Serologic evidence of a Rickettsia akari-like infection among wild-caught rodents in Orange County and humans in Los Angeles County, California.

We detected antibodies reactive with Rickettsia akari, the etiologic agent of rickettsialpox in humans and in 83 of 359 (23%) rodents belonging to several species, collected in Orange County, CA. Reciprocal antibody titers >1:16 to R. akari were detected in native mice and rats (Peromyscus maniculatus, P. eremicus, and Neotoma fuscipes) and in Old World mice and rats (Mus musculus, Rattus rattus, and R. norvegicus), representing the first time that antibodies reactive with this agent have been detected in four of these species and the first report of these antibodies in rodents and humans west of the Mississippi River. We then tested serum samples from individuals who used a free clinic in downtown Los Angeles and found that 25 of 299 (8%) of these individuals had antibody titers >1:64 to R. akari. Serologic evidence suggested that R. akari or a closely related rickettsia is prevalent among several rodent species at these localities and that infection spills over into certain segments of the human population. Isolation or molecular confirmation of the agent is needed to conclusively state that R. akari is the etiologic agent infecting these rodents.

Epizootiology of Tacaribe serocomplex viruses (Arenaviridae) associated with neotomine rodents (Cricetidae, Neotominae) in southern California.

The objective of this study was to advance our knowledge of the epizootiology of Bear Canyon virus and other Tacaribe serocomplex viruses (Arenaviridae) associated with wild rodents in California. Antibody (immunoglobulin G [IgG]) to a Tacaribe serocomplex virus was found in 145 (3.6%) of 3977 neotomine rodents (Cricetidae: Neotominae) captured in six counties in southern California. The majority (122 or 84.1%) of the 145 antibody-positive rodents were big-eared woodrats (Neotoma macrotis) or California mice (Peromyscus californicus). The 23 other antibody-positive rodents included a white-throated woodrat (N. albigula), desert woodrat (N. lepida), Bryant's woodrats (N. bryanti), brush mice (P. boylii), cactus mice (P. eremicus), and deer mice (P. maniculatus). Analyses of viral nucleocapsid protein gene sequence data indicated that Bear Canyon virus is associated with N. macrotis and/or P. californicus in Santa Barbara County, Los Angeles County, Orange County, and western Riverside County. Together, analyses of field data and antibody prevalence data indicated that N. macrotis is the principal host of Bear Canyon virus. Last, the analyses of viral nucleocapsid protein gene sequence data suggested that the Tacaribe serocomplex virus associated with N. albigula and N. lepida in eastern Riverside County represents a novel species (tentatively named "Palo Verde virus") in the genus Arenavirus.

Rapid and simple method for screening wild rodents for antibodies to Sin Nombre hantavirus.

Sin Nombre hantavirus (SNV) is the primary etiologic agent of hantavirus cardiopulmonary syndrome (HCPS) in the United States and Canada. Hantavirus cardiopulmonary syndrome is a zoonotic disease. The most common reservoir is the deer mouse (Peromyscus maniculatus), although numerous other species of wild rodent can carry the viruses that cause HCPS throughout the Americas. Infected rodents show no signs of clinical disease but they develop persistent infection. Sin Nombre virus can be contracted by exposure to feces, urine, or saliva of its rodent reservoirs. Detection of infection in rodents is most often based upon detection of specific antibodies; many laboratories use enzyme linked immunosorbent assays (ELISAs), which require a specialized electrical ELISA reader. Enzyme linked immunosorbent assay readers are not readily amenable to field usage. We describe a portable test, the strip immunoblot assay (SIA), which we have utilized in field diagnosis. The test can be conducted in approximately 6 hr during the day or can be conducted overnight. The test can be used to detect rodents positive for SNV antibody while they are in traps. We show that results with the SIA have excellent concordance with western blot and reverse transcriptase polymerase chain reaction tests.

GENETIC VARIATION IN MULTILOCUS MICROSATELLITE GENOTYPES IN TWO SPECIES OF WOODRATS (NEOTOMA MACROTIS AND N. FUSCIPES) FROM CALIFORNIA.

Five microsatellite loci were used to develop multilocus genotypes for Neotoma macrotis (n = 128) and N. fuscipes (n = 29). Several statistical analyses were used to estimate genetic structure, levels of genetic variability, and degree of relatedness within groups of these 2 species. Samples of N. macrotis represented 2 groups and 4 population clusters throughout southern California. Samples of N. fuscipes represented 2 regions in northern and southern California. Genetic structure was detected among samples of N. macrotis and N. fuscipes at a regional level. Both species displayed moderate to high genetic diversity in terms of mean expected heterozygosity (0.939 and 0.804 for N. macrotis and N. fuscipes, respectively) and mean polymorphic information content (0.930 and 0.761 for N. macrotis and N. fuscipes, respectively). Mean relatedness values within regions and populations of N. macrotis indicated 4th-order levels of relatedness within groups (e.g., distant-cousin relationships). Mean relatedness values within regions of N. fuscipes indicated 2nd-order (e.g., half-sibling) relationships within the northern region and 3rd-order (e.g., cousin) relationships in the southern region. One locus in particular (Nma04) was determined to be diagnostic in distinguishing between these 2 species.

The gastrostomy button as a catheterizable urinary stoma: a pilot study.

PURPOSE: We assessed the impact of the gastrostomy button used as a catheterizable urinary stoma on the infection, encrustation and erosion rates, and quality of life in a series of 19 patients. MATERIALS AND METHODS: Patients were selected as candidates for the button based on multichannel urodynamic studies that confirmed an areflexic neurogenic bladder. At study enrollment each patient completed a quality of life questionnaire based on a visual analog scale. If the patient had a preexisting indwelling suprapubic tube, it was replaced with a button. If no preexisting suprapubic tube was present, one was inserted. The button was then inserted approximately 1 month later after an adequate tract was established. For 1 year the patient underwent cystoscopy with urine culture every 2 months for a total of 6 times. Symptomatic infections were treated but asymptomatic colonization was not. A quality of life questionnaire was completed at each visit. RESULTS: Of the 19 patients 10 had failure, necessitating button removal. These failures were due to an excessive suprapubic distance from skin to bladder, which prevented adequate button fit. All patients in whom the button remained showed significant improvements in quality of life. The colonization rate was 100% but the rate of symptomatic infections was low. The incidence of bladder stones was zero and the rate of encrustation was low. CONCLUSIONS: When used as a catheterizable stoma to treat areflexic neurogenic bladder, a gastrostomy button is a safe, effective option for these patients. The rate of symptomatic infections is low, the risk of bladder stone formation is minimal and erosion was not observed in properly sized button insertions. The current limiting factor is the length of the button compared with the patient suprapubic measurement (length from skin to bladder). Each patient reported that quality of life with the button was significantly better than prior to button placement.

Bear Canyon virus: an arenavirus naturally associated with the California mouse (Peromyscus californicus).

Thirty-four rodents captured in southern California were studied to increase our knowledge of the arenaviruses indigenous to the western United States. An infectious arenavirus was isolated from 5 of 27 California mice but none of the 7 other rodents. Analyses of viral nucleocapsid protein gene sequence data indicated that the isolates from the California mice are strains of a novel Tacaribe serocomplex virus (proposed name "Bear Canyon") that is phylogenetically most closely related to Whitewater Arroyo and Tamiami viruses, the only other Tacaribe serocomplex viruses known to occur in North America. The discovery of Bear Canyon virus is the first unequivocal evidence that the virus family Arenaviridae is naturally associated with the rodent genus Peromyscus and that a Tacaribe serocomplex virus occurs in California.