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Current knowledge of rickettsial diseases in Italy

Lorenzo Ciceroni1, Antonella Pinto, Simonetta Ciarrocchi

  • 1Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. ciceroni@iss.it

Annals of the New York Academy of Sciences
|November 23, 2006
PubMed

Insights

Rickettsial diseases, primarily Mediterranean spotted fever (MSF), pose significant health risks in Italy, with thousands of cases reported. Imported rickettsioses and Rickettsia helvetica infections also occur, highlighting the diverse threat of these tick-borne illnesses.

Area of Science:

  • Medical Entomology
  • Infectious Diseases
  • Public Health

Background:

  • Rickettsial diseases represent a significant public health concern in Italy, with a notable incidence of Mediterranean spotted fever (MSF).
  • Historical documentation includes murine typhus and epidemic typhus, though current prevalence is low.
  • Imported rickettsial infections, such as rickettsialpox, African tick-bite fever (ATBF), and scrub typhus, are also observed, reflecting international disease transmission.

Observation:

  • Between 1998 and 2002, Italy reported 4,604 clinical cases of rickettsial diseases, resulting in 33 deaths from 1998 to 2001.
  • Mediterranean spotted fever (MSF) accounts for the vast majority of reported cases within Italy.
  • Sporadic cases of murine typhus have been reported since 1950, and epidemic typhus appears to be eradicated.
  • In 2004, three cases of a mild rickettsiosis were identified and serologically linked to Rickettsia helvetica.

Findings:

  • Mediterranean spotted fever (MSF) is the predominant rickettsial illness in Italy.
  • While historically present, epidemic typhus is no longer a concern, and murine typhus occurs only sporadically.
  • Emerging or imported rickettsial diseases, including Rickettsia helvetica infections, indicate a broadening spectrum of tick-borne pathogens.

Implications:

  • Effective surveillance and control strategies are crucial for managing endemic and imported rickettsial diseases in Italy.
  • Increased awareness among healthcare professionals is necessary for timely diagnosis and treatment of various rickettsioses.
  • Further research into Rickettsia helvetica and other emerging tick-borne pathogens is warranted to understand their epidemiological significance and clinical impact.

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