title: Molecular and serological evidence of flea-associated typhus group and spotted fever group rickettsial infections in Madagascar.
abstract: Rickettsiae are obligate intracellular bacteria responsible for many febrile syndromes around the world, including in sub-Saharan Africa. Vectors of these pathogens include ticks, lice, mites and fleas. In order to assess exposure to flea-associated Rickettsia species in Madagascar, human and small mammal samples from an urban and a rural area, and their associated fleas were tested.
  
  
  
  Anti-typhus group (TGR)- and anti-spotted fever group rickettsiae (SFGR)-specific IgG were detected in 24 (39%) and 21 (34%) of 62 human serum samples, respectively, using indirect ELISAs, with six individuals seropositive for both. Only two (2%) Rattus rattus out of 86 small mammals presented antibodies against TGR. Out of 117 fleas collected from small mammals, Rickettsia typhi, a TGR, was detected in 26 Xenopsylla cheopis (24%) collected from rodents of an urban area (n = 107), while two of these urban X. cheopis (2%) were positive for Rickettsia felis, a SFGR. R. felis DNA was also detected in eight (31%) out of 26 Pulex irritans fleas.
  
  
  
  The general population in Madagascar are exposed to rickettsiae, and two flea-associated Rickettsia pathogens, R. typhi and R. felis, are present near or in homes. Although our results are from a single district, they demonstrate that rickettsiae should be considered as potential agents of undifferentiated fever in Madagascar.
authors.affiliation: Plague Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar. radoupty@pasteur.mg.|Ecole Doctorale Science de la Vie et de l'Environnement, Université d'Antananarivo, Antananarivo, Madagascar. radoupty@pasteur.mg.
authors.forename: Rado J L
authors.initials: RJ
authors.lastname: Rakotonanahary
authors.affiliation: Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Harrison
authors.affiliation: Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA.
authors.forename: Alice N
authors.initials: AN
authors.lastname: Maina
authors.affiliation: Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA.
authors.forename: Ju
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA.
authors.forename: Allen L
authors.initials: AL
authors.lastname: Richards
authors.affiliation: Plague Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
authors.forename: Minoarisoa
authors.initials: M
authors.lastname: Rajerison
authors.affiliation: Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Sandra
authors.initials: S
authors.lastname: Telfer
mesh_terms: D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D006801:Humans; D007303:Insect Vectors / Q000382:microbiology; D008270:Madagascar; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D051381:Rats / Q000382:microbiology*; D012281:Rickettsia / Q000145:classification / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification*; D012373:Rocky Mountain Spotted Fever / Q000097:blood / Q000382:microbiology* / Q000662:veterinary*; D012376:Rodent Diseases / Q000097:blood / Q000382:microbiology*; D012788:Shrews / Q000382:microbiology; D005423:Siphonaptera / Q000382:microbiology*; D014438:Typhus, Epidemic Louse-Borne / Q000097:blood / Q000382:microbiology* / Q000662:veterinary*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: Flea-borne spotted fever; Fleas; Madagascar; Murine typhus; Prevalence; Rickettsia; Rickettsioses