Detection of relapsing fever in human blood samples from Israel using PCR targeting the glycerophosphodiester phosphodiesterase (GlpQ) gene

Halperin, Tami; Orr, Nadav; Cohen, Regev; Hasin, Tal; Davidovitch, Nadav; Klement, Eyal; Kayouf, Raid; Baneth, Gad; Cohen, Dani; Yavzori, Miri

doi:10.1016/j.actatropica.2006.04.004

Cited by 39 publications

(36 citation statements)

References 14 publications

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“…The definitive diagnosis of TBRF is primarily based on the detection of Borrelia spirochetes in smears of peripheral blood collected during the febrile period. The PCR techniques (e.g., glpQbased PCR) along with sequence analysis can often identify the infectious Borrelia species 3 ; although the preferred treatment is doxycycline 100 mg twice daily for 10 days, we prescribed minocycline as an alternative treatment in this case. De Pierpont and others all reported that minocycline was as effective as doxycycline in areas with limited resources.…”

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confidence: 99%

The First Case of Imported Relapsing Fever in Japan

Kutsuna

Kawabata²,

Kasahara³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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confidence: 99%

The First Case of Imported Relapsing Fever in Japan

Kutsuna

Kawabata²,

Kasahara³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…This is the first report to describe a multiplex, quantitative, high-throughput real-time assay for RF and malaria and to apply it to assess a large cohort with possible RF Borrelia infection and/or malaria. We chose glpQ to broadly detect RF Borrelia but not B. burgdorferi (8); Halperin et al showed that this target shares 98% identity with B. persica (11). We found that ϳ0.08% of blood samples obtained for surveillance gave Our assay detected all but 1 blood smear-identified case of RF.…”

Section: Discussionmentioning

confidence: 85%

Multiplex 5′ Nuclease-Quantitative PCR for Diagnosis of Relapsing Fever in a Large Tanzanian Cohort

Reller¹,

Clemens²,

Schachterle³

et al. 2011

J Clin Microbiol

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Relapsing fever (RF) is caused by tick-and louse-borne Borrelia spp., is characterized by recurrent fever, and is often misdiagnosed as malaria. Because of submicroscopic bacteremia, microscopy can be insensitive between febrile bouts. We designed a multiplex quantitative PCR (qPCR) assay to distinguish RF Borrelia from Plasmodium falciparum and P. vivax. The assay specifically (100%) amplified pathogenic RF Borrelia (1 copy/reaction). We then tested blood from participants within a Tanzanian cohort assessed at scheduled intervals and with fever. Among 8,617 blood samples from 2,057 participants surveyed routinely, 7 (0.08%) samples and 7 (0.3%) participants had RF DNA (median, 4.4 ؋ 10 3 copies/ml). Of 382 samples from 310 febrile persons, 15 (3.9%) samples from 13 (4.2%) participants had RF DNA (median, 7.9 ؋ 10 2 copies/ml). Five (1.3%) samples from 4 (1.3%) participants were found to harbor Borrelia by microscopy. We conclude that multiplex qPCR holds promise for improved clinical diagnosis and epidemiologic assessment of RF.Relapsing fever (RF) is an acute febrile illness caused by multiple Borrelia species, which differ by geographic location and are transmitted either by argasid (soft body) ticks or by human body lice. Fever recurs over weeks or months as Borrelia alters surface antigens, immune system escape occurs, and new waves of bacteremia with Յ10 6 bacteria/ml ensue (2, 7, 26). The sensitivity of Giemsa-stained peripheral blood smear analysis is limited for low-level bacteremia, and the technique is not useful during asymptomatic intervals. Microscopy is impractical for large studies and cannot accurately assess disease burden. Therefore, we developed a high-throughput, real-time multiplex quantitative PCR (qPCR) assay to detect RF Borrelia, Plasmodium falciparum, and P. vivax to support a large clinical trial in Tanzania. Herein we report diagnostic and epidemiological findings related to identification of RF Borrelia among trial participants. MATERIALS AND METHODSParticipants. (i) Setting. We sought to identify incidents of symptomatic and asymptomatic relapsing fever as an ancillary study to that of mass treatment with azithromycin for trachoma (Partnership for the Rapid Elimination of Trachoma [PRETϩ]). In the parent study, four villages in the Kongwa district in the central Dodoma region of Tanzania were selected for WHO-recommended single-dose mass treatment with azithromycin (20 mg/kg of body weight, up to 1 g) for highly prevalent (Ն10%) active (trachomatous follicular or intense) trachoma (17,21,25). Within villages, 130 households per village (intervention group) were randomly selected. Within households, children Ͻ7 years of age, caregivers, and pregnant women were eligible; one child and one caregiver were randomly selected in addition to pregnant women. Four otherwise similar villages in the same geographic area with less-prevalent active trachoma (Ͻ10%) were chosen as controls. Enrollment was per the intervention group.(ii) Routine surveillance. Young children (0 months to 7 years of ...

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“…infections, real-time PCR is significantly more sensitive than microscopy to diagnose louse-borne relapsing fever, and its use should be considered to describe relapsing fever epidemiology. 28 Among the limitations of the study, we need to acknowledge the fact that a small number of children were enrolled, which limited our chances of describing statistically significant associations. In addition, a single missionary hospital was used for enrollment, but in Ethiopia, the use of health services is divided between the public, private, and community sectors.…”

Section: Discussionmentioning

confidence: 99%

Treatable Bacterial Infections Are Underrecognized Causes of Fever in Ethiopian Children

Aarsland

Castellanos-González²,

Lockamy

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Febrile illnesses remain a major cause of morbidity and mortality in resource-poor countries, but too often, tests are not available to determine the causes, leading to misdiagnosis and inappropriate treatment. To determine the cause of febrile illnesses, we recovered the malaria smears from 102 children presenting with fever to Soddo Christian Hospital in Wolaitta Soddo, Ethiopia. DNA was isolated from the smears and evaluated by real-time polymerase chain reaction. We identified pathogen DNA with probes for Plasmodium spp., Streptococcus pneumoniae, Rickettsia spp., Salmonella spp., and Borrelia spp. Overall, we showed that it is possible to isolate high-quality DNA and identify treatable pathogens from malaria blood smears. Furthermore, our data showed that bacterial pathogens (especially Pneumococcus, Rickettsia spp., and Borrelia spp.) are common and frequently unrecognized but treatable causes of febrile illnesses in Ethiopian children. BACKGROUND

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Detection of relapsing fever in human blood samples from Israel using PCR targeting the glycerophosphodiester phosphodiesterase (GlpQ) gene

Cited by 39 publications

References 14 publications

The First Case of Imported Relapsing Fever in Japan

The First Case of Imported Relapsing Fever in Japan

Multiplex 5′ Nuclease-Quantitative PCR for Diagnosis of Relapsing Fever in a Large Tanzanian Cohort

Treatable Bacterial Infections Are Underrecognized Causes of Fever in Ethiopian Children

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