High Seroprevalence for Typhus Group Rickettsiae, Southwestern Tanzania

Dill, Tatjana; Dobler, Gerhard; Saathoff, Elmar; Clowes, Petra; Kroidl, Inge; Ntinginya, Elias N.; Machibya, Harun; Maboko, Leonard; Löscher, Thomas; Höelscher, Michael; Heinrich, Norbert

doi:10.3201/eid1902.120601

Cited by 20 publications

(24 citation statements)

References 11 publications

(11 reference statements)

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“…Together with previous reports on RVFV, rickettsiae of the typhus group and spotted fever group, we are demonstrating comparably high seroprevalences which could be caused by considerable exposure of the population to arthropod-borne infections other than malaria [23], [26], [27]. Akin to RVFV, a near-linear correlation of anti- Alphavirus IgG prevalence with age suggests endemic exposure rather than single or few epidemic events.…”

Section: Discussionsupporting

confidence: 80%

Seroprevalence of Alphavirus Antibodies in a Cross-Sectional Study in Southwestern Tanzania Suggests Endemic Circulation of Chikungunya

Weller¹,

Clowes

Dobler

et al. 2014

PLoS Negl Trop Dis

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BackgroundTo date, Alphavirus infections and their most prominent member, chikungunya fever, a viral disease which first became apparent in Tanzania in 1953, have been very little investigated in regions without epidemic occurrence. Few data exist on burden of disease and socio-economic and environmental covariates disposing to infection.MethodsA cross-sectional seroprevalence study was undertaken in 1,215 persons from Mbeya region, South-Western Tanzania, to determine the seroprevalence of anti-Alphavirus IgG antibodies, and to investigate associated risk factors.Results18% of 1,215 samples were positive for Alphavirus IgG. Seropositivity was associated with participant age, low to intermediate elevation, flat terrain and with IgG positivity for Rift Valley fever, Flaviviridae, and rickettsiae of the spotted fever group. When comparing the geographical distribution of Alphavirus seropositivity to that of Rift Valley fever, it was obvious that Alphaviruses had spread more widely throughout the study area, while Rift Valley fever was concentrated along the shore of Lake Malawi.Conclusion Alphavirus infections may contribute significantly to the febrile disease burden in the study area, and are associated with several arthropod-borne infections. Their spread seems only limited by factors affecting mosquitoes, and seems less restricted than that of Rift Valley fever.

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Section: Discussionsupporting

confidence: 80%

Seroprevalence of Alphavirus Antibodies in a Cross-Sectional Study in Southwestern Tanzania Suggests Endemic Circulation of Chikungunya

Weller¹,

Clowes

Dobler

et al. 2014

PLoS Negl Trop Dis

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“…The course of disease of endemic typhus is generally milder than that of epidemic typhus. The lethality of R. typhi infection is estimated to be Ͻ5% (14,15), while the lethality of R. prowazekii infection is much higher (20 to 30%) (13,15,16) if untreated with an effective antibiotic, such as a tetracycline or chloramphenicol.…”

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confidence: 99%

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

et al. 2016

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bRickettsioses are emerging febrile diseases caused by obligate intracellular bacteria belonging to the family Rickettsiaceae. Rickettsia typhi belongs to the typhus group (TG) of this family and is the causative agent of endemic typhus, a disease that can be fatal. In the present study, we analyzed the course of R. typhi infection in C57BL/6 RAG1 ؊/؊ mice. Although these mice lack adaptive immunity, they developed only mild and temporary symptoms of disease and survived R. typhi infection for a long period of time. To our surprise, 3 to 4 months after infection, C57BL/6 RAG1 ؊/؊ mice suddenly developed lethal neurological disorders. Analysis of these mice at the time of death revealed high bacterial loads, predominantly in the brain. This was accompanied by a massive expansion of microglia and by neuronal cell death. Furthermore, high numbers of infiltrating CD11b ؉ macrophages were detectable in the brain. In contrast to the microglia, these cells harbored R. typhi and showed an inflammatory phenotype, as indicated by inducible nitric oxide synthase (iNOS) expression, which was not observed in the periphery. Having shown that R. typhi persists in immunocompromised mice, we finally asked whether the bacteria are also able to persist in resistant C57BL/6 and BALB/c wild-type mice. Indeed, R. typhi could be recultivated from lung, spleen, and brain tissues from both strains even up to 1 year after infection. This is the first report demonstrating persistence and reappearance of R. typhi, mainly restricted to the central nervous system in immunocompromised mice.

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“…9,10 Critical social conditions have been shown to be among the main factors influencing the reemergence of epidemic typhus. 11,12 This was probably the case for the youth rehabilitation center in western Rwanda. Environmental assessments carried out during the outbreak response revealed evidence of poor hygiene and infestation of lice in the clothing and bedding of the residents in the camp.…”

Section: Discussionmentioning

confidence: 99%

A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012

Umulisa

Omolo

Muldoon³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. In August 2012, laboratory tests confirmed a mixed outbreak of epidemic typhus fever and trench fever in a male youth rehabilitation center in western Rwanda. Seventy-six suspected cases and 118 controls were enrolled into an unmatched case-control study to identify risk factors for symptomatic illness during the outbreak. A suspected case was fever or history of fever, from April 2012, in a resident of the rehabilitation center. In total, 199 suspected cases from a population of 1,910 male youth (attack rate = 10.4%) with seven deaths (case fatality rate = 3.5%) were reported. After multivariate analysis, history of seeing lice in clothing (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [CI] = 1.1-5.8), delayed (≥ 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6-9.6), and delayed (≥ 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0-11) were associated with illness, whereas having stayed in the rehabilitation camp for ≥ 6 months was protective (aOR = 0.20, 95% CI = 0.10-0.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks.

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High Seroprevalence for Typhus Group Rickettsiae, Southwestern Tanzania

Cited by 20 publications

References 11 publications

Seroprevalence of Alphavirus Antibodies in a Cross-Sectional Study in Southwestern Tanzania Suggests Endemic Circulation of Chikungunya

Seroprevalence of Alphavirus Antibodies in a Cross-Sectional Study in Southwestern Tanzania Suggests Endemic Circulation of Chikungunya

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012

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