Acute spotted fever rickettsiosis among febrile patients, Cameroon
Acute spotted fever rickettsiosis among febrile patients, Cameroon
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DOI：
10.3201/eid1003.020713
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发表时间：
2004-03-01
影响因子：
11.8
通讯作者：
Walker, DH
中科院分区：
文献类型：
--
作者：
Ndip, LM;Bouyer, DH;Walker, DH
尽管喀麦隆有大量潜在的节肢动物媒介，但很少对急性发热性疾病进行虫媒病毒或立克次体感染评估。对喀麦隆Tiko和Buea诊所234名急性发热患者的血清样本进行了非洲立克次体、非洲甲病毒和黄病毒抗体检测。这些血清样本不含伤寒抗体，也未检出血疟寄生虫。32%的血清样品经免疫荧光法检测与非洲血吸虫免疫球蛋白IM抗体有反应，免疫印迹法检测与非洲血吸虫外膜蛋白A、B有反应。这些发现确定了急性立克次体病的诊断，很可能是非洲蜱叮咬热。血清样品的血凝抑制试验还检测到基孔肯雅病毒（47%）和黄病毒（47%）的抗体。在一个以地方性疟疾和伤寒为主要诊断考虑因素的地区，虫媒病毒抗体的高流行率可能是一个重大的、以前未被认识到的公共卫生问题。
Although potential arthropod vectors are abundant in Cameroon, acute febrile illnesses are rarely evaluated for arboviral or rickettsial infections. Serum samples from 234 acutely febrile patients at clinics in Tiko and Buea, Cameroon, were examined for antibodies to Rickettsia africae and African alphaviruses and flaviviruses. These serum samples did not contain antibodies against typhoid, and blood malarial parasites were not detected. Serum samples of 32% contained immunoglobulin IM antibodies reactive with R. africae by immunofluorescence assay and were reactive with outer membrane proteins A and B of R. africae by immunoblotting. These findings established a diagnosis of acute rickettsiosis, most likely African tick-bite fever. Hemagglutination inhibition testing of the serum samples also detected antibodies to chikungunya virus (47%) and flaviviruses (47%). High prevalence of antibodies to arboviruses may represent a major, previously unrecognized public health problem in an area where endemic malaria and typhoid fever have been the principal diagnostic considerations.