title: Rickettsial Disease in the Peruvian Amazon Basin.
abstract: Using a large, passive, clinic-based surveillance program in Iquitos, Peru, we characterized the prevalence of rickettsial infections among undifferentiated febrile cases and obtained evidence of pathogen transmission in potential domestic reservoir contacts and their ectoparasites. Blood specimens from humans and animals were assayed for spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR) by ELISA and/or PCR; ectoparasites were screened by PCR. Logistic regression was used to determine associations between patient history, demographic characteristics of participants and symptoms, clinical findings and outcome of rickettsial infection. Of the 2,054 enrolled participants, almost 2% showed evidence of seroconversion or a 4-fold rise in antibody titers specific for rickettsiae between acute and convalescent blood samples. Of 190 fleas (Ctenocephalides felis) and 60 ticks (Rhipicephalus sanguineus) tested, 185 (97.4%) and 3 (5%), respectively, were positive for Rickettsia spp. Candidatus Rickettsia asemboensis was identified in 100% and 33% of the fleas and ticks tested, respectively. Collectively, our serologic data indicates that human pathogenic SFGR are present in the Peruvian Amazon and pose a significant risk of infection to individuals exposed to wild, domestic and peri-domestic animals and their ectoparasites.
authors.affiliation: Kantonsspital Baden, Baden, Switzerland.|U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Claudine
authors.initials: C
authors.lastname: Kocher
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Morrison
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Mariana
authors.initials: M
authors.lastname: Leguia
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Steev
authors.initials: S
authors.lastname: Loyola
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Roger M
authors.initials: RM
authors.lastname: Castillo
authors.affiliation: Instituto Veterinario de Investigaciones Tropicales y de Altura, Iquitos, Peru.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Galvez
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Helvio
authors.initials: H
authors.lastname: Astete
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Carmen
authors.initials: C
authors.lastname: Flores-Mendoza
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Julia S
authors.initials: JS
authors.lastname: Ampuero
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Bausch
authors.affiliation: U.S. Naval Medical Research Unit No. 6, Lima and Iquitos, Peru.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Halsey
authors.affiliation: Instituto Nacional de Salud, Lima, Peru.
authors.forename: Manuel
authors.initials: M
authors.lastname: Cespedes
authors.affiliation: Laboratorio de Investigacion y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Karine
authors.initials: K
authors.lastname: Zevallos
authors.affiliation: U.S. Naval Medical Research Center, Silver Spring, Maryland, United States of America.
authors.forename: Ju
authors.initials: J
authors.lastname: Jiang
authors.affiliation: U.S. Naval Medical Research Center, Silver Spring, Maryland, United States of America.
authors.forename: Allen L
authors.initials: AL
authors.lastname: Richards
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D012281:Rickettsia / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D012282:Rickettsia Infections / Q000097:blood / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D005423:Siphonaptera / Q000145:classification / Q000382:microbiology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial