Rare Case of Rickettsiosis Caused by Rickettsia monacensis, Portugal, 2021.

We report a case of rickettsiosis caused by Rickettsia monacensis in an immunocompetent 67-year-old man in Portugal who had eschar, erythematous rash, and an attached Ixodes ricinus tick. Seroconversion and eschar biopsy led to confirmed diagnosis by PCR. Physicians should be aware of this rare rickettsiosis, especially in geographic regions with the vector.

A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study.

INTRODUCTION: In 2016-18, the Democratic Republic of São Tomé and Príncipe suffered a necrotic skin infection epidemic. METHODS: A surveillance system was established after increased hospitalisations for this infection. Microbiology results were available for samples analysed in December 2016 and March 2017 using whole genome sequencing and metagenomics. Negative binomial regression was used to study the association of weather conditions with monthly case counts in a time-series analysis. RESULTS: From October 2016 to October 2018, the epidemic cumulative attack rate was 1.5%. The first peak lasted 5 months, accounting for one-third of total cases. We could not conclusively identify the aetiological agent(s) due to the country's lack of microbiology capacity. Increased relative humidity was associated with increased monthly cases (incidence rate ratio (IRR) 1.05, 95% CI 1.02-1.09), and higher precipitation in the previous month with a higher number of cases in the following month (months with 0-49 mm rainfall compared with months with 50-149 mm and ≥150 mm: IRR 1.44, 95 % CI 1.13-1.78 and 1.50, 95% CI 1.12-1.99, respectively). DISCUSSION: This epidemic was favoured by increased relative humidity and precipitation, potentially contributing to community-based transmission of ubiquitous bacterial strains superinfecting skin wounds. FUNDING: World Health Organization Regional Office for Africa, Ministry of Health.

Serological screening and toxoplasmosis exposure factors among pregnant women in the Democratic Republic of Sao Tome and Principe.

The seroprevalence of Toxoplasma gondii infection among pregnant women in the Democratic Republic of Sao Tome and Principe (DRSTP) from November 2003 to March 2004 was determined by detection of serum anti-T. gondii antibodies. A short questionnaire interview for pregnant women was performed to investigate risk factors associated with T. gondii infection, including consumption of raw meat or unwashed vegetables, drinking unboiled water and keeping pets (cats and dogs). The overall seroprevalence of T. gondii infection was high (75.2%; 375/499). The older age group of > or =35 years had a significantly higher seroprevalence (85.7%; 54/63) than that of the younger age group of 15-25 years (70.4%; 178/253) (odds ratio 2.5, 95% CI 1.2-5.4; P=0.01). No significant difference in the seroprevalence of T. gondii infection was found between the pregnant women with and without exposure to the risk factors studied. However, among pregnant women with high antibody titers of > or =1:1024, it seemed likely that continual contact with pets and consumption of oocyst-contaminated water or raw unwashed vegetables rather than tissue cysts in meat was the primary route of infection. The incidence of congenital toxoplasmosis in unborn babies should be intensively monitored in the DRSTP.

Seroprevalence of Toxoplasma gondii infection among pre-schoolchildren aged 1-5 years in the Democratic Republic of Sao Tome and Principe, Western Africa.

The prevalence status of Toxoplasma gondii infection in children of the Democratic Republic of Sao Tome and Principe (DRSTP), Western Africa, is unknown to date. A serologic survey of T. gondii infection among pre-schoolchildren aged <5 years in the DRSTP was assessed by the latex agglutination (LA) test from November 2003 to March 2004. The overall seroprevalence of T. gondii infection was not low, reaching 21.49% (26/121). No significant gender difference in seroprevalence was found between boys (19.30%; 11/57) and girls (23.44%; 15/64) (chi2 = 0.31, P = 0.58). The older age group of 4-5 years had significantly higher seroprevalence (36.67%; 11/30) than the younger age group of <2 years (10.34%; 3/29) (chi2 = 5.64, P = 0.02). It was noteworthy that the majority of seropositive boys (90.91%; 10/11) or older children aged > or = 2 years (82.61%; 19/23) had high LA titres of > or = 1:1024, indirectly indicating acute Toxoplasma infection. This study is the first report indicating that T. gondii infection is not low in pre-schoolchildren aged <5 years in the DRSTP. Whether the DRSTP pre-schoolchildren acquire T. gondii infection through constant exposure to the parasite from their daily activities owing to poor environmental hygiene should be further evaluated.