Questions on Mediterranean spotted fever a century after its discovery

Clarisse Rovery, Philippe Brouqui, Didier Raoult, Clarisse Rovery, Philippe Brouqui, Didier Raoult

Abstract

Mediterranean spotted fever (MSF) was first described in 1910. Twenty years later, it was recognized as a rickettsial disease transmitted by the brown dog tick. In contrast to Rocky Mountain spotted fever (RMSF), MSF was thought to be a benign disease; however, the first severe case that resulted in death was reported in France in the 1980s. We have noted important changes in the epidemiology of MSF in the last 10 years, with emergence and reemergence of MSF in several countries. Advanced molecular tools have allowed Rickettsia conorii conorii to be classified as a subspecies of R. conorii. New clinical features, such as multiple eschars, have been recently reported. Moreover, MSF has become more severe than RMSF; the mortality rate was as high as 32% in Portugal in 1997. Whether Rhipicephalus sanguineus is the only vector and reservoir for R. conorii conorii is a question not yet answered.

Figures

Figure 1
Figure 1
Rickettsia conorii conorii observed in Vero cells (red rods; magnification ×1,000).
Figure 2
Figure 2
Rickettsia conorii conorii localized in cytoplasm of host cells as seen by electron microscopy (magnification ×100,000).
Figure 3
Figure 3
Fluctuation of incidence of Mediterranean spotted fever (MSF) in Italy and Portugal and of Rocky Mounted spotted fever (RMSF) in the United States, by year.
Figure 4
Figure 4
Distribution of the cases of Mediterranean spotted fever (MSF) in the world and incidence of the disease in countries where MSF is endemic.
Figure 5
Figure 5
Typical eschar and spots on the leg of a patient with Mediterranean spotted fever.
Figure 6
Figure 6
Rhipicephalus sanguineus adult tick, the suspected vector for Rickettsia conorii conorii.

