Archive for the ‘Q Fever’ Category

Rickettsia burneti and Brucella melitensis Co-Infection: A Case Report & Literature Review

https://bmcmicrobiol.biomedcentral.com/articles/10.1186/s12866-021-02323-x

Rickettsia burneti and Brucella melitensis co-infection: a case report and literature review

Abstract

Rickettsia is the pathogen of Q fever, Brucella ovis is the pathogen of brucellosis, and both of them are Gram-negative bacteria which are parasitic in cells. The mixed infection of rickettsia and Brucella ovis is rarely reported in clinic. Early diagnosis and treatment are of great significance to the treatment and prognosis of brucellosis and Q fever. Here, we report a case of co-infection Rickettsia burneti and Brucella melitensis. The patient is a 49-year-old sheepherder, who was hospitalized with left forearm trauma. Three days after admission, the patient developed fever of 39.0°C, accompanied by sweating, fatigue, poor appetite and headache. Indirect immunofluorescence (IFA) was used to detect Rickettsia burneti IgM. After 72 hours of blood culture incubation, bacterial growth was detected in aerobic bottles, Gram-negative bacilli were found in culture medium smear, the colony was identified as Brucella melitensis by mass spectrometry. Patients were treated with doxycycline (100 mg bid, po) and rifampicin (600 mg qd, po) for 4 weeks. After treatment, the symptoms disappeared quickly, and there was no sign of recurrence or chronic infection. Q fever and Brucella may exist in high-risk practitioners, so we should routinely detect these two pathogens to prevent missed diagnosis.

Study Shows 35% of Atypical Pneumonia in Chile Caused by Q Fever & Rickettsia

https://pubmed.ncbi.nlm.nih.gov/32545152/

Evidence of Q Fever and Rickettsial Disease in Chile

Affiliation

Free PMC article

Abstract

Q fever and rickettsial diseases occur throughout the world and appear to be emergent zoonoses in Chile. The diagnosis of these diseases is currently uncommon in Chile, as their clinical presentations are non-specific and appropriate diagnostic laboratory assays are of limited availability. During a recent outbreak of undiagnosed human atypical pneumonia, we serologically investigated a series of 357 cases from three regions of southern Chile. The aim was to identify those caused by Coxiella burnetii and/or Rickettsia spp. Serological analysis was performed by ELISA and an immunofluorescence assay (IFA) for acute and convalescence sera of patients. Our results, including data from two international reference laboratories, demonstrate that

  • 71 (20%) of the cases were Q fever
  • 44 (15%) were a likely rickettsial infection, although the rickettsial species could not be confirmed by serology
This study is the first report of endemic Q fever and rickettsial disease affecting humans in Chile.

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For more on Q Fever:  

For more on Rickettsia:  

Two Exotic Disease-Carrying Ticks Identified in Rhode Island & First Case of Parasitic Soft Ticks Reported in New Jersey

https://www.sciencetimes.com/articles/27511/20200929/two-exotic-disease-carrying-ticks-identified-rhode-island.

Two Exotic Disease-Carrying Ticks Have Just Been Identified in Rhode Island

Sep 29, 2020

Local authorities in Rhode Island announced that two new tick species were identified on Block Island. The tick species were traced back to Eurasia and Asia origins.

Dr. Danielle Tufts from Columbia University identified the two species Haemaphysalis longicornis (Asian long-horned tick) and Haemaphysalis punctata (red sheep tick), reported the state’s Department of Environmental Management (DEM). (See link for article) 

Two Exotic Disease-Carrying Ticks Had Just Been Identified in Rhode Island

(Photo: Asian long-horned tick, adult female dorsal view climbing on a blade of grass – Photo by James Gathany; CDC)

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**Comment**

Both ticks are considered live-stock pests but they can and do bite humans, transmitting diseases.  Farmers, hunters, and hikes are at greater risk.

