Stavroula Labropoulou1, Ekatherina Charvalos2, Stylianos Chatzipanagiotou3, Anastasios Ioannidis4, Panagiotis Sylignakis5, Styliani Τaka6, Ioulia Karageorgou1, Maria Linou1, Giota Mpizta1, Andreas Mentis1, Sophie Edouard7, Didier Raoult7,8, Emmanouil Angelakis1,8. 1. Laboratory of Medical Microbiology, Hellenic Pasteur Institute, Athens, Greece. 2. IASO Medical Research (IMR) department, IASO Gynecology Obstretrics and Pediatrics Hospital, Marousi, Greece. 3. Department of Biopathology and Clinical Microbiology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 4. Department of Nursing, Faculty of Health Sciences University of Peloponnese, Tripoli, Greece. 5. Pananio-Venizelio General Hospital of Heraklion, Heraklion, Greece. 6. Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece. 7. Aix Marseille Univ, IRD, IHU Méditerranée Infection, MEPHI, Marseille, France. 8. Aix Marseille Université, IRD, APHM, VITROME, IHU-Méditerranée Infection, Marseille, France.
Abstract
BACKGROUND: There are few studies about the presence of murine typhus in Greece. Our objective was to conduct a large scale retrospective investigation to determine the clinical and epidemiological features of patients diagnosed with murine typhus in Greece. METHODOLOGY/PRINCIPAL FINDINGS: From 2012 to 2019 serum samples from hospitalized patients and outpatients throughout Greece suspected for murine typhus infection were tested by immunofluorescence assay for Rickettsia typhi. Immunofluorescence positive samples obtained since 2016 were also tested by qPCR targeting R. typhi. Clinical and epidemiological data were retrospectively collected for the patients with confirmed murine typhus. Overall, we tested 5,365 different patients and, in total, 174 patients from all geographic regions of Greece were diagnosed with murine typhus. The most frequently reported sign or symptom was fever (89%), followed by headache (84%) and rash (81%). The classical triad of fever, headache, and rash was present in 72% of patients during their illness. Severe infections with complications including acute renal failure or septic shock were not recorded. The majority of cases (81%) occurred during May-October and peaked in June and September. Most of patients (81%) infected in Athens, recalled that their only activity the last weeks before symptoms onset was swimming on the beach and 59% of them also reported an insect bite while sunbathing. CONCLUSIONS/SIGNIFICANCE: Our results may reflect the reemergence of murine typhus in Greece and we highlight the importance of awareness of this difficult-to-recognize undifferentiated febrile illness.
BACKGROUND: There are few studies about the presence of murine typhus in Greece. Our objective was to conduct a large scale retrospective investigation to determine the clinical and epidemiological features of patients diagnosed with murine typhus in Greece. METHODOLOGY/PRINCIPAL FINDINGS: From 2012 to 2019 serum samples from hospitalized patients and outpatients throughout Greece suspected for murinetyphus infection were tested by immunofluorescence assay for Rickettsia typhi. Immunofluorescence positive samples obtained since 2016 were also tested by qPCR targeting R. typhi. Clinical and epidemiological data were retrospectively collected for the patients with confirmed murine typhus. Overall, we tested 5,365 different patients and, in total, 174 patients from all geographic regions of Greece were diagnosed with murine typhus. The most frequently reported sign or symptom was fever (89%), followed by headache (84%) and rash (81%). The classical triad of fever, headache, and rash was present in 72% of patients during their illness. Severe infections with complications including acute renal failure or septic shock were not recorded. The majority of cases (81%) occurred during May-October and peaked in June and September. Most of patients (81%) infected in Athens, recalled that their only activity the last weeks before symptoms onset was swimming on the beach and 59% of them also reported an insect bite while sunbathing. CONCLUSIONS/SIGNIFICANCE: Our results may reflect the reemergence of murine typhus in Greece and we highlight the importance of awareness of this difficult-to-recognize undifferentiated febrile illness.
Authors: Gaëlle Walter; Elisabeth Botelho-Nevers; Cristina Socolovschi; Didier Raoult; Philippe Parola Journal: Am J Trop Med Hyg Date: 2012-06 Impact factor: 2.345
Authors: Emmanouil Angelakis; Aruna Munasinghe; Iranga Yaddehige; Veranja Liyanapathirana; Vasanthi Thevanesam; Anne Bregliano; Cristina Socolovschi; Sophie Edouard; Pierre Edouard Fournier; Didier Raoult; Philippe Parola Journal: Am J Trop Med Hyg Date: 2012-04 Impact factor: 2.345
Authors: G Grouteau; O Lancelot; A Bertolotti; P Poubeau; R Manaquin; A Foucher; J Jaubert; P Parola; F Pagès; G Camuset Journal: Med Mal Infect Date: 2019-08-03 Impact factor: 2.152