Serosurveillance of Orientia tsutsugamushi and Rickettsia typhi in Bangladesh

Maude, Rapeephan R.; Maude, Richard J.; Ghose, Aniruddha; Amin, M. Robed; Islam, M. Belalul; Ali, Mohammad; Bari, M. S.; Majumder, Mrinmoyee; Tanganuchitcharnchai, Ampai; Dondorp, Arjen M.; Paris, Daniel; Bailey, Robin L.; Faiz, M. Abul; Blacksell, Stuart D.; Day, Nicholas P. J.

doi:10.4269/ajtmh.13-0570

Cited by 39 publications

(43 citation statements)

References 14 publications

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“…However acute infection as well as serological evidence of infection has been published from metropolitan cities [10,11,13] . Outbreaks generally occur during the cooler months of the year after monsoons [12] .…”

Section: Distribution Of Diseasementioning

confidence: 99%

“…Scrub typhus is seen in several parts of South-East Asia including India [4][5][6][7][8][9][10][11] , Bangladesh [12] , China [13] , Taiwan [14] , South Korea [15] , Japan [16] and Northern Australia [17] . Although scrub typhus has been reported from isolated parts of these countries [2,5,9,13,14] , it is likely that this disease is ubiquitous.…”

Section: Distribution Of Diseasementioning

confidence: 99%

See 1 more Smart Citation

Severe scrub typhus infection: Clinical features, diagnostic challenges and management

Peter

Sudarsan

Prakash

et al. 2015

WJCCM

139

121

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Scrub typhus infection is an important cause of acute undifferentiated fever in South East Asia. The clinical picture is characterized by sudden onset fever with chills and non-specific symptoms that include headache, myalgia, sweating and vomiting. The presence of an eschar, in about half the patients with proven scrub typhus infection and usually seen in the axilla, groin or inguinal region, is characteristic of scrub typhus. Common laboratory findings are elevated liver transaminases, thrombocytopenia and leukocytosis. About a third of patients admitted to hospital with scrub typhus infection have evidence of organ dysfunction that may include respiratory failure, circulatory shock, mild renal or hepatic dysfunction, central nervous system involvement or hematological abnormalities. Since the symptoms and signs are non-specific and resemble other tropical infections like malaria, enteric fever, dengue or leptospirosis, appropriate laboratory tests are necessary to confirm diagnosis. Serological assays are the mainstay of diagnosis as they are easy to perform; the reference test is the indirect immunofluorescence assay (IFA) for the detection of IgM antibodies. However in clinical practice, the enzyme-linked immuno-sorbent assay is done due to the ease of performing this test and a good sensitivity and sensitivity when compared with the IFA. Paired samples, obtained at least two weeks apart, demonstrating a ≥ 4 fold rise in titre, is necessary for confirmation of serologic diagnosis. The mainstay of treatment is the tetracycline group of antibiotics or chloramphenicol although macrolides are used alternatively. In mild cases, recovery is complete. In severe cases with multi-organ failure, mortality may be as high as 24%.

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Section: Distribution Of Diseasementioning

confidence: 99%

Section: Distribution Of Diseasementioning

confidence: 99%

Severe scrub typhus infection: Clinical features, diagnostic challenges and management

Peter

Sudarsan

Prakash

et al. 2015

WJCCM

139

121

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“…prowazekii and R. typhi are the causative agents of epidemic and endemic typhus, respectively. Endemic typhus is distributed worldwide and highly prevalent in low-income countries in Africa (5) and Asia (6)(7)(8)(9). The disease primarily occurs in ports and coastal towns where rodents such as rats and mice that serve as natural hosts of R. typhi are common.…”

mentioning

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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“…Hamaguchi et al studied acute undifferentiated fever in hospitalized patients in Northern Vietnam, where 33% were seropositive for R. typhi . Certain communities, notably, homeless populations, have higher seroprevalence rates, ranging from 9.6% in the U.S. to 22% in Marseille, France, and to 67% in Bangladesh [84] and 21% in Lao PDR [85]. A pilot meta-analysis conducted using the search terms “murine typhus + incidence”, “murine typhus + acute febrile illness”, and “murine typhus” retrieved 880 articles through 1934 and only the 325 articles dating to 2001 were reviewed for adequacy of details and methodology, including geographic location for inclusion in the study, and with sole focus on studies of incidence among prospective acute febrile disease studies (Supplemental Table 2).…”

Section: Murine Typhus and Spotted Fever Rickettsiosismentioning

confidence: 99%

Neglected bacterial zoonoses

Chikeka

Dumler

2015

Clinical Microbiology and Infection

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Bacterial zoonoses comprise a group of diseases in humans or animals acquired by direct contact with or by oral consumption of contaminated animal materials, or via arthropod vectors. Among neglected infections, bacterial zoonoses are among the most neglected given emerging data on incidence and prevalence as causes of acute febrile illness, even in areas where recognized neglected tropical diseases occur frequently. While many other bacterial infections could also be considered in this neglected category, five distinct infections stand out because they are globally distributed, are acute febrile diseases, have high rates of morbidity and case fatality, and are reported as commonly as malaria, typhoid or dengue virus infections in carefully designed studies in which a broad spectrum diagnoses are actively sought. Thus, this review will focus attention on leptospirosis, relapsing fever borreliosis, and rickettsioses, including scrub typhus, murine typhus and spotted fever group rickettsiosis. Of greatest interest is the lack of distinguishing clinical features among these infections when in humans, which confounds diagnosis where laboratory confirmation is lacking, and in regions where clinical diagnosis is often attributed to one of several perceived more common threats. As diseases such as malaria come under improved control, the real impact of these common and under-recognized infections will become evident, as will the requirement for the strategies and allocation of resources for their control.

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Serosurveillance of Orientia tsutsugamushi and Rickettsia typhi in Bangladesh

Cited by 39 publications

References 14 publications

Severe scrub typhus infection: Clinical features, diagnostic challenges and management

Severe scrub typhus infection: Clinical features, diagnostic challenges and management

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

Neglected bacterial zoonoses

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