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Published on: October 11, 2022
Human Rickettsia felis infections in Mainland China
Zhongqiu Teng1, Na Zhao1, Ruotong Ren2,3
1The State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Abstract:
We identified four flea-borne spotted fever cases caused by Rickettsia felis in a retrospective survey of 182 patients with fever of unknown origin (FUO) in China between 2021 and 2022. The clinical signs and symptoms of the patients were similar to those of other rickettsioses, including fever, rash, and liver and kidney dysfunction. All four patients in the present study developed pneumonia or lung lesions after R. felis infection. The cases of R. felis infection, a neglected infectious disease, were sporadic in multiple provinces of the country. The high prevalence (2.14%, 4/187) of R. felis among patients with FUO highlights the risk posed by this pathogen to public health in China.
Insights
Four cases of flea-borne spotted fever caused by Rickettsia felis were found in Chinese patients with fever of unknown origin. This highlights R. felis as a public health risk, with infected patients developing lung issues.
Area of Science:
- Infectious Diseases
- Medical Microbiology
- Public Health
Background:
- Flea-borne spotted fever is a rickettsiosis with diverse clinical presentations.
- Rickettsia felis is an emerging cause of infectious disease globally.
- Fever of unknown origin (FUO) presents a diagnostic challenge, potentially masking uncommon infections.
Purpose of the Study:
- To investigate the prevalence and clinical characteristics of Rickettsia felis infections in patients with FUO in China.
- To assess the public health implications of R. felis in the studied population.
Main Methods:
- Retrospective analysis of 182 patients with FUO in China (2021-2022).
- Identification of Rickettsia felis through diagnostic testing.
- Clinical data collection and symptom analysis.
Main Results:
- Four cases (2.14%) of Rickettsia felis infection were identified among patients with FUO.
- Clinical manifestations included fever, rash, and liver/kidney dysfunction, typical of rickettsioses.
- All identified patients developed pneumonia or lung lesions post-infection.
Conclusions:
- Rickettsia felis is a cause of flea-borne spotted fever in China, presenting with symptoms overlapping other rickettsioses.
- The pathogen poses a significant public health risk, particularly with observed pulmonary complications.
- Increased awareness and diagnostic efforts for R. felis in FUO cases are warranted.
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