Long-term persistence of anti-Rickettsia rickettsii antibodies in capybaras, with passive transfer to offspring.

The bacterium Rickettsia rickettsii is the etiological agent of Brazilian spotted fever (BSF), and its most important vector to humans in Brazil is the tick Amblyomma sculptum. Capybaras are the main hosts of A. sculptum in many BSF-endemic areas and are considered valuable sentinels for BSF surveillance. This study aimed to assess the persistence of anti-R. rickettsii antibodies for long periods in capybaras and their passive transfer to offspring. For this purpose, three adult capybaras previously exposed to multiple infections with R. rickettsii were followed up until 3.1 years after their last exposure. During the study, one female delivered five cubs, of which three survived. Blood samples were collected monthly from adults and infants, and serum samples were titrated by indirect immunofluorescence assay (IFA) to determine endpoint titers of anti-R. rickettsii antibodies. All three adults remained seroreactive to R. rickettsii with high endpoint titers until the end of the study. All infants were seroreactive to R. rickettsii after birth and remained seroreactive for one to four months. This study showed that exposure of capybaras to R. rickettsii-infected A. sculptum ticks elicits a persistent antibody response. In addition, there was evidence of passive transfer of R. rickettsii-reactive antibodies to offspring.

Capybaras (Hydrochoerus hydrochaeris) as amplifying hosts of Rickettsia rickettsii to Amblyomma sculptum ticks: Evaluation during primary and subsequent exposures to R. rickettsii infection.

Rickettsia rickettsii is the agent of Brazilian spotted fever (BSF), the most lethal tick-borne disease in the western hemisphere. Amblyomma sculptum is the main vector of R. rickettsii in southeastern Brazil. Capybaras act as primary hosts for this tick species, and as amplifying hosts for R. rickettsii, creating new infected lineages of A. sculptum in BSF-endemic areas. In a recent study, we demonstrated that capybaras successively exposed to R. rickettsii-infected A. sculptum ticks developed a mean rickettsemic period of 9.2 days during primary infection, but no rickettsemia during subsequent expositions, when capybaras were immune to R. rickettsii. During the primary and subsequent infections, capybaras were also infested with uninfected A. sculptum ticks. These infestations compose the present study, which aimed to evaluate: (i) if either rickettsemic or non-rickettsemic capybaras could serve as infection sources of R. rickettsii for A. sculptum larvae and nymphs; (ii) the vector competence of the subsequent nymphs and adults (molted from the engorged ticks collected from capybaras); and (iii) if there were R. rickettsii-acquisition by uninfected ticks co-feeding with infected ticks on immune capybaras (without rickettsemia). Through experimental infection of capybaras with R. rickettsii via tick feeding, simulating a natural condition, we demonstrated that primarily infected capybaras developed rickettsemia that resulted in successful acquisition feeding of larvae and nymphs of A. sculptum, since part of these ticks maintained R. rickettsii transstadially, and the resultant molted ticks (either nymphs or adults) successfully transmitted the bacterium by feeding on susceptible rabbits. Contrastingly, all rabbit infestations with ticks derived from acquisition feeding on R. rickettsii-immune capybaras (including when acquisition ticks fed in direct contact with donor ticks) evidenced absence of R. rickettsii transmission due to lack of clinical signs and antibody response in those rabbits. Our results indicate that capybaras could serve as R. rickettsii-amplifying hosts for A. sculptum ticks only during the capybara's primary infection, but not during subsequent infections on immune capybaras. Finally, the probable co-feeding nonsystemic transmission of R. rickettsii seems to be irrelevant in the context of BSF epidemiology, in areas where capybaras are incriminated as main amplifying hosts of R. rickettsii for A. sculptum ticks.

Author Correction: Clinical and serological evaluation of capybaras (Hydrochoerus hydrochaeris) successively exposed to an Amblyomma sculptum-derived strain of Rickettsia rickettsii.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Clinical and serological evaluation of capybaras (Hydrochoerus hydrochaeris) successively exposed to an Amblyomma sculptum-derived strain of Rickettsia rickettsii.

