Abstract
Rickettsia typhi and Bartonella henselae are the causative agents of murine typhus and cat-scratch disease, respectively. A small-scale survey (N = 202) was conducted in the Attica region, Greece, for determining the prevalence rates of IgG antibodies against B. henselae and R. typhi by indirect fluorescence antibody test. IgG against B. henselae and R. typhi were present in 17.8% (36/202) and 4.5% (9/202) of the participants, respectively; co-occurring IgG against both B. henselae and R. typhi were detected in 3.5% (7/202), whereas only anti-B. henselae IgG in 14.3% (29/202), and only anti-R. typhi IgG in 1.0% (2/202). Titres 1/64, 1/128, 1/256, and 1/512, of anti-B. henselae IgG were identified in 6.4%, 4.5%, 4.5%, and 2.4%, whereas titres 1/40 and 1/80 of anti-R. typhi IgG were detected in 4.0%, and 0.5%, respectively. A positive association of anti-B. henselae IgG prevalence with a coastal area featuring a major seaport (p = 0.009) and with younger age (p = 0.046) was identified. The findings of this survey raise concern for exposure of the population of Attica to B. henselae and R. typhi, which should be considered in the differential diagnosis when compatible symptoms are present. Our results also suggest that seaports may represent high-risk areas for exposure to Bartonella spp.
Highlights
Among flea-borne pathogens, Rickettsia typhi and Bartonella henselae are causative agents of murine typhus and cat-scratch disease, well described disease entities, for which conventional serological tests are widely available [1].Murine typhus frequently appears as a non-eschar forming malaise, with variable manifestations commonly including fever, headache and rash [2]
We examined sera of residents of Attica in Greece for IgG antibodies against R. typhi and B. henselae and investigated potential risk factors for association with seropositivity
Examined sera corresponded to 202 individuals with a male to female ratio of 0.64 (N = 202) and a mean age of 51 years (95%CI:49–54); six, 20, 67 and 109 of the participants were allocated to the age groups of 2–14, 15–29, 30–50 and >50 years, respectively (N = 201)
Summary
Among flea-borne pathogens, Rickettsia typhi and Bartonella henselae are causative agents of murine typhus and cat-scratch disease, well described disease entities, for which conventional serological tests are widely available [1].Murine (endemic) typhus frequently appears as a non-eschar forming malaise, with variable manifestations commonly including fever, headache and rash [2]. Immunocompromised patients may develop severe vasoproliferative tumor-like lesions Chronic sequelae, such as endocarditis, arthritis, endophthalmitis, neuroretinitis, and neurologic disorders, may occur [6,7]. Transmission of B. henselae occurs through direct skin inoculation of the pathogen by cat claws; exposure to Ctenocephalides spp. has been strongly suggested as another potential route of infection [6,8,9]. B. henselae may cause chronic infections and the bacterial DNA has been detected in saliva of cats and dogs, other transmission pathways from those animal species to humans have been suggested but not demonstrated [1,8,10,11,12]
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