PUBLIC HEALTH workers have new tick-borne rickettsial diseases
to keep on their radar screens, according to updated federal guidelines.
Nevertheless, insect localization and removal as soon as possible, preferably within 36 hours, remain recommended strategies to prevent ixodid tickborne rickettsial diseases
. Ticks should always be removed with forceps (or tweezers), not fingers (as squishing ticks can transmit several tickborne diseases across dermal barriers or create infectious aerosols), and in contiguity with their feeding mouthparts, rather than burning ticks with spent matches or painting embedded ticks with adhesives or nail polishes.
Of patients who had samples tested at the CDPH Viral and Rickettsial Disease
Laboratory as described in this report, only two met the specifications for ruling out poliovirus infection as recommended by WHO or CDC guidelines * ([dagger]) ([section]); all others lacked two stool specimens collected [greater than or equal to] 24 hours apart and <14 days after symptom onset.
Suspected cases of tickborne rickettsial diseases
should be reported promptly to the state or local health department, and suspected transfusion-associated transmission should be reported to the supplying blood center and appropriate public health authorities.
Reported by: A Deckert, MD, Shasta County Public Health, Redding; C Glaser, MD, Viral and Rickettsial Disease
Laboratory: B Sun, DVM, Div of Communicable Disease Control, California Dept of Health Svcs.
A microbiologic diagnosis of recent rickettsial disease
was in most cases based on immunofluorescence antibody (IFA) tests and, occasionally, on PCR and Western blot.
On March 27, rabies was suspected, and samples, including serum, corneal impressions, a nuchal biopsy, and saliva, were collected and sent to the CDHS Viral and Rickettsial Disease
Although hemorrhages have not been described for rickettsialpox, dissimilarities in the clinical features of rickettsial disease
among countries have been reported (13).
Local clinicians are asked to refer patients with evidence of WNV disease, including encephalitis, aseptic meningitis, acute flaccid paralysis, or illness compatible with West Nile fever, for testing which is performed by 33 local public health laboratories and the state Viral and Rickettsial Disease
We describe 7 cases of a rickettsial disease
similar to FISF, which occurred in the eastern half of Australia.
The aim of the present study was to retrospectively diagnose suspected rickettsial disease
(scrub typhus) by using MIF assay and molecular methods in patients with acute febrile illness of unknown origin.
Subsequent damage to the endothelium is followed by endothelial-cell activation and perivascular infiltration of lymphocytes, macrophages, and polymorphonuclear leukocytes, resulting in inflammatory vasculitis of dermal vessels, the histopathologic hallmark of rickettsial disease
, and possibly thrombosis (23).