São relatados três novos casos humanos de rickettsiose no Uruguai. Os três casos clínicos apresentam manifestações clínicas semelhantes às descritas em casos de infecção por Rickettsia parkeri previamente relatados nos Estados Unidos, tais como: febre moderada (< 40 ºC), mal-estar, cefaléia, exantema, escara de inoculação no sítio de fixação do carrapato, linfadenopatia regional e ausência de letalidade. Testes sorológicos de absorção de anticorpos com antígenos de R. parkeri e Rickettsia rickettsii, associados à reação de imunofluorescência indireta, sugerem que os pacientes de dois casos foram infectados por R. parkeri. Evidências clínicas e epidemiológicas, associadas com nossas análises sorológicas, sugerem que R. parkeri é o agente etiológico de casos humanos de febre maculosa no Uruguai, uma doença que tem sido reconhecida naquele país como rickettsiose cutâneo-ganglionar.

We report three new rickettsiosis human cases in Uruguay. The three clinical cases presented clinical manifestations similar to previous reported cases of Rickettsia parkeri in the United States; that is mild fever (< 40 ºC), malaise, headache, rash, inoculation eschar at the tick bite site, regional lymphadenopathy, and no lethality. Serological antibody-absorption tests with purified antigens of R. parkeri and Rickettsia rickettsii, associated with immunofluorescence assay indicated that the patients in two cases were infected by R. parkeri. Epidemiological and clinical evidences, coupled with our serological analysis, suggest that R. parkeri is the etiological agent of human cases of spotted fever in Uruguay, a disease that has been recognized in that country as cutaneous-ganglionar rickettsiosis.

O presente estudo investigou a etiologia da erliquiose monocítica canina em 70 cães atendidos no Hospital Veterinário da Universidade Estadual Paulista, na cidade de Botucatu, durante 2001 e 2002. Os cães foram avaliados segundo achados clínicos, epidemiológicos e laboratoriais e pela amplificação parcial e sequenciamento do gene dsb de Ehrlichia. DNA de Ehrlichia canis foi amplificado e sequenciado em 28 (40,0%) cães. Observou-se maior frequência deanimais positivos com idade até 12 meses (P < 0,05). Diarreia, apatia e anorexia foram os sinais clínicos mais frequentes observados em 55,2% (P = 0,05), 47,0% (P > 0,05) e 42,2% (P > 0,05) dos cães PCR positivos, respectivamente. Vinte e cinco cães com anemia (<5,5 × 10(6) eritrócitos.µL-1) e 8 com leucopenia (<5,5 × 10³ leucócitos.µL-1) foram positivos na PCR, porém não apresentaram associação estatística (P > 0,05) frente à infecção por E. canis. Todos os 28 cães positivos na PCR apresentaram trombocitopenia (<175 × 10³ plaquetas.µL-1; P < 0,05). E. canis foi a única espécie de Ehrlichia detectada em cães da região estudada, com alta taxa de infecção em cães jovens e, estatisticamente, associadaa cães trombocitopênicos.

This study investigated the etiology of canine ehrlichiosis and possible clinical and epidemiological data associated with the infection in 70 dogs suspect of ehrlichiosis attended at the Veterinary Hospital of the São Paulo State University in Botucatu city during 2001 and 2002. Dogs were evaluated by clinical-epidemiological and hematological data and molecular analysis by partial amplification and DNA sequencing of the ehrlichial dsb gene. E. canis DNA was amplified and sequenced in 28 (40.0%) dogs. Dogs younger than 12 months old showed significantly higher infection rates (65.0%; P < 0.05). Diarrhea, apathy, and anorexia were the major clinical signs observed in 55.2% (P = 0.05), 47.0% (P > 0.05), and 42.4% (P > 0.05) of the PCR-positive dogs, respectively. Twenty-five anemic (<5.5 × 10(6) RBC.µL-1), and 8 leukopenic (<5.5 × 10³ WBC.µL-1) dogs were PCR-positive (P > 0.05). All 28 PCR-positive dogs showed thrombocytopenia (<175 × 10³ platelets.µL-1) and revealed statistical significance (P < 0.05). E. canis was the only Ehrlichia species found in dogs in the studied region, with higher infection rates in younger dogs, and statisticallyassociated with thrombocytopenia.

The bacterium Rickettsia rickettsii is the etiological agent of an acute, severe disease called Rocky Mountain spotted fever in the United States or Brazilian spotted fever (BSF) in Brazil. In addition to these two countries, the disease has also been reported to affect humans in Mexico, Costa Rica, Panama, Colombia and Argentina. Like humans, dogs are also susceptible to R. rickettsii infection. However, despite the wide distribution of R. rickettsii in the Western Hemisphere, reports of R. rickettsii-induced illness in dogs has been restricted to the United States. The present study evaluated the pathogenicity for dogs of a South American strain of R. rickettsii. Three groups of dogs were evaluated: group 1 (G1) was inoculated ip with R. rickettsii; group 2 (G2) was infested by R. rickettsii-infected ticks; and the control group (G3) was infested by uninfected ticks. During the study, no clinical abnormalities, Rickettsia DNA or R. rickettsii-reactive antibodies were detected in G3. In contrast, all G1 and G2 dogs developed signs of rickettsial infection, i.e., fever, lethargy, anorexia, ocular lesions, thrombocytopenia, anemia and detectable levels of Rickettsia DNA and R. rickettsii-reactive antibodies in their blood. Rickettsemia started 3-8 days after inoculation or tick infestation and lasted for 3-13 days. Our results indicate that a Brazilian strain of R. rickettsii is pathogenic for dogs, suggesting that canine clinical illness due to R. rickettsii has been unreported in Brazil and possibly in the other South American countries where BSF has been reported among humans.

Este estudo avaliou a ocorrência de anticorpos anti-Rickettsia em 25 cães e 35 humanos, em uma área endêmica para a febre maculosa brasileira no Estado de São Paulo, onde o principal vetor é o carrapato Amblyomma aureolatum. Soros dos cães e humanos foram testados pela técnica de imunofluorescência indireta contra quatro antígenos de riquétsias (R. rickettsii, R. parkeri, R. felis, R. bellii), mostrando que soros de 16 (64%) cães e 1 (2,8%) humano reagiram com títulos <FONT FACE=Symbol>³</FONT> 64 para pelo menos um dos antígenos de riquétsias. Sete soros caninos e o único soro humano reativo demonstraram títulos para R. rickettsii no mínimo quatro vezes maior do que aqueles para os outros antígenos de riquétsias. Os títulos de anticorpos nesses cães e um humano foram considerados homólogos a R. rickettsii, enquanto que nenhum soro de cão ou humano foi considerado reativamente homólogo para R. parkeri, R. felis ou R. bellii. Os resultados sorológicos mostraram que cães são importantes sentinelas para a presença da bactéria R. rickettsii em áreas onde o carrapato A. aureolatum é o principal vetor da febre maculosa brasileira.

The present study provides a rickettsial serosurvey in 25 dogs and 35 humans in an endemic area for Brazilian spotted fever in the State of São Paulo, where the tick Amblyomma aureolatum is the main vector. Testing canine and human sera by indirect immunofluorescence against four Rickettsia antigens (R. rickettsii, R. parkeri, R. felis and R. bellii) showed that 16 (64%) of canine sera and 1 (2.8%) of human sera reacted to at least one of these rickettsial antigens with titers <FONT FACE=Symbol>³</FONT> 64. Seven canine sera and the single reactive human serum showed titers to R. rickettsii at least four times those of any of the other three antigens. The antibody titers in these 7 animals and 1 human were attributed to stimulation by R. rickettsii infection. No positive canine or human serum was attributed to stimulation by R. parkeri, R. felis, or R. bellii. Our serological results showed that dogs are important sentinels for the presence of R. rickettsii in areas where the tick A. aureolatum is the main vector of Brazilian spotted fever.

Este estudo avaliou a ocorrência de anticorpos anti-Rickettsia em 25 cães e 35 humanos, em uma área endêmica para a febre maculosa brasileira no Estado de São Paulo, onde o principal vetor é o carrapato Amblyomma aureolatum. Soros dos cães e humanos foram testados pela técnica de imunofluorescência indireta contra quatro antígenos de riquétsias (R. rickettsii, R. parkeri, R. felis, R. bellii), mostrando que soros de 16 (64%) cães e 1 (2,8%) humano reagiram com títulos <FONT FACE=Symbol>³</FONT> 64 para pelo menos um dos antígenos de riquétsias. Sete soros caninos e o único soro humano reativo demonstraram títulos para R. rickettsii no mínimo quatro vezes maior do que aqueles para os outros antígenos de riquétsias. Os títulos de anticorpos nesses cães e um humano foram considerados homólogos a R. rickettsii, enquanto que nenhum soro de cão ou humano foi considerado reativamente homólogo para R. parkeri, R. felis ou R. bellii. Os resultados sorológicos mostraram que cães são importantes sentinelas para a presença da bactéria R. rickettsii em áreas onde o carrapato A. aureolatum é o principal vetor da febre maculosa brasileira.

The present study provides a rickettsial serosurvey in 25 dogs and 35 humans in an endemic area for Brazilian spotted fever in the State of São Paulo, where the tick Amblyomma aureolatum is the main vector. Testing canine and human sera by indirect immunofluorescence against four Rickettsia antigens (R. rickettsii, R. parkeri, R. felis and R. bellii) showed that 16 (64%) of canine sera and 1 (2.8%) of human sera reacted to at least one of these rickettsial antigens with titers <FONT FACE=Symbol>³</FONT> 64. Seven canine sera and the single reactive human serum showed titers to R. rickettsii at least four times those of any of the other three antigens. The antibody titers in these 7 animals and 1 human were attributed to stimulation by R. rickettsii infection. No positive canine or human serum was attributed to stimulation by R. parkeri, R. felis, or R. bellii. Our serological results showed that dogs are important sentinels for the presence of R. rickettsii in areas where the tick A. aureolatum is the main vector of Brazilian spotted fever.

