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Tick-Borne Rickettsioses Around the World: Emerging Diseases Challenging Old Concepts Philippe Parola,1 Christopher D

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CLINICAL MICROBIOLOGY REVIEWS, Oct. 2005, p. 719–756 Vol. 18, No. 4 0893-8512/05/$08.00ϩ0 doi:10.1128/CMR.18.4.719–756.2005 Copyright © 2005, American Society for Microbiology. All Rights Reserved. Tick-Borne Rickettsioses around the World: Emerging Diseases Challenging Old Concepts Philippe Parola,1 Christopher D. Paddock,2 and Didier Raoult1* Unite´ des Rickettsies, CNRS UMR 6020, IFR 48, Universite´delaMe´diterrane´e, Faculte´deMe´decine, 13385 Marseille Cedex 5, France,1 and Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Mailstop G-32, 1600 Clifton Road, Atlanta, Georgia2 INTRODUCTION .......................................................................................................................................................719 RECENT DEVELOPMENTS AND CONTINUING GAPS IN RICKETTSIOLOGY........................................720 Microbiology and Taxonomy: What Defines a Rickettsia sp.?...........................................................................720 The Genome Era .....................................................................................................................................................722 Tick-Rickettsia Relationships................................................................................................................................723 Pathogenicity of Tick-Borne Rickettsiae..............................................................................................................724 TICK-BORNE RICKETTSIAE IDENTIFIED AS HUMAN PATHOGENS .......................................................725 Pathogens Described Prior to 1984......................................................................................................................725 Rickettsia rickettsii (Rocky Mountain spotted fever).......................................................................................725 “Rickettsia conorii subsp. conorii” (Mediterranean spotted fever) ...............................................................728 “Rickettsia conorii subsp. israelensis” (Israeli spotted fever).........................................................................729 “Rickettsia sibirica subsp. sibirica” (Siberian tick typhus or North Asian tick typhus)............................730 Rickettsia australis (Queensland tick typhus) ..................................................................................................730 Emerging Pathogens (1984 to 2004) ....................................................................................................................731 Rickettsia japonica (Japanese or Oriental spotted fever)...............................................................................731 “Rickettsia conorii subsp. caspia” (Astrakhan fever) ......................................................................................731 Rickettsia africae (African tick bite fever) ........................................................................................................732 Rickettsia honei (Flinders Island spotted fever)..............................................................................................733 “Rickettsia sibirica subsp. mongolitimonae” ......................................................................................................733 Rickettsia slovaca..................................................................................................................................................734 Rickettsia heilongjiangensis ..................................................................................................................................735 Rickettsia aeschlimannii.......................................................................................................................................736 Rickettsia parkeri..................................................................................................................................................736 Rickettsia massiliae...............................................................................................................................................737 “Rickettsia marmionii”.........................................................................................................................................737 TICK-BORNE SFG RICKETTSIAE PRESUMPTIVELY ASSOCIATED WITH HUMAN ILLNESSES ......738 “Rickettsia conorii subsp. indica” (Indian Tick Typhus)....................................................................................738 Rickettsia canadensis ................................................................................................................................................738 “Rickettsia amblyommii”..........................................................................................................................................738 “Rickettsia texiana” ..................................................................................................................................................738 Rickettsia helvetica....................................................................................................................................................739 RICKETTSIAE ISOLATED FROM OR DETECTED IN TICKS ONLY...........................................................739 NEW APPROACHES TO DIAGNOSIS...................................................................................................................739 Serology ....................................................................................................................................................................740 Culture......................................................................................................................................................................745 Histochemical and Immunohistochemical Methods ..........................................................................................745 Molecular Tools ......................................................................................................................................................745 TREATMENT..............................................................................................................................................................746 CONCLUSION............................................................................................................................................................746 ACKNOWLEDGMENT..............................................................................................................................................749 REFERENCES ............................................................................................................................................................749 INTRODUCTION Rickettsiales (276). These zoonoses are among the oldest known vector-borne diseases. In 1899, Edward E. Maxey re- Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted fever group (SFG) of the ported the first clinical description of Rocky Mountain spotted genus Rickettsia within the family Rickettsiaceae in the order fever (RMSF), the prototypical tick-borne rickettsiosis (198). In 1906, Howard T. Ricketts reported the role of the wood tick in the transmission of the causative agent, subsequently named * Corresponding author. Mailing address: Unite´ des Rickettsies, Rickettsia rickettsii (283, 284, 365). In 1919, S. Burt Wolbach CNRS UMR 6020, IFR 48, Universite´delaMe´diterrane´e, Faculte´de provided definitive experimental evidence that R. rickettsii, re- Me´decine, 27 Bd. Jean Moulin, 13385 Marseille Cedex 5, France. Phone: (33) 4 91 32 43 75. Fax: (33) 4 91 32 03 90. E-mail: ferred to as “Dermacentroxenus rickettsii” at that time, was [email protected]. maintained by ticks and also described the fundamental his- 719 720 PAROLA ET AL. CLIN.MICROBIOL.REV. topathologic lesions of RMSF (365). For approximately the janghensis” (proposed name) in China and the Russian Far next 90 years, R. rickettsii would be the only tick-borne rickett- East; Rickettsia aeschlimannii in Africa and Europe; “Rickettsia sia conclusively associated with disease in humans in the West- marmionii” (proposed name) in Australia (N. Unsworth, J. ern Hemisphere. During the 20th century, many other formally Stenos, and J. Graves, Abstr. 4th Int. Conf. Rickettsiae Rick- described or incompletely characterized SFG rickettsiae were ettsial Dis., abstr. O-50, 2005), and R. parkeri in the United detected in North American ticks, including Rickettsia parkeri States (267). The last rickettsia is probably the best illustration, in 1939, Rickettsia montanensis (formerly R. montana) in 1963, as R. parkeri was considered a nonpathogenic rickettsia for and Rickettsia rhipicephali in 1978. However, these rickettsiae more than 60 years. Furthermore, the pathogenicity of Rick- were generally considered nonpathogenic (267, 276). ettsia massiliae has been recently demonstrated, 13 years after Distinctions between the occurrences of a single pathogenic its isolation from ticks (349). Other recently described rickett- tick-borne rickettsia and the various other nonpathogenic rick- siae, including Rickettsia helvetica strains in Europe and Asia, ettsiae that resided in ticks were also made by investigators have been presented as possible pathogens (267). from other continents. In 1910, the first case of Mediterranean The last major review on rickettsioses was published in 1997 spotted fever (MSF)
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