Chapter 2 : Emerging Rickettsioses

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Emerging Rickettsioses, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818418/9781555811686_Chap02-1.gif /docserver/preview/fulltext/10.1128/9781555818418/9781555811686_Chap02-2.gif


Rickettsioses present some of the oldest recognized infectious diseases. Ricketts proved that the wood tick , was involved in the transmission of the Rocky Mountain spotted fever (RMSF). In 1910, the first cases of Mediterranean spotted fever (MSF) were reported in Tunis, Tunisia. The role of was established in 1930. Prior to 1984, only eight rickettsioses were recognized, and in the subsequent 13 years, seven new rickettsial diseases were described. The advent of novel diagnostic tools has dramatically improved the efficiency of diagnosis of rickettsioses and the recognition of new rickettsial species. Cell culture is the most widely used system for primary isolation. The oriental rat flea, , is the main flea vector of flea-borne bacterial diseases, including rickettsioses. These fleas are associated with Old World commensal rats, and consequently, the disease associated with these fleas is prevalent in harbors and large cities, The cat flea, , is the vector for cat-scratch disease and cat-flea typhus. Eleven new rickettsioses have been described since 1974. An entirely new clinical entity, such as the one caused by , which results in disease without the typical rash associated with other spotted fevers was described. The future of such new diseases is unpredictable because rickettsioses have not been systematically studied in such cases. This is an area for future research.

