title: Typhus and other rickettsioses: emerging infections in Germany.
abstract: BACKGROUND
  Rickettsioses are diseases caused by rickettsiae, obligate intracellular bacteria that are transmitted by arthropods to humans. They cause various types of spotted fever and typhus.
  
  
  METHODS
  A review of the literature is presented along with the authors' own findings.
  
  
  RESULTS
  Six indigenous species of rickettsiae have been found in Germany to date, five of which have been described as human pathogens in other countries. Rickettsia slovaca causes tick-borne lymphadenitis (TIBOLA). Rickettsia helvetica is a known pathogen of nonspecific fever; its role in endocarditis is still under investigation. Rickettsia felis causes so-called flea-borne spotted fever. Rickettsia monacensis and Rickettsia massiliae were recently shown to cause the classical form of tick-borne spotted fever. The sixth indigenous species in Germany, Rickettsia sp. RpA4, has not yet been associated with any human disease. The most important rickettsioses imported to Germany by travelers are African tick bite fever and Mediterranean spotted fever.
  
  
  CONCLUSIONS
  Modern molecular biological techniques have enabled the detection of a number of rickettsial species in Germany. The medical importance of these illnesses in Germany remains to be determined. In travel medicine, imported rickettsioses play a role that should not be underestimated.
authors: Institut für Mikrobiologie der Bundeswehr, München, Germany. gerharddobler@bundeswehr.org
authors: Gerhard
authors: G
authors: Dobler
authors: Roman
authors: R
authors: Wölfel
mesh_terms: D021821:Communicable Diseases, Emerging / Q000453:epidemiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D011159:Population Surveillance; D012282:Rickettsia Infections / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors