Imported scrub typhus in Europe: Report of three cases and a literature review

Costa, Cecilia A.; Ferrari, Anna; Binazzi, Raffaella; Beltrame, Anna; Tacconi, Danilo; Moro, Lucía; Edouard, Sophie; Parola, Philippe; Buonfrate, Dora; Gobbi, Federico

doi:10.1016/j.tmaid.2021.102062

Cited by 15 publications

(13 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In recent years, scrub typhus is no longer confined to the Asia Pacific region and has become a public health problem worldwide (Costa et al, 2021; Silva-Ramos et al, 2021; Weitzel et al, 2019). In China, the incidence of scrub typhus increased steadily before 2012 and increased rapidly but unevenly after 2012(Sun et al, 2017; Yu et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Spatiotemporal heterogeneity and the long-term impact of meteorological, environmental and socio-economic factors of scrub typhus in China from 2012 to 2018

Qian

Zhu

et al. 2022

Preprint

View full text Add to dashboard Cite

Large-scale outbreaks of scrub typhus combined with the emergence of this vector-borne rickettsiosis in new areas indicate that this disease remains seriously neglected. This study aimed to explore the long-term changes and regional leading factors of scrub typhus in China, so as to provide fresh insights for the prevention and control of this disease. In this study, a Bayesian space-time hierarchical model (BSTHM) was used to identify the long-term spatiotemporal heterogeneity of scrub typhus and quantify the association between meteorological factors and scrub typhus in southern and northern China from 2012 to 2018. GeoDetector model was used to quantify the dominant forces of environmental and socioeconomic factors in the Northern and the Southern China. Scrub typhus often appeared in summer and autumn (June to November), and epidemically peaked in October, with obvious temporal seasonality . Spatially, the hot spots (high-risk regions) were concentrated in the south, on the contrary the cold spots (low-risk regions) in the north. In addition, the main meteorological factor, average temperature, gave a significant impact in both areas. The average temperature increased by 1 ?, resulting in a decrease of 1.10% in southern China and an increase of 0.96% in northern China in the risk of scrub typhus. The determinant environmental and socio-economic factors of scrub typhus in the two areas were altitude and per capita GDP, with q-values of 0.91 and 0.87, respectively. Meteorological, environmental and socio-economic factors had a significant impact on the distribution of scrub typhus, with obvious seasonality and spatial heterogeneity. This study provides helpful suggestions and basis for reasonably allocating resources and controlling the occurrence of scrub typhus.

show abstract

Section: Discussionmentioning

confidence: 99%

Spatiotemporal heterogeneity and the long-term impact of meteorological, environmental and socio-economic factors of scrub typhus in China from 2012 to 2018

Qian

Zhu

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Prioritisation of travel, particularly for emergencies or humanitarian purposes, is recommended. According to the World Tourism Organization, global international tourist arrivals in January 2021 showed an 87% reduction compared with 2020 and a 96% reduction for the Asia and Pacific regions [60]. However, these travel restrictions may have only moderately reduced COVID-19 transmission unless combined with other interventions [61].…”

Section: Impact Of the Covid-19 Pandemic On Rickettsiosismentioning

confidence: 99%

Rickettsiosis in Southeast Asia: Summary for International Travellers during the COVID-19 Pandemic

2022

View full text Add to dashboard Cite

Rickettsiosis is an important cause of febrile illness among travellers visiting Southeast Asia (SEA). The true incidence of rickettsiosis is underestimated; however, murine typhus and scrub typhus are widely distributed across SEA. Among travellers visiting SEA, scrub typhus was mostly reported from Thailand, whereas murine typhus was frequently found in Indonesia. Although most cases are self-limited or present with mild symptoms, a few cases with severe clinical manifestations have been reported. Doxycycline remains the key treatment of rickettsiosis. Some travellers, such as backpackers, trekkers, or cave explorers, are at a higher risk for rickettsiosis than others. Therefore, in resource-limited conditions, empirical treatment should be considered in these travellers. The coronavirus disease 2019 (COVID-19) pandemic has contributed to difficulty in the diagnosis of rickettsiosis because of the clinical similarities between these diseases. In addition, physical distancing mandated by COVID-19 management guidelines limits accurate physical examination, resulting in misdiagnosis and delayed treatment of rickettsiosis. This review summarises the characteristics of murine typhus and scrub typhus, describes travel-associated rickettsiosis, and discusses the impact of the COVID-19 pandemic on rickettsiosis.