Citation: Raoult D, Olson J. 1999. Emerging Rickettsioses, p 17-36. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch2
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. 1 Anderson, B. E.,, J. E. Dawson,, D. C. Jones,, and K. H. Wilson. 1991. Ehrlichia chaffeensis, a new species associated with human ehrlichiosis. J. Clin. Microbiol. 29: 2838 2842.
2. Anderson, B. E.,, G. S. Kimetha,, J. G. Olson,, J. E. Childs,, J. F. Piesman,, C. M. Happ,, G. O. Maupin,, and B. J. Johnson. 1993. Amblyomma americanum: a potential vector of human echrlichiosis. Am. J. Trap. Med. Hyg. 49: 239 244.
3.Anonymous. 1994. Epidemic typhus risk in Rwandan refugee camps. Weekly Epidemiol. Rec. 69: 259.
4.Anonymous. 1997. A large outbreak of epidemic louse-borne typhtls in Burundi. WHO Weekly Epidemiol. Rec. 72: 152153.
5. Azad, A. F.,, S. Radulovic, .J. A. Higgins, B. H. Noden, and J. M. Troyer. 1997. Flea-borne rickettsioses: ecologic considerations. Emerg, Infect. Dis. 3: 319 327.
6. Bacellar, F.,, I. Lencastre,, and A. R, Filipe. 1998. Is murine typhus re-emerging in Portugal? Eurosurveillance 3: 18 20.
7. Baird, R. W.,, J. Stenos,, R. Stewart,, B. Hudson,, M. Lloyd,, S. Aiulo,, and B. Dwyer. 1996. Genetic variation in Australian spotted fever group rickettsiae. J. Clin. Microbial. 34: 1526 1530.
8. Beati, L.,, V. Roux,, A. Ortuno,, J. Castella,, F. Segura Porta,, and D. Raoult. 1996. Phenotypic and genotypic characterization of spotted fever group rickettsiae isolated from catalan Rhipicephalus sanguineus ticks. J. Clin. Microbiol. 34: 2688 2694.
9. Bella, F.,, E. Espejo-Arenas,, S. Uriz,, J. A. Serrano,, M. D. Alegre,, and J. Tort. 1991. Randomized trial of five-day rifampin versus one-day doxycycline therapy for Mediterranean spotted fever. J. Infect. Dis. 164: 433 434.
10.Berbari, E, F., F. R. Cockerill, and J. M. Steckelberg. 1997. Infective endocarditis due to unusual or fastidious microorganisms. Mayo Clin. Proc. 72: 532542.
11. Bernabeu-Wittel, M.,, J. L. Villanueva-Marcos,, A. de Alarcon-Gonzalez,, and J. Pachon. 1998. Septic shock and multiorganic failure in murine typhus. Eur.J. Clin. Microbial. Infect. Dis. 17: 131 132.
12. Billings, A. N.,, G. J. Teltow,, S. C. Weaver,, and D. H. Walker. 1998. Molecular characterization of a novel Rickettsia species from Ixodes scapularis in Texas. Emerg. Infect. Dis. 4: 305 309.
12.a. Bjoersdorff, A. Personal communication.
13. Bozeman, F. M.,, S. A. Masiello,, M. S. Williams,, and B. L. Elisberg. 1975. Epidemic typhus rickettsiae isolated from flying squirrels, Nature 255: 545 547.
14. Brouqui, P.,, P. Houpikian,, H. Tissot-Dupont,, P. Toubiana, Y, Obadia, V. Lafay and D. Raoult, 1996. Survey of the seroprevalence of Bartonella quintana in homeless people. Clin. infect. Dis. 23: 756 759.
15. Burgdorfer, W.,, R. A. Ormsbee,, M. L. Schmidt,, and H. Hoogstraal. 1973. A search for the epidemic typhus agent in Ethiopian ticks. Bull. W H. O. 48: 563 569.
16. Carl, M.,, C. W. Tibbs,, M. E. Dobson,, S. Paparello,, and G. A. Dasch. 1990. Diagnosis of acute typhus infection using the polymerase chain reaction. J. Infect. Dis. 161: 791 793.
17. Chanteau, S.,, L. Ratsifaoamanana,, B. Rasoamanana,, L. Rahalison,, J. Randriambelosoa,, J. Roux,, and D. Rabeson. 1998. Plague, a reemerging disease in Madagascar. Emerg. Infect Dis. 4: 101 104.
18. Chen, S.,, J. S. Dumler,, J. S. Bakken,, and D. H. Walker. 1994. Identification of a granulocytotropic Ehrlichia species as the etiologic agent of human disease. J. Clin. Microbial. 32: 589 595.
