Rickettsialpox—A Newly Recognized Rickettsial Disease

Greenberg, Morris; Pellitteri, Ottavio; Jellison, William L.

doi:10.2105/ajph.37.7.860

Cited by 52 publications

(23 citation statements)

References 2 publications

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“…21,24 In contrast to rickettsialpox, the greater severity of morbidity 4 and the high case-fatality ratio of Rocky Mountain spotted fever 4,5 suggests that it most likely would be recognized if it occurred routinely among IV drug users. Although both R. akari and R. rickettsii may occur as highly focal zoonoses in urban areas, 8,12 the mite vector of rickettsialpox has a ubiquitous host in the house mouse that allows ample opportunity for human contact throughout the urban environment. 25 Epizootic lymphocytic choriomeningitis virus (LCMV) infections among house mouse populations could result in mice becoming an unsuitable host for mites associated with R. akari transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there was a significant association between seropositivity to spotted fever group rickettsiae and seropositivity to any of three Bartonella species. Because both R. akari 8 and B. elizabethae (Ellis B, CDC, unpublished data) have been associated with rodents that are common in the urban environment, such associations might be expected.…”

Section: Discussionmentioning

confidence: 99%

“…7 Patients with confirmed rickettsialpox are usually unaware of the mite bite or the subsequent eschar that forms. 8,9 Simple and effective control measures, emphasizing commensal rodent control in the discrete foci where rickettsialpox occurs, were developed soon after R. akari was discovered and the epidemiology of rickettsialpox was elucidated. 8 We recently found elevated prevalences of antibodies to three Bartonella species in inner-city Baltimore intravenous (IV) drug users, 10 and the agent responsible for the greatest number of seropositive serum samples (B. elizabethae) has recently been isolated from a Norway rat (Rattus norvegicus) captured in an urban environment in Baltimore (Ellis B, Centers for Disease Control and Prevention [CDC], unpublished data).…”

mentioning

confidence: 99%

“…8,9 Simple and effective control measures, emphasizing commensal rodent control in the discrete foci where rickettsialpox occurs, were developed soon after R. akari was discovered and the epidemiology of rickettsialpox was elucidated. 8 We recently found elevated prevalences of antibodies to three Bartonella species in inner-city Baltimore intravenous (IV) drug users, 10 and the agent responsible for the greatest number of seropositive serum samples (B. elizabethae) has recently been isolated from a Norway rat (Rattus norvegicus) captured in an urban environment in Baltimore (Ellis B, Centers for Disease Control and Prevention [CDC], unpublished data). Recent rickettsialpox infections in New York City, 11 as well as an earlier report of a focus of Rocky Mountain spotted fever in a New York City park, 12 indicated that inner-city residents might be exposed to spotted fever group rickettsiae.…”

mentioning

confidence: 99%

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Serologic evidence of rickettsialpox (Rickettsia akari) infection among intravenous drug users in inner-city Baltimore, Maryland.

Comer

Tzianabos²,

Flynn

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. We tested single serum samples from 631 intravenous (IV) drug users from inner-city Baltimore, Maryland for serologic evidence of exposure to spotted fever group rickettsiae. A total of 102 (16%) individuals had titers Ն 64 to Rickettsia rickettsii by an indirect immunofluorescence assay. Confirmation that infection was caused by R. akari was obtained by cross-adsorption studies on a subset of serum samples that consistently resulted in higher titers to R. akari than to R. rickettsii. Current IV drug use, increased frequency of injection, and shooting gallery use were significant risk factors for presence of group-specific antibodies reactive with R. rickettsii. There was a significant inverse association with the presence of antibodies reactive to R. rickettsii and antibodies reactive to the human immunodeficiency virus. This study suggests that IV drug users are at an increased risk for R. akari infections. Clinicians should be aware of rickettsialpox, as well as other zoonotic diseases of the urban environment, when treating IV drug users for any acute febrile illness of undetermined etiology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Serologic evidence of rickettsialpox (Rickettsia akari) infection among intravenous drug users in inner-city Baltimore, Maryland.

Comer

Tzianabos²,

Flynn

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…Rickettsia akari causes rickettsialpox, a febrile illness with a rash, associated with mites and house mice. 9,10 Rickettsia parkeri causes a febrile illness with a characteristic eschar. 11,12 The Gulf Coast tick (Amblyomma maculatum) was the first discovered vector of R. parkeri, but the lone star tick (Amblyomma americanum) is also a potential vector.…”

Section: Introductionmentioning

confidence: 99%

Expanding Range of Amblyomma americanum and Simultaneous Changes in the Epidemiology of Spotted Fever Group Rickettsiosis in the United States

Dahlgren¹,

Paddock²,

Springer³

et al. 2016

The American Society of Tropical Medicine and Hygiene

107

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Abstract. Spotted fever group (SFG) Rickettsia species are etiologic agents of a wide range of human infections from asymptomatic or mild infections to severe, life-threatening disease. In the United States, recent passive surveillance for SFG rickettsiosis shows an increased incidence and decreased severity of reported cases. The reasons for this are not well understood; however, we hypothesize that less pathogenic rickettsiae are causing more human infections, while the incidence of disease caused by more pathogenic rickettsiae, particularly Rickettsia rickettsii, is relatively stable. During the same period, the range of Amblyomma americanum has expanded. Amblyomma americanum is frequently infected with "Candidatus Rickettsia amblyommii", a SFG Rickettsia of unknown pathogenicity. We tested our hypothesis by modeling incidence rates from 1993 to 2013, hospitalization rates from 1981 to 2013, and case fatality rates from 1981 to 2013 regressed against the presence of A. americanum, the decade of onset of symptoms, and the county of residence. Our results support the hypothesis, and we show that the expanding range of A. americanum is associated with changes in epidemiology reported through passive surveillance. We believe epidemiological and acarological data collected on individual cases from enhanced surveillance may further elucidate the reasons for the changing epidemiology of SFG rickettsiosis.

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Increased Detection of Rickettsialpox in a New York City Hospital Following the Anthrax Outbreak of 2001

Koss

Carter²,

Grossman³

et al. 2003

Arch Dermatol

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Rickettsialpox—A Newly Recognized Rickettsial Disease

Cited by 52 publications

References 2 publications

Serologic evidence of rickettsialpox (Rickettsia akari) infection among intravenous drug users in inner-city Baltimore, Maryland.

Serologic evidence of rickettsialpox (Rickettsia akari) infection among intravenous drug users in inner-city Baltimore, Maryland.

Expanding Range of Amblyomma americanum and Simultaneous Changes in the Epidemiology of Spotted Fever Group Rickettsiosis in the United States

Increased Detection of Rickettsialpox in a New York City Hospital Following the Anthrax Outbreak of 2001

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