Rickettsial Diseases: From Epidemiology to Molecular Biology, The Pathway Toward Disease Control

  • David H. Walker


Rickettsial diseases comprise a heterogeneous group of illnesses that occur throughout the world (Table 1) . They are remarkably underrecognized owing to the absence of clinical distinctiveness and unavailability of effective, specific laboratory diagnostic methods in many geographic areas (1).


Scrub Typhus Spotted Fever Major Outer Membrane Protein Spotted Fever Group Rickettsial Infection 
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  1. 1.
    Walker DH (1989) Rocky Mountain spotted fever: a disease in need of microbiological concern. Clin Microbiol Rev 2: 227–240PubMedGoogle Scholar
  2. 2.
    Weisburg WG, Dobson ME, Samuel JE, Dasch GA, Mallavia LP, Baca O, Mandelco, Sechrest JE, Weiss E, Woese CR (1989) Phylogenetic diversity of the rickettsiae. J Bacteriol 171: 4202–4206PubMedGoogle Scholar
  3. 3.
    Hattwick MAW, O’Brien RJ, Hanson BF (1976) Rocky Mountain spotted fever: epidemiology of an increasing problem. Ann Intern Med 84: 732–739PubMedGoogle Scholar
  4. 4.
    Fishbein DB, Yevich SJ, Sanchez JL, Dawson JE, Greene CR, Reid-Sanden F, Kardatzke JT (1991) Serologic studies of military personnel exposed to ticks during field exercises in Arkansas. Abstract from the American Society for Rickettsiology and Rickettsial Diseases Sesqui-Annual Meeting, May 1–5, 1991, abstract 19Google Scholar
  5. 5.
    Cwikel BJ, Ishbarieh J, Sarov I (1990) Antigenic polypeptides of Israeli spotted fever isolates compared with other spotted fever group rickettsiae. Ann NYAcad Sci 590: 381–388CrossRefGoogle Scholar
  6. 6.
    Walker DH, Liu Q- H, Yu X-J, Li H, Taylor C (1991) Antigenic analysis of the major outer membrane proteins of Rickettsia conorii, Rickettsia parkeri, and the Israel spotted fever group rickettsia. Abstract of the American Society for Rickettsiology and Rickettsial Diseases Sesqui-Annual Meeting, May 1–5 1991, abstract 65Google Scholar
  7. 7.
    Sexton DJ, Dwyer B, Kemp R, Graves S (1991) Spotted fever group rickettsial infections in Australia. Rev Infect Dis 13: 876–886PubMedCrossRefGoogle Scholar
  8. 8.
    Uchida T, Yu XJ, Uchiyama T, Walker DH (1989) Identification of a unique spotted fever group rickettsia from humans in Japan. J Infect Dis 159: 1122–1126PubMedCrossRefGoogle Scholar
  9. 9.
    Phillip RN, Casper EA (1981) Serotypes of spotted fever group rickettsiae isolated from Dermacentor andersoni (Stiles) ticks in western Montana. Am J Trop Med Hyg 30: 230— 238Google Scholar
  10. 10.
    Burgdorfer W, Hayes SF, Mavros AJ (1981) Nonpathogenic rickettsiae in Dermacentor andersoni: a limiting factor for the distribution of Rickettsia rickettsii. In: Burgdorfer W, Anacker RL (eds) Rickettsiae and Rickettsial Diseases. New York, Academic Press, pp 585— 594Google Scholar
  11. 11.
    Zinsser H (1935) Rats, Lice, and History. New York, Little, Brown, and Co.Google Scholar
  12. 12.
    Sonenshine DE, Bozeman FM, Williams MS, Masiello SA, Chadwick DP, Stocks NI, Lauer DM, Elisberg L (1978) Epizootiology of epidemic typhus (Rickettsia prowaezekii) in flying squirrels. Am J Trop Med Hyg 27: 339–349PubMedGoogle Scholar
  13. 13.
    Traub R, Wisseman CL, Farhang-Azad A (1978) The ecology of murine typhus — a critical review. Trop Dis Bull 75: 237–317PubMedGoogle Scholar
  14. 14.
