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Published on: October 11, 2022
Rickettsial Disease in the Peruvian Amazon Basin
Claudine Kocher1,2, Amy C Morrison2, Mariana Leguia2
1Kantonsspital Baden, Baden, Switzerland.
Abstract:
Using a large, passive, clinic-based surveillance program in Iquitos, Peru, we characterized the prevalence of rickettsial infections among undifferentiated febrile cases and obtained evidence of pathogen transmission in potential domestic reservoir contacts and their ectoparasites. Blood specimens from humans and animals were assayed for spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR) by ELISA and/or PCR; ectoparasites were screened by PCR. Logistic regression was used to determine associations between patient history, demographic characteristics of participants and symptoms, clinical findings and outcome of rickettsial infection. Of the 2,054 enrolled participants, almost 2% showed evidence of seroconversion or a 4-fold rise in antibody titers specific for rickettsiae between acute and convalescent blood samples. Of 190 fleas (Ctenocephalides felis) and 60 ticks (Rhipicephalus sanguineus) tested, 185 (97.4%) and 3 (5%), respectively, were positive for Rickettsia spp. Candidatus Rickettsia asemboensis was identified in 100% and 33% of the fleas and ticks tested, respectively. Collectively, our serologic data indicates that human pathogenic SFGR are present in the Peruvian Amazon and pose a significant risk of infection to individuals exposed to wild, domestic and peri-domestic animals and their ectoparasites.
Insights
Rickettsial infections are prevalent in Peru, with nearly 2% of febrile patients showing evidence of infection. Pathogen transmission was confirmed in domestic animals and their ectoparasites, highlighting a significant risk in the Peruvian Amazon.
Area of Science:
- * Infectious Diseases
- * Medical Entomology
- * Zoonotic Pathogens
Background:
- * Rickettsial infections, including spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR), are significant public health concerns globally.
- * Undifferentiated febrile illnesses in endemic regions often require etiological diagnosis to guide treatment and surveillance.
- * The Peruvian Amazon is a region with potential for emerging infectious diseases due to its rich biodiversity and human-animal interactions.
Purpose of the Study:
- * To determine the prevalence of rickettsial infections in undifferentiated febrile cases in Iquitos, Peru.
- * To investigate the presence and transmission of spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR) in domestic animals and their ectoparasites.
- * To identify risk factors associated with rickettsial infections in the study population.
Main Methods:
- * A passive, clinic-based surveillance program enrolled 2,054 participants with undifferentiated febrile illness.
- * Blood samples from humans and animals were tested for SFGR and TGR using ELISA and PCR.
- * Ectoparasites (fleas and ticks) were collected from animals and screened for Rickettsia spp. by PCR. Logistic regression was used for statistical analysis.
Main Results:
- * Nearly 2% of human participants showed serological evidence of rickettsial infection.
- * Rickettsia spp. were detected in a high proportion of fleas (97.4%) and ticks (5%).
- * Candidatus Rickettsia asemboensis was identified in 100% of fleas and 33% of ticks, indicating pathogen presence in the local ectoparasite fauna.
Conclusions:
- * Human pathogenic SFGR are circulating in the Peruvian Amazon.
- * Domestic animals and their ectoparasites serve as reservoirs and vectors for rickettsial pathogens.
- * Individuals exposed to domestic and peri-domestic animals and their ectoparasites face a significant risk of rickettsial infection.
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