19. Conor, A.,, and A. Bruch. 1910. Une fiévre éruptive observée en Tunisie. Bull. Soc. Pathol. Exot. Filial. 8: 492 496.
20. Dasch, G. A.,, and E. Weiss,. 1992, The genera Rickettsia, Rochalimaea, Ehrlichia, Cowdria, and Neorickettsia, p. 2407–2470. In A. Balows,, H. G. Trüper,, M. Dworkin,, W. Harder,, and K. Schleifer (ed.), The Prokaryotes. Springer-Verlag, New York, N.Y..
21. Dasch, G. A.,, and A. Bourgeois,. 1981. Antigens of the typhus group of rickettsiae: importance of species-specific surface protein antigens in eliciting immunity. p. 61 70. In W. Burgdorfer, and R. L. Anacker (ed.), Rickeffsiae and Rickettsial Diseases. Academic Press, Inc. New York, N.Y..
22. Dawson, J. E.,, D. E. Stallknecht,, E. W, Howerth, C. Warner, K. Biggie, W. R. Davidson, J. M. Lockhart, V. F. Nettles, J. G, Olson. and J. E. Childs. 1994. Susceptibility of white-tailed deer (Odocoileus virginianus} to infection with Ehrlichia chaffeensis. the etiologic agent of human ehrlichiosis. J. Clin. Microbial. 32: 2725 2728.
23. Drancourt, M.,, L. Beati,, I. V. Tarasevich, and D, Raoult. 1992. Astrakhan fever rickettsia is identical to Israeli tick typhus rickettsia, a genotype of the Rickettsia conoril complex. J. Infect. Dis. 165: 1167 1168.
24. Drancourt, M.,, J., L. Mainardi, P. Brouqui, F. Vandenesch, A. Carta, F. Lehnert, J, Etienne, F. Goldstein, J. Acar, and D. Raoult. 1995. Bartonella (Rochalimaea) quintana endocarditis in three homeless men. N. Engl. J. Med. 332: 419 423.
25. Eremeeva, M. E.,, L. Beati,, V. A. Makarova,, N. F. Fetisova,, I. V. Tarasevich,, N. M. Balayeva,, and D. Raoult. 1994. Astrakhan fever rickettsiae: antigenic and genotypic of isolates obtained from human and Rhipicephalus pumilio ticks. Am. J. Trop. Med. Hyg. 51: 697 706.
26. Emez, M.,, M. Chakroun, A, Letaief, and L. Jemni. 1995, Particularités cliniques et biologiques du typhus exanthérnatique. Presse Med. 24: 1358.
27.Fan, M, Y., D, H. Walker, S. R, Yu, and Q, H. Liu. 1987. Epidemiology and ecology of rickettsial diseases in the People's Republic of China. Rev. Infect Dis. 9: 823840.
28., Fishbeint D. D.,, J. E. Dawson,, and L. E. Robinson. 1994. Human ehrlichiosis in the CnHed States, 1985 to 1990. Ann. Intern. Med. 120: 736 743.
29.Fournier, p, E., V. Roux, E. Caumes, M, Donzel, and D. Raoul!. 1998. Outbreak of Rickettsia africae infections in participants of an adventure race from South Africa. Clin. Infect. Dis. 27: 316323.
30. Fournier, P. E.,, V. Roux,, and D. Raoult, 1998. Phylogenetic analysis of spetted fever group rickettsiae by study of the outer surface protein rOrnpA Int J. Syst Bacterial. 48: 839 849.
31. Gan, F.,, F, C. Cadigan, Jr.,, and J. S. Walker. 1972. Filter paper collection of blood for use in a screening and diagnostic test for scrub typhus using the IFAT. Trans. R. Soc. Trap. Med. Hyg. 66: 588 593.
32. Gear, J. H. S. 1938. South African typhus. S Afr. J. Med. Sci. 3: 134 160.
33. Grav, S. R. 1998. Rickettsial diseases: the Australian story so far. Pathology 30: 147 152.
34. Hansen, W.,, and J. Freney. 1996. Le typhus épidémique, sa transmission et la découverte de l'agent étiologique. Lyon Pharm. 47: 130 138.
35. Jackson, L. A.,, and D. H. Spach. 1996. Emergence of Bartonella quintana infection among homeless persons. Emerg. Infect. Dis. 2: 141 144.
36.Kelly, P, J., L. Beati, P. R. Mason, L. A. Matthewman, V. Roux, and D. Raoult, 1996. Rickettsia africae sp. nov., the etiological agent of African tick bite fever. Int. J, Syst. Bacteriol. 46: 611614.
37. Kelly, P. J.,, P. R. Mason,, L. A. Matthewman, and D, Raoult. 1991. Seroepidemiology of spotted fever group rickettsial infections in human in Zimbabwe. J. Trop. Med, Hyg. 94: 304 309.
38.Kelly, p, J., L. A. Matthewman, L, Beali, D. Raoult, P. Mawn, M. Dreary, and R. Makombe. 1992. African tick-bite fever-a new spotted fever group rickettsiosls under an old name. Lancet 340: 982983.
39.Kelly. P. J., D. Raoult, and P. R. Mason. 1991. Isolation of spotted fever group rickettsias from triturated ticks using a modification of the centrifugation-shll vial technique. Trans. R. Soc. Trop. Med. Hyg. 85: 397398.
40. Koehler, J. E.,, M. A. Sanchez,, C. S. Garrido,, M. J. Whitfeld,, F. M. Chen,, T. G. Berger,, M. C. Rodriguez-Barradas,, P. E. Leboit,, and J. W. Tappero. 1997. Molecular epidemiology of Bartonella infections in patients with bacillary angiomatosis-peliosis. N. Engl. J. Med. 337: 1876 1883.
41. La Scola, B.,, and D. Raoult. 1997. Laboratory diagnosis of rickettsioses: current approaches to the diagnosis of old and new rickettsial diseases. J. Clin. Microbial. 35: 2715 2727.
42. Lebech, A.,, K. Hansen,, P. Pancholi,, L. Sloan,, J. Magera,, and D. Persing. 1998. Immunoserologic evidence of human granulocytic ehrlichiosis in Danish patients with Lyme neuroborreliosis. Scand. J. Infect. Dis. 30: 173 176.
43. Loltric-Furlan, S.,, M. Petrovec,, T. A. Zupanc,, W. L. Nicholson,, J. W. Sumner,, J. Childs,, and F. Strle. 1998. Human granulocytic ehrlichiosis in Europe: clinical and laboratory findings for four patients from Slovenia. Clin. Infect. Dis. 27: 424 428.
44. Maeda, K.,, N. Markowitz,, R. C. Hawley,, M. Ristic,, D. Cox,, and J. E. McDade. 1987. Human infectcion with Ehrlichia canis, a leukocytic rickettsia. N. Engl. .J. Med. 316: 853 856.
45.Mahara, F 1984. Three Weil-Felix reaction OX2 positive cases with skin eruptions and high fever .JAMA 68: 47.
46. Mahan, F. 1997. Japanese spotted fever: report of 31 cases and review of the literature, Emerg. Infect. Dis. 3: 105 111.
47. Maunder, J. W. 1983. The appreciation of lice. Proc. R. Inst. Great Britain 55: 1 31.
48. Mittermayer, T.,, R. Brezina, and J- Urvolgyi. 1980. First report of an infection with Rickettsia slovaca. Folia Parasitol. 27: 373 376.
49. Parola, P.,, D. Vogelaers,, C. Roure,, F. Janbon,, and D. Raoul!. 1998. Munne typhus in travelers returning from Indonesia. Emerg. Infect Dis. 4: 677 680.
50. Parola, P.,, J. Jourdan,, and D. Raoult. 1998. Tick-borne infection caused by Rickettsia africae in the West Indies. N Engl. J. Med. 338: 1391.
51. Parola, P.,, G. Vestrls,, D. Martinez,, B. Brochler,, V. Roux,, and D. Raoult. TIck-borne rickettsiosis in Guadeloupe, the French West Indies: isolation of Rickettsia africae from Amblyomma variegatum ticks and serosurvey in humans, cattle and goats. Am J. Trop. Med. Hyg, in press.
52. Patterson, K. D. 1993. Typbus and its control in Russia. 1870 1940. Med. Hist. 37: 361 381.
53. Perine, P. L.,, B. P. Chandler,, D. K. Krause,, P. McCardle,, S. Awoke,, E. Habte-Gabr,, C. L. Wisseman, Jr.,, and J. E. McDade. 1992. A dinico-epidemiological study of epidemic typhus in Africa. Clin. Infect. Dis. 14: 1149 1158.
54. Petrovec, M., .T. W. Sumner, W. L. Nicholson, J. E. Childs, F. Strle, J. Barlii:, S. Lotrie-Furlan, and T. Avsic Zupanc. 1999. Identity of ehrlichial DNA sequences derived from Ixodes ricinus ticks with those obtained from patients with human granulocytic ehrlichiosis in Slovenia. J. Clin. Microbiol. 37: 209 210.
55. Pijper, A. 1936. Etude experimenrale comparee de la fie'te bOUlonneuse et de la tick-bite-fever. Arch. Inst. Pasteur Tunis 25: 388 401.