References

    1. Parola P, Paddock C, Raoult D. Tick-borne rickettsioses around the world: emerging diseases challenging old concepts. Clin Microbiol Rev. 2005;18:719–56. 10.1128/CMR.18.4.719-756.2005
    1. Mouffok N, Benabdellah A, Richet H, Rolain JM, Razik F, Belamadani D, et al. Reemergence of rickettsiosis in Oran, Algeria. Ann N Y Acad Sci. 2006;1078:180–4. 10.1196/annals.1374.033
    1. Raoult D, Kohler JL, Gallais H, de Micco P, Rousseau S, Casanova P. Fatal rickettsiosis [letter] [in French]. Nouv Presse Med. 1982;11:607.
    1. De Sousa R, Nobrega SD, Bacellar F, Torgal J. Mediterranean spotted fever in Portugal: risk factors for fatal outcome in 105 hospitalized patients. Ann N Y Acad Sci. 2003;990:285–94.
    1. Olmer D. Sur une infection épidémique, avec exanthème de nature indéterminée. Mars Med. 1925;22:1291–3.
    1. Durand P, Conseil E. Transmission expérimentale de la fièvre boutonneuse par Rhipicephalus sanguineus. C R Acad Sci [D]. 1930;190:1244.
    1. Blanc G, Caminopetros J. Etudes épidémiologiques et expérimentales sur la fièvre boutonneuse, faites à l'Institut Pasteur d'Athènes. Arch Inst Pasteur Tunis. 1932;343–94.
    1. Ogata H, Audic S, Renesto-Audiffren P, Fournier PE, Barbe V, Samson D, et al. Mechanisms of evolution in Rickettsia conorii and R. prowazekii. Science. 2001;293:2093–8. 10.1126/science.1061471
    1. Zhu Y, Fournier PE, Eremeeva M, Raoult D. Proposal to create subspecies of Rickettsia conorii based on multi-locus sequence typing and an emended description of Rickettsia conorii. BMC Microbiol. 2005;5:11. 10.1186/1471-2180-5-11
    1. Mansueto S, Tringali G, Walker DH. Widespread, simultaneous increase in the incidence of spotted fever group rickettsiosis. J Infect Dis. 1986;154:539–40.
    1. Raoult D, Jean-Pastor MJ, Xeridat B, Garnier JM, Weiller PJ, Garcin G, et al. Mediterranean boutonneuse fever. A propos of 154 recent cases [in French]. Ann Dermatol Venereol. 1983;110:909–14.
    1. Alexandrov E, Mitov D, Kamarintchev B, Bogdanov N. Current features of Mediterranean spotted fever in Bulgaria in contemporary conditions. In: Raoult D, Brouqui P, editors. Rickettsiae and rickettsial diseases at the turn of the third millennium. Paris: Elsevier; 1999. p. 279–81.
    1. Dantas-Torres F. Rocky Mountain spotted fever. Lancet Infect Dis. 2007;7:724–32. 10.1016/S1473-3099(07)70261-X
    1. Chapman AS, Murphy SM, Demma LJ, Holman RC, Curns AT, McQuiston JH, et al. Rocky Mountain spotted fever in the United States, 1997–2002. Vector Borne Zoonotic Dis. 2006;6:170–8. 10.1089/vbz.2006.6.170
    1. Espejo Arenas E, Font Creus B, Bella Cueto F, Segura Porta F. Climatic factors in resurgence of Mediterranean spotted fever [letter]. Lancet. 1986;1:1333. 10.1016/S0140-6736(86)91259-6
    1. Raoult D, Tissot-Dupont H, Caraco P, Brouqui P, Drancourt M, Charrel C. Mediterranean spotted fever in Marseille: descriptive epidemiology and the influence climatic factors. Eur J Epidemiol. 1992;8:192–7. 10.1007/BF00144799
    1. Rolain JM, Jensenius M, Raoult D. Rickettsial infections—a threat to travellers? Curr Opin Infect Dis. 2004;17:433–7. 10.1097/00001432-200410000-00008
    1. Cascio A, Dones P, Romano A, Titone L. Clinical and laboratory findings of boutonneuse fever in Sicilian children. Eur J Pediatr. 1998;157:482–6. 10.1007/s004310050859
    1. Colomba C, Saporito L, Frasca Polara V, Rubino R, Titone L. Mediterranean spotted fever: clinical and laboratory characteristics of 415 Sicilian children. BMC Infect Dis. 2006;6:60. 10.1186/1471-2334-6-60
    1. Martin Farfan A, Juarez Fernandez C, Calbo-Torrecillas F, Porras Ballesteros J, Diaz Recio M, Bermundez Recio F. Clinico-epidemiological study of 164 cases of boutonneuse fever [in Spanish]. Rev Clin Esp. 1985;176:333–9.
