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Archive Number 20080813.2502
Published Date 13-AUG-2008
Subject PRO/AH> Tick-borne lymphadenopathy - Spain (02):(CT) background

TICK-BORNE LYMPHADENOPATHY - SPAIN (02): (CATALONIA) BACKGROUND
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Date: Tue 12 Aug 2008
Source: GIDEON (Global Infectious Disease & Epidemiology Network) [edited]
<http://www.gideononline.com>


The following background data on tick-borne lymphadenopathy in Spain
have been abstracted from Gideon
<http://www.gideononline.com/blog/2008/08/12/spotted-fever-group-rickettsia-in-spain/>.
Primary references are available on request.

An interesting variety of spotted fever group rickettsiae are
reported in Spain.

The incidence of Mediterranean spotted fever cases has decreased in
recent years, from 870 cases in 1989, to 234 in 2003. 77.76 percent
of cases are reported from [Andalusia], Castilla La Mancha, Castilla
y Leon, and [Catalonia], with most occurring during July through
October. 38 fatal cases were reported during 1980 to 1994.

Seroprevalence surveys:
- 8 percent of healthy persons and 26.1 percent of dogs in Catalonia  
-- highest rates in semirural areas (1997)
- 8.7 percent of persons in southern Spain (2002)
- 3.4 percent of persons in southern Spain (Bar29 infection, 2006 publication)
- 3.7 percent of persons in Catalonia (_Rickettsia slovaca_, 2008 publication)
- 56.4 percent of dogs in northeastern Spain (2006 publication)
- 24.6 percent of dogs in Ourense and Pontevedra (northwestern Spain,  
2008 publication)
- 44 percent of cats in northeastern Spain (2006 publication)

19.9 percent of _Rhipicephalus sanguineus_ and 16.4 percent of _Rh.  
pusillus_ ticks collected in La Rioja, Aragon, and Catalonia were  
found to carry spotted fever rickettsiae.

A distinct _Rickettsia_ species (Bar29, "Catalan strain" or
_Rickettsia massiliae_) has been implicated in human infections from
Catalonia and may account for 20 percent of spotted fever cases in
Barcelona. Bar29 has been isolated from dog ticks (_Rhipicephalus
sanguineus_) in Catalonia and Andalusia and is resistant to rifampin.

_Rickettsia aeschlimannii_ has been found in 6 species of ticks in
the Castilla y Leon region: _Ixodes ricinus_, _Hyalomma marginatum_,
_Haemaphysalis punctata_, _Rhipicephalus sanguineus_, _Rh. bursa_ and
_Rh. turanicus_.

_Rickettsia slovaca_ has been identified in ticks (_Dermacentor
marginatus_) in northern Spain. 3.3 percent of the general population
in northern Spain is seropositive for _R. slovaca_.

In 2003, 2 cases of _Rickettsia monacensis_ infection (La Rioja and
Basque region) were reported.

--
Communicated by:
Dr Steve Berger
Geographic Medicine
Tel Aviv Medical Center
Israel
<mberger@post.tau.ac.il>

[ProMED-mail thanks Dr Berger for his continued contributions to our
postings. _R. massiliae_ (1), _R. aeschlimannii_ (2), and _R.
monacensis_ (3) all seem to cause clinical disease similar to
Mediterranean spotted fever including fever, headache, rash, and an
eschar [dry scab] at the bite site.

References
----------
1. Vitale G, Mansueto S, Rolain J-M, Raoult D: _Rickettsia massiliae_
human isolation. Emerg Infect Dis 2006; 12: 174-5 (available at
<http://www.cdc.gov/ncidod/EID/vol12no01/05-0850.htm>).

2. Raoult D, Fournier P-E, Abboud P, Caron F: First documented human
_Rickettsia aeschlimannii_ infection. Emerg Infect Dis 2002; 8: 748-9
(available at
<http://www.cdc.gov/ncidod/eid/vol8no7/01-0480.htm>).

3. Jado I, Oteo JA, Aldamiz M, et al: _Rickettsia monacensis_ and
human disease, Spain. Emerg Infect Dis 2007; 13: 1405-7 (available at
<http://www.cdc.gov/eid/content/13/9/1405.htm>). - Mod.LL

Spain map -- click bottom right corner to enlarge:
<http://www.fiestavillas.co.uk/UserFiles/Image/maps/spain_map.jpg>
- Mod.JW]

[see also:
Tick-borne lymphadenopathy - Spain: (CT) 20080811.2484
2004
----
Spotted fever - Russia (Siberia) (02): background 20040514.1301]
........................................ll/mj/jw
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