Molecular and serological evidence of flea-associated typhus group and spotted fever group rickettsial infections in Madagascar

This research was supported by the Wellcome Trust (RCDF and Senior Fellowship to ST, #081705 and #095171), the Institut Pasteur de Madagascar, and the Global Emerging Infections Surveillance and Response System, a Division of the Armed Forces Health Surveillance Center [847705.82000.25GB.A0074].Peer reviewedPublisher PD

Rickettsial Diseases: Risk For Indonesia

Penyakit Rickettsia bersifat endemik hampir di seluruh bagian dunia, dan begitu juga di Indonesia. Termasuk dalam penyakit-penyakit rickettsia adalah tifus epidemik, tifus murine, "scrub typhus," dan "spotted fever." Tifus epidemik, yang ditularkan kepada manusia melalui tuma pada tubuh manusia, dan dapat menyebabkan sakit berat dan kematian. Tifus murine (tifus endemik), bersumber pada pinjal hewan, merupakan penyakit yang mirip tifus epidemik, tetapi dengan gejala-gejala yang lebih ringan dan jarang menyebabkan kematian. "Scrub typhus", merupakan penyakit yang dapat ringan sampai berat dan dapat membahayakan hidup, ditularkan kepada manusia melalui gigitan tungau yang belum dewasa yang dikenal sebagai "chigger". "Spotted fever: (demam yang disertai dengan bintik-bentik pada kulit), disebabkan karena terinfeksi oleh salah satu dari berbagai spesies rickettsia dari kelompok "spotted fever", dan ditularkan kepada manusia oleh pejamu (hospes) vertebrata melalui gigitan caplak (tick) yang terinfeksi. Penyakit yang disebabkan oleh organisma yang menyerupai rickettsia (rickettsia-like organism) adalah: "Q fever", yaitu penyakit yang akut atau kronis yang diduga ditularkan secara alamiah akibat terhirup oleh partikel udara yang terinfeksi Coxiella burnetti sejenis bakteri yang sangat resisten terhadap upaya menonaktifkannya secara kimiawi dan fisik. Bartonellosis atau penyakit Carrion, ditemukan pada daerah dengan ketinggian sedang di Andes, Amerika Selatan. Penyakit ini ditularkan oleh lalat pasir (sand flies). "Trench fever", mirip dengan tifus epidemik, ditularkan kepada manusia oleh tuma; penyakit ini sembuh sendiri. Penyakit garutan kucing (Cat-scratch disease), disebabkan oleh infeksi Bartonella henselae di tempat gigitan atau garutan kucing rumah yang merupakan hospes. Demam sennetsu, merupakan penyakit yang dapat sembuh sendiri dan hanya ditemukan di Jepang dan Malaysia. Pengobatan dengan tetrasiklin atau kloramfenikol untuk penyakit Rickettsia dan penyakit yang menyerupai Rickettsia, serta monositik dan granulositik ehrlichiosis pada manusia, menunjukkan hasil yang baik. Ehrlichiosis pada manusia merupakan penyakit baru yang tidak diketahui penyebarannya di seluruh dunia, sangat mungkin ditularkan oleh "tick". Walaupun umumnya dapat sembuh sendiri, angka kematian ehrlichiosis dilaporkan mencapai 2-10%. Sebagian besar penyakit rickettsia dan penyakit yang menyerupai rickettsia tersebut di atas belum dikaji secara intensif di Asia Tenggara. Walaupun masih terbatas, di Indonesia sudah dilakukan penelitian-penelitian tentang "scrub typhus" dan "murine typhus." Sedangkan penyakit-penyakit yang ada hubungan dengan kutu penyebar Rickettsia seperti "tick typhus" atau "spottedfever", "trench fever", bartonellosis, "Q fever", dan ehrlichiosis masih terabaikan di Indonesia. Tinjauan ini bertujuan untuk memperkenalkan hasil-hasil penelitian tentang penyakit-penyakit rickettsia di Indonesia, dan memperlihatkan berberapa penyakit yang penyebarannya sekarang telah diketahui disebabkan oleh arthropoda

In Vitro Propagation of Candidatus Rickettsia andeanae Isolated From Amblyomma maculatum

Candidatus Rickettsia andeanae was identified during an investigation of a febrile outbreak in northwestern Peru (2002). DNA sequencing from two ticks (Amblyomma maculatum, Ixodes boliviensis) collected during the investigation revealed a novel Rickettsia agent with similarity to the spotted fever group rickettsiae. Since then, Candidatus R. similar to andeanae has been detected in A. maculatum ticks collected in the southeastern and southcentral United States, Argentina, and Peru. To date, Candidatus R. andeanae has not been successfully cultivated in the laboratory. We present evidence for the continuous cultivation in three cell lines of Candidatus R. similar to andeanae isolated from an A. maculatum tick (Portsmouth, Virginia)

Exploring the Niche of \u3ci\u3eRickettsia montanensis\u3c/i\u3e (Rickettsiales: Rickettsiaceae) Infection of the American Dog Tick (Acari: Ixodidae), Using Multiple Species Distribution Model Approaches

The American dog tick, Dermacentor variabilis (Say) (Acari: Ixodidae), is a vector for several human diseasecausing pathogens such as tularemia, Rocky Mountain spotted fever, and the understudied spotted fever group rickettsiae (SFGR) infection caused by Rickettsia montanensis. It is important for public health planning and intervention to understand the distribution of this tick and pathogen encounter risk. Risk is often described in terms of vector distribution, but greatest risk may be concentrated where more vectors are positive for a given pathogen. When assessing species distributions, the choice of modeling framework and spatial layers used to make predictions are important. We first updated the modeled distribution of D. variabilis and R. montanensis using maximum entropy (MaxEnt), refining bioclimatic data inputs, and including soil variables. We then compared geospatial predictions from five species distribution modeling frameworks. In contrast to previous work, we additionally assessed whether the R. montanensis positive D. variabilis distribution is nested within a larger overall D. variabilis distribution, representing a fitness cost hypothesis. We found that 1) adding soil layers improved the accuracy of the MaxEnt model; 2) the predicted ‘infected niche’ was smaller than the overall predicted niche across all models; and 3) each model predicted different sizes of suitable niche, at different levels of probability. Importantly, the models were not directly comparable in output style, which could create confusion in interpretation when developing planning tools. The random forest (RF) model had the best measured validity and fit, suggesting it may be most appropriate to these data

Application of Fiber Optic Instrumentation

Fiber optic sensing technology has emerged in recent years offering tremendous advantages over conventional aircraft instrumentation systems. The advantages of fiber optic sensors over their conventional counterparts are well established; they are lighter, smaller, and can provide enormous numbers of measurements at a fraction of the total sensor weight. After a brief overview of conventional and fiber-optic sensing technology, this paper presents an overview of the research that has been conducted at NASA Dryden Flight Research Center in recent years to advance this promising new technology. Research and development areas include system and algorithm development, sensor characterization and attachment, and real-time experimentally-derived parameter monitoring for ground- and flight-based applications. The vision of fiber optic smart structure technology is presented and its potential benefits to aerospace vehicles throughout the lifecycle, from preliminary design to final retirement, are presented

High prevalence of <i>Rickettsia africae</i> variants in <i>Amblyomma variegatum</i> ticks from domestic mammals in rural western Kenya: implications for human health

Tick-borne spotted fever group (SFG) rickettsioses are emerging human diseases caused by obligate intracellular Gram-negative bacteria of the genus Rickettsia. Despite being important causes of systemic febrile illnesses in travelers returning from sub-Saharan Africa, little is known about the reservoir hosts of these pathogens. We conducted surveys for rickettsiae in domestic animals and ticks in a rural setting in western Kenya. Of the 100 serum specimens tested from each species of domestic ruminant 43% of goats, 23% of sheep, and 1% of cattle had immunoglobulin G (IgG) antibodies to the SFG rickettsiae. None of these sera were positive for IgG against typhus group rickettsiae. We detected Rickettsia africae–genotype DNA in 92.6% of adult Amblyomma variegatum ticks collected from domestic ruminants, but found no evidence of the pathogen in blood specimens from cattle, goats, or sheep. Sequencing of a subset of 21 rickettsia-positive ticks revealed R. africae variants in 95.2% (20/21) of ticks tested. Our findings show a high prevalence of R. africae variants in A. variegatum ticks in western Kenya, which may represent a low disease risk for humans. This may provide a possible explanation for the lack of African tick-bite fever cases among febrile patients in Kenya

