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Rat Bite Fever Iowa State University Center for Food Security and Public Health Center for Food Security and Public Health Center for Food Security and Public Health Technical Factsheets 8-1-2013 Rat Bite Fever Iowa State University Center for Food Security and Public Health Follow this and additional works at: http://lib.dr.iastate.edu/cfsph_factsheets Part of the Animal Diseases Commons, and the Veterinary Infectious Diseases Commons Recommended Citation Iowa State University Center for Food Security and Public Health, "Rat Bite Fever" (2013). Center for Food Security and Public Health Technical Factsheets. 107. http://lib.dr.iastate.edu/cfsph_factsheets/107 This Report is brought to you for free and open access by the Center for Food Security and Public Health at Iowa State University Digital Repository. It has been accepted for inclusion in Center for Food Security and Public Health Technical Factsheets by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected]. Importance Rat Bite Fever Rat bite fever is a human illness that can be caused by two different bacteria, Streptobacillus moniliformis and Spirillum minus. Although this disease is readily Streptobacillus moniliformis cured with antibiotics, untreated infections are sometimes fatal. Both S. moniliformis Infection: and Sp. minus are acquired primarily from rodents, especially rats. At one time, rat Streptobacillary Fever, bite fever was mainly a hazard of exposure to wild rats or laboratory rodents; Streptobacillosis however, pet owners, pet shop employees and veterinary staff may be at increased Epidemic Arthritic Erythema, risk with the growing popularity of rodent pets. Clinical cases can be a diagnostic Haverhill Fever, challenge, as the initial symptoms are nonspecific and there are few good, widely Streptobacilliosis available, diagnostic tests. S. moniliformis is fastidious and can be difficult to isolate, while Sp. minus is uncultivable and can be identified only by its morphology. Spirillum minus Infection: In animals, S. moniliformis is known mainly as a pathogen of rodents. This Sodoku, organism can cause septicemia, abscesses and arthritis in mice, and cervical Spirillary Fever lymphangitis or pneumonia in guinea pigs. Outbreaks in laboratory colonies can result in major economic losses, in addition to the zoonotic risks to personnel. Rare clinical cases or outbreaks have also been reported in other species of mammals and birds; Last Updated: August 2013 however, the host range of S. moniliformis, and its effects on most animals, are still incompletely understood. Very little is known about Sp. minus infections in animals. Etiology Rat-bite fever is caused by two unrelated bacterial species, Streptobacillus moniliformis and Spirillum minus. S. moniliformis is a Gram negative, pleomorphic bacillus in the family Leptotrichiaceae. Sp. minus is a short, thick, Gram negative spiral. The latter organism has never been cultivated in artificial media, and much about it, including its taxonomic relationships, is poorly understood. The two forms of the disease in people are known, respectively, as streptobacillary rat bite fever and spirillary rat bite fever. In animals, infections caused by S. moniliformis may be called streptobacillosis. Haverhill fever is a S. moniliformis infection acquired by ingesting contaminated food or water. Species Affected Streptobacillus moniliformis Rats are thought to be the reservoir hosts for S. moniliformis, and usually carry this organism asymptomatically. It can be found in both Rattus rattus, the black rat, and R. norvegicus, the Norwegian rat, which is the ancestor of most laboratory and pet rats. S. moniliformis can also infect or colonize other species, although its full host range is still uncertain. It can cause illness in laboratory mice (Mus musculus) or infect them asymptomatically, and spinifex hopping mice (Notomys alexis) were affected at a zoo. How long the organism can persist in laboratory mice is uncertain; estimates vary from no persistence to 6 months. Gerbils and African squirrels might also be hosts, based on their (rare) association with human cases of rat bite fever. In addition, S. moniliformis has been linked to illnesses in guinea pigs, turkeys and nonhuman primates, as well as clinical cases in two dogs, an owl and a koala (Phascolarctos cinereus). Bacteria similar to S. moniliformis (described as ‘‘S. actinoides’’) were found in the lungs of calves and sheep with pneumonia, but it is not certain they were the same organism. Animals that eat rodents might be infected or colonized, as a few human cases occurred after bites from dogs, ferrets, a weasel and a pig. The ability of these animals to act as hosts remains to be confirmed, because there could have been other sources of the organism, and there was usually no concrete evidence that it came directly from the biting animal. Nucleic acids of S. moniliformis were recently detected in the mouths of dogs, although the organism has not yet been isolated. Other carnivores have not been tested. Many species of animals have never