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Rickettsioses in Swedish travellers, 1997-2001

Adnan Rahman1, Anders Tegnell, Sirkka Vene

  • 1Swedish Institute for Infectious Disease Control, Solna, Sweden.

Scandinavian Journal of Infectious Diseases
|July 4, 2003
PubMed

Insights

Rickettsioses, including typhus and spotted fever groups, pose a risk to travelers. Southern Africa presents a higher risk, necessitating consideration of rickettsiosis in febrile travelers.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Travel Medicine

Background:

  • Rickettsioses are bacterial infections transmitted by arthropods.
  • Two main groups exist: typhus and spotted fever groups.
  • Laboratory records from Sweden (1997-2001) provided case data.

Purpose of the Study:

  • To analyze the incidence and risk factors of rickettsioses in Sweden.
  • To estimate the risk of rickettsioses for international travelers.
  • To highlight rickettsiosis as a differential diagnosis for febrile travelers.

Main Methods:

  • Retrospective analysis of 77 rickettsiosis cases diagnosed in Sweden (1997-2001).
  • Categorization into typhus (14 cases) and spotted fever (63 cases) groups.
  • Utilized a commercial tourist database to estimate travel exposure and infection risk.

Main Results:

  • Hepatic involvement was more common in the typhus group.
  • Estimated risk varied by destination: 1 in 140,000 to Southeast Asia, 1 in 1600 to Southern Africa.
  • Risk in Southern Africa increased significantly over the study period.

Conclusions:

  • Rickettsiosis is a significant concern for travelers, particularly from Southern Africa.
  • Consider rickettsiosis in febrile travelers, especially those returning from endemic areas.
  • Delayed serological response necessitates repeat testing; empirical treatment may be required.

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