A cluster of Rickettsia rickettsii infection at an animal shelter in an urban area of Brazil

Rickettsia rickettsii infection is being increasingly recognized as an important cause of fatal acute illness in Brazil, where this tick-borne disease is designated Brazilian spotted fever (BSF). In this study we report five fatal cases of BSF in employees of an animal shelter in an urban area in th...

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Bibliographic Details
Published in:	Epidemiology and infection Vol. 143; no. 11; pp. 2446 - 2450
Main Authors:	ROZENTAL, T., FERREIRA, M. S., GOMES, R., COSTA, C. M., BARBOSA, P. R. A., BEZERRA, I. O., GARCIA, M. H. O., OLIVEIRA E CRUZ, D. M., GALLIEZ, R., OLIVEIRA, S., BRASIL, P., REZENDE, T., DE LEMOS, E. R. S.
Format:	Journal Article
Language:	English
Published:	Cambridge, UK Cambridge University Press 01-08-2015
Subjects:	Adult Animal shelters Animals Antibodies, Bacterial - immunology Arachnids Blood platelets Brazil Creatinine Dengue - diagnosis Dengue fever Diagnosis, Differential Dog Diseases - diagnosis Dogs Employees Fatal Outcome Female Headaches Hemoglobin Hospitals Housing, Animal Humans Illnesses Laboratories Leptospirosis Leptospirosis - diagnosis Leukocytes Male Middle Aged Multiple organ dysfunction syndrome Occupational Diseases - diagnosis Occupational Diseases - immunology Parasitic diseases Pathogens Public health Rickettsia and Orientia Rickettsia rickettsii - immunology Rocky Mountain Spotted Fever - diagnosis Rocky Mountain Spotted Fever - immunology Rocky Mountain Spotted Fever - veterinary SHORT REPORT Thrombocytopenia Ticks Urban areas Urban Population Brazil United States > US Rio de Janeiro Brazil spotted fever Brazil cluster Animal shelter Rickettsia rickettsii fatal cases
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Summary:	Rickettsia rickettsii infection is being increasingly recognized as an important cause of fatal acute illness in Brazil, where this tick-borne disease is designated Brazilian spotted fever (BSF). In this study we report five fatal cases of BSF in employees of an animal shelter in an urban area in the municipality of Rio de Janeiro in southeast Brazil after a natural disaster on 11 January 2011. Four of the cases occurred from 27 January to 11 April 2011, while the fifth fatal case was identified in April 2012. Three cases were confirmed by molecular analysis and two by epidemiological linkage. An investigation of BSF was performed in the animal shelter, and blood samples were collected from 115 employees and 117 randomly selected dogs. The presence of high levels (1024–4096) of antibodies against spotted fever group rickettsiae was found in three (2·6%) employees and 114 (97·5%) dogs. These findings emphasize the need to consider BSF as a possible cause of undifferentiated febrile illness, especially dengue and leptospirosis, in patients occupationally exposed to dogs heavily infested by ticks, mainly working at kennels and animal shelters that have inadequate space for the animals housed and frequently providing an environment conducive to exposure to pathogens such as R. rickettsii.
ISSN:	0950-2688 1469-4409
DOI:	10.1017/S0950268814003161