    Farhang-Azad A, Traub R, Baqar S (1985) Transovarial transmission of murine typhus rickettsiae in Xenopsylla cheopis fleas. Science 227: 543–545PubMedCrossRefGoogle Scholar
  15. 15.
    Walker DH, Parks FM, Betz TG, Taylor JP, Muehlberger JW (1989) Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus. Am J Clin Pathol 91: 720–724PubMedGoogle Scholar
  16. 16.
    Silverman DJ, Wisseman CL Jr (1978) Comparative ultrastructural study on the cell envelopes of Rickettsia prowazekii, Rickettsia rickettsii, and Rickettsia tsutsugamushi. Infect Immun 21: 1020–1023PubMedGoogle Scholar
  17. 17.
    Ching W-M, Dasch GA, Carl M, Dobson ME (1990) Structural analysis of the 120 kDa serotype protein antigens of typhus group rickettsiae. Comparison with other S-layer proteins. Ann NY Acad Sci 590: 334–351PubMedCrossRefGoogle Scholar
  18. 18.
    Anacker RL Mann RE, Gonzales C (1987) Reactivity of monoclonal antibodies to Rickettsiaa ricketsii with spotted fever and typhus group rickettsiae. J Clin Microbiol 25: 167–171PubMedGoogle Scholar
  19. 19.
    Anderson BE (1990) The 17-kilodalton protein antigens of spotted fever and typhus group rickettsiae. Ann NY Acad Sci 590: 326–333PubMedCrossRefGoogle Scholar
  20. 20.
    Li H, Lenz B, Walker DH (1988) Protective monoclonal antibodies recognize heat labile epitopes on surface proteins of spotted fever group rickettsiae. Infect Immun 56: 2587—2593PubMedGoogle Scholar
  21. 21.
    Anderson BE, McDonald GA, Hones DC, Regnery RI (1990) A protective antigen of Rickettsia rickettsii has tandemnly repeated, near-identical sequences. Infect Immun 58: 2760–2769PubMedGoogle Scholar
  22. 22.
    Williams JC, Walker DH, Peacock MG, Stewart ST (1986) Humoral immune response to Rocky Mountain spotted fever in experimentally infected guinea pigs: immunoprecipitation of lactoperoxidase 125I-labeled proteins and detection of soluble antigens of Rickettsia rickettsii. Infect Immun 52: 120–127PubMedGoogle Scholar
  23. 23.
    Silverman DJ, Wisseman CL Waddell AD, Jones M (1978) External layers of Rickettsia prowazekii and Rickettsia rickettsii: occurrence of a slime layer. Infect Immun 22: 233–245PubMedGoogle Scholar
  24. 24.
    Winkler HH (1990) Rickettsia species (as organisms) . Ann Rev Microbiol 44: 131–153CrossRefGoogle Scholar
  25. 25.
    Weiss KL Walker DH (1990) New and improved vaccines against rickettsial infections. Rocky Mountain spotted fever, epidemic typhus, and scrub typhus. In: Woodrow GC, Levine MM (eds) New generation vaccines. New York, Marcel Dekker, pp 357–374Google Scholar
  26. 26.
    Bourgeois AL, Dasch GA (1981) The species-specific surface protein antigen of Rickettsia typhi: immunogenicity and protective efficacy in guinea pigs. In: Burgdorfer W, Anacker RL (eds) Rickettsiae and rickettsial diseases. New York, Academic Press, pp 71–80Google Scholar
  27. 27.
    Churilla A, Ching W-M, Dasch GA, Carl M (1990) Human T lymphocyte recognition of cyanogen bromide fragments of the surface protein of Rickettsia typhi. Ann NY Acad Sci 590: 215–220PubMedCrossRefGoogle Scholar
  28. 28.
    Dasch GA, Burans JP, Dobson ME, Rollwagen FM, Misiti J (1984) Approaches to subunit vaccines against the typhus rickettsiae, Rickettsia typhi and Rickettsia prowazekii. In: Lieve L, Schlessinger D (eds) Microbiology 1984. Washington, Am Soc Microbiol, 251–256Google Scholar
  29. 29.
