title: A cluster of Rickettsia rickettsii infection at an animal shelter in an urban area of Brazil.
abstract: Rickettsia rickettsii infection is being increasingly recognized as an important cause of fatal acute illness in Brazil, where this tick-borne disease is designated Brazilian spotted fever (BSF). In this study we report five fatal cases of BSF in employees of an animal shelter in an urban area in the municipality of Rio de Janeiro in southeast Brazil after a natural disaster on 11 January 2011. Four of the cases occurred from 27 January to 11 April 2011, while the fifth fatal case was identified in April 2012. Three cases were confirmed by molecular analysis and two by epidemiological linkage. An investigation of BSF was performed in the animal shelter, and blood samples were collected from 115 employees and 117 randomly selected dogs. The presence of high levels (1024-4096) of antibodies against spotted fever group rickettsiae was found in three (2·6%) employees and 114 (97·5%) dogs. These findings emphasize the need to consider BSF as a possible cause of undifferentiated febrile illness, especially dengue and leptospirosis, in patients occupationally exposed to dogs heavily infested by ticks, mainly working at kennels and animal shelters that have inadequate space for the animals housed and frequently providing an environment conducive to exposure to pathogens such as R. rickettsii.
authors.affiliation: Oswaldo Cruz Institute/FIOCRUZ,Rio de Janeiro,Brazil.
authors.forename: T
authors.initials: T
authors.lastname: Rozental
authors.affiliation: Oswaldo Cruz Institute/FIOCRUZ,Rio de Janeiro,Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Ferreira
authors.affiliation: Oswaldo Cruz Institute/FIOCRUZ,Rio de Janeiro,Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Gomes
authors.affiliation: Centre for Strategic Information and Health Surveillance,Rio de Janeiro,Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Costa
authors.affiliation: Centre for Strategic Information and Health Surveillance,Rio de Janeiro,Brazil.
authors.forename: P R A
authors.initials: PR
authors.lastname: Barbosa
authors.affiliation: Health Secretariat of the Municipality of Rio de Janeiro,Rio de Janeiro,Brazil.
authors.forename: I O
authors.initials: IO
authors.lastname: Bezerra
authors.affiliation: Health Secretariat of the Municipality of Rio de Janeiro,Rio de Janeiro,Brazil.
authors.forename: M H O
authors.initials: MH
authors.lastname: Garcia
authors.affiliation: Centre for Strategic Information and Health Surveillance,Rio de Janeiro,Brazil.
authors.forename: D M
authors.initials: DM
authors.lastname: Oliveira E Cruz
authors.affiliation: São Sebastião Infectious Diseases Institute of Rio de Janeiro State,Rio de Janeiro,Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Galliez
authors.affiliation: Brazilian Public Health Laboratories Coordination,Brasília,Brazil.
authors.forename: S
authors.initials: S
authors.lastname: Oliveira
authors.affiliation: Evandro Chagas Institute of Clinical Research,FIOCRUZ,Rio de Janeiro,Brazil.
authors.forename: P
authors.initials: P
authors.lastname: Brasil
authors.affiliation: Health Secretariat of the Municipality of Rio de Janeiro,Rio de Janeiro,Brazil.
authors.forename: T
authors.initials: T
authors.lastname: Rezende
authors.affiliation: Oswaldo Cruz Institute/FIOCRUZ,Rio de Janeiro,Brazil.
authors.forename: E R S
authors.initials: ER
authors.lastname: De Lemos
mesh_terms: D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000276:immunology*; D001938:Brazil; D003715:Dengue / Q000175:diagnosis; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000175:diagnosis*; D004285:Dogs; D017809:Fatal Outcome; D005260:Female; D006799:Housing, Animal; D006801:Humans; D007922:Leptospirosis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis* / Q000276:immunology; D012284:Rickettsia rickettsii / Q000276:immunology*; D012373:Rocky Mountain Spotted Fever / Q000175:diagnosis / Q000276:immunology / Q000662:veterinary*; D013987:Ticks; D014505:Urban Population
chemical_list: D000907:Antibodies, Bacterial
keywords: Animal shelter; Brazil; Rickettsia rickettsii; cluster; fatal cases; spotted fever