Tämä koirapunkkilaatu teettää ongelmiä sikäli, että siihen ei tehoa tavallinen rokote, joka sisältää tapettuja R. rickettsii lajeja. Lisäksi punkki toimii sekä vektorina että reservoaarina ja sen elinsykli on täten pinttynyt, monisukupolvinen. .
Outbreaks of life-threatening Rocky Mountain spotted fever in
humans and dogs associated with a canine-tick maintenance cycle
constitute an important One Health opportunity. The reality of the
problem has been observed strikingly in Mexico, Brazil, Colombia, and
Native American tribal lands in Arizona. The brown dog tick, Rhipicephalus sanguineus sensu lato,
acquires the rickettsia from bacteremic dogs and can maintain the
bacterium transtadially to the next tick stage. The subsequent adult
tick can then transmit infection to a new host, as shown by guinea pig
models. These brown dog ticks maintain spotted fever group rickettsiae
transovarially through many generations, thus serving as both vector and
reservoir.
Vaccine containing whole-killed R. rickettsii does not stimulate sufficient immunity. Studies of Rickettsia
subunit antigens have demonstrated that conformationally preserved
outer-membrane autotransporter proteins A and B are the leading vaccine
candidates. The possibility of a potentially safe and effective live
attenuated vaccine has only begun to be explored as gene knockout
methods are applied to these obligately intracellular pathogens.Keywords:
One Health; Rhipicephalussanguineus; Rickettsia rickettsii; Rocky
Mountain spotted fever; canine vector-borne disease; live attenuated
vaccine; subunit vaccine.
RockyMountainspottedfever (RMSF) is an acute febrile tick-borne illness caused by Rickettsia rickettsii. ...
Excerpt: Rocky Mountain spotted fever (RMSF) is an acute febrile tick-borne illness caused by Rickettsia rickettsii. It is the most severe and most common of the rickettsial infections in North America.
Boutonneuse fever (BF) is an illness first detailed in Tunisia,
North Africa, nearly a century ago and was called “boutonneuse” (French
for “spotty”) because of the pimpled or papular skin rash that followed
the fever. Boutonneuse fever is a type of infectious disease caused by
bacteria of the rickettsia genus, typically found in the Mediterranean
region of Europe. Other common regions include sub-Saharan Africa,
India, Greece, and select regions surrounding the Black Sea. Rickettsia conorii (thecausative organism) is an obligate
intracellular bacterium that cannot reproduce outside of a host cell. It
is a type of gram-negative bacteria (it does not retain the crystal
violet stain during the Gram staining technique of bacterial
identification). Boutonneuse fever (BF) is transmitted by the bite of a dog tick(Rhipicephalus sanguineus)
and is classified as a spotted fever; most people that get sick with a
spotted fever will have a black eschar (a “tache noire” or black spot)
at the site of the bite. The tick bite causes the zoonotic (non-human to
human) bacteria to enter the blood and disseminate.
Boutonneuse fever (BF) typically has an incubation period of 5 to7 days
following the tick bite. The tick bite is usually painless and may not
be noticed if it occurs in an inconspicuous location. The diagnosis is
commonly made based on a history of travel to an endemic location and
clinical findings: fever, exanthem (rash), and the tache noire (black
eschar). This disease that follows classically causes flu-like symptoms.
It typically follows a similar, yet more benign clinical course
compared to that of Rocky Mountain spotted fever (RMSF) but can occasionally
cause more advanced signs and symptoms such as hepatomegaly, jaundice,
meningitis, other neurologic complications, orchitis, retinopathy,
gastrointestinal bleeding, and pneumonia.
Treatment of BF is largely the same as for all rickettsial
infections. Doxycycline is a tetracycline that remains useful in the
management of obligately intracellular bacterial pathogens such as
rickettsia. Patients with a more benign progression are treated with
antibiotics for 7 days. Those with more progressive symptoms are usually
treated for 14 days. Macrolides such as azithromycin are efficacious in
children and pregnant women.
Drexler NA, Close R, Yaglom HD, Traeger M, Parker K, Venkat H, Villarroel L, Brislan J, Pastula DM, Armstrong PA.Open Forum Infect Dis. 2022 Oct 5;9(10):ofac506. doi: 10.1093/ofid/ofac506. eCollection 2022 Oct.PMID: 36324320
BACKGROUND: RockyMountainspottedfever (RMSF) is a deadly tickborne disease disproportionately affecting Arizona tribal communities. ... Conclusions:
Although the etiology of sequelae is not able to be determined
using this study design, life-altering sequelae were common among
patients surviving severe RMSF illness. Delayed administration of the
antibiotic doxycycline after day 5 was the strongest predictor of
morbidity. Keywords:
Rickettsia; neurology; sequela; tick.
A three-year-old boy presented with fever, maculopapular rash
involving palms and soles, and hyponatremia two weeks following a tick
bite. Empiric doxycycline that he was on was discontinued following
negative initial rickettsial serology based on the non-endemicity of
Rocky Mountain spotted fever (RMSF) in Northeast Ohio. He demonstrated
high inflammatory markers and met the criteria for hemophagocytic
lymphohistiocytosis (HLH). With a working diagnosis of macrophage
activation syndrome secondary to presumed systemic-onset juvenile
idiopathic arthritis (soJIA), he received HLH-directed therapy. Rising
antibody titers in convalescent sera established the diagnosis of RMSF.
