Evidence of rodent-associated Bartonella and Rickettsia infections among intravenous drug users from Central and East Harlem, New York City.

Abstract

Abstract. We tested serum samples collected in 1997 and 1998 from a cohort of 204 injection drug users (IDUs) recruited from Central and East Harlem, New York City, New York, for antibodies reactive with seven rickettsial or Bartonella spp. antigens. Rodent-associated Bartonella elizabethae and Rickettsia akari were the primary etiologic agents of interest. The testing panel also included Bartonella henselae, Bartonella quintana, Rickettsia prowazekii, Rickettsia rickettsii, and Rickettsia typhi. The highest prevalence of seroreactive serum samples (46%) was found with B. elizabethae antigens; 10% of the samples reacted with B. henselae antigens, while 2% reacted with B. quintana antigens. Reactivity to the latter two antigens was likely due to cross-reactivity with B. elizabethae antigens in most instances. Among the spotted fever group rickettsiae, 18 (9%) samples reacted with R. akari, including 10 samples (5%) that also reacted with R. rickettsii. Cross-adsorption studies demonstrated that most of the spotted fever group rickettsiae antibodies were due to R. akari infections. Among the typhus group rickettsiae, 5 samples reacted weakly to R. prowazekii antigens, and no samples reacted with R. typhi antigens. These findings suggest that Harlem IDUs are commonly exposed to two rodent-associated zoonotic agents. Further study of IDU populations may help elucidate transmission cycles of these agents in inner cities where higher levels of transmission occur.

Cat scratch disease and other zoonotic Bartonella infections

“…Among IV drug users, seroprevalence for B elizabethae ranged from 33% in Baltimore 37 to 39% in Stockholm 38 and 46% in New York. 39 The seroprevalence was 12.5% among homeless people from Los Angeles. 40 Interestingly, 355 of 1,136 (31%) Swedish orienteers were seropositive against B elizabethae.…”

Factors associated with the rapid emergence of zoonotic Bartonella infections

“…Human exposure to some rodent-borne Bartonellae, especially B. elizabethae has been associated with exposure to rats among homeless people or intravenous drug users in urban areas of the USA [42,56,57,77] or to outdoor activity in northern Europe, especially in orienteers in Sweden [155,229]. Exposure to ticks has also been suggested for human infections [78,152,235].…”

“…Among the rodent-borne Bartonellae, B. elizabethae infection seems to be quite prevalent in intravenous (IV) drug users and homeless people in various parts of the USA and also in Sweden [56,57,156], based on serological studies. In IV drug users, B. elizabethae seroprevalence ranged from 33% in Baltimore [56] to 39% in Stockholm [156] and 46% in New York [57]. In homeless people from Los Angeles, California, the seroprevalence was 12.5% [210].…”

High Prevalence of Rickettsia typhi and Bartonella Species in Rats and Fleas, Kisangani, Democratic Republic of the Congo

“…1 Endemic foci do usually refer to rural settings, but the focal distribution of pathogens may occur in urban areas offering a mosaic of habitats suitable to hosts, 2 vectors, 3 pathogens survival, 4 and exposed human population. 5 At different spatial and temporal scales, the anthropogenic modifications directly and indirectly play a role in the host and vector dynamics and act on the probability for (re)emergence of zoonotic diseases. Factors leading to an increase in the incidence of illnesses caused by zoonotic bacteria in urban areas include societal changes ad intrinsic components of the natural history of these organisms that favor their survival in cities.…”