    1. Lopez Pares P, Munoz Espin T, Espejo Arenas E, Font Creus B, Segura Porta F, Martinez Vila I, et al. Mediterranean spotted fever in childhood. Prospective study of 130 cases [in Spanish]. An Esp Pediatr. 1988;28:293–6.
    1. Fernández-Soto P, Pérez-Sánchez R, Alamo-Sanz R, Encinas-Grandes A. Spotted fever group rickettsiae in ticks feeding on humans in northwestern Spain: is Rickettsia conorii vanishing? Ann N Y Acad Sci. 2006;1078:331–3. 10.1196/annals.1374.063
    1. Ricketts HT. Some aspects of Rocky Mountain spotted fever as shown by recent investigations. Med Rec. 1909;16:843–55.
    1. Ruiz Beltran R, Herrerro-Herrero JI, Martin-Sanchez AM, Vincente-Garcia V, Sanz-Ortega F, Mateos-Sanchez AA, et al. Formas graves de fiebre exantematica mediterranea. Analisis prospectivo de 71 enfermos. Ann Med Interna (Madrid). 1985;2:365–8.
    1. McBride WJ, Hanson JP, Miller R, Wenck D. Severe spotted fever group rickettsiosis, Australia. Emerg Infect Dis. 2007;13:1742–4.
    1. Treadwell TA, Holman RC, Clarke MJ, Krebs JW, Paddock CD, Childs JE. Rocky Mountain spotted fever in the United States, 1993–1996. Am J Trop Med Hyg. 2000;63:21–6.
    1. Olmer D, Olmer J. Répartition géographique actuelle de la fièvre boutonneuse. Mars Med. 1957;8:525–36.
    1. Fournier PE, Zhu Y, Ogata H, Raoult D. Use of highly variable intergenic spacer sequences for multispacer typing of Rickettsia conorii strains. J Clin Microbiol. 2005;43:4708–12. 10.1128/JCM.43.9.4708-4712.2005
    1. Moraga FA, Martinez-Roig A, Alonso JL, Boronat M, Domingo F. Boutonneuse fever. Arch Dis Child. 1982;57:149–51.
    1. Raoult D, Weiller PJ, Chagnon A, Chaudet H, Gallais H, Casanova P. Mediterranean spotted fever: clinical, laboratory and epidemiological features of 199 cases. Am J Trop Med Hyg. 1986;35:845–50.
    1. Gilot B. Study of rickettsias harbored by ticks (acaria, ixodoidea) in south-eastern France [in French]. Bull Soc Pathol Exot Filiales. 1975;68:529–38.
    1. Hemmersbach-Miller M, Parola P, Brouqui P, Raoult DBB. A homeless man with maculopapular rash who died in Marseille, France. Clin Infect Dis. 2004;38:1493–4. 10.1086/420751
    1. Beati L, Kelly PJ, Matthewman LA, Mason P, Raoult D. Prevalence of rickettsia-like organisms and spotted fever group rickettsiae in ticks (Acari: Ixodidae) from Zimbabwe. J Med Entomol. 1995;32:787–92.
    1. Raoult D, Tissot-Dupont H, Chicheportiche C, Peter O, Gilot B, Drancourt M. Mediterranean spotted fever in Marseille, France: correlation between prevalence of hospitalized patients, seroepidemiology, and prevalence of infected ticks in three different areas. Am J Trop Med Hyg. 1993;48:249–56.
    1. Matsumoto K, Brouqui P, Raoult D, Parola P. Experimental infection models of ticks of the Rhipicephalus sanguineus group with Rickettsia conorii. Vector Borne Zoonotic Dis. 2005;5:363–72. 10.1089/vbz.2005.5.363
    1. Demma LJ, Traeger MS, Nicholson WL, Paddock CD, Blau DM, Eremeeva ME, et al. Rocky Mountain spotted fever from an unexpected tick vector in Arizona. N Engl J Med. 2005;353:587–94. 10.1056/NEJMoa050043
    1. Herrero-Herrero JI, Ruiz Beltran R, Martin-Sanchez AM, Garcia EJ. Mediterranean spotted fever in Salamanca, Spain. Epidemiological study in patients and serosurvey in animals and healthy human population. Acta Trop. 1989;46:335–50. 10.1016/0001-706X(89)90046-6
    1. Solano-Gallego L, Kidd L, Trotta M, Di Marco M, Caldin M, Furnanello T, et al. Febrile illness associated with Rickettsia conorii infection in dogs in Sicily. Emerg Infect Dis. 2006;12:1985–8.
    1. Le Gac P. Repercussions of myxomatosis on Mediterranean boutonneuse exanthematic fever [in French]. Bull World Health Organ. 1966;35:143–7.
    1. Ruiz Beltran R, Herrero-Herrero JI, Martin-Sanchez AM, Criado-Gutierrez LA. Role of lagomorpha in the wild cycle of Rickettsia conorii in Salamanca (Spain). Eur J Epidemiol. 1992;8:136–9. 10.1007/BF00145366

Source: PubMed

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