Identification of Bartonella Infections in Febrile Human Patients from Thailand and Their Potential Animal Reservoirs

Michael Kosoy Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Ying Bai Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Kelly Sheff Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Christina Morway Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Henry Baggett Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Susan A. Maloney Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Sumalee Boonmar Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Saithip Bhengsri Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Scott F. Dowell Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Anussorn Sitdhirasdr Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Kriangkrai Lerdthusnee Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Jason Richardson Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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Leonard F. Peruski Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; International Emerging Infections Program, Nonthaburi, Thailand; Office of Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Public Health, Nonthaburi, Thailand; Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand

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To determine the role of Bartonella species as causes of acute febrile illness in humans from Thailand, we used a novel strategy of co-cultivation of blood with eukaryotic cells and subsequent phylogenetic analysis of Bartonella-specific DNA products. Bartonella species were identified in 14 blood clots from febrile patients. Sequence analysis showed that more than one-half of the genotypes identified in human patients were similar or identical to homologous sequences identified in rodents from Asia and were closely related to B. elizabethae, B. rattimassiliensis, and B. tribocorum. The remaining genotypes belonged to B. henselae, B. vinsonii, and B. tamiae. Among the positive febrile patients, animal exposure was common: 36% reported owning either dogs or cats and 71% reported rat exposure during the 2 weeks before illness onset. The findings suggest that rodents are likely reservoirs for a substantial portion of cases of human Bartonella infections in Thailand.

Author Notes

*Address correspondence to Michael Kosoy, Division and Vector Borne Infectious Diseases, Centers for Diseases Control and Prevention, Fort Collins, CO 80521. E-mail: mkosoy@cdc.gov

Financial support: This project was supported by the International Emerging Infections Program and Global Disease Detection Network of the United States Centers for Disease Control and Prevention.

Authors' addresses: Michael Kosoy, Ying Bai, Kelly Sheff, and Christina Morway, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO. Henry Baggett, Susan A. Maloney, Sumalee Boonmar, Saithip Bhengsri, and Leonard F. Peruski, International Emerging Infections Program, Nonthaburi, Thailand. Scott F. Dowell, Office of Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Anussorn Sitdhirasdr, Ministry of Public Health, Nonthaburi, Thailand. Kriangkrai Lerdthusnee, and Jason Richardson, Department of Entomology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

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