been systematically examined for S. moniliformis. Spirillum minus Rats are thought to be the reservoir hosts for Spirillum minus, and carry it asymptomatically. This organism is also reported to infect mice. However, it is very © 2006-2013 CFSPH page 1 of 8 Rat Bite Fever difficult to assess its full host range, as Sp. minus has been implicating conjunctival secretions in the contamination identified only by its morphology and could be confused of saliva), but not before. with bacteria that have a similar appearance. Guinea pigs People usually become infected with S. moniliformis and rhesus macaques became ill after inoculation with blood and Sp. minus after bites or scratches from rats, or tissue extracts thought to contain this organism. Similar occasionally other rodents, and possibly carnivores. experiments in rabbits were equivocal. One clinical case in a Human infections with S. moniliformis have also been person occurred after a cat bite. documented after handling a rat, being exposed to its urine, kissing it or sharing food. Haverhill fever, caused by Zoonotic potential S. moniliformis, results from eating or drinking food or Humans can be affected by both S. moniliformis and Sp. water that has been contaminated with rat excrement. minus. Person-to-person transmission of rat bite fever or Haverhill Geographic Distribution fever has not been reported. S. moniliformis seems to be cosmopolitan, and If carnivores are hosts, they probably acquire the streptobacillary rat bite fever has been documented on most organism when they bite or eat rodents, and colonization continents. Although there are only a few published human might be temporary. cases from Asia (Taiwan and Thailand), the illness may be Disinfection underdiagnosed. A recent study found that S. moniliformis S. moniliformis is susceptible to various disinfectants was common among wild rats in Japan. including 70% ethanol, sodium hypochlorite (500–1,000 Human infections with Sp. minus have been reported ppm free chlorine), accelerated hydrogen peroxide and mainly from Asia, but a few cases of rat bite fever were quaternary ammonium compounds. It can also be attributed to this organism in North America, Europe and inactivated by moist heat of 121°C (250°F) for 15 minutes Africa, and organisms with a similar appearance can be or dry heat of 160–-70°C (320–338°F) for at least one hour. found in the blood of rodents. However, the attribution of Sp. minus has never been cultured in artificial media some or all of these human cases may be uncertain. One and its disinfectant susceptibility is unknown. early case from the U.S. was linked to Sp. minus not because the organims was found in the sick individual, but because spirilla were seen in the blood of wild mice on the property Infections in Animals where the patient had been bitten. In another early case from Edinburgh, there was some evidence for both organisms in Incubation Period the patient. Incubation periods for S. moniliformis in experimentally infected mice were a) approximately 7 days Transmission from oral inoculation to the development of visible neck In rats, S. moniliformis is thought to be a commensal abscesses, with deaths from septicemia usually occurring 3 and part of the normal nasopharyngeal flora. It has also to 5 days later, and b) 5 days or less for the development of been found in the middle ear, salivary gland, larynx and arthritis after intravenous inoculation. Guinea pigs upper trachea of rats. Proposed methods of transmission inoculated subcutaneously with S. moniliformis developed from rats to other animals include bites, aerosols or fomites, abscesses at the inoculation site in about 5 to 6 days. and contaminated food or water. Experimental infections Guinea pigs inoculated with Sp. minus in tissues or have been established in rats and guinea pigs by oronasal or blood developed clinical signs after approximately 1 to 2 parenteral inoculation, and in guinea pigs by feeding. Mice weeks in one experiment, and 14 to 18 days in another. This have been infected by intranasal or parenteral inoculation, organism has also been found in the blood of guinea pigs by feeding (the organism is thought to enter the body via after 5 to 37 days, and in the blood of mice after 5 to 30 the mouth and pharynx) and by contact with rats. days. Sp. minus is also carried in asymptomatic rats, but there is little or no definitive information on its Clinical Signs transmission. Rodents can be infected by inoculating them Streptobacillus moniliformis with contaminated blood or tissues. Sp. minus occurs in Rats usually carry S. moniliformis asymptomatically. the blood of animals, and possibly in conjunctival Occasionally, this organism has been reported as a exudates. Whether it is shed in the saliva, and under what secondary invader in subcutaneous abscesses, conditions, is still unclear. Some early experiments bronchopneumonia, chronic pneumonia or otitis media. suggested that Sp. minus was not transmitted readily Mouse strains differ in their susceptibility to S. between mice by casual contact.
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