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Emergence of murine typhus in La Réunion, France, 2012-2017

G Grouteau1, O Lancelot2, A Bertolotti1

  • 1Service de maladies infectieuses et tropicales, centre hospitalier universitaire de La Réunion, site sud, avenue Prés-Mitterrand, 97448 St-Pierre, Reunion.

Medecine Et Maladies Infectieuses
|August 8, 2019
PubMed
Abstract

Insights

Murine typhus (MT), a flea-borne illness, is emerging in La Réunion. Physicians should consider MT in patients with prolonged fever, asthenia, and headaches, especially during warmer months.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Murine typhus (MT) is an acute zoonosis caused by Rickettsia typhi.
  • The first autochthonous case of MT in La Réunion was reported in 2012.
  • Physician awareness of MT is crucial due to its potential for misdiagnosis.

Purpose of the Study:

  • To describe the clinical and epidemiological features of autochthonous Murine typhus in La Réunion.
  • To raise physician awareness of MT as an emerging disease.
  • To differentiate MT from other febrile illnesses like leptospirosis.

Main Methods:

  • A prospective observational study was conducted in La Réunion from 2012 to 2017.
  • Confirmed MT cases were identified through clinical compatibility, specific serology, and/or PCR.
  • Data on clinical presentation, biological abnormalities, and seasonality were collected.

Main Results:

  • Sixty-one confirmed cases of MT were identified.
  • Key clinical features included prolonged fever (90%), asthenia (87%), and headaches (79%).
  • Common biological findings were elevated liver enzymes (84%) and thrombocytopenia (75%), with normal renal function in 90% of cases.
  • A seasonal pattern was observed, with 79% of cases occurring in the warm season, primarily in the island's dry western and southern regions.

Conclusions:

  • Murine typhus is an emerging infectious disease in La Réunion, with potential for endemicity.
  • Acute undifferentiated fever with headaches, particularly during the warm season and in dry areas, should prompt consideration of MT.
  • MT is distinct from leptospirosis, notably by its epidemiological profile and the lower incidence of acute renal dysfunction.
Keywords:
Endemic typhusFleaMurine typhusPuceRickettsia typhiRickettsiosesRickettsiosisTyphus endémiqueTyphus murin

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