Serologic Evidence of Infection With Ehrlichiae and Spotted Fever Group Rickettsiae Among Residents of Gag Island, Indonesia

Richards, Allen L.; Ratiwayanto, Sutanti; Rahardjo, Eko; Kelly, Daryl J.; Dasch, Gregory A.; Fryauff, David J.; Bangs, Michael J.

doi:10.4269/ajtmh.2003.68.480

Cited by 25 publications

(14 citation statements)

References 29 publications

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“…Thus, the high prevalence of murine typhus reported in Indonesia likely also includes fleaborne spotted fever. In addition, previously demonstrated serologic evidence of spotted fever group rickettsiae infection among residents of Gag Island, in eastern Indonesia (15), could have been due to R. felis. On the basis of data presented here and of recent reports of R. felis in other countries in Asia (2)(3)(4)(5)8,9), healthcare providers in Indonesia should be alerted to the possibility of fleaborne spotted fever among their patients.…”

Section: Discussionmentioning

confidence: 99%

Rickettsia felis inXenopsylla cheopis, Java, Indonesia

Jiang¹,

Soeatmadji²,

Henry³

et al. 2006

Emerg. Infect. Dis.

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Rickettsia typhi and R. felis, etiologic agents of murine typhus and fleaborne spotted fever, respectively, were detected in Oriental rat fleas (Xenopsylla cheopis) collected from rodents and shrews in Java, Indonesia. We describe the first evidence of R. felis in Indonesia and naturally occurring R. felis in Oriental rat fleas.M urine typhus (endemic typhus, fleaborne typhus), caused by Rickettsia typhi, is transmitted to humans by infected fleas and is relatively common wherever susceptible rodent hosts reside (1). Fleaborne spotted fever (cat flea typhus), caused by Rickettsia felis, is another zoonotic disease carried by fleas and appears to have an equally wide, cosmopolitan distribution; human infections with R. felis have a clinical syndrome similar to that of murine typhus (1-4). The cat flea, Ctenocephalides felis, has been identified as the primary arthropod vector of R. felis in North and South America (United States, Mexico, Peru, Brazil), Europe (Spain, France, United Kingdom, Cyprus), Africa (Gabon, Ethiopia), Asia (Thailand, Afghanistan, Israel), Australia, and New Zealand (1,5-10). We describe the first evidence of R. felis in Indonesia and apparent natural infections of R. felis in the Oriental rat flea, Xenopsylla cheopis, implicating this flea species for the first time as a potential vector for fleaborne spotted fever. The StudySamples of X. cheopis were collected from 39 live-captured, peridomestic rodents and shrews from 3 localities in Malang, East Java, Indonesia, during an epidemiologic study conducted in 1994 (11). In this study the fleas were reidentified by using morphologic criteria, stored in fresh 70% ethanol, and subsequently evaluated for the presence of rickettsial DNA. DNA sample preparations were derived from triturates of 103 individual fleas in 100 µL PrepManUltra sample preparation reagent (Applied Biosystems, Foster City, CA, USA). DNA preparations of 1 to 5 fleas collected from the same rodent were pooled for testing. Reaction mixtures for the quantitative real-time PCR (qPCR) assays had a total volume of 25 µL and contained 3 µL DNA template. The master mixes were prepared for the 17-kDa Rickettsia-, R. typhi-and R. felis-specific qPCR assays in a separate, clean (DNA-free) room as previously described (6,12). The primer and probe sequences for the 17-kDa Rickettsia-specific and R. felis-specific assays have been reported (6,11). The R. typhi forward (Rt557F: 5′-TGG TAT TAC TGC TCA ACA AGC T-3′) and reverse (Rt678R: 5′-CAG TAA AGT CTA TTG ATC CTA CAC C-3′) primers and probe (Rt640BP: 5′-TET-CGC GAT CGT TAA TAG CAG CAC CAG CAT TAT CGC G-DABCYL-3′) sequences are listed here. Included in each run were 3 negative controls (GIBCO Ultrapure DNA-free distilled water, Invitrogen Corporation, Grand Island, NY, USA), 1 produced in the clean room and 2 in a biosafety cabinet in another laboratory where DNA templates were added. A TOPO TA plasmid (Invitrogen Corporation) that contained the target sequence at 10 3 copies for each assay was used as a positive control. qPCR reactions w...

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Section: Discussionmentioning

confidence: 99%

Rickettsia felis inXenopsylla cheopis, Java, Indonesia

Jiang¹,

Soeatmadji²,

Henry³

et al. 2006

Emerg. Infect. Dis.