  • The red sheep tick is identified with Tick paralysis, Tick Borne Encephalitis virus, Tribec virus, Bhanja virus, Crimean-Congo haemorrhagic fever virus, Babesia bovis, Theileria recondita, Coxiella burneti, Francisella tularensis.  http://www.bristoluniversitytickid.uk/page/Haemaphysalis+punctata/17/#.X3S-TS2ZOWgCattle: Babesia major, Babesia bigemina, Theileria mutans, Anaplasma marginale and Anaplasma centrale

    Sheep: Babesia motasi, Theileria ovis

H.-punctata-female-dorsal-0-300x225

Red sheep tick, Adult female dorsal view

https://medicalxpress.com/news/2020-09-jersey-1.html

Bat tick found for the first time in New Jersey

Bat tick found for the first time in New Jersey

A tick species associated with bats has been reported for the first time in New Jersey and could pose health risks to people, pets and livestock, according to a Rutgers-led study in the Journal of Medical Entomology.

This species (Carios kelleyi) is a “soft” . Deer ticks, which carry Lyme disease, are an example of “hard” ticks.

“All ticks feed on blood and may transmit pathogens (disease-causing microbes) during feeding,” said lead author James L. Occi, a doctoral student in the Rutgers Center for Vector Biology at Rutgers University-New Brunswick. “We need to be aware that if you remove from your belfry, attic or elsewhere indoors, ticks that fed on those bats may stay behind and come looking for a new source of blood. There are records of C. kelleyi biting humans.”  (See link for article)

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**Comment**

A few important points:

  1. A related species, Carios jersey, was found in amber 2001
  2. C. kelleyi has been found in 29 states so far
  3. Public health risk remains unknown, but it has been found to be infected with harmful pathogens in other states
  4. There are reports of this tick feeding on humans
  5. The bat it feeds on regularly roosts in attics and barns
  6. It has been identified with rickettsia and borrelia (Lyme):  https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/carios
I can’t help but notice the bat connection, as well as the following:

https://www.newsbreak.com/news/2058858379813/first-case-of-parasitic-soft-ticks-reported-in-new-jersey  The current pandemic has been accompanied by cases of other illnesses and diseases such as African Swine Flu, Ebola, Bubonic Plague, West Nile Virus, Dengue outbreaks around the world.

Seroepidemiological & Molecular Investigation of Spotted Fever Group Rickettsiae & Coxiella Burnetii in Sao Tome Island: A One Health Approach

https://www.ncbi.nlm.nih.gov/pubmed/31231971

Seroepidemiological and molecular investigation of spotted fever group rickettsiae and Coxiella burnetii in Sao Tome Island: A One Health approach.

Abstract

Spotted fever group rickettsiae (SFGR) and Coxiella burnetii are intracellular bacteria that cause potentially life-threatening tick-borne rickettsioses and Q fever respectively. Sao Tome and Principe (STP), small islands located in the Gulf of Guinea, recently experienced a dramatic reduction in the incidence of malaria owing to international collaborative efforts. However, unexplained febrile illnesses persist. A One Health approach was adopted to investigate exposure to SFGR and C. burnetii in humans and examine the diversity of these bacteria in ticks parasitizing domestic ruminants. A cross-sectional human serological study was conducted in Agua Grande district in Sao Tome Island from January to March 2016, and ticks were collected from farmed domestic ruminants in 2012 and 2016. In total, 240 individuals varying in age were randomly screened for exposure to SFGR and C. burnetii by indirect immunofluorescence assay. Twenty of 240 individuals (8.3%) were seropositive for SFGR (4 for Rickettsia africae and 16 for R. conorii) and 16 (6.7%) were seropositive for C. burnetii. Amblyomma astrion were collected exclusively in 2012, as were A. variegatum in 2016 and Rickettsia spp. were detected in 22/42 (52.4%) and 49/60 (81.7%) respectively. Sequence analysis of multiple gene targets from Rickettsia spp. detected in ticks suggests the presence of a single divergent R. africae strain (Sao Tome). While no ticks were found positive for C. burnetii, Coxiella-like endosymbionts were detected in nearly all ticks.

