Tropheryma whippleias a Cause of Epidemic Fever, Senegal, 2010–2012

Abstract

Findings suggest that the bacterium has role in febrile episodes, is contagious, and has an epidemic character.

Acute Infections Caused by Tropheryma Whipplei

“…In the second study, which included a control group with healthy people living in the same area, and which was performed in the same two villages, between June 2010 and March 2012, whole-blood finger-prick samples were analyzed from 786 febrile and 385 healthy villagers. Tropheryma whipplei DNA was detected in the blood samples of 36 febrile patients (4.6%) and one control (0.25%) [17]. Seasonality was observed because 100% of the cases occurred during the rainy season (June-October) but none of the cases occurred during the dry season (November-May).…”

“…Interestingly, the local baker lived in the household where the prevalence of T. whipplei was the highest. Since the departure of this baker and his family, no outbreaks were observed and a concomitant decrease of T. whipplei prevalence was also noted [17].…”

“…The main clinical manifestations were a headache (69%) and a cough (36%) with no significant difference between the T. whipplei positive and negative groups. Familial cases were observed, with 75% of the patients living in a household that had experienced the T. whipplei bacteremia [17]. Finally, because of the lack of samples available, genotyping has been only established for eight patients.…”

“…Indeed, we consider that T. whipplei is one of the main significant examples of the absolute need to use controls in the study of epidemiological acute infectious diseases [40]. Tropheryma whipplei is a proof of this concept, whether on stool samples or in BAL fluids samples, or in blood samples where this bacterium was sometimes detected in totally asymptomatic individuals [16][17][18].…”

“…However, in addition to these chronic infections and asymptomatic carriage, acute T. whipplei infections may be sometimes encountered [2] (Figure 2). Recently, new data were made available on T. whipplei bacteremia in febrile Senegalese patients, on T. whipplei acute gastroenteritis as well as on T. whipplei pneumonia [16][17][18]. In this paper, we propose focusing on these acute infections, highlighting the possible natural history of this surprising bacterium.…”