North Asian tick typhus (NATT) is a tick-borne zoonosis caused by Rickettsia sibirica subsp. sibirica (R. sibirica) in the Asiatic part of Russia [1,2]. In the Russian Far East, this disease was identified as early as 1932 [3]. Currently, active foci of this communicable disease are identified in 18 administrative territories of Siberia and the Russian Far East. More than 66 000 cases of NATT have been registered in Russia between 1936 and summer 2007. The Altay region of western Siberia (average morbidity 24.3–70.4 per 100 000 inhabitants per year) and the Altai Republic (54.2–97.3) exhibit the highest morbidity for NATT in Russia. The highest incidence was observed in 2001 in Altay when 1867 cases of NATT were registered, representing 54% of all NATT cases in Russia. Cases of NATT are registered between April and October–November, with a peak in May–June (67.4% of cases). Following a period of decrease in July and August, a second peak, though less intense than the first one, is registered in September. The morbidity of NATT is registered in all landscapegeographical areas of the Altaian region, but is distributed unevenly [4]. NATT is known to be transmitted to humans by Dermacentor nuttalli, D. silvarum, D. marginatus, D. reticulatus, Haemaphysalis concinna and Ixodes persulcatus. However, the diagnosis of NATT is mostly based on clinical and serological data, and no direct confirmation is available. As R. raoultii has also been detected in D. nuttalli ticks in the Altai Republic using PCR, we investigated whether some patients diagnosed serologically or by culture as having NATT could have another rickettsiosis. In addition, we searched for members of the Rickettsiales order in ticks collected in this area, and we characterised genetically 13 rickettsial strains cultivated from ticks.
Read full abstract