Tropheryma whipplei as a Cause of Epidemic Fever, Senegal, 2010-2012.

Hubert Bassene,Pavel Ratmanov,Alpha K Keita,Florence Fenollar,Cristina Socolovschi,Oleg Mediannikov,Cheikh Sokhna,Didier Raoult

doi:10.3201/eid2207.150441

Abstract

The bacterium Tropheryma whipplei, which causes Whipple disease in humans, is commonly detected in the feces of persons in Africa. It is also associated with acute infections. We investigated the role of T. whipplei in febrile patients from 2 rural villages in Senegal. During June 2010-March 2012, we collected whole-blood finger-prick samples from 786 febrile and 385 healthy villagers. T. whipplei was detected in blood specimens from 36 (4.6%) of the 786 febrile patients and in 1 (0.25%) of the 385 apparently healthy persons. Of the 37 T. whipplei cases, 26 (70.2%) were detected in August 2010. Familial cases and a potential new genotype were observed. The patients' symptoms were mainly headache (68.9%) and cough (36.1%). Our findings suggest that T. whipplei is a cause of epidemic fever in Senegal.

Highlights

Determining the etiologic causes of febrile illness in tropical settings provides public health and local community benefits
Prevalence of T. whipplei Bacteremia A total of 786 febrile patients and 385 healthy controls were included in the study, among whom 36 (4.6%) and 1 (0.25%), respectively, were positive for T. whipplei DNA (p
We report the detection of T. whipplei DNA in the blood of patients in Dielmo and Ndiop, Senegal

Summary

Introduction

Determining the etiologic causes of febrile illness in tropical settings provides public health and local community benefits. In our preliminary study in Senegal, which was conducted in 2 villages (Dielmo and Ndiop) during December 2008–July 2009, we detected T. whipplei bacteremia in 6.4% of the analyzed specimens [8]. To better characterize T. whipplei bacteremia, we extended our analysis, beginning in 2010, in this same area of rural Senegal to include the collection of >1,000 blood samples from healthy persons and ambulatory patients with acute fever.

Results

Conclusion