    Anacker RL, List RH, Mann RE, Hayes SF, Thomas LA (1985) Characterization of monoclonal antibodies protecting mice against Rickettsia rickettsii. J Infect Dis 151: 1052— 1060PubMedCrossRefGoogle Scholar
  30. 30.
    Feng HM, Walker DH, Wang JG (1987) Analysis of T-cell-dependent and independent antigens of Rickettsia conorii with monoclonal antibodies. Infect Immun 55: 7–15PubMedGoogle Scholar
  31. 31.
    Vishwanath S, McDonald GA, Watkins NG (1990) A recombinant Rickettsia conorii vaccine protects guinea pigs from experimental boutonneuse fever and Rocky Mountain spotted fever. Infect Immun 58: 646–653PubMedGoogle Scholar
  32. 32.
    Turco J, Winkler HH (1983) Inhibition of the growth of Rickettsia prowazekii in cultured fibroblasts by lymnphokines. J Exp Med 157: 974–986PubMedCrossRefGoogle Scholar
  33. 33.
    Wisseman CL Jr, Waddell A (1983) Interferonlike factors from antigen- and mitogenstimulated human leukocytes with antirickettsial and cytolytic actions on Rickettsia prowazekii.J Exp Med 157: 1780–1793PubMedCrossRefGoogle Scholar
  34. 34.
    Manor E, Sarov I (1990) Inhibition of Rickettsia conorii growth by recombinant tumor necrosis factor alpha: enhancement of inhibition by gamma intereferon. Infect Immun 58: 1886–1889PubMedGoogle Scholar
  35. 35.
    Rollwagen FM, Dasch GA, Jerrells TR (1986) Mechanisms of immunity to rickettsial infection: characterization of a cytotoxic effector cell. J Immunol 136: 1418–1421PubMedGoogle Scholar
  36. 36.
    Carl M, Ching W-M, Dasch GA (1988) Recognition of typhus group rickettsia-infected targets by human lymphokine-activated killer cells. Infect Immun 56: 2526–2529PubMedGoogle Scholar
  37. 37.
    Walker DH, Occhino C, Tringali GR, DiRosa S, Mansueto S (1988) Pathogenesis of rickettsial eschars: the tache noire of boutonneuse fever. Human Pathol 19: 1449–1454CrossRefGoogle Scholar
  38. 38.
    Li H, Jerrells TR, Walker DH (1991) Characterization of rickettsial attachment to target cells by flow cytometry. Abstract of the American Society for Rickettsiology and Rickettsial Diseases Sesqui-Annual Meeting, May 1–5, 1991, abstract 34Google Scholar
  39. 39.
    Walker TS (1984) Rickettsial interactions with human endothelial cells in vitro: adherence and entry. Infect Immun 44: 205–210PubMedGoogle Scholar
  40. 40.
    Wisseman CL Jr, Waddell AD (1975) In vitro studies on rickettsia-host cell interactions: intracellular growth cycle of virulent and attenuated Rickettsia prowazekii in chicken embryo cells in slide chamber cultures. Infect Immun 11: 1391–141PubMedGoogle Scholar
  41. 41.
    Walker DH, Cain BG (1980) The rickettsial plaque. Evidence for direct cytopathic effect of Rickettsia rickettsii. Lab Invest 43: 388–396PubMedGoogle Scholar
  42. 42.
    Harrell GT, Aikawa JK (1949) Pathogenesis of circulatory failure in Rocky Mountain spotted fever. Arch Intern Med 83: 331–347CrossRefGoogle Scholar
  43. 43.
    Kaplowitz LG, Fischer JJ, Sparling PF (1981) Rocky Mountain spotted fever: a clinical dilemma. Curr Clin Top Infect Dis 2: 89–108Google Scholar
  44. 44.
    Horney LF, Walker DH (1988) Meningoencephalitis as a major manifestation of Rocky Mountain spotted fever. South Med J 81: 915–8PubMedCrossRefGoogle Scholar
  45. 45.