56. Pusterla, N.,, R. Weber,, C. Wolfensberger,, G. Schar,, R. Zbinden,, W. Fierz,, J. Madigan,, J. Dumler,, and H. Lutz 1998. Serologic evidence of human granulocytic ehrlichiosis in Switzerland. Eur. J. Clin. Microbial. Infect. Dis. 17: 207 209.
57. Raoult, D.,, P. Berbis,, V. Roux,, W. Xu,, and M. Maurin. 1997. A new tick-transmitted disease due to Rickettsia slavaca. Lancet 350: 112 113.
58. Raoult, D.,, P. Brouqui,, and V. Roux. 1996. A new spotted-fever group rickettsiosis. Lancet 348: 412.
59., Raoult, D.,, J. B. Ndihokubwayo,, H. Tissot-Dupont,, V. Roux,, B. Fangere,, R. Abegbinni,, and R. J. Dirties. 1998. Outbreak of epidemic typhus associated with trench fever in Burundi. Lancet 352: 353 358.
60.. Raoult D.,, and V. Roux. 1997, Rickettsioses as paradigms of new or emerging infectious diseases. Clin. Microbiol. Rev. 10: 694 719.
61. Raoult, D.,, V. Roux,, J. B. Ndihokubwaho,, G. Bise, D, Baudon, G. Martet, and R. J. Birtles. 1997. Jail fever (epidemic typhus) outbreak in Burundi. Emerg. Infect. Dis. 3: 357 360.
61.a, Regnery, R. L.,, B. E. Anderson,, J. E. Clarridge III, , M. C. Rodriguez-Barradas,, D. C. Jones,, and J. H. Carr. 1992 Characterization of a novel Rochalimaea species, R. henselae sp. nov., isolated from blood of a febrile, human immunodeficiency virus-positive patient. J. Clin. Microbiol. 30: 265 274.
62., Rebaeek, J. 1984 ,Rickettsia slovaca, the organism and its ecology, Acta Sci. Nat, Acad. Sci. Biochem. Brno 18: 1 50.
63.Reilly. P. J., and R. W, Kalinske. 1980. Brill-Zinsser disease in North America. West. J. Med. 133: 338340.
64. Ricketts, H. T. 1991 , Some aspects of Rocky Mountain spotted fever as shown by recent investigations, Rev. Infect. Dis. 13: 1227 1240.
65.Rolain, J, M., M. Maurin, G. Vestris, and D. Raoult. 1998. In vitro susceptibilities of 27 rickettsiae to 13 antimicrobials, Antimicrob. Agents Chemother. 42: 15371541.
66. Roux, V., and D, Raoult. 1993. Genotypic identification and phylogenetic analysis of the spotted fever group rickettsiae by pulsed-field gel electrophoresis. J. Bacteriol. 175: 4895 4904.
67., Roux, V.,, and D. Raoult. 1995. Phylogenetic analysis of the genus Rickettsia by 16S rDNA sequencing. Res. Microbiol. 146: 385 396.
68. Roux, V.,, E. Rydkina,, M. Eremeeva,, and D. Raoult. 1997. Citrate synthase gene comparison, a new tool for phylogenetic analysis, and its application for the rickettsiae, Int. J. Syst. Bacteriol. 47: 252 261,
69. Rydkina, E. B.,, V. Roux,, E. M. Gagua,, A. B, Predtechenski, I. V. Tarasevich, and D. Raoult. 1999 , Bartonella quintana in body lice collected from homeless persons in Russia, Emerg. Infect. Dis. 5: 176 178.
69.a. Sanz, R. A. Personal communication,
70. Schriefer, M. E.,, J. B. J. Sacci,, J. S. Dumler,, M. G. Bullen,, and A. F. Azad. 1994. Identification of a novel rickettsial infection in a patient diagnosed with murine typhus. J. Clin. Microbiol. 32: 949 954.
71., Sekeyova, Z.,, V. Raux,. W. Xu,, J. Rehacek,, and D. Raoult. 1998. Rickettsia slovaca sp. nov., a member of the spotted fever group rickettsiae. Int. J. Syst. Bacteriol. 48: 1455 1462.
72. Sparrow, H. 1955. Les spirochetes des fievres recurrentes et le pou (de l'origine des epidemies de recurrent a poux), Arch. Inst. Pasteur Tunis 32: 25 49.
73. Stein, A.,, and D. Raoult. 1995, Return of trench fever. Lancet 345: 450 451.
74. Tarasevich, I.,, E. Rydkina,, and D. Raoult. 1998, Epidemic typhus in Russia, Lancet 352: 1151.
75. Tarasevich, I. V.,, V. Makarova,, N. F Fetisova,, A. Stepanov,, E. Mistkarova,, N. M. Balayeva. and D. Raoult. 1991 Astrakhan fever: new spotted fever group rickettsiosis. Lancet 337: 172 173.
