Seroepidemiololgy of rickettsioses in Sri Lanka: a patient based study

Abstract

BackgroundRickettsioses are emerging infections in Sri Lanka as shown by the increase in the number of clinically diagnosed rickettsial patients being reported to the Epidemiology Unit, Sri Lanka. However, mapping the disease for the whole island with laboratory confirmed cases has not been previously carried out.Methods615 samples received from 23 hospital representing 8 provinces were tested using ELISA or IFA methods and clinical data was collected using a validated questionnaire.ResultsRash was found among more spotted fever seropositive patients than scrub typhus seropositive patients while the opposite was true for the presence of eschar. Spotted fever and scrub typhus was found in a geographically restricted manner. Consistent temporal patterns were seen for the presentation of patients with rickettsioses in Kandy and Kurunegala districts for 2009 and 2010.ConclusionsThis study expanded knowledge on the distribution of rickettsioses in Sri Lanka and their clinical profiles which in turn helps in the clinical diagnosis of these infections.

Rickettsioses in the central hills of Sri Lanka: serological evidence of increasing burden of spotted fever group

“…The final diagnosis of rickettsial infection was defined on the basis of clinical criteria and the presence of specific IFA IgM and IgG seroreactivity. 2,3,7,8 Serological evidence with high antibody titers in acute serum samples alone has been considered confirmative in certain previous studies. 7,8 Premaratna et al, in 2012, attempted to determine a clinically helpful diagnostic algorithm, and showed that if the acute serum sample was obtained after 7 days of the illness, a single IgG titer of 1/256 could be considered diagnostic, with the presence of supportive clinical evidence.…”

Rickettsioses in Sri Lanka – A mini review

“…Mawanella, Kegalle, Gampola and Nawalapitiya hospitals as well as the major tertiary care centre for these areas, Teaching Hospital, Peradeniya has a regular influx of patients with rickettsioses. 15,17,18,19,20 Serological evidence of scrub typhus and murine typhus has also been reported to a lower extent. 15,19 The Western Province has predominantly reported patients with scrub typhus, while serological evidence for spotted fever has also been present.…”

Congenital dyserythropoietic anaemia type II

“…CDAtype II is also known by the acronym HEMPAS denoting Hereditary Erythroblastic Multinuclearity with Positive Acidified Serum lysis test. Nearly 450 cases have been reported worldwide (1). We report a case of CDAtype II in a young male.…”

“…Abnormal band 3 proteins is hydrophobic which tends to cluster at the cell surface leading to increased binding of IgG to the red cell surface and increased phagocytosis by macrophages. Defects in glycophorin A which has complement regulating activity, make the CDA II red cells more liable to lysis in acidified heterologous sera by naturally occurring complement fixing IgM anti HEMPAS antibodies (1,4,5).…”