The patient recovered completely with HLH directed therapy and
re-institution of doxycycline. This is the first pediatric case report
of Rickettsia rickettsii induced HLH demonstrating a favorable outcome despite modified therapy. Keywords:
Hemophagocytic lymphohistiocytosis; Rickettsia rickettsii; Rocky Mountain spotted fever.
Zhou C, Woods P, Abouzeid A, Brooks MN.Am J Case Rep. 2022 Jan 31;23:e934505. doi: 10.12659/AJCR.934505.PMID: 35100242Free PMC article.
BACKGROUND RockyMountainspottedfever
(RMSF) is a potentially fatal infectious disease caused by the
gram-negative intracellular bacterium Rickettsia rickettsii. The classic
triad includes fever, rash, and history of tick exposure; however, th …
Barbina S, Quiroga M, Petz C.J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221145014. doi: 10.1177/23247096221145014.PMID: 36541205Free PMC article.
Rocky Mountain spotted fever (RMSF), a tick-borne illness, can
cause serious illness or death even in a healthy individual.
Unfortunately, this illness can be difficult to diagnose as symptoms are
nonspecific and oftentimes mimic benign viral illnesses. Delayed
diagnosis can be detrimental as the timing of antibiotic administration
is critical to prevent associated morbidity and mortality. A careful
travel and social history can sometimes provide clues to make the
diagnosis. Being aware of lesser-known objective findings such as
hyponatremia, neurologic derangements, transaminitis, and
thrombocytopenia may help raise suspicion for the disease. This is a
case of a 72-year-old woman who presented with nonspecific symptoms and
hyponatremia without known tick exposure. She was eventually diagnosed
with RMSF. The timing of her presentation corresponded with a surge in
COVID-19 infections throughout her area of residence, which further
complicated her presentation and contributed to a delayed diagnosis. Keywords:
Rocky Mountain spotted fever; hyponatremia; rickettsial disease; tick-borne illness.
Bestul N, Padilla R, Montaño T, Márquez A, Fierro M, Zazueta OE, Armstrong PA.Am J Trop Med Hyg. 2022 Aug 22;107(4):773-779. doi: 10.4269/ajtmh.21-1017. Print 2022 Oct 12.PMID: 35995132Free PMC article.
Rocky Mountain spotted fever (RMSF) is a potentially fatal tickborne
disease caused by the bacterium, Rickettsia rickettsii and transmitted
primarily by the brown dog tick (Rhipicephalus sanguineus) in the
southwestern United States and Mexico. RMSF can be rapidly fatalif not
treated early with doxycycline, making healthcare worker awareness and
education critical to reduce morbidity and mortality. During 2008-2019,
Mexicali experienced a RMSF epidemic with 779 confirmed cases, and an
11-year case-fatality rate of 18% (N = 140). A cross-sectional study was
conducted with 290 physicians and physicians-in-training across 12
medical facilities in Mexicali. They were asked to complete a 23-item
questionnaire to assess knowledge, attitudes, and practices for
clinical, epidemiologic, and preventive aspects of RMSF. Half of
participants were female, the largest age group was aged 25 to 44 (47%),
and median time in practice was 6 years (interquartile rate: 1-21.5).
Less than half (48%) surveyed were confident where diagnostic testing
could be performed, and two-thirds did not regularly order serology
(67%) or molecular diagnostic (66%) tests for RMSF when a patient
presented with fever. Sixty-four percent knew doxycycline as first-line
treatment of children < 8 years with suspected RMSF. When comparing
healthcare workers with < 6 years of experience to those with ≥ 6
years, more experience was associated with greater confidence in where
to have diagnostic testing performed (prevalence odds ratio [prevalence
odds ratios [pOR]] = 2.3; P = 0.004), and frequency of ordering
laboratory tests (serology, pOR = 3.3; P = 0.002; polymerase chain
reaction, pOR = 3.9; P = 0.001). Continued education, including
information on diagnostic testing is key to reducing morbidity and
mortality from RMSF.
Alvarez-Hernandez G, Trejo AV, Ratti V, Teglas M, Wallace DI.Insects. 2022 Mar 7;13(3):263. doi: 10.3390/insects13030263.PMID: 35323561Free PMC article.
RockyMountainspottedfever (RMSF) is a significant health problem in Sonora, Mexico. The tick vector, Rhipicephalus sanguineus, feeds almost exclusively on domestic dogs that, in this region, also serve as the reservoir for the tick-borne pathogen, Rickettsia rickettsii. A process-based mathematical model of the life cycle of R. sanguineus
was developed to predict combinations of insecticidal dog collars and
long-lasting insecticidal wall treatments resultingin suppression of indoor tick populations. Because of a high burden of RMSF in a rural
community near the Sonora state capital of Hermosillo, a test area was
treated with a combination of insecticidal dog collars and long-lasting
insecticidal wall treatments from March 2018 to April 2019, with
subsequent reduction in RMSF cases and deaths. An estimated 80% of the
dogs in the area had collars applied and 15% of the houses were treated.
Data on tick abundance on walls and dogs, collected during this
intervention, were used to parameterize the model. Model results show a
variety of treatment combinations likely to be as successful as the one
carried out in the test community.Keywords:
Rhipicephalus sanguineus; Rickettsia rickettsi; Rocky Mountain
spotted fever; dog collars; insecticidal wall treatment; tick control;
tick-borne disease.
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