76.Tarasevich. I, v., V. A, Makarova. N, F. Fetisava, A. V. Stepanov. E. D, Miskarova, and D. Raoult 1991. Studies of a "new" rickettsiosis "Astrakhan" spotted fever. Eur. J. Epidemiol. 7: 294298.
77., Telford, S, R. I.,, J. E. Dawson,, P. Katavalos,, C. K. Warner,, C. P. Kolbert,, and D, H. Persing, 1996, Perpetuation of the agent of human granulocytic ehrlichios.is. in a deer tick-rodent cycle. Proc. Natl. Acad. Sci. USA 93: 6209 6214.
78., Tesfayohannes, T. 1989. Prevalence of body lice in elementary school students in three Ethiopian lowns at different altitudes. Ethiop Med. 1. 27: 201 207.
79. Tissot-Dupont, H.,, P. Brouqui,, B. Faugere,, and D. Raoult. 1995 , Prevalence of antibodies to Coxiella burnetii, Rickettsia conorii, and Rickettsia typhi in seven African countries. Clin. Infect. Dis. 21: 1126 1133.
80. Tselentls, Y.,, E. Edlinger,, G. Alexious,, D. Chrysanlis,, and A. Levendis. 1986. An endemic focus of murine typhus in Europe, J. Infect. 13: 91 92. (letter.)
81. Uchida, T. 1993 , Rickettsia japanica, the etiologic agent of Oriental spotted fever, Microbiol. Immunol. 37: 91 102.
82. Uchida, T., R Tashiro, T. Funato, and Y. Kitamura. 1986. Immunofluorescence test with Rickettsia montana for serologic diagnosis of rickettsial infection of the spotted fever group in Shikoku. Japan. Microbiol. Immunol 30: 1061 1066.
83., Uchida, T.,, F. Tashiro,, T. Funato,, and Y. Kitamura. 1986. Isolation of a spotted fever group rickettsia from a patient with febrile exanthematous illness in Shikoku, Japan. Microbiol Immunol. 30: 1323 1326.
84. Van Der Laan, J. R.,, and R. B. Smit. 1996. Back again: the clothes louse (Pediculus humanus var. corporis). Ned. Tijdschr. Geneeskd. 140: 1912 1915.
85. Walker, D. H.,, and D. B. Fishbein. 1991. Epidemiology of rickettsial diseases. Eur. J. Epidemiol. 7: 237 245.
86. Weiss, E., 1988. History of rickettsio1ogy, p. 15 32. In D. H. Walker (ed.), Biology of Rickettsial Disease. CRC Press, Inc., Boca Raton, Fla..
87. Weiss, K. 1988. The role of rickettsiose in history, p. 1 14. In D. H. Walker (ed.), Biology of Rickettsial Disease. CRC Press, Inc., Boca Raton, Fla..
88.World Health Organization. 1982. Rickettsioses: a continuing disease problem. Weekly Epidemiol. Rec. 60: 157164.
89. Yu, X.,, M. Fan,, G. Xu,, Q. Liu,, and D. Raoult. 1993. Genotypic and antigenic identification of two new strains of spotted fever group rickettsiae isolated from China. J. Clin. Microbial. 31: 83 88.
90. Zavala-Velazquez, J.,, J. Ruiz-Soja,, B. Jimenez,, I. Vado-Solis,, J. Zavala-Castro,, and D. Walker. Rickettsia felis: the etiologic agent of a case of rickettsiosis in the Yucatan. In American Society for Tropical Medicine and Hygiene Annual Conference 1998, in press.
91. Zavala-Velazquez, J. E.,, X. J. Yu,, and D. H. Walker. 1996. Unrecognized spotted fever group rickettsiosis masquerading as dengue fever in Mexico. Am. J. Trap. Med. Hyg. 55: 157 159.


Generic image for table
Table 1

Rickettsial diseases

Citation: Raoult D, Olson J. 1999. Emerging Rickettsioses, p 17-36. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch2
Generic image for table
Table 2

Rickettsiae of unknown pathogenicity isolated from ticks

Citation: Raoult D, Olson J. 1999. Emerging Rickettsioses, p 17-36. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch2
Generic image for table
Table 3

New rickettsial pathogens recognized since 1974

Citation: Raoult D, Olson J. 1999. Emerging Rickettsioses, p 17-36. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch2

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error