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We describe the first molecular confirmation of Rickettsia rickettsii, the cause of Rocky Mountain spotted fever (RMSF), from a tick vector, Amblyomma cajennense, and from a cluster of fatal spotted fever cases in Argentina. Questing A. cajennense ticks were collected at or near sites of presumed or confirmed cases of spotted fever rickettsiosis in Jujuy Province and evaluated by polymerase chain reaction assays for spotted fever group rickettsiae. DNA of R. rickettsii was amplified from a pool of A. cajennense ticks and from tissues of one of four patients who died during 2003–2004 after illnesses characterized by high fever, severe headache, myalgias, and petechial rash. The diagnosis of spotted fever rickettsiosis was confirmed in the other patients by indirect immunofluorescence antibody and immunohistochemical staining techniques. These findings show the existence of RMSF in Argentina and emphasize the need for clinicians throughout the Americas to consider RMSF in patients with febrile rash illnesses.
Received October 4, 2007. Accepted for publication December 29, 2007.
Acknowledgments: The authors thank Carlos Ripoll (Ministerio de Bienstar Social, Area Epidemiologia, Departamento de Chagas y Patalogia Regional, San Salvador de Jujuy, Jujuy, Argentina) for assisting with tick the collections; Lance Durden (Georgia Southern University, Statesboro, GA) for help with tick identifications; James Gathany (CDC) for the photographs of A. cajenennse; Joseph Singleton, Jr. (CDC) for performing the IFA tests; Patricia Greer, Gillian Genrich, and Michelle Packard (CDC) for performing the IHC tests; and Jeannette Guarner and Giliane Trindade (CDC) for translating several of the references.
Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily reflect the views of the US Department of Health and Human Services.
* Address correspondence to Christopher D. Paddock, 1600 Clifton Road, MS G-32, Atlanta, GA 30333. E-mail: cdp9{at}cdc.gov
Authors’ addresses: Christopher D. Paddock, Infectious Disease Pathology Branch, Mailstop G-32, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, Telephone: 404-639-1309, Fax: 404-639-3043, E-mail: CPaddock{at}cdc.gov. Susana Fernandez, Hospital Pablo Soria, Guemes 1345, (4600) San Salvador de Jujuy, Jujuy, Argentina, Telephone: 54-388-685-3852, E-mail: nfag10fernandez{at}hotmail.com. Gustavo A. Echenique, Hospital San Roque, San Martin 330, (4600) San Salvador de Jujuy, Jujuy, Argentina, Telephone: 54-388-424-0390, Fax: 54-388-422-5357, E-mail: gusechenique{at}hotmail.com. John W. Sumner, Infectious Disease Pathology Branch, Mailstop G-32, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, Telephone: 404-639-1097, Fax: 404-639-3043, E-mail: JSumner{at}cdc.gov. Will K. Reeves, Rickettsial Zoonoses Branch, Mailstop G-13, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333. Current address: Arthropod-Borne Animal Diseases Research Laboratory, USDA–ARS, College of Agriculture, Dept. 3354, 1000 East University Avenue, Laramie, WY 82071, Telephone: 307-766-3630, E-mail: Will.Reeves{at}ars.usda.gov. Sherif R. Zaki, Infectious Disease Pathology Branch, Mailstop G-32, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, Telephone: 404-639-3133. Fax: 404-639-3043, E-mail: SZaki{at}cdc.gov. Carlos E. Remondegui, Servicio Infectologia and Tropical Medicine, Hospital San Roque, San Martin 330, (4600) San Salvador de Jujuy, Jujuy, Argentina, Telephone: 54-388-422-1307, Fax: 54-388-426-0019, E-mail: remondegui{at}arnet.com.ar.
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