Emergence of murine typhus in Reunion Island, South West Ocean Indian Island: epidemiological, clinical, laboratory features of 10 cases

Publié le 1 Avril 2014
Mis à jour le 5 juillet 2019

Background: murine typhus (MT) is an acute zoonotic infection caused by Rickettsia typhi, worldwide distributed but under-diagnosed and largely under-reported. In early 2012, two MT autochthonous cases were identified in Reunion Island. Thereafter new cases were confirmed. The objective was to describe clinical manifestations of the disease and epidemiological data. Methods & Materials: suspect case of MT, presenting prolongated fever, headache and/or arthromyalgia reported by clinicians were confirmed by laboratories. A case was defined as a patient was confirmed by Western Blot study,or real-time quantitativePCR assay, or by seroconversion or increase the level of antibody response against Rickettsia typhi using the indirect immunofluorescence test, performed or confimed by the National Reference Center-WHO collaborative center for Rickettsial Diseases, Marseille. Clinical and epidemiological data using a grid of reading and a specific form were collected by phone. Results: (preliminary results)a total of 10 autochthonous cases have been identified so far: 6 in 2012, 2 in 2013 and 2 cases were retrospectively notified in 2011. Eight cases occurred during the southern summer. The average age of the patients was 45 (range 21- 55 years) and 5 were male. The patients all lived in private house located in the Western and Southern part of the island in peri-urban areas and none of them had travelled overseas. All the patients developed a fever (average of 13,6 days). Other main symptoms were arthromyalgia (9/10), headaches (8/10), and skin rash (6/10). One of the clinical specifities was the presence of pharyngitis (5/10) and ophthalmological signs like uveitis, floater (2/10). Biochemical findings were hepatitis (transaminases greater than 2N) in 8/10 cases, lymphopenia (lymphocytes less than 1000/mL) in 7/10 cases and thrombocytopenia (platelets less than 150 000/mL) in 7/10 cases. Risk factors such as close contact with pets were observed (6/7), recent derattings of their accommodations and neighborhoods (4/6), and outdoor activities (4/7). Conclusion: there is sufficient evidence to indicate an autochtonous transmission occurs in Reunion Island. Specifics studies have to be conducted to assess the impact on public health, and to describe the epidemiology of the disease (vector, reservoir, human cases). Health professionals should be aware for early diagnosis and early administration of effective treatments. (R.A.)

16th International Congress on Infectious Diseases (ICID), Cap Town, 2-5 avril 2014

Auteur : Balleydier E, Camuset G, Socolovsci C, Moiton MP, Kuli B, Foucher A, Poubeau P, Borgherini G, Wartel G, Audin H, Parola P, Raoult D, Pages F, Filleul L
International Journal of Infectious Diseases, 2014, vol. 21, p. 223-4