Brazilian spotted fever (BSF), caused by Rickettsia rickettsii, is the most lethal tick-borne disease in the western hemisphere. In Brazil, Amblyomma sculptum ticks are the main vector. Capybaras (Hydrochoerus hydrochaeris), the largest living rodents of the world (adults weighing up to 100 Kg), have been recognized as amplifying hosts of R. rickettsii for A. sculptum in BSF-endemic areas; i.e., once primarily infected, capybaras develop bacteremia for a few days, when feeding ticks acquire rickettsial infection. We conducted experimental infections of five capybaras with an A. sculptum-derived strain of R. rickettsii and performed clinical and bacteremia evaluation during primary and subsequent infections. Bacteremia was detected in all capybaras during primary infection, but not in subsequent infections. All animals seroconverted to R. rickettsii (titres range: 64-32,768), and remained seropositive throughout the study. Primary infection resulted in clinical spotted fever illness in four capybaras, of which two had a fatal outcome. Subsequent infections in seropositive capybaras resulted in no clinical signs. Capybaras developed a sustained immune response that prevented a second bacteremia. This condition may imply a high reproduction rate of capybaras in BSF-endemic areas, in order to continuously generate capybaras susceptible to bacteremia during primary infection.

Epidemiology of capybara-associated Brazilian spotted fever.

BACKGROUND: Brazilian spotted fever (BSF), caused by the bacterium Rickettsia rickettsii, has been associated with the transmission by the tick Amblyomma sculptum, and one of its main hosts, the capybara (Hydrochoerus hydrochaeris). METHODS: During 2015-2019, we captured capybaras and ticks in seven highly anthropic areas of São Paulo state (three endemic and four nonendemic for BSF) and in two natural areas of the Pantanal biome, all with established populations of capybaras. RESULTS: The BSF-endemic areas were characterized by much higher tick burdens on both capybaras and in the environment, when compared to the BSF-nonendemic areas. Only two tick species (A. sculptum and Amblyomma dubitatum) were found in the anthropic areas; however, with a great predominance of A. sculptum (≈90% of all ticks) in the endemic areas, in contrast to a slight predominance of A. dubitatum (≈60%) in the nonendemic areas. Tick species richness was higher in the natural areas, where six species were found, albeit with a predominance of A. sculptum (≈95% of all ticks) and environmental tick burdens much lower than in the anthropic areas. The BSF-endemic areas were characterized by overgrowth populations of A. sculptum that were sustained chiefly by capybaras, and decreased populations of A. dubitatum. In contrast, the BSF-nonendemic areas with landscape similar to the endemic areas differed by having lower tick burdens and a slight predominance of A. dubitatum over A.sculptum, both sustained chiefly by capybaras. While multiple medium- to large-sized mammals have been incriminated as important hosts for A. sculptum in the natural areas, the capybara was the only important host for this tick in the anthropic areas. CONCLUSIONS: The uneven distribution of R. rickettsii infection among A. sculptum populations in highly anthropic areas of São Paulo state could be related to the tick population size and its proportion to sympatric A. dubitatum populations.

Antibodies for Rickettsia spp. in patients with negative serology for dengue virus, leptospirosis, and meningococcal disease in municipalities of São Paulo State, Brazil.

INTRODUCTION: Brazilian spotted fever is an infectious disease with a high mortality rate if not treated early. Differential diagnosis is difficult, as the first clinical signs are non-specific and can be confused with other diseases. The aim of the study was to investigate evidence of infection with Rickettsia rickettsii and Rickettsia parkeri in negative sera samples, collected in 2014, from patients with suspected leptospirosis, dengue fever, and meningococcal disease in Atibaia and Bragança Paulista municipalities of the State of São Paulo. METHODS: The samples stored at the Institute Adolfo Lutz in Campinas were tested using an indirect immunofluorescence assay (IFA) with IgG and IgM against R. rickettsii and R. parkeri. Real-time polymerase chain reaction (PCR) testing was performed for the sera samples of patients who died (n = 3), those with initial suspicion of meningococcal disease (n = 6), and those with positive IFA results. RESULTS: Of 258 samples from Bragança Paulista, 4 (1.6%) were positive, with IgG titers of 1:64 and 1:128 against R. rickettsii and R. parkeri, respectively. Of 155 samples from Atibaia, 2 (1.3%) were positive, with IgG titers of 1:64 and 1:128 against R. rickettsii and R. parkeri, respectively. No sample showed positive PCR results. CONCLUSIONS: This serological investigation suggests there is evidence of exposure to Rickettsia spp. in residents of areas that have environmental conditions favorable to the spread of bacteria, in which Brazilian spotted fever incidence was not previously confirmed.