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“…47,52,61 Outbreaks have also been reported mainly in rural agricultural areas, 29 but cases have been seen in urban centers of Southeast Asia. 22,30,63 Unlike murine typhus, seasonal variations can be found with scrub typhus; incidence increases towards the end of the rainy season and the beginning of winter months (July-November) in Southeast Asia. 27,28 Most scrub typhus cases are mild and characterized by acute onset fever, myalgia, generalized lymphadenopathy, maculopapular rash, and splenomegaly.…”

Section: Clinical Featuresmentioning

confidence: 99%

Rickettsial Infections in Southeast Asia: Implications for Local Populace and Febrile Returned Travelers

Aung¹,

Spelman²,

Murray³

et al. 2014

The American Society of Tropical Medicine and Hygiene

102

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Abstract. Rickettsial infections represent a major cause of non-malarial febrile illnesses among the residents of Southeast Asia and returned travelers from that region. There are several challenges in recognition, diagnosis, and management of rickettsioses endemic to Southeast Asia. This review focuses on the prevalent rickettsial infections, namely, murine typhus (Rickettsia typhi), scrub typhus (Orientia tsutsugamushi), and members of spotted fever group rickettsiae. Information on epidemiology and regional variance in the prevalence of rickettsial infections is analyzed. Clinical characteristics of main groups of rickettsioses, unusual presentations, and common pitfalls in diagnosis are further discussed. In particular, relevant epidemiologic and clinical aspects on emerging spotted fever group rickettsiae in the region, such as Rickettsia honei, R. felis, R. japonica, and R. helvetica, are presented. Furthermore, challenges in laboratory diagnosis and management aspects of rickettsial infections unique to Southeast Asia are discussed, and data on emerging resistance to antimicrobial drugs and treatment/prevention options are also reviewed.

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“…felis, the agent that causes ßea-borne spotted fever, has been shown to infect ßeas of peridomestic rodents and ßeas other than the primary vector, Ctenocephalides felis, in Java, Indonesia (Azad et al 1997, Parola et al 1998, Richards et al 2003, Jiang et al 2006. R. felis was Þrst shown to infect Indonesian X. cheopis collected in Java in 1994 (Jiang et al 2006).…”

Section: Discussionmentioning

confidence: 98%

“…Scrub typhus (Orientia tsutsugamushi) has been recognized in Indonesia since World War II, where it was a major nonbattle injury for military forces (GrifÞths 1945). Richards et al (2003) found evidence of spotted fever group (SFG) rickettsiae (SFGR) infection in human residents of Gag Island, Indonesia, located northwest of the island of Irian Jaya in Eastern Indonesia.…”

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Rickettsial Infections of Fleas Collected From Small Mammals on Four Islands in Indonesia

et al. 2010

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Ectoparasites were sampled from small mammals collected in West Java, West Sumatra, North Sulawesi, and East Kalimantan, Indonesia, in 2007-2008 and were screened for evidence of infection from bacteria in the Rickettsaceae family. During eight trap nights at eight sites, 208 fleas were collected from 96 of 507 small mammals trapped from four orders (379 Rodentia; 123 Soricomorpha; two Carnivora; three Scandentia). Two species of fleas were collected: Xenopsylla cheopis (n = 204) and Nosopsyllus spp. (n = 4). Among the 208 fleas collected, 171 X. cheopis were removed from rats (Rattus spp.) and 33 X. cheopis from shrews (Suncus murinus). X. cheopis were pooled and tested for DNA from rickettsial agents Rickettsia typhi, Rickettsia felis, and spotted fever group rickettsiae. R. typhi, the agent of murine typhus, was detected in X. cheopis collected from small mammals in West Java and East Kalimantan. R. felis was detected in X. cheopis collected from small mammals in Manado, North Sulawesi. R. felis and spotted fever group rickettsiae were detected in a pool of X. cheopis collected from an animal in East Kalimantan. Sixteen percent of the X. cheopis pools were found positive for Rickettsia spp.; four (10.8%) R. typhi, one (2.7%) R. felis, and one (2.7%) codetection of R. felis and a spotted fever group rickettsia. These data suggest that rickettsial infections remain a threat to human health across Indonesia.

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Serologic Evidence of Infection With Ehrlichiae and Spotted Fever Group Rickettsiae Among Residents of Gag Island, Indonesia

Cited by 25 publications

References 29 publications

Rickettsia felis inXenopsylla cheopis, Java, Indonesia

Rickettsia felis inXenopsylla cheopis, Java, Indonesia

Rickettsial Infections in Southeast Asia: Implications for Local Populace and Febrile Returned Travelers

Rickettsial Infections of Fleas Collected From Small Mammals on Four Islands in Indonesia

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