show abstract

“…From 1996 to 2021 a total of 2831 cases of rickettsiosis that occurred in Italy were reported in 48 papers. 2787 cases were attributable to MSF (only in 56 of the above cases the diagnosis was made by molecular methods), 7 cases of ISF were reported in 2 papers (in both cases the diagnosis was made by molecular methods), [15,34], 9 were Human Granulocytic Anaplasmosis (HGA) [35][36][37][38] (in 7 of them, the diagnosis was made by molecular methods), 6 were TIBOLA [39][40][41][42] (in all of them, the diagnosis was made by molecular methods), 12 were ATBF [43,44], (in none of them the diagnosis was made by molecular methods), 2 were scrub typhus [45] (one diagnosed with serology and one diagnosed with molecular methods), 1 was a case of murine typhus (serologically diagnosed) [46], one case was ehrlichiosis (serologically diagnosed) [19], and other 7 case reports did present atypical clinical manifestation [47][48][49][50][51]. Almost all the cases came from the major islands.…”

Section: Infections In Italymentioning

confidence: 99%

“…18 imported cases were reported [43,44,48,50,51], 12 were African Tick Bite Fevers (ATBF) [43,44,48], 4 were non-specific fever accounted to R. helvetica and R. felis [50,51]. One was a sacral syndrome in which R. africae was identified with molecular techniques [48] and the last two were cases of scrub typhus [45]. Other clinical manifestations included: a case of acute hepatitis caused by R. aeschlimannii [47] and a case of thrombosis of the ophthalmic vein accounted to R. conorii [49].…”

Section: Infections In Italymentioning

confidence: 99%

Rickettsiosis with Pleural Effusion: A Systematic Review with a Focus on Rickettsiosis in Italy

et al. 2022

View full text Add to dashboard Cite

Background: Motivated by a case finding of Mediterranean spotted fever (MSF) associated with atypical pneumonia and pleural effusion in which Rickettsia conorii subsp. israelensis was identified by molecular methods in the pleural fluid, we wanted to summarize the clinical presentations of rickettsiosis in Italy by systematic research and to make a systematic review of all the global cases of rickettsiosis associated with pleural effusion. Methods: For the literature search, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. We chose to select only the studies published in last 25 years and confirmed both with serological and molecular assays. Results: Human cases of rickettsiosis in Italy were reported in 48 papers describing 2831 patients with very different clinical presentations; the majority was MSF accounted to R. conorii and was reported in Sicily. Pleural effusion associated with infection with microorganisms belonging to Rickettsiales was described in 487 patients. It was rarely associated with microorganisms different from O. tsutsugamushi; also rarely, cases of scrub typhus were reported outside Southeast Asia and in the largest majority, the diagnosis was achieved with serology. Conclusions: MSF, especially when caused by R. conorii subsp. israelensis, may be a severe disease. A high index of suspicion is required to promptly start life-saving therapy. Pleural effusion and interstitial pneumonia may be part of the clinical picture of severe rickettsial disease and should not lead the physician away from this diagnosis

show abstract

Imported scrub typhus in Europe: Report of three cases and a literature review

Cited by 15 publications

References 49 publications

Spatiotemporal heterogeneity and the long-term impact of meteorological, environmental and socio-economic factors of scrub typhus in China from 2012 to 2018

Spatiotemporal heterogeneity and the long-term impact of meteorological, environmental and socio-economic factors of scrub typhus in China from 2012 to 2018

Rickettsiosis in Southeast Asia: Summary for International Travellers during the COVID-19 Pandemic

Rickettsiosis with Pleural Effusion: A Systematic Review with a Focus on Rickettsiosis in Italy

Contact Info

Product

Resources

About