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Rickettsiosis in Northern Tunisia
Fatma KHROUF1, Youmna M’GHIRBI1, Saba ZOUARI1, Souha BOUGATEF2, Ali BOUATTOUR1
1 Université Tunis El Manar, IPT, LR11IPT03, Service d’entomologie médicale
2. Observatoire Nationale des Maladies nouvelles et émergentes
Introduction
Rickettsiosis are anthropozoonotic vector borne diseases caused by an obligate
intracellular bacteria of Rickettsia genus. These organisms are classically
transmitted to animals (and accidentally to humans) via arthropod vector bites.
In recent years, the re-emergence of these diseases has attracted scientific
attention. Domestic animals are preferential hosts of several ticks (Ixodidae)
that are principal vectors for this disease. Two rickettsial groups, spotted fever
group and typhus group, have been described since the beginning of the 20th
century, and more than 26 species have been described all over the world [1].
In Tunisia, about 200 cases were registered every year in different medical
centers. However, there is scarce information about the epidemiological
situation of rickettsiosis. Our aim was to determine Rickettsia species infected
in suspected patients through a multicentric study and to detect and
characterise Rickettsia species in ticks collected from domestic animals.
Materials and Methods
During our survey (2014-2015), we received human blood and skin biopsies
samples from different hospitals, in addition, ticks infesting domestic animals
(cattle, sheep and goats), were collected from several farms located in 5 cities
(Bizerte, Béja, Tunis, Ariana, Nabeul). DNA extraction was performed from
samples using QIAamp DNA tissue extraction kit to determine rickettsial
infection by molecular (qPCR and IFI) (Figure 1, Map 1). The DNA of ticks and
human samples was tested by qPCR for Rickettsia infection. The amplified
23S-5S intergenic spacer and citrate synthase gene (gltA) of some positive
samples were sequenced to confirm the infection [2] (Figure 2).
Map 1. Sudied area (collection of human samples and ticks)
Using qPCR, the global prevalence of Rickettsia infection in
ticks was 46% with an average bacterial rate of 105 Rickettsia
spp/tick. This prevalence varies according to ticks species ,
season and localities (Map 2).
Figure 2. Target genes
Figure 1. Collection of tick and
Human samples
Results and discussion
Map 2. Rickettsial infection of ticks using qPCR
We first elucidated the important role of tick infesting domestic
animals in the transmission of rickettsial bacteria and as well as a
reservoir of several Rickettsia species. Then, we demonstrated
the importance of the infection rate of Rickettsia in suspected
patients. Thus, we should improve the surveillance of these
vectorial diseases such as Mediterranean Spotted Fever caused
by R. conorii and Typhus caused by R. typhi, in Tunisia.
More investigations in animals and studies on the vectors are
needed to determine the risk zones of such diseases in Tunisia.
Conclusion
1. Parola P, Paddock CD, Socolovschi C, Labruna MB, Mediannikov O, Kernif T, et al. Update on Tick-Borne Rickettsioses around the
World: a Geographic Approach. Clin. Microbiol. Rev. 2013;26:657–702.
2. Khrouf F, M’Ghirbi Y, Znazen A, Ben Jemaa M, Hammami A, Bouattour A. Detection of Rickettsia in Rhipicephalus sanguineus ticks and
Ctenocephalides felis fleas from southeastern Tunisia by reverse line blot assay. J. Clin. Microbiol. 2014;52:268–74.
Bibliography
Boophilus
annulatus
Hyalomma
excavatum and Hy.
marginatum
Rhipicephalus
turanicus and Rh.
bursa
Ixodes ricinus
R. aeschlimannii R. helveticaR. massiliae R. massiliae
Laboratoire d’Epidémiologie et Microbiologie Vétérinaire
Service d’Entomologie Médicale
Université Tunis El Manar
Institut Pasteur de Tunis
Béja
9%
Bizerte
20%
Nabeul
37%
Tunis
34%
Total of tested patients
IgM IgG
R. conorii R. typhi R. conorii
Réaction croisée
10/4014/40 18/40
40 patients were tested
by IFI and 4 skin biopsies
by qPCR.
