Aspectos etioepidemiológicos da febre maculosa brasileira: revisão sistemática / Etioepidemiological aspects of Brazilian spotted fever: systematic review / Aspectos etioepidemiológicos de fiebre manchada brasileña: revisión sistemática

A Febre Maculosa Brasileira (FMB) é uma zoonose, febril aguda, de gravidade variável, que geralmente se desenvolve em caráter endêmico, com distribuição mundial, causada por bactérias da família Rickettsiaceae, denominadas Rickettsia rickettsii, Rickettsia sp. cepa Mata Atlântica e Rickettsia parkeri. O presente estudo foi delineado com o objetivo de realizar uma revisão sistemática da literatura acerca dos aspectos epidemiológicos da febre maculosa brasileira, entre estudos empíricos publicados em periódicos entre os anos de 2010 e 2021, indexados nas bases de dados das plataformas de busca LILACS, PubMed, Google Scholar e SciELO. Foram encontrados um total de 42 artigos científicos catalogados no período de 2010 até abril de 2021. Dos trabalhos obtidos, 17 encontram-se na PubMed, 4 na LILACS,11 no SciELO e 10 no Google Scholar. Seguindo os critérios de exclusão, 30 resumos publicados antes do ano de 2010 não foram considerados. Foram também excluídos 6 dissertações, 2 teses e 2 capítulos de livro. Entre os 42 artigos analisados, 24 foram publicados em inglês, 18 em português e nenhum foi publicado em espanhol. Sendo assim, a partir desse estudo será possível adotar e atualizar as medidas preventivas contra a FMB, tais como: divulgação de informações, orientar os profissionais do sistema de saúde, educação em saúde para população de risco, guiar as ações de vigilância em saúde e orientação de novas diretrizes das políticas públicas, relacionadas a um importante problema de saúde única, considerando-se os aspectos ambientais, de saúde humana e da presença dos animais, como as capivaras entre outros, e ainda dos vetores, como os carrapatos.

Brazilian Spotted Fever (BSF) is a zoonosis, acute febrile, of variable severity, which usually develops in an endemic character, with worldwide distribution, caused by bacteria of the Rickettsiaceae family, called Rickettsia rickettsii, Rickettsia sp. strains Mata Atlântica and Rickettsia parkeri. The present study was designed with the objective of carrying out a systematic review of the literature on the epidemiological aspects of Brazilian spotted fever, among empirical studies published in journals between the years 2010 and 2021, indexed in the databases of the search platforms LILACS, PubMed, Google Scholar and SciELO. A total of 42 scientific articles cataloged from 2010 to April 2021 were found. Of the works obtained, 17 are in PubMed, 4 in LILACS, 11 in SciELO and 10 in Google Scholar. Following the exclusion criteria, 30 abstracts published before the year 2010 were not considered. 6 dissertations, 2 theses and 2 book chapters were also excluded. Among the 42 articles analyzed, 24 were published in English, 18 in Portuguese and none were published in Spanish. Therefore, from this study it will be possible to adopt and update preventive measures against FMB, such as: dissemination of information, guide health system professionals, health education for the population at risk, guide health surveillance actions and guidance of new public policy guidelines, related to an important single health problem, considering the environmental aspects, human health and the presence of animals, such as capybaras, among others, and also vectors, such as ticks.