Antibodies for Rickettsia spp. in patients with negative serology for dengue virus, leptospirosis, and meningococcal disease in municipalities of São Paulo State, Brazil

Abstract INTRODUCTION Brazilian spotted fever is an infectious disease with a high mortality rate if not treated early. Differential diagnosis is difficult, as the first clinical signs are non-specific and can be confused with other diseases. The aim of the study was to investigate evidence of infection with Rickettsia rickettsii and Rickettsia parkeri in negative sera samples, collected in 2014, from patients with suspected leptospirosis, dengue fever, and meningococcal disease in Atibaia and Bragança Paulista municipalities of the State of São Paulo. METHODS The samples stored at the Institute Adolfo Lutz in Campinas were tested using an indirect immunofluorescence assay (IFA) with IgG and IgM against R. rickettsii and R. parkeri. Real-time polymerase chain reaction (PCR) testing was performed for the sera samples of patients who died (n = 3), those with initial suspicion of meningococcal disease (n = 6), and those with positive IFA results. RESULTS Of 258 samples from Bragança Paulista, 4 (1.6%) were positive, with IgG titers of 1:64 and 1:128 against R. rickettsii and R. parkeri, respectively. Of 155 samples from Atibaia, 2 (1.3%) were positive, with IgG titers of 1:64 and 1:128 against R. rickettsii and R. parkeri, respectively. No sample showed positive PCR results. CONCLUSIONS This serological investigation suggests there is evidence of exposure to Rickettsia spp. in residents of areas that have environmental conditions favorable to the spread of bacteria, in which Brazilian spotted fever incidence was not previously confirmed.

High Seroprevalence for Rickettsia rickettsii in Equines Suggests Risk of Human Infection in Silent Areas for the Brazilian Spotted Fever.

Equines play a role in the epidemiology of Brazilian spotted fever (BSF) since they are a primary host for the tick Amblyomma sculptum. We studied the seroprevalence for three species of Rickettsia in equines in four endemic (with human cases) and in four non-endemic areas (no human cases) in the Piracicaba River Basin, São Paulo, Brazil. A serological survey of 504 equines was performed: around 63 animals were sampled in each area and tested through indirect immunofluorescence assay for R. rickettsii, R. parkeri, and R. bellii in 2012-2013. Blood samples were seropositive for 183 equines (36.3%) in which 73 (39.9%) were from non-endemic areas. In the studied sites equines were highly exposed to Rickettsia infection ranging from 6.1% to 54.7%, with Geometric Mean Titers greater in endemic area (p = 0.012). Results suggest that Rickettsia may be more widespread than the surveillance of BSF has detected. These results highlight the need to include data on the seroprevalence of sentinel animals to improve human diagnoses and surveillance in areas with no reported human cases.

Risk factors associated with the transmission of Brazilian spotted fever in the Piracicaba river basin, State of São Paulo, Brazil.

INTRODUCTION: Brazilian spotted fever (BSF) is a disease transmitted by ticks for which the etiological agent is Rickettsia rickettsii. The present essay evaluates the risk factors associated with the transmission of cases of BSF in the time period between 2003 and 2013 in the Piracicaba river basin, state of São Paulo. METHODS: This essay presents a retrospective study to identify the factors associated with the transmission of cases of BSF among all suspected cases identified by the System for Epidemiological Surveillance of São Paulo (CVE). After the description of temporal distribution (onset of symptoms) and the environmental and demographic variations of the confirmed and discarded cases, a multiple logistic regression model was applied. RESULTS: We searched 569 probable locations of infection (PLI) with 210 (37%) confirmed cases of BSF and 359 (63%) discarded cases. The associated variables for the confirmation of BSF in the multiple logistic model using a confidence interval (CI) of 95% were age (OR = 1.025 CI: 1.015-1.035), the presence of Amblyomma sculptum in the environment (OR = 1.629 CI: 1.097-2.439), the collection of ticks from horses (OR = 1.939 CI: 0.999-3.764), the presence of capybaras (OR = 1.467 CI: 1.009-2.138), an urban environment (OR = 1.515 CI: 1.036-2.231), and the existence of a dirty pasture (OR = 1.759 CI: 1.028-3.003). CONCLUSIONS: The factors associated with the confirmation of BSF cases included an urban environment, age, presence of the A. sculptum vector, the collection of ticks from horses, the presence of a capybara population, and a dirty pasture environment.

Risk factors associated with the transmissionof Brazilian spotted fever in the Piracicaba river basin, State of São Paulo, Brazil

INTRODUCTION : Brazilian spotted fever (BSF) is a disease transmitted by ticks for which the etiological agent is Rickettsia rickettsii. The present essay evaluates the risk factors associated with the transmission of cases of BSF in the time period between 2003 and 2013 in the Piracicaba river basin, state of São Paulo. METHODS : This essay presents a retrospective study to identify the factors associated with the transmission of cases of BSF among all suspected cases identified by the System for Epidemiological Surveillance of São Paulo (CVE). After the description of temporal distribution (onset of symptoms) and the environmental and demographic variations of the confirmed and discarded cases, a multiple logistic regression model was applied. RESULTS : We searched 569 probable locations of infection (PLI) with 210 (37%) confirmed cases of BSF and 359 (63%) discarded cases. The associated variables for the confirmation of BSF in the multiple logistic model using a confidence interval (CI) of 95% were age (OR = 1.025 CI: 1.015-1.035), the presence of Amblyomma sculptum in the environment (OR = 1.629 CI: 1.097-2.439), the collection of ticks from horses (OR = 1.939 CI: 0.999-3.764), the presence of capybaras (OR = 1.467 CI: 1.009-2.138), an urban environment (OR = 1.515 CI: 1.036-2.231), and the existence of a dirty pasture (OR = 1.759 CI: 1.028-3.003). CONCLUSIONS : The factors associated with the confirmation of BSF cases included an urban environment, age, presence of the A. sculptum vector, the collection of ticks from horses, the presence of a capybara population, and a dirty pasture environment. .

[Survey of Rickettsia spp in the ticks Amblyomma cajennense and Amblyomma dubitatum in the State of São Paulo]. / Pesquisa de Rickettsia spp em carrapatos Amblyomma cajennense e Amblyomma dubitatum no Estado de São Paulo.

The presence of rickettsial infection was surveyed in 3,545 Amblyomma cajennense ticks and 2,666 Amblyomma dubitatum ticks. Using the hemolymph test, polymerase chain reaction and isolation of Rickettsia in cell cultures, all of the Amblyomma cajennense were negative, whereas 634 (23.8%) of the Amblyomma dubitatum ticks were shown to be infected with Rickettsia bellii.

Pesquisa de Rickettsia spp em carrapatos Amblyomma cajennense e Amblyomma dubitatum no Estado de São Paulo / Survey of Rickettsia spp in the ticks Amblyomma cajennense and Amblyomma dubitatum in the State of São Paulo

Foi pesquisada a presença de riquétsias em 3.545 carrapatos Amblyomma cajennense e 2.666 Amblyomma dubitatum. Através do teste de hemolinfa, reação em cadeia pela polimerase e isolamento de rickettsia em cultivo celular, todos os Amblyomma cajennense foram negativos, sendo que 634 (23,8 por cento) Amblyomma dubitatum mostraram-se infectados com Rickettsia bellii.

