Volume 70, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Between May and October 2002, a cluster of acute febrile illnesses occurred in the subtropical Andean foothills of Peru. Serologic evidence in villages where disease had been documented showed that the prevalence of IgM antibody to ranged from 6% to 52%, that of IgM antibody to spotted fever group (SFG) rickettsia ranged from 10% to 19%, and that of IgM antibody to from 1% to 15%. Measurement of IgG antibodies for SFG rickettsiae suggested that this disease was endemic. In contrast, IgG antibodies against were largely absent. In humans, microagglutination tests identified pathogenic variants of . The presence of an SFG rickettsial infection was confirmed in four febrile patients following polymerase chain reaction and sequencing of the conserved 17-kD common antigen gene (htrA). Collectively, these analyses indicated that sp., , and sp. were circulating in the region during the time of disease outbreak and implicate the involvement of an as yet undetermined SFG rickettsia in northwestern Peru.


Article metrics loading...

Loading full text...

Full text loading...



  1. Gotuzzo E, 2000. Emerging and re-emerging diseases in Latin America. Infect Dis Clin North Am 14 : 1–261.
  2. Pellegrini FA, Goldbaum M, Silvi J, 1997. Production of scientific articles about health in six Latin American countries, 1973-1992. Rev Panam Salud Publica 1 : 23–34.
  3. Cowan G, 2000. Rickettsial diseases: the typhus group of fevers—a review. Postgrad Med J 76 : 269–272.
  4. Vishwanath S, 1991. Antigenic relationships among the rickettsiae of the spotted fever and typhus groups. FEMS Microbiol Lett 65 : 341–344.
  5. Sexton DJ, Muniz M, Corey GR, Breitschwerdt EB, Hegarty BC, Dumler S, Walker DH, Pecanha PM, 1993. Brazilian spotted fever in Espirito Santo, Brazil: description of a focus of infection in a new endemic region. Am J Trop Med Hyg 49 : 222–226.
  6. Rozental T, Bustamante MC, Amorim M, Serra-Freire NM, Lemos ER, 2002. Evidence of spotted fever group rickettsiae in state of Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo 44 : 155–158.
  7. Eremeeva ME, Dasch GA, Silverman DJ, 2001. Quantitative analyses of variations in the injury of endothelial cells elicited by 11 isolates of Rickettsia rickettsii. Clin Diagn Lab Immunol 8 : 788–796.
  8. Martino O, Orduna T, Lourtau L, Scapellato P, Cernigo B, Seijo A, 2001. Spotted fever group rickettsial disease in Argentinean travelers. Rev Soc Bras Med Trop 34 : 559–562.
  9. Maurin M, Raoult D, 1999. Q fever. Clin Microbiol Rev 12 : 518–553.
  10. Baret M, Klement E, Dos SG, Jouan M, Bricaire F, Caumes E, 2000. Coxiella burnetii pneumopathy on return from French Guiana. Bull Soc Pathol Exot 93 : 325–327.
  11. Vinetz JM, 2001. Leptospirosis. Curr Opin Infect Dis 14 : 527–538.
  12. Cole JR Jr, Sulzer CR, Pursell AR, 1973. Improved microtechnique for the leptospiral microscopic agglutination test. Appl Microbiol 25 : 976–980.
  13. Tzianabost T, Anderson BE, McDade JE, 1989. Detection of Rickettsia rickettsii DNA in clinical specimens by using polymerase chain reaction technology. J Clin Microbiol 27 : 2866–2868.
  14. Anderson BE, Tzianabos T, 1989. Comparative sequence analysis of a genus-common rickettsial antigen gene. J Bacteriol 171 : 5199–5201.