La Fiebre Maculosa Brasileña (BSF) es una zoonosis, febril aguda, de severidad variable, que suele desarrollarse con carácter endémico, con distribución mundial, causada por bacterias de la familia Rickettsiaceae, denominadas Rickettsia rickettsii, Rickettsia sp. cepas Mata Atlântica y Rickettsia parkeri. El presente estudio fue diseñado con el objetivo de realizar una revisión sistemática de la literatura sobre los aspectos epidemiológicos de la fiebre maculosa brasileña, entre estudios empíricos publicados en revistas entre los años 2010 y 2021, indexadas en las bases de datos de las plataformas de búsqueda LILACS, PubMed, Google Scholar y SciELO. Se encontraron un total de 42 artículos científicos catalogados desde 2010 hasta abril de 2021. De los trabajos obtenidos, 17 se encuentran en PubMed, 4 en LILACS, 11 en SciELO y 10 en Google Scholar. Siguiendo los criterios de exclusión, no se consideraron 30 resúmenes publicados antes del año 2010. También se excluyeron 6 disertaciones, 2 tesis y 2 capítulos de libros. Entre los 42 artículos analizados, 24 fueron publicados en inglés, 18 en portugués y ninguno en español. Por lo tanto, a partir de este estudio será posible adoptar y actualizar medidas preventivas frente a la FMB, tales como: difusión de información, orientar a los profesionales del sistema de salud, educación en salud para la población en riesgo, orientar acciones de vigilancia en salud y orientación de nuevos lineamientos de política pública, relacionado con un importante problema único de salud, considerando los aspectos ambientales, la salud humana y la presencia de animales, como capibaras, entre otros, y también vectores, como las garrapatas.

A survey for spotted fever group rickettsiae and ehrlichiae in Amblyomma variegatum from St. Kitts and Nevis.

Eighty-nine Amblyomma variegatum ticks were collected from the islands of St. Kitts and Nevis in the Caribbean and preserved in 70% ethanol or local rum. After being washed in sterile water, their DNA was extracted and analyzed by a polymerase chain reaction (PCR) for DNA of spotted fever group rickettsiae and ehrlichiae. None of the tested ticks was positive in a PCR assay using the primers 16S EHRD and 16S EHRR for the 16S rRNA gene of Ehrlichia spp.. Forty-one percent of the A. variegatum (36 of 89 of which 34 [47%] of 72 were adult males, 2 (13%) of 16 were adult females, and 0 (0%) of 1 were nymphs) were positive in a PCR assay using the primer pair 190-70 and 190-701 for the outer membrane protein A (ompA) gene of spotted fever group rickettsiae. All PCR amplification products obtained had 100% sequence homology with Rickettsia africae, the agent of African tick-bite fever.

Diagnosis of heartwater in the live animal: experiences with goats in Guadeloupe.

A presumptive diagnosis of heartwater in the living animal can be based on clinical and epidemiologic observations. In Guadeloupe, heartwater can be confused with haemonchosis in goats or cerebral babesiosis in cattle. Confirmation of the clinical diagnosis by brain biopsy is useful in experimental infections but is hardly applicable in the field. Positive results were obtained from 92% of animals 16 to 18 days after experimental infection. In febrile animals the best results were obtained between the 3rd and 6th days of the thermal response. Diagnosis can also be supported by serological tests. These are useful for monitoring experimental infections and for checking recovered animals in the field. Nineteen goats out of 27 were negative on Day 1 of the febrile reaction but positive a week later. The remaining 8 goats were positive on Day 1 and had greatly increased antibody titres a week later. Confirmation of a diagnosis can also be achieved by subinoculating into susceptible animals either blood or suspensions of ticks collected from suspect animals and then homogenized. Ticks that have engorged on a suspect animal can be allowed to moult and then fed on a susceptible animal to test their infectivity. These methods are time consuming but useful for heartwater surveys.

Epidemiology of heartwater in Guadeloupe and in the Caribbean.

At present, heartwater in the Caribbean is known with certainty only on Guadeloupe, Marie Galante and Antigua; the first 2 islands are widely infected. The most important factors responsible for particular aspects of heartwater in Guadeloupe are: Cowdria ruminantium of high virulence. A very resistant cattle population (Creole), not normally clinically affected. A fairly susceptible goat population (Creole) (22% goats born in endemic areas die after experimental inoculation) which, fortunately, includes breeding lines with inherited resistance characteristics. Amblyomma variegatum which is present all over the island and all through the year, but with a low infection rate (1-2% of adult ticks are infected) because of the short period of rickettsemia in infected animals. The low rate of tick infection results in a low endemicity of the disease. For goats, the epidemiologic situation can be regarded as unstable because the low rate of infection in ticks does not allow a natural immunization of the majority of young kids when they still have a non-specific resistance. The possible evolution of heartwater in the Caribbean and in the United States in considered.