Evidence of Rickettsia and Orientia Infections Among Abattoir Workers in Djibouti

Katherine C. Horton Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt.

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Ju Jiang Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland.

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Alice Maina Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland.

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Erica Dueger Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt.
Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.

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Alia Zayed Vector Biology Research Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt.

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Ammar Abdo Ahmed Department of Epidemiology and Health Information, Ministry of Health, Djibouti, Djibouti.

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Guillermo Pimentel Biological Defense Research Directorate, Naval Medical Research Center, Silver Spring, Maryland.

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Allen L. Richards Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland.

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Of 49 workers at a Djiboutian abattoir, eight (16%, 95% confidence interval [CI]: 9–29) were seropositive against spotted fever group rickettsiae (SFGR), two (4%, 95% CI: 1–14) against typhus group rickettsiae, and three (6%, 95% CI: 2–17) against orientiae. One worker (9%, 95% CI: 2–38) seroconverted against orientiae during the study period. This is the first evidence of orientiae exposure in the Horn of Africa. SFGR were also identified by polymerase chain reaction in 32 of 189 (11%, 95% CI: 8–15) tick pools from 26 of 72 (36%) cattle. Twenty-five (8%, 95% CI: 6–12) tick pools were positive for Rickettsia africae, the causative agent of African tick-bite fever. Health-care providers in Djibouti should be aware of the possibility of rickettsiae infections among patients, although further research is needed to determine the impact of these infections in the country.

Author Notes

* Address correspondence to Katherine C. Horton, Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, PSC 452, Box 5000, FPO AE 09835. E-mail: katherinehorton12@gmail.com

Financial support: This project was funded by the Department of Defense Global Emerging Infections System (GEIS), work units 847705.82000.25GB.E0018 and 0000188M.0931.001.A0074, and the Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, U.S. Centers for Disease Control and Prevention.

Authors' addresses: Katherine C. Horton, Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt, E-mail: katherinehorton12@gmail.com. Ju Jiang, Alice Maina, and Allen L. Richards, Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD, E-mails: ju.jiang2.ctr@mail.mil, alice.n.maina.ctr@mail.mil, and allen.l.richards.civ@mail.mil. Erica Dueger, Global Disease Detection Regional Center, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt, and Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mail: duegere@wpro.who.int. Alia Zayed, Vector Biology Research Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt, E-mail: alia.zayed.eg@med.navy.mil. Ammar Abdo Ahmed, Department of Epidemiology and Health Information, Ministry of Health, Djibouti, Djibouti, E-mail: epiafrivac@gmail.com. Guillermo Pimentel, Biological Defense Research Directorate, Naval Medical Research Center, Silver Spring, MD, E-mail: guillermo.pimentel2.mil@mail.mil.

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