Seroepidemiology of Flea-borne Rickettsiosis in Northern Taiwan
Date Issued
2014
Date
2014
Author(s)
Yang, Wan-Hsiu
Abstract
Rickettsioses are common agent as a cause of fever of unknown origin. In Taiwan, endemic rickettsial diseases including scrub typhus and murine typhus which brought about 300 to 400 and 30 to 40 annual cases separately in the past five years. However, positive rate of diagnosis in rickettsial diseases remained low in the past few years. In 2008, first human case of Rickettsia felis was reported in Taiwan. Clinical symptoms of R. felis are similar to other rickettsial diseases including fever, headache, myalgia, and macular rash, which make clinical diagnosis difficult. Also, R. felis may have cross reaction with R. typhi in serologic tests which may lead to misdiagnosis. Human cases of R. felis infection may be underestimated. To realize the epidemiology of R. felis infection in Taiwan, we analyzed 221 serological samples sent from National Taiwan University Hospital to the Centers for Disease Control (Taiwan CDC) for rickettsioses diagnosis during 2009 (86 samples) and 2010 (135 samples) which collected from 127 patients have negative diagnostic results of scrub typhus, murine typhus and Q fever. Three whole cell antigens were tested in immunofluorescence assay including R. felis which isolated from the cat flea, R. typhi and R. japonica. A total of 23 patients were positive for Rickettsia infection, 8 were positive for R. felis infection, 7 were positive for other spotted rickettsiae infection, because of the cross reaction in immunofluorescence assay, source of infection in 8 patients are further examined by absorb Western blot. Medical records of 3 cases are examined, clinical symptoms including fever, skin rash, chills, abdominal dullness, lymphadenopathy, hepatitis, septic shock with acute renal failure, and pneumonia with acute respiratory distress syndrome. The results confirm that R. felis is a potential pathogen in northern Taiwan, and other spotted rickettsiae infection may need further studies.
Subjects
蚤傳立克次體病
斑點熱群立克次體病
血清流行病學
SDGs
Type
thesis
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