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Letter
Rickettsia felis, Bartonella
henselae, and B.
clarridgeiae, New Zealand
Patrick J. Kelly,*
Natalie Meads,* Anita Theobald,* Pierre-Edouard Fournier,† and Didier
Raoult†
*Massey University, Palmerston North, New Zealand; and †Faculté de Médecine,
Marseille, France
Suggested citation
for this article:
Kelly PJ, Meads N, Theobald A, Fournier PE, Raoult D. Rickettsia
felis, Bartonella henselae, and B. clarridgeiae, New Zealand.
Emerg Infect Dis [serial on the Internet]. 2004 May [date cited].
Available from: http://www.cdc.gov/ncidod/EID/vol10no5/03-0986.htm
To the Editor: The cat flea (Ctenocephalides felis felis
Bouché, 1935) is a ubiquitous parasite of domestic and wild animals that
also feeds readily on people. Recent studies have implicated the cat flea
as a vector of new and emerging infectious diseases (1).
To determine the pathogens in C. felis in New Zealand, we collected
3 cat fleas from each of 11 dogs and 21 cats at the Massey University
Veterinary Teaching Hospital from May to June 2003. The fleas were stored
in 95% alcohol until they were identified by using morphologic criteria
and washed in sterile phosphate-buffered saline. The DNA from each flea
was extracted individually by using the QiaAmp Tissue Kit (QIAGEN Ltd.,
Hilden, Germany), according to the manufacturer's instructions. When polymerase
chain reaction (PCR) was performed with primers for gltA and rOmpA
as described (2), products were obtained with DNA from
15 (15%) of the fleas. The sequences of the products were identical to
those of Rickettsia felis (GenBank AF191026) with infected fleas
taken from both dogs (3/11; 27%) and cats (7/21; 33%). When PCR was performed
with primers for the 16S-23S rDNA interspacer region as described (3),
products were obtained with DNA of four fleas. The sequences of the products
from three fleas (from two cats) were identical to that of Bartonella
henselae (GenBank AF312495), and the sequence of the product of one
flea (from a cat) was identical to that of B. clarridgeiae (GenBank
AF167989).
Our study is the first to identify R. felis in Oceania. The organism
is a recently described human pathogen, and infections with this spotted
fever group rickettsia have already been reported in 11 persons: 4 persons
in the United States, 2 persons in Brazil, 4 persons in Europe, and 1
person in Thailand. The symptoms of the patients were nonspecific and
included fever, headache, and rash. Diagnoses were made by sequencing
products obtained by PCR with primers for the 17-kDa protein (4),
citrate synthase (4), and PS 120 protein (5)
genes. R. felis has been established in tissue culture (XTC-2 and
Vero cells) (6), and serologic testing has been used
to diagnose infections (5). Reports indicate that patients
respond rapidly to doxycycline therapy (5), and in vitro
studies have shown the organism is susceptible to rifampin, thiamphenicol,
and fluoroquinolones.
B. henselae is an agent of cat-scratch disease, bacillary angiomatosis,
bacillary peliosis, endocarditis, bacteremia, and various neurologic and
ocular conditions. Cats are the reservoir hosts, and contact with cats
and their fleas is an established risk factor for most infections. Although
B. henselae has been isolated from 17% of domestic cats in New
Zealand (7), only two human infections have been reported
in the country; neuroretinitis was diagnosed in both patients (8).
In neighboring Australia, however, cat-scratch disease, bacillary angiomatosis,
and endocarditis have been diagnosed in numerous patients. Cats are also
the reservoir hosts of B. clarridgeiae which has been implicated
as an agent of cat-scratch disease in humans and aortic valve endocarditis
and hepatic disease in dogs (9). The organism has been
found in cat fleas (as great as 17%) in Europe (1), and
although we found only one flea infected with B. clarridgeiae in
New Zealand, this description is the first of the organism in Oceania.
However, B. clarridgeiae has been found in domestic cats in nearby
Indonesia and the Philippines (10).
Our findings add to the accumulating data on R. felis, B. henselae,
and B. clarridgeiae and should alert medical workers in New Zealand,
a common tourist destination, to the possibility that their patients may
be infected with these organisms.
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