The presence of rickettsial infection was surveyed in 3,545 Amblyomma cajennense ticks and 2,666 Amblyomma dubitatum ticks. Using the hemolymph test, polymerase chain reaction and isolation of Rickettsia in cell cultures, all of the Amblyomma cajennense were negative, whereas 634 (23.8 percent) of the Amblyomma dubitatum ticks were shown to be infected with Rickettsia bellii.

Serological identification of Rickettsia spp from the spotted fever group in capybaras in the region of Campinas - SP - Brazil / Identificação sorológica de Rickettsia spp do grupo da febre maculosa em capivaras na região de Campinas, SP, Brasil

Diseases transmitted by ticks have been an important health problem all over the world. Brazilian Spotted Fever (BSF) stands for a serious epidemiological concern due to the high mortality rates pointed out. Capybaras are commonly incriminated as possible reservoirs in the BSF transmission cycle. In the last decades the numbers of these animals raised sharply and they have invaded human areas. They intensify the contact between ticks and humans beings. This study aim is to contribute to the possible role performed for this rodent in the BSF epidemiology in some areas located in Campinas region, São Paulo. Cabybaras infected by rickettsiae of BSF group were studied through the analysis of the frequencies of BSF-group rickettisae antibodies titer = 64 by indirect immunofluorescence test (IFA), and data from human cases epidemiological surveillance. The serum frequency positiveness varied greatly according to areas where animals were captured. However it was found serum positiviness only in the areas where human cases of BSF were reported. These findings suggest the capybara may be seen as sentinel animal. Due to presence of serological cross reactivity between microorganisms belonging to SF group, the results must be interpreted carefully and additional methods to distinguish pathogenic rickettsiae are required in our country.

Doenças transmitidas por carrapatos vêm sendo um importante problema de saúde pública no mundo. A Febre Maculosa Brasileira (FMB) representa um sério risco epidemiológico devido às altas taxas de letalidade apresentadas. As capivaras são freqüentemente incriminadas como possíveis reservatórios no ciclo de transmissão da FMB. Nas últimas décadas o número desses animais cresceu intensamente e eles invadiram os espaços humanos. As capivaras intensificam o contato entre carrapatos e seres humanos na medida em que se apresentam muito infestadas por estes parasitos. O objetivo deste estudo é contribuir para o conhecimento do possível papel desempenhado por este roedor na epidemiologia da FMB em algumas áreas da região de Campinas, SP. Foi estudada a infecção das capivaras por rickettsias do grupo da FMB, por meio da análise das freqüências de anticorpos contra este grupo, nestes animais, e dados da vigilância epidemiológica de casos humanos. A freqüência desses anticorpos variou amplamente entre as localidades, entretanto, só foram encontrados soros com anticorpos com titulagem =64 naquelas onde havia notificação de casos humanos. Estes achados sugerem que a capivara poderá ser um animal sentinela. No entanto, devido à ocorrência de reação cruzada entre os microorganismos do grupo de FM estes resultados devem ser interpretados com cautela e são necessários métodos capazes de distinguir rickettsias patogênicas.

Valores hematológicos de capivaras ( Hydrochoerus hydrochaeris ) Rodentia: Hydrochoeridae ) de vida livre na região de Campinas-SP / Capybara's ( Hydrochoerus hydrochaeris ) hematological values free ranging life from Campinas regions, São Paulo state, Brazil

O objetivo deste estudo foi determinar os valores hematológicos de 14 capivaras de vida livre capturadas nos municípios de Campinas, Monte Alegre do Sul e de São João da Boa Vista. Para a obtenção das amostras de sangue, os animais foram anestesiados via intramuscular, mediante associação de cloridrato de xilazina 2 por cento e cloridrato de ketamina 1 por cento, em doses de 4,5mg/kg/pv e 5,0mg/kg/pv, respectivamente. O sangue foi coletado em tubos contendo EDTA. Para a determinação dos números de eritrócitos e leucócitos, foi utilizada a metodologia tradicional da câmara de Neubauer. O hematócrito foi determinado pelo método de microhematócrito e a hemoglobina pelo método da cianometahemoglobina. Para a contagem diferencial de leucócitos, foi utilizada a técnica de Shilling. Os índices hematimétricos (VCM, HCM E CHCM) foram determinados com os valores encontrados na série vermelha. Os resultados da série eritrocitária foram: 4,5 x10(6)/miL ± 0,2; hemoglobina: 13.5g/dL ± 0,7; hematócrito: 40,4 por cento ± 2; VCM: 90,2 fL ± 0,9; HCM: 30,1 pg ± 0,7; CHCM: 33,3g/dL ± 1. Na série leucocitária: 5,3 x10 /miL ± 2; bastonetes: 1 por cento ± 2,1; segmentados: 36,6 por cento ± 19,9; eosinófilos: 3,5 por cento ± 11,7; basófilos: 0 por cento; linfócitos: 58,8 por cento ± 19,6; monócitos: 1,5 por cento ± 2,1. Não foram encontrados os mielócitos e metamielócitos.