Introducción. En Brasil, los capibaras (Hydrochoerus hydrochaeris) son importantes huéspedes para garrapatas del género Amblyomma, las cuales transmiten rickettsiosis a humanos y animales. Por lo tanto, estos roedores pueden ser potenciales centinelas para detectar infección por rickettsia. Objetivos. Este trabajo evaluó la infección por rickettsia en capibaras de diferentes regiones del estado de São Paulo, donde las rickettsiosis nunca han sido reportadas. Materiales y métodos. Se examinarion los sueros de 73 capibaras de seis localidades en São Paulo con la prueba de immunofluorescencia indirecta con antígenos de Rickettsia rickettsii, Rickettsia parkeri y Rickettsia bellii. Los bazos de los capibaras se extrajeron y se analizaron por reacción en cadena de la polimerasa para un fragmento del gene gltA de rickettsia. Las garrapatas se recolectaron de los capibaras y se identificaron hasta especie. Resultados. Diecinueve (26,0%), 25 (34,2%) y 50 (68,5%) sueros de los capibaras reaccionaron con R. rickettsii, R. parkeri y R. bellii, respectivamente. De los 50 sueros que reaccionaron con antígenos de R. bellii, 25 presentaron títulos, por lo menos, cuatro veces mayores que los otros dos antígenos. Estos sueros fueron considerados homólogos de R. bellii. Usando el mismo criterio, tres sueros de los capibaras se consideraron homólogos de R. parkeri. Ningún suero se consideró homólogo de R. rickettsii. No se detectó ADN de rickettsia en bazo. Las garrapatas recolectadas de los capibaras fueron identificadas como Amblyomma dubitatum y Amblyomma cajennense. Conclusiones. Este trabajo reporta la primera evidencia de infección natural por R. bellii en vertebrados y, también, la primera evidencia de infección por R. parkeri en capibaras. Se sabe que R. parkeri infecta y produce enfermedad en humanos; sin embargo, no hay evidencia de infección humana por R. bellii.

Introduction. In Brazil, capybaras (Hydrochoerus hydrochaeris) are important hosts for Amblyomma ticks, which in turn can transmit rickettsiae to humans and animals. Therefore, capybaras are potential sentinels for rickettsial infection. Objective. The present study evaluated rickettsial infection in capybaras in different areas of the state of São Paulo, where rickettsiosis has never been reported. Materials and methods. Blood sera from 73 capybaras from six localities in São Paulo were tested by indirect immunofluorescence assay using Rickettsia rickettsii, Rickettsia parkeri, and Rickettsia bellii antigens. Capybara spleens were tested by PCR, targeting a fragment of the rickettsial gltA gene. Ticks were collected from each capybara sample and taxonomically identified to species. Results. A total of 94 positively reacting capybara samples, 19 (26.0%), 25 (34.2%), and 50 (68.5%) capybara sera reacted to R. rickettsii, R. parkeri, and R. bellii, respectively. Twenty-five capybara sera showed titers to R. bellii at least four-fold higher than to any of the other two antigens. These sera were considered homologous to R. bellii. Using the same criteria, 3 capybara sera were considered homologous to R. parkeri. No sera were be considered homologous to R. rickettsii. No rickettsial DNA was detected in capybara spleen samples. Ticks collected on capybaras were Amblyomma dubitatum and Amblyomma cajennense. Conclusions. The first evidence is reported of R. bellii natural infection in vertebrate hosts, and the first evidence of R. parkeri infection in capybaras. While R. parkeri is known to infect and cause disease in humans, no similar evidence for human infection has been indicated by R. bellii.

The present study evaluated rickettsial infection in Amblyomma spp. ticks collected in a farm in Coronel Pacheco, a Brazilian spotted fever (BSF) endemic area. A total of 78 A. cajennense and 78 A. dubitatum free-living adult ticks were collected and tested by polymerase chain reaction (PCR) targeting a fragment of the rickettsial gene gltA. Only one pool of three A. cajennense ticks showed the expected product by PCR. This pool was further tested by PCR using sets of primers targeting the rickettsial genes gltA, ompA, and ompB. All reactions yielded the expected bands that by sequencing, showed 100% identity to the corresponding sequences of the Rickettsia rickettsii gene fragments gltA (1063-bp), ompA (457-bp), and ompB (720-bp). The minimal infection rate of R. rickettii in the A. cajennense population was 1.28% (at least one infected tick within 78 ticks).The present study showed molecular evidence for the presence of R. rickettsii in A. cajennense from a BSF-endemic area in Coronel Pacheco, state of Minas Gerais. Although R. rickettsii has been previously reported infecting A. cajennense ticks in Brazil and other Latin American countries, the present study performed the first molecular characterization of R. rickettsii from the tick A. cajennense.