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An Electroporation Method to Transform Rickettsia spp. with a Fluorescent Protein-Expressing Shuttle Vector in Tick Cell Lines
Published on: October 11, 2022
Rickettsioses imported by travellers and migrants to Spain attended in the +Redivi network, 2009-2020
Jara Llenas-García1,2,3, Ramiro Cañaveral4, Marta Arsuaga5,6
1Internal Medicine Department, Infectious Diseases Section, Hospital Vega Baja, 03314 Orihuela, Spain.
Background:
Rickettsioses are emerging zoonotic diseases with worldwide prevalence, recognized as a cause of imported fever in travellers and migrants. Our objective is to describe the microbiological, clinical and epidemiological characteristics of imported rickettsioses in travellers and migrants included in a Spanish collaborative network database.
Methods:
This multicentre retrospective observational study was nested in +Redivi, the Cooperative Network for the Study of Infections Imported by Immigrants and Travellers. We asked collaborating centres for microbiological, clinical and epidemiological data on the rickettsiosis cases from the inception of the network in 2009 to December 2020.
Results:
Fifty-four cases of imported rickettsioses were included; 35 (64.8%) patients were men, and the median age was 37 years (interquartile range 26, 51.2). Only 7.4% of patients were travellers visiting friends and relatives, and 5.6% were migrants. The most frequent travel destination (38.9%) was South Africa, and 90.7% engaged in a high-risk activity. Twenty-seven patients (50.0%) started presenting symptoms after their return to Spain. The most frequent symptoms were febrile syndrome (55.6%) and cutaneous manifestations (27.8%). Most diagnoses (63.0%) were confirmed by serology. Only a few cases (9.3%) required hospitalization. All participants had a full recovery.
Conclusions:
Clinicians should suspect rickettsial diseases in travellers coming from high-risk areas, especially Southern Africa, who have engaged in activities in rural areas and natural parks. Doxycycline should be considered in the empiric treatment of imported fever of travellers coming from those areas or who have engaged in high-risk activities. There is a need to improve access to molecular diagnosis of rickettsiosis in Spain.
Insights
Imported rickettsioses are a growing concern for travelers. This study highlights key clinical and epidemiological features of these infections in individuals returning to Spain, emphasizing the need for prompt diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Travel Medicine
- Epidemiology
Background:
- Rickettsioses are emerging zoonotic diseases with global prevalence.
- They are a significant cause of imported fever in travelers and migrants.
- Understanding their characteristics is crucial for public health.
Purpose of the Study:
- To describe the microbiological, clinical, and epidemiological features of imported rickettsioses.
- To analyze cases in travelers and migrants within a Spanish collaborative network.
- To inform clinical suspicion and management strategies.
Main Methods:
- A multicenter retrospective observational study.
- Data collected from the +Redivi network (2009-2020).
- Inclusion of microbiological, clinical, and epidemiological data for rickettsiosis cases.
Main Results:
- Fifty-four cases of imported rickettsioses were analyzed.
- Most common symptoms included febrile syndrome and cutaneous manifestations.
- South Africa was a frequent travel destination, with high-risk activities often preceding symptom onset.
Conclusions:
- Rickettsial diseases should be suspected in travelers from high-risk areas, particularly Southern Africa.
- Doxycycline is recommended for empiric treatment of imported fever in at-risk travelers.
- Improved access to molecular diagnostics for rickettsiosis in Spain is needed.
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