Dinâmica sazonal de carrapatos (Acari: Ixodidae) na mata ciliar de uma área endêmica para febre maculosa na região de Campinas, São Paulo, Brasil / Seasonal dynamics of ticks (Acari: Ixodidae) in an endemic area for spotted fever in the Campinas region, state of São Paulo, Brazil

A febre maculosa é mundialmente reconhecida como um problema reemergente de saúde pública. Na região de Campinas-SP, observam-se uma ampliação da área de transmissão do agente da doença e a ocorrência de um maior número de casos confirmados nos últimos anos. Nesta região, a maioria dos casos desta doença está quase sempre relacionada com o aumento populacional de capivaras, que são um dos principais hospedeiros primários do estádio adulto do carrapato Amblyomma cajennense. O principal objetivo deste estudo foi determinar o comportamento populacional de larvas, ninfas e adultos de Amblyomma spp no habitat de mata ciliar de uma área endêmica. De novembro de 2000 a outubro de 2002, carrapatos de vida livre foram coletados com armadilhas de CO2. Picos populacionais de larvas do gênero Amblyomma se estenderam por praticamente todos os meses do ano. Ninfas do gênero Amblyomma ocorreram o ano todo na mata ciliar, sendo mais abundantes de julho a dezembro. Adultos de A. cajennense foram mais abundantes na estação de primavera e verão. Adultos de A. dubitatum (=Amblyomma cooperi) apresentaram um padrão sazonal diferenciado, com os maiores picos populacionais ocorrendo de agosto a fevereiro.

Spotted fever is recognized worldwide as a reemerging public health problem. In Campinas region, state of São Paulo, the transmission area has expanded and the number of positive cases has increased in the lastest years. In these region most cases are usually related to the increased number of capybaras, which are one of the main primary hosts for the tick Amblyomma cajennense. The main objective of this study was to determine the seasonal dynamic of larvaes, nymphs and adults of Amblyomma species in a gallery forest. From November 2000 to October 2002 free-living ticks were collected using carbon dioxid traps. Larvae of Amblyomma spp were abundant during almost all months. Nymphs of Amblyomma spp occurred during the whole year and were more abundants from July to December. Adults of A.cajennense were more abundants during the spring-summer months. Adults of A. dubitatum showed higher populational peaks from August to February.

[Rickettsiae detection in Amblyomma ticks (Acari: Ixodidae) collected in the urban area of Campinas City, SP]. / Detecção de riquétsias em carrapatos do gênero Amblyomma (Acari: Ixodidae) coletados em parque urbano do município de Campinas, SP.

The city of Campinas is located in an endemic area for Brazilian spotted fever in São Paulo State, where several cases have recently occurred. Capybaras have been associated with the cycle of this disease, for they present positive serology and serve as host for ticks of the genus Amblyomma, the main vectors of Brazilian spotted fever. Ticks were collected both from Capybaras and from the vegetation in the city park Lago do Café, located in the urban area of Campinas City, SP, a site associated with suspected human cases of Brazilian spotted fever. The ticks collected were examinated for the presence of rickettsiae using polymerase chain reaction and the haemolymph test. Through analysis of the gene gltA nucleotide sequence, adults of Amblyomma cajennense and Amblyomma cooperi were found to be infected with the non pathogenic Rickettsia bellii. However, no rickettsiae of the Spotted Fever Group were detected. These results indicate that the role of capybaras as reservoirs of rickettsiae of the Spotted Fever Group is still uncertain and further studies are required.

