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Human spotted fever group rickettsioses are underappreciated in southern Taiwan, particularly for the species closely-related to Rickettsia felis.
[scrub typhus]
Despite
increased
identification
of
spotted
fever
group
rickettsioses
(
SFGR
)
in
animals
and
arthropods
,
human
SFGR
are
poorly
characterized
in
Taiwan
.
Patients
with
suspected
Q
fever
,
scrub
typhus
,
murine
typhus
,
leptospirosis
,
and
dengue
fever
from
April
2004
to
December
2009
were
retrospectively
investigated
for
SFGR
antibodies
(
Abs
)
.
Sera
were
screened
for
Rickettsia
rickettsii
Abs
by
indirect
immunofluorescence
antibody
assay
(
IFA
)
,
and
those
with
positive
results
were
further
examined
for
Abs
against
R
.
rickettsii
,
R
.
typhi
,
R
.
felis
,
R
.
conorii
,
and
R
.
japonica
using
micro-immunofluorescence
(
MIF
)
tests
.
Polymerase
chain
reaction
(
PCR
)
for
detection
of
SFGR
DNA
was
applied
in
those
indicated
acute
infections
.
Case
geographic
distribution
was
made
by
the
geographic
information
system
software
.
A
total
of
413
cases
with
paired
serum
,
including
90
cases
of
Q
fever
,
47
cases
of
scrub
typhus
,
12
cases
of
murine
typhus
,
6
cases
of
leptospirosis
,
3
cases
of
dengue
fever
,
and
255
cases
of
unknown
febrile
diseases
were
investigated
.
Using
IFA
tests
,
a
total
of
49
cases
with
47
(
11
.
4
%
)
and
4
(
1
.
0
%
)
cases
had
sera
potentially
positive
for
R
.
rickettsii
IgG
and
IgM
,
respectively
.
In
the
49
cases
screened
from
IFA
,
MIF
tests
revealed
that
there
were
5
cases
of
acute
infections
(
3
possible
R
.
felis
and
2
undetermined
SFGR
)
and
13
cases
of
past
infections
(
3
possible
R
.
felis
and
10
undetermined
SFGR
)
.
None
of
the
5
cases
of
acute
infection
had
detectable
SFGR
DNA
in
the
blood
specimen
by
PCR
.
Possible
acute
infection
of
R
.
felis
was
identified
in
both
one
case
of
Q
fever
and
scrub
typhus
.
The
geographic
distribution
of
SFGR
cases
is
similar
with
that
of
scrub
typhus
.
Human
SFGR
exist
and
are
neglected
diseases
in
southern
Taiwan
,
particularly
for
the
species
closely-related
to
R
.
felis
.
Diseases
Validation
Diseases presenting
"blood specimen"
symptom
22q11.2 deletion syndrome
scrub typhus
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