a retrospective cohort analysis

Background Allergy immunotherapy is an effective treatment for patients with allergic rhinitis whose symptoms are unresolved with pharmacotherapy. Allergy immunotherapy for grass pollen-induced allergic rhinitis is available in three modalities: subcutaneous immunotherapy and sublingual immunotherapy as a tablet or drop. This study aimed to understand trends in allergy immunotherapy prescribing and practice patterns for grass allergies in adult and paediatric patients in Germany. Methods A retrospective cohort study was conducted using IMS Disease Analyzer in Germany. Patients with an allergy immunotherapy prescription for grass pollen (Anatomical Therapeutic Chemical [ATC] classification code V01AA02) from September 2005 to December 2012 were included in the study. General Practitioners (GPs), dermatologists, Ear, Nose and Throat (ENT)-specialists, paediatricians and pneumologists were included as the allergy immunotherapy prescribing physicians in the study. Descriptive analyses were conducted on patient characteristics at index and prescribing physician specialty; a test for trend was conducted for timing of initiation of first allergy immunotherapy prescription in each annual prescribing season. Results Eighteen thousand eight hundred fifty eligible patients were identified during the study period. The majority of patients received subcutaneous immunotherapy; however, the proportion of patients receiving sublingual immunotherapy tablets increased from 8 % in 2006/2007 to 29 % in 2011/2012 (p < 0.001). Initiation of subcutaneous immunotherapy and Oralair® generally peaked during each prescribing year in two seasons (September- October and January) while GRAZAX® prescriptions peaked in autumn (September- October). ENT-specialists and dermatologists were the largest allergy immunotherapy prescribers in adults, while paediatricians and ENT-specialists were the largest prescribers of allergy immunotherapy in paediatric patients. Conclusions Subcutaneous immunotherapy remained the dominant allergy immunotherapy modality for grass pollen-induced allergic rhinitis in Germany for adult and paediatric patients; however, there was a marked increase in proportion of patients receiving sublingual immunotherapy tablets from 2006/2007 to 2011/2012, after their introduction to the market in 2006. ENT- specialists, dermatologists and paediatricians were responsible for the majority of prescribing. The predominance of particular modalities within certain physician specialties likely reflects different treatment goals or needs

A qualitative analysis of smokers’ perceptions about lung cancer screening

Background In 2013, the US Preventive Services Task Force (USPSTF) began recommending lung cancer screening for high risk smokers aged 55–80 years using low-dose computed tomography (CT) scan. In light of these updated recommendations, there is a need to understand smokers’ knowledge of and experiences with lung cancer screening in order to inform the design of patient education and tobacco cessation programs. The purpose of this study is to describe results of a qualitative study examining smokers’ perceptions around lung cancer screening tests. Methods In 2009, prior to the release of the updated USPSTF recommendations, we conducted 12 120-min, gender-specific focus groups with 105 current smokers in Charlotte, North Carolina and Cincinnati, Ohio. Focus group facilitators asked participants about their experience with three lung cancer screening tests, including CT scan, chest x-ray, and sputum cytology. Focus group transcripts were transcribed and qualitatively analyzed using constant comparative methods. Results Participants were 41–67 years-old, with a mean smoking history of 38.9 pack-years. Overall, 34.3% would meet the USPSTF’s current eligibility criteria for screening. Most participants were unaware of all three lung cancer screening tests. The few participants who had been screened recalled limited information about the test. Nevertheless, many participants expressed a strong desire to pursue lung cancer screening. Using the social ecological model for health promotion, we identified potential barriers to lung cancer screening at the 1) health care system level (cost of procedure, confusion around results), 2) cultural level (fatalistic beliefs, distrust of medical system), and 3) individual level (lack of knowledge, denial of risk, concerns about the procedure). Although this study was conducted prior to the updated USPSTF recommendations, these findings provide a baseline for future studies examining smokers’ perceptions of lung cancer screening. Conclusion We recommend clear and patient-friendly educational tools to improve patient understanding of screening risks and benefits and the use of best practices to help smokers quit. Further qualitative studies are needed to assess changes in smokers’ perceptions as lung cancer screening with CT scan becomes more widely used in community practice

Evidence of Rickettsia and Orientia Infections Among Abattoir Workers in Djibouti.

Of 49 workers at a Djiboutian abattoir, eight (16%, 95% confidence interval [CI]: 9-29) were seropositive against spotted fever group rickettsiae (SFGR), two (4%, 95% CI: 1-14) against typhus group rickettsiae, and three (6%, 95% CI: 2-17) against orientiae. One worker (9%, 95% CI: 2-38) seroconverted against orientiae during the study period. This is the first evidence of orientiae exposure in the Horn of Africa. SFGR were also identified by polymerase chain reaction in 32 of 189 (11%, 95% CI: 8-15) tick pools from 26 of 72 (36%) cattle. Twenty-five (8%, 95% CI: 6-12) tick pools were positive for Rickettsia africae, the causative agent of African tick-bite fever. Health-care providers in Djibouti should be aware of the possibility of rickettsiae infections among patients, although further research is needed to determine the impact of these infections in the country