Deteccão de riquétsias em carrapatos do gênero Amblyomma (Acari: Ixodidae) coletados em parque urbano do município de Campinas, SP / Rickettsiae detection in Amblyomma ticks (Acari: Ixodidae) collected in the urban area of Campinas city, SP

O Município de Campinas situa-se em região endêmica para febre maculosa brasileira do Estado de São Paulo, onde vários casos desta doenca vem ocorrendo. Capivaras têm sido associadas ao ciclo dessa riquetsiose por apresentarem sorologia positiva e serem hospedeiras de carrapatos Amblyomma spp principais vetores da doenca. Carrapatos foram coletados no parque urbano do Lago do Café, Campinas, SP, local associado a casos humanos suspeitos de febre maculosa brasileira, sobre a vegetacão e das capivaras ali presentes, e pesquisados quanto à presenca de riquétsias pela reacão em cadeia da polimerase e pelo teste de hemolinfa. Adultos de Amblyomma cajennense e Amblyomma cooperi albergavam Rickettsia bellii, não patogênica, identificada pela análise das seqüências de nucleotídeos do gene gltA, porém, não foram constatadas riquétsias do Grupo da Febre Maculosa. Estes resultados associados à ausência de um isolado de riquétsias do Grupo da Febre Maculosa de capivaras indicam que seu papel, enquanto reservatório, necessita de maior investigacão.

[Spotted fever in Campinas region, State of São Paulo, Brazil]. / Situação da febre maculosa na Região Administrativa de Campinas, São Paulo, Brasil.

Brazilian spotted fever was detected for the first time in the State of S o Paulo in 1929. However, there is no systematic reporting of the disease in the State. In 1985, three cases of the disease occurred in the municipality of Pedreira, located in the Campinas Region, belonging to the 5th Administrative Region, in the Northeast part of the State, including 88 municipalities. An investigation was conducted at the time, but the lack of case registry limited its scope. The present study was undertaken with the aim of recovering the history of the disease in the Region. Data recovered from several public health services for 1985-2000 were used to analyze incidence patterns. It was observed that the transmission area expanded and the number of suspected cases increased, especially after 1996, when mandatory reporting was established. Deaths due to spotted fever were observed in most of the years under study. The study concluded that spotted fever incidence is increasing in the Campinas Region. Complementary bio-ecological studies are currently under way to better understand the epidemiology of this disease, recognized worldwide as an emerging public health problem.

Situaçäo da febre maculosa na Regiäo Administrativa de Campinas, São Paulo, Brasil / Spotted fever in Campinas region, State of São Paulo, Brazil

A febre maculosa brasileira foi detectada pela primeira vez no Estado de São Paulo em 1929. No entanto, näo há registro sistemático de casos neste Estado. Em 1985 ocorreram três casos desta doença no Município de Pedreira, situado na regiäo de Campinas, que fica no nordeste do Estado de São Paulo, Brasil, correspondendo à 5ª Regiäo Administrativa, e compreendendo 88 municípios. Alguns estudos foram realizados no Município de Pedreira, mas a falta de registro de casos foi um obstáculo encontrado. Com a finalidade de recuperar o histórico da doença, resolveu-se pesquisar e registrar as ocorrências de febre maculosa na regiäo no período de 1985 a 2000 e analisar o seu comportamento. Foram recuperados todos os registros da doença nos diversos serviços de saúde pública. Observou-se uma ampliaçäo da área de transmissäo e a ocorrência de um aumento dos casos suspeitos a partir de 1996, ano em que a doença foi determinada como de notificaçäo compulsória na regiäo. Esta doença foi causa de óbito na maioria dos anos do período de estudo. Conclui-se que a febre maculosa está em ascensäo na regiäo e estudos bioecológicos complementares estäo sendo desenvolvidos para melhor compreensäo da epidemiologia dessa doença, que é mundialmente reconhecida como um problema emergente de saúde pública