Abstract
The identification of pathogenic rickettsial agents has expanded over the last two decades. In North America, the majority of human cases are caused by tick-borne rickettsioses but rickettsiae transmitted by lice, fleas, mites and other arthropods are also responsible for clinical disease. Symptoms are generally nonspecific or mimic other infectious diseases; therefore, diagnosis and treatment may be delayed. While infection with most rickettsioses is relatively mild, delayed diagnosis and treatment may lead to increased morbidity and mortality. This review will discuss the ecology, epidemiology and public health importance of suspected and confirmed vector-transmitted Rickettsia species of North America associated with human diseases.
Highlights
Rickettsia (Order: Rickettsiales, Family: Rickettsiaceae) are Gram-negative, obligate, intracellular alphabacteria; more than 30 species and subspecies are reported worldwide and more than half are confirmed or suspected human pathogens [1]
Dis. 2018, 3, 2 In North America, the majority of reported human rickettsiosis cases are associated with ticks but rickettsiae transmitted by fleas, lice, mites and other arthropods are responsible for clinical disease (Table 1)
The geographic distribution of A. americanum seems to correlate most closely to human exposure [26,27] and infections with R. amblyommatis [28], R. amblyommatis can be detected in Amblyomma spp. ticks in other parts of North America
Summary
Rickettsia (Order: Rickettsiales, Family: Rickettsiaceae) are Gram-negative, obligate, intracellular alphabacteria; more than 30 species and subspecies are reported worldwide and more than half are confirmed or suspected human pathogens [1]. Rickettsiae are transmitted to vertebrate hosts via a hematophagous arthropod vector such as ticks, fleas, or mites. Possible mechanisms utilized by some rickettsial species as a way to infect naïve arthropod vectors while feeding on a non-rickettsemic host include co-feeding and sexual transmission routes [9,10]. Headache, maculopapular rash including palms and soles a Based on the detection of rickettsiae DNA in an arthropod or confirmed laboratory experimental transmission studies; b No confirmed human cases. In North America, the majority of reported human rickettsiosis cases are associated with ticks but rickettsiae transmitted by fleas, lice, mites and other arthropods are responsible for clinical disease (Table 1). This review will discuss the ecology, epidemiology and public health importance of suspected and confirmed vector transmitted Rickettsia species of North America associated with human diseases
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