    Walker DH, Crawford CG, Cain BG (1980) Rickettsial infection of the pulmonary microcirculation: the basis of interstitial pneumonitis of Rocky Mountain spotted fever. Human Pathol 11: 263–272CrossRefGoogle Scholar
  46. 46.
    Wolbach SB, Todd JL, Palfrey FW (1922) Clinical observations, pp. 15–33, Pathology of typhus, pp 152–227. In: The Etiology and Pathology of Typhus. The League of Red Cross Societies, Cambridge, Harvard PressGoogle Scholar
  47. 47.
    Winkler HH, Daugherty RM (1989) Phospholipase A activity associated with the growth of Rickettsia prowazekii in L929 cells. Infect Immun 57: 36–40PubMedGoogle Scholar
  48. 48.
    Walker DH, Tidwell RR, Rector TM, Geratz JD (1984) Effect of synthetic protease inhibitors of the amidine type on cell injury by Rickettsia rickettsii. Antimicrob Agents Chemother 25: 582–585PubMedCrossRefGoogle Scholar
  49. 49.
    Silverman DJ, Santucci LA (1990) A potential protective role for thiols against cell injury caused by Rickettsia rickettsii. Ann NYAcad Sci 590: 111–117CrossRefGoogle Scholar
  50. 50.
    Schramek S, Brezina R, Kazar J (1977) Some biological properties of an endotoxic lipopolysaccharide from the typhus group rickettsiae. Acta Virol 21: 439–441PubMedGoogle Scholar
  51. 51.
    Kaplowitz LG, Lange JV, Fischer JJ, Walker DH (1983) Correlation of rickettsial titers, circulating endotoxin, and clinical features in Rocky Mountain spotted fever. Arch Intern Med 143: 1149–1151PubMedCrossRefGoogle Scholar
  52. 52.
    Walker TS, Dersch MW, White WE (1991) Effects of typhus rickettsiae on peritoneal and alveolar macrophages: rickettsiae stimulate leukotriene and prostaglandin secretion. J Infect Dis 163: 568–573PubMedCrossRefGoogle Scholar
  53. 53.
    Walker TS, Brown JS, Hoover CS, Morgan DA (1990) Endothelial prostaglandin secretion: effects of typhus rickettsiae. J Infect Dis 162: 1136–1144PubMedCrossRefGoogle Scholar
  54. 54.
    Yamada T, Harber P, Pettit GW, Wing DA, Oster CN (1978) Activation of the kallikreinkinin system in Rocky Mountain spotted fever. Ann Intern Med 88: 764–768PubMedGoogle Scholar
  55. 55.
    Rollwagen FM, Bakun AJ, Dorsey CH, Dasch GA (1985) Mechanisms of immunity to infection with typhus rickettsiae: infected fibroblasts bear rickettsial antigens on their surfaces. Infect Immun 50: 911–916PubMedGoogle Scholar
  56. 56.
    Walker DH, Mattern WD (1980) Rickettsial vasculitis. Am Heart J 100: 896–906PubMedCrossRefGoogle Scholar
  57. 57.
    Fan MY, Walker DH, Yu SR, Liu QH (1987) Epidemiology and ecology of rickettsial diseases in the People’s Republic of China. Rev Infect Dis 9: 823–840PubMedCrossRefGoogle Scholar
  58. 58.
    Yagupsky P, Sarov B, Sarov I (1989) A cluster of cases of spotted fever in a kibbutz in southern Israel. Scand J Infect Dis 21: 155–160PubMedCrossRefGoogle Scholar
  59. 59.
    Wilfert CM, MacCormack JN, Kleeman K, Philip RN, Austin E, Dickinson V, Turner I (1984) Epidemiology of Rocky Mountain spotted fever as determined by active surveillance. J Infect Dis 150: 469–479PubMedCrossRefGoogle Scholar
  60. 60.
    Walker DH, Peacock MG (1988) Laboratory diagnosis of rickettsial diseases. In: Walker DH (ed) Biology of rickettsial diseases