title: Investigation of an outbreak of rickettsial febrile illness in Guatemala, 2007.
abstract: OBJECTIVE
  We describe an outbreak of spotted fever group (SFG) rickettsiosis that occurred in 2007 in a farming community in southeastern Guatemala. We identified 17 cases of an acute febrile illness, among which 10, including two fatalities, were confirmed or probable cases of rickettsial disease (case-fatality proportion 12%).
  
  
  METHODS
  PCR, a microimmunofluorescence assay (IFA), and Western blotting were performed on patient samples, and PCR was performed on ticks.
  
  
  RESULTS
  Using an indirect IFA, seven of 16 (44%) ill persons tested had both IgM and IgG antibodies reacting with one or more Rickettsia spp antigens; the other nine (56%) had only IgM titers or were seronegative. Antibodies to SFG protein and lipopolysaccharide were detected by Western blotting with antigens of Rickettsia typhi, Rickettsia rickettsii, and Rickettsia akari. Only one sample, from an ill person who died, tested positive by PCR for a SFG Rickettsia. PCR analysis of Amblyomma cajennense ticks from domestic animals in the area detected the presence of SFG Rickettsia DNA in one of 12 ticks collected.
  
  
  CONCLUSIONS
  Further studies in Guatemala are warranted to establish the prevalence of rickettsioses and to fully characterize the identity of the etiologic agents and vectors.
authors.affiliation: Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Marina E
authors.initials: ME
authors.lastname: Eremeeva
authors.forename: Elsa
authors.initials: E
authors.lastname: Berganza
authors.forename: Gloria
authors.initials: G
authors.lastname: Suarez
authors.forename: Lorena
authors.initials: L
authors.lastname: Gobern
authors.forename: Erica
authors.initials: E
authors.lastname: Dueger
authors.forename: Leticia
authors.initials: L
authors.lastname: Castillo
authors.forename: Lissette
authors.initials: L
authors.lastname: Reyes
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wikswo
authors.forename: Kyle F
authors.initials: KF
authors.lastname: Abramowicz
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Dasch
authors.forename: Kim A
authors.initials: KA
authors.lastname: Lindblade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D026863:Ixodidae / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D012284:Rickettsia rickettsii / Q000235:genetics / Q000276:immunology*; D012373:Rocky Mountain Spotted Fever / Q000175:diagnosis / Q000276:immunology / Q000401:mortality*; D012424:Rural Population; D055815:Young Adult