This is the first study in STP to provide serological evidence in humans of SFGR and C. burnetii and additional molecular evidence in ticks for SFGR, which may be responsible for some of the unexplained febrile illnesses that persist despite the control of malaria. Future epidemiological studies are needed to confirm the occurrence and risk factors associated with SFG rickettsioses and Q fever in both humans and animals.

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For more:  https://madisonarealymesupportgroup.com/2019/03/20/rocky-mountain-spotted-fever-is-not-the-only-rickettsiosis/

Great article on SFGR: https://www.galaxydx.com/rickettsia-spp/

C. burnetii:  https://madisonarealymesupportgroup.com/2019/03/28/human-tick-borne-diseases-in-australia/

https://madisonarealymesupportgroup.com/2018/10/18/study-finds-q-fever-rickettsia-typhus-in-australian-ticks-and-people/

https://madisonarealymesupportgroup.com/2018/02/03/understanding-q-fever-risk-to-minnesotans/  Excerpt: 

The CDC reports that 60% of cases are in patients without livestock contact (CDC unpublished data, 2010) and the need for health-care professionals to consider Q fever in the differential diagnosis in patients with a compatible illness, even in the absence of occupational risk or history of direct contact with animal reservoirs.

Supposedly, he United States ended its biological warfare program in 1969. When it did, C. burnetii was one of seven agents it had standardized as biological weapons.  https://en.wikipedia.org/wiki/Coxiella_burnetii

Q Fever can cause acute or chronic illness.

https://www.medscape.com/viewarticle/803800
Excellent video by Alicia Anderson, DVM, MPH on new CDC guidelines for Q Fever

https://madisonarealymesupportgroup.com/2019/06/24/other-arthropod-borne-bacteria-causing-nonmalarial-fever-in-ethiopia/  African patients presenting with fever but testing negative for malaria had DNA for these pathogens: Borrelia spp., Francisella spp. Rickettsia spp. and Bartonella. Thus, in this rural area of Africa, febrile symptoms could be due to bacteria transmitted by arthropods.

 

 

 

Study Finds Q Fever & Rickettsia (Typhus) in Australian Ticks and People

https://www.ncbi.nlm.nih.gov/m/pubmed/30270855/

Ixodes holocyclus Tick-Transmitted Human Pathogens in North-Eastern New South Wales, Australia.

Graves SR, et al. Trop Med Infect Dis. 2016.

Abstract

A group of 14 persons who live in an area of Australia endemic for the Australian paralysis tick, Ixodes holocyclus, and who were involved in regularly collecting and handling these ticks, was examined for antibodies to tick-transmitted bacterial pathogens.

Five (36%) had antibodies to Coxiella burnetii, the causative agent of Q fever and three (21%) had antibodies to spotted fever group (SFG) rickettsiae (Rickettsia spp). None had antibodies to Ehrlichia, Anaplasma, Orientia, or Borrelia (Lymedisease) suggesting that they had not been exposed to these bacteria.

A total of 149 I. holocyclus ticks were examined for the citrate synthase (gltA) gene of the SFG rickettsiae and the com1 gene of C. burnetii; 23 (15.4%) ticks were positive for Rickettsia spp. and 8 (5.6%) positive for Coxiella spp. Sequencing of fragments of the gltA gene and the 17 kDa antigen gene from a selection of the ticks showed 99% and 100% homology, respectively, to Rickettsia australis, the bacterium causing Queensland tick typhus.

Thus, it appears that persons bitten by I. holocyclus in NE NSW, Australia have an approximate one in six risk of being infected with R. australis. Risks of Q fever were also high in this region but this may have been due to exposure by aerosol from the environment rather than by tick bite. A subset of 74 I. holocyclus ticks were further examined for DNA from Borrelia spp., Anaplasma spp. and Ehrlichia spp. but none was positive. Some of these recognised human bacterial pathogens associated with ticks may not be present in this Australian tick species from northeastern New South Wales.

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**Comments**

Folks in Australia have been fighting the denial of authorities for decades regarding Lyme Disease:  https://madisonarealymesupportgroup.com/2018/08/21/our-battle-ongoing-lyme-disease-in-australia/

https://madisonarealymesupportgroup.com/2016/11/03/ld-not-in-australia-here-we-go-again/

https://madisonarealymesupportgroup.com/2018/10/03/aussie-widow-of-lyme-disease-victim-to-sue-nsw-health/  A SYDNEY woman launches a class action against NSW Health after autopsy results showed her husband was riddled with Lyme in his liver, heart, kidney, and lungs.  He was only 44 years old and was bitten by a tick while filming a TV show in Sydney.

Now how in the world did that happen?

While they still deny Lyme (borrelia) this recent study definitively shows a number of pathogens in Australian ticks and humans including Rickettsia (more commonly known as Tick & arthropod TyphusQueensland typhus or Rickettsia australis), as well as Q Fever.

Tick Typhus is similar to Rocky Mountain spotted fever, but deemed not as severe.  Symptoms include:

  • Fever
  • Headache
  • Malaise
  • Bloodshot eyes
  • Red lump at tick bite site
  • Ulceration at tick bite site
  • Black scab at tick bite site
  • Enlarged local lymph nodes
  • Forearm red rash
  • Red body rash
  • Palm rash
  • Rash on soles of feet

Doxycycline is the front-line drug for typhus and broad-spectrum antibiotics aren’t helpful.

Fact sheet on typhus:  https://www.health.nsw.gov.au/Infectious/factsheets/Factsheets/typhus.PDF  The perps are typically lice, fleas, mites, and ticks.

https://madisonarealymesupportgroup.com/2018/08/19/monster-ticks-found-in-germany-threaten-europe-with-deadly-disease-crimean-congo-fever/  In this article, they found a tropical form of tick typhus in tropical ticks found in Germany. Typhus is making a comeback, particularly in the southern U.S. Migrating birds are transporting ticks as well as the diseases they carry worldwide 

Fact sheet on Q Fever: http://www.stopticks.org/ticks/qfever.asp

Caused by the bacteria Coxiella burnetii, it can cause pneumonia and hepatitis (liver inflammation) in its early stage, and infection of the heart valves (endocarditis) in its chronic stage.  Perps are the Brown Dog Tick (Rhipicephalus sanguine us), Rocky Mountain Wood Tick (Dermacentor andersoni), and the Lone Star Tick (Amblyomma americium).

https://coloradoticks.org/tick-borne-diseases/q-fever/  This article states it’s usually a mild disease with flu-like symptoms but sometimes it can resurface years later.  This more deadly, chronic form, of Q fever can damage heart, liver, brain and lungs. C. burnetii is highly infectious. Humans that are susceptible to this disease can be infected by a single organism. It is considered a significant threat for bio warfare and is classified as a Category B agent of bioterrorism.

The severity and combination of signs and symptoms vary greatly. About half the people infected with Q fever will get sick. Symptoms include:

  • High fever (up to 105°F)
  • Fatigue
  • Severe headache
  • General malaise
  • Myalgia
  • Chills or sweats
  • Non-productive cough
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Chest pain

Doxycycline is also the front-line drug for this with quinolone antibiotics as an alternative.

Add the Ixodes holocyclus tick to this list as well.

And before you think it can only ever be in Australia, this article in the 2013 issue of the Australian Veterinary Journal shows the likelihood of a population of Ixodes holocyclus breeding outside their common range.  https://conference.ava.com.au/13097.

Well there goes the neighborhood.

Here’s a nifty chart:  https://www.lymedisease.org/lyme-basics/co-infections/other-co-infections/ (Please remember this is constantly changing)

Screen-Shot-2014-08-26-at-5.27.54-PM

If there’s one think I know for sure, it’s that nothing about ticks and the diseases they carry is sure.

They are finding tropical ticks in Germany (where they shouldn’t be)  https://madisonarealymesupportgroup.com/2018/08/19/monster-ticks-found-in-germany-threaten-europe-with-deadly-disease-crimean-congo-fever/ and they are finding Asian ticks in the U.S. (where they shouldn’t be)  https://madisonarealymesupportgroup.com/2018/10/03/1st-person-bitten-by-east-asian-longhorned-tick/.

When is the CDC going to get the memo and scrap the tick maps?