Three skin biopsies were
positives against R.
conorii
The seroprevalence of
Rickettsia infection in
suspected patients
was 53.6%
Finance

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Rickettsiosis in northern Tunisia

  • 1. Rickettsiosis in Northern Tunisia Fatma KHROUF1, Youmna M’GHIRBI1, Saba ZOUARI1, Souha BOUGATEF2, Ali BOUATTOUR1 1 Université Tunis El Manar, IPT, LR11IPT03, Service d’entomologie médicale 2. Observatoire Nationale des Maladies nouvelles et émergentes Introduction Rickettsiosis are anthropozoonotic vector borne diseases caused by an obligate intracellular bacteria of Rickettsia genus. These organisms are classically transmitted to animals (and accidentally to humans) via arthropod vector bites. In recent years, the re-emergence of these diseases has attracted scientific attention. Domestic animals are preferential hosts of several ticks (Ixodidae) that are principal vectors for this disease. Two rickettsial groups, spotted fever group and typhus group, have been described since the beginning of the 20th century, and more than 26 species have been described all over the world [1]. In Tunisia, about 200 cases were registered every year in different medical centers. However, there is scarce information about the epidemiological situation of rickettsiosis. Our aim was to determine Rickettsia species infected in suspected patients through a multicentric study and to detect and characterise Rickettsia species in ticks collected from domestic animals. Materials and Methods During our survey (2014-2015), we received human blood and skin biopsies samples from different hospitals, in addition, ticks infesting domestic animals (cattle, sheep and goats), were collected from several farms located in 5 cities (Bizerte, Béja, Tunis, Ariana, Nabeul). DNA extraction was performed from samples using QIAamp DNA tissue extraction kit to determine rickettsial infection by molecular (qPCR and IFI) (Figure 1, Map 1). The DNA of ticks and human samples was tested by qPCR for Rickettsia infection. The amplified 23S-5S intergenic spacer and citrate synthase gene (gltA) of some positive samples were sequenced to confirm the infection [2] (Figure 2). Map 1. Sudied area (collection of human samples and ticks) Using qPCR, the global prevalence of Rickettsia infection in ticks was 46% with an average bacterial rate of 105 Rickettsia spp/tick. This prevalence varies according to ticks species , season and localities (Map 2). Figure 2. Target genes Figure 1. Collection of tick and Human samples Results and discussion Map 2. Rickettsial infection of ticks using qPCR We first elucidated the important role of tick infesting domestic animals in the transmission of rickettsial bacteria and as well as a reservoir of several Rickettsia species. Then, we demonstrated the importance of the infection rate of Rickettsia in suspected patients. Thus, we should improve the surveillance of these vectorial diseases such as Mediterranean Spotted Fever caused by R. conorii and Typhus caused by R. typhi, in Tunisia. More investigations in animals and studies on the vectors are needed to determine the risk zones of such diseases in Tunisia. Conclusion 1. Parola P, Paddock CD, Socolovschi C, Labruna MB, Mediannikov O, Kernif T, et al. Update on Tick-Borne Rickettsioses around the World: a Geographic Approach. Clin. Microbiol. Rev. 2013;26:657–702. 2. Khrouf F, M’Ghirbi Y, Znazen A, Ben Jemaa M, Hammami A, Bouattour A. Detection of Rickettsia in Rhipicephalus sanguineus ticks and Ctenocephalides felis fleas from southeastern Tunisia by reverse line blot assay. J. Clin. Microbiol. 2014;52:268–74. Bibliography Boophilus annulatus Hyalomma excavatum and Hy. marginatum Rhipicephalus turanicus and Rh. bursa Ixodes ricinus R. aeschlimannii R. helveticaR. massiliae R. massiliae Laboratoire d’Epidémiologie et Microbiologie Vétérinaire Service d’Entomologie Médicale Université Tunis El Manar Institut Pasteur de Tunis Béja 9% Bizerte 20% Nabeul 37% Tunis 34% Total of tested patients IgM IgG R. conorii R. typhi R. conorii Réaction croisée 10/4014/40 18/40 40 patients were tested by IFI and 4 skin biopsies by qPCR. Three skin biopsies were positives against R. conorii The seroprevalence of Rickettsia infection in suspected patients was 53.6% Finance