Hospital based serological evidence of rickettsial diseases and assessment diagnostic tests of pyrexia of unknown origin.

The present study examined hospital-based serological tests of rickettsial infections and assessment for diagnosis of pyrexia of unknown origin (PUO). Blood samples were tested for Weil Felix antigens, ELISA for scrub typhus group and polymerase chain reaction (PCR) to detect the presence of DNA of spotted and scrub typhus group with the help of specific oligonucleotide. We tested 450 patient samples and found 101 Weil Felix-positive with 15 having ≥320 titres. IgM ELISA identified 32 (7.1%) positive cases. Positive PCR was seen in 13 (2.9%) samples, being only 40.1% of those testing positive for ELISA. Rickettsial infection is predominantly diagnosed through serological evidence in combination with molecular techniques. The Weil Felix test has a number of disadvantages and tends to provide false-positive results in a number of scenarios, especially where scrub typhus and spotted fever are widely distributed.

An assessment of the role of white-tailed deer in the epizootiology of anaplasmosis in the southeastern United States.

The role of white-tailed deer (Odocoileus virginianus) in the epizootiology of anaplasmosis in the southeastern United States was examined through retrospective and prospective serosurveys and by experimental infection studies. No serum antibody reactive to Anaplasma marginale was detected with an indirect fluorescent antibody (IFA) assay from any of 1,376 free-ranging deer sampled from 1968 through 1990 from 13 states and Puerto Rico. Thirty-one additional deer from three bovine anaplasmosis enzootic premises also were negative by IFA and Giemsa-stained blood films. Three captive deer given A. marginale intravenously developed antibodies 38 to 41 days post-inoculation (DPI) and remained seropositive for the duration of the study (161 to 287 DPI). At 42 DPI, rickettsemias of approximately 0.0001% infected erythrocytes were observed in all three deer using a DNA probe; low rickettsemias (maximum 0.01%) persisted through 56, 63, and 87 DPI, respectively. One deer had a recrudescent infection from 126 to 146 DPI (maximum rickettsemia 0.001%). We believe that white-tailed deer in the southeastern United States, even though susceptible to A. marginale infection, are not exposed naturally, even at enzootic sites. Furthermore, white-tailed deer did not develop rickettsemias sufficient to support mechanical transmission by biting flies, which is believed to be the primary means of anaplasmosis transmission in this region.