Detection of Rickettsioses and Q fever in Sri Lanka

Emmanouil Angelakis Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Aruna Munasinghe Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Iranga Yaddehige Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Veranja Liyanapathirana Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Vasanthi Thevanesam Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Anne Bregliano Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Cristina Socolovschi Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Sophie Edouard Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Pierre Edouard Fournier Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Didier Raoult Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Philippe Parola Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, Marseille cedex 05, France; District General Hospital, Matara, Sri Lanka; Teaching Hospital Kandy, Kandy, Sri Lanka

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Current serological evidence suggests the presence of scrub typhus and spotted fever group (SFG) rickettsiosis in Sri Lanka. Our objective was to identify rickettsial agents/Q fever as aetiological causes for patients who were presumed having rickettsioses by the presence of an eschar or a rash. Sera from patients with unknown origin fever from Matara were tested by immunofluorescence for SFG rickettsial antigens, typhus group rickettsiae, Orientia tsutsugamushi, and Coxiella burnetii antigens. Thirteen (7.3%) of the patients presented with a rash, 11 (6.1%) had an inoculation eschar, and 16 patients recalled a tick or flea bite. We found that 25 (14%) patients had scrub typhus, 6 (3%) SFG rickettsioses, 3 (1.6%) acute Q fever, 3 (1.6%) murine typhus, and 3 (1.6%) were infected by Rickettsia felis. In addition to already described scrub and murine typhus, we found that R. felis and C. burnetii infections should be considered in Sri Lanka.

Author Notes

*Address correspondence to Philippe Parola, Université Aix Marseille, URMITE CNRS-IRD UMR 6236, 27 Bd Jean Moulin, 13385 Marseille cedex 05, France. E-mail: philippe.parola@univmed.fr

Authors' addresses: Emmanouil Angelakis, Anne Bregliano, Cristina Socolovschi, Sophie Edouard, Pierre Edouard Fournier, Didier Raoult, and Philippe Parola, Université Aix Marseille, URMITE CNRS-IRD UMR 6236, 27 Bd Jean Moulin, 13385 Marseille cedex 05, France, E-mails: angelotasmanos@msn.com, neunetts@hotmail.com, cristina.socolovschi@univmed.fr, soph.edouard@gmail.com, pierre-edouard.fournier@univmed.fr, didier.raoult@gmail.com, and philippe.parola@univmed.fr. Aruna Munasinghe, District General Hospital, Matara, Sri Lanka, E-mail: drakmunasinghe@gmail.com. Iranga Yaddehige, District General Hospital, Matara, Sri Lanka, E-mail: iranga1@yahoo.com. Veranja Liyanapathirana and Vasanthi Thevanesam, Teaching Hospital Kandy, Kandy, Sri Lanka, E-mails: veranjacl@yahoo.com and vasanthithevanesam@yahoo.com.

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