  15. Belman AL, 1999. Tick-borne diseases. Semin Pediatr Neurol 6 : 249–266.
  16. Plank R, Dean D, 2000. Overview of the epidemiology, microbiology, and pathogenesis of Leptospira spp. in humans. Microbes Infect 2 : 1265–1276.
  17. Webb L, Carl M, Malloy DC, Dasch GA, Azad AF, 1990. Detection of murine typhus infection in fleas by using the polymerase chain reaction. J Clin Microbiol 28 : 530–534.
  18. Bunnell JE, Hice CL, Watts DM, Montrueil V, Tesh RB, Vinetz JM, 2000. Detection of pathogenic Leptospira spp. infections among mammals captured in the Peruvian Amazon basin region. Am J Trop Med Hyg 63 : 255–258.
  19. Alexander AD, 1960. The distribution of leptospirosis in Latin America. Bull World Health Organ 23 : 113–125.
  20. Fournier PE, Marrie TJ, Raoult D, 1998. Diagnosis of Q fever. J Clin Microbiol 36 : 1823–1834.
  21. Matthewman L, Kelly P, Hayter D, Downie S, Wray K, Bryson N, Rycroft A, Raoult D, 1997. Exposure of cats in southern Africa to Coxiella burnetii, the agent of Q fever. Eur J Epidemiol 13 : 477–479.
  22. Gardon J, Heraud JM, Laventure S, Ladam A, Capot P, Fouquet E, Favre J, Weber S, Hommel D Hulin A, Couratte Y, Talarmin A, 2001. Suburban transmission of Q fever in French Guiana: evidence of a wild reservoir. J Infect Dis 184 : 278–284.
  23. Rubel D, Seijo A, Cernigoi B, Viale A, Wisnivesky-Colli C, 1997. Leptospira interrogans in a canine population of greater Buenos Aires: variables associated with seropositivity. Rev Panam Salud Publica 2 : 102–105.
  24. Hackstadt T, 1996. The biology of rickettsiae. Infect Agents Dis 5 : 127–143.
  25. Liceras de Hidalgo JL, Sulzer KR, 1984. Six new leptospiral serovars isolated from wild animals in Peru. J Clin Microbiol 19 : 944–945.
  26. Bajani MD, Ashford DA, Bragg SL, Woods CW, Aye A, Spiegel RA, Plikaytis BD, Perkins BA, Phelan M, Levett PN, Weyant RS, 2003. Evaluation of four commercially available rapid serologic tests for diagnosis of leptospirosis. J Clin Microbiol 41 : 803–809.
  27. Zochowski WJ, Palmer MF, Coleman TJ, 2001. An evaluation of three commercial kits for use as screening methods for the detection of leptospiral antibodies in the UK. J Clin Pathol 54 : 25–30.
  28. Levett PN, 2001. Leptospirosis. Clin Microbiol Rev 14 : 296–326.
  29. Regnery RL, Spruill CL, Plikaytis BD, 1991. Genotypic identification of rickettsiae and estimation of intraspecies sequence divergence for portions of two rickettsial genes. J Bacteriol 173 : 1576–1589.
  30. McClain JB, Ballou WR, Harrison SM, Steinweg DL, 1984. Doxycycline therapy for leptospirosis. Ann Intern Med 100 : 696–698.
  31. Costa E, Lopes AA, Sacramento E, Costa YA, Matos ED, Lopes MB, Bina JC, 2003. Penicillin at the late stage of leptospirosis: a randomized controlled trial. Rev Inst Med Trop Sao Paulo 45 : 141–145.
  32. Panaphut T, Domrongkitchaiporn S, Vibhagool S, Thinkamrop B, Susaengrat W, 2003. Ceftriaxone compared with sodium penicillin g for treatment of severe leptospirosis. Clin Infect Dis 36 : 1507–1513.
  33. Amaro M, Bacellar F, Franca A, 2003. Report of eight cases of fatal and severe Mediterranean spotted fever in Portugal. Ann N Y Acad Sci 990 : 331–343.

Data & Media loading...

  • Received : 01 Oct 2003
  • Accepted : 15 Jan 2004

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error