% and 33% of the fleas and ticks tested, respectively. Collectively, our serologic data indicates that human pathogenic SFGR are present in the Peruvian Amazon and pose a significant risk of infection to individuals exposed to wild, domestic and peri-domestic animals and their ectoparasites.

Citing Articles

Spotted fever group rickettsiae in black rats, pets, and humans in Zungarococha community, A rural area in the surroundings of Iquitos, Peru.

Ferradas C, Salvatierra G, Payahuanca D, Contreras W, Lopez-Perez A, Hangawatte T Ticks Tick Borne Dis. 2025; 16(1):102436.

PMID: 39799873 PMC: 11806410. DOI: 10.1016/j.ttbdis.2024.102436.

Meningitis and neurosensory hypoacousia due to Rickettsia sp. in Peru: case report.

Agramonte M, Vilcarromero S, Nunez-Melgar Z Rev Peru Med Exp Salud Publica. 2024; 41(3):316-320.

PMID: 39442115 PMC: 11495936. DOI: 10.17843/rpmesp.2024.413.13393.

Isolated from Four Human Cases with Acute Undifferentiated Febrile Illness in Peru.

Loyola S, Palacios-Salvatierra R, Caceres-Rey O, Richards A Pathogens. 2024; 13(6).

PMID: 38921787 PMC: 11206278. DOI: 10.3390/pathogens13060489.

Leptospira spp. and Rickettsia spp. as pathogens with zoonotic potential causing acute undifferentiated febrile illness in a central-eastern region of Peru.

Silva-Caso W, Aguilar-Luis M, Espinoza-Espiritu W, Vilcapoma-Balbin M, Del Valle L, Misaico-Revate E BMC Res Notes. 2024; 17(1):171.

PMID: 38902784 PMC: 11188165. DOI: 10.1186/s13104-024-06837-1.

Wide distribution of Mediterranean and African spotted fever agents and the first identification of Israeli spotted fever agent in ticks in Uganda.

Eneku W, Erima B, Byaruhanga A, Atim G, Tugume T, Ukuli Q PLoS Negl Trop Dis. 2023; 17(7):e0011273.

PMID: 37498943 PMC: 10409254. DOI: 10.1371/journal.pntd.0011273.

References

Richards A, Soeatmadji D, Widodo M, Sardjono T, Yanuwiadi B, Hernowati T . Seroepidemiologic evidence for murine and scrub typhus in Malang, Indonesia. Am J Trop Med Hyg. 1997; 57(1):91-5. DOI: 10.4269/ajtmh.1997.57.91. View

Flores-Mendoza C, Florin D, Felices V, Pozo E, Graf P, Burrus R . Detection of Rickettsia parkeri from within Piura, Peru, and the first reported presence of Candidatus Rickettsia andeanae in the tick Rhipicephalus sanguineus. Vector Borne Zoonotic Dis. 2013; 13(7):505-8. PMC: 3700472. DOI: 10.1089/vbz.2012.1028. View

Forshey B, Guevara C, Laguna-Torres V, Cespedes M, Vargas J, Gianella A . Arboviral etiologies of acute febrile illnesses in Western South America, 2000-2007. PLoS Negl Trop Dis. 2010; 4(8):e787. PMC: 2919378. DOI: 10.1371/journal.pntd.0000787. View

Kelly D, Richards A, Temenak J, Strickman D, Dasch G . The past and present threat of rickettsial diseases to military medicine and international public health. Clin Infect Dis. 2002; 34(Suppl 4):S145-69. DOI: 10.1086/339908. View

Suputtamongkol Y, Suttinont C, Niwatayakul K, Hoontrakul S, Limpaiboon R, Chierakul W . Epidemiology and clinical aspects of rickettsioses in Thailand. Ann N Y Acad Sci. 2009; 1166:172-9. DOI: 10.1111/j.1749-6632.2009.04514.x. View

Azad A, Radulovic S, Higgins J, Noden B, Troyer J . Flea-borne rickettsioses: ecologic considerations. Emerg Infect Dis. 1997; 3(3):319-27. PMC: 2627639. DOI: 10.3201/eid0303.970308. View

Keirans J, Litwak T . Pictorial key to the adults of hard ticks, family Ixodidae (Ixodida: Ixodoidea), east of the Mississippi River. J Med Entomol. 1989; 26(5):435-48. DOI: 10.1093/jmedent/26.5.435. View

Oteo J, Portillo A, Portero F, Zavala-Castro J, Venzal J, Labruna M . 'Candidatus Rickettsia asemboensis' and Wolbachia spp. in Ctenocephalides felis and Pulex irritans fleas removed from dogs in Ecuador. Parasit Vectors. 2014; 7:455. PMC: 4186946. DOI: 10.1186/s13071-014-0455-0. View

Kasper M, Blair P, Touch S, Sokhal B, Yasuda C, Williams M . Infectious etiologies of acute febrile illness among patients seeking health care in south-central Cambodia. Am J Trop Med Hyg. 2012; 86(2):246-253. PMC: 3269275. DOI: 10.4269/ajtmh.2012.11-0409. View

10.

Graf P, Chretien J, Ung L, Gaydos J, Richards A . Prevalence of seropositivity to spotted fever group rickettsiae and Anaplasma phagocytophilum in a large, demographically diverse US sample. Clin Infect Dis. 2008; 46(1):70-7. DOI: 10.1086/524018. View

11.

Blair P, Schoeler G, Moron C, Anaya E, Caceda R, Cespedes M . Evidence of rickettsial and leptospira infections in Andean northern Peru. Am J Trop Med Hyg. 2004; 70(4):357-63. View

12.

Prabhu M, Nicholson W, Roche A, Kersh G, Fitzpatrick K, Oliver L . Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania. Clin Infect Dis. 2011; 53(4):e8-15. PMC: 3148261. DOI: 10.1093/cid/cir411. View

13.

Raoult D, Fournier P, Fenollar F, Jensenius M, Prioe T, De Pina J . Rickettsia africae, a tick-borne pathogen in travelers to sub-Saharan Africa. N Engl J Med. 2001; 344(20):1504-10. DOI: 10.1056/NEJM200105173442003. View

14.

Schoeler G, Moron C, Richards A, Blair P, Olson J . Human spotted fever rickettsial infections. Emerg Infect Dis. 2005; 11(4):622-4. PMC: 3320320. DOI: 10.3201/eid1104.040287. View

15.

Forshey B, Stewart A, Morrison A, Galvez H, Rocha C, Astete H . Epidemiology of spotted fever group and typhus group rickettsial infection in the Amazon basin of Peru. Am J Trop Med Hyg. 2010; 82(4):683-90. PMC: 2844554. DOI: 10.4269/ajtmh.2010.09-0355. View

16.

Angelakis E, Richet H, Rolain J, La Scola B, Raoult D . Comparison of real-time quantitative PCR and culture for the diagnosis of emerging Rickettsioses. PLoS Negl Trop Dis. 2012; 6(3):e1540. PMC: 3295807. DOI: 10.1371/journal.pntd.0001540. View

17.

Smoak B, McClain J, Brundage J, Broadhurst L, Kelly D, Dasch G . An outbreak of spotted fever rickettsiosis in U.S. Army troops deployed to Botswana. Emerg Infect Dis. 1996; 2(3):217-21. PMC: 2626803. DOI: 10.3201/eid0203.960309. View

18.

Fournier P, Roux V, Caumes E, Donzel M, Raoult D . Outbreak of Rickettsia africae infections in participants of an adventure race in South Africa. Clin Infect Dis. 1998; 27(2):316-23. DOI: 10.1086/514664. View

19.

Parker T, Murray C, Richards A, Samir A, Ismail T, Fadeel M . Concurrent infections in acute febrile illness patients in Egypt. Am J Trop Med Hyg. 2007; 77(2):390-2. View

20.

Halsey E, Vilcarromero S, Forshey B, Rocha C, Bazan I, Stoddard S . Performance of the tourniquet test for diagnosing dengue in Peru. Am J Trop Med Hyg. 2013; 89(1):99-104. PMC: 3748494. DOI: 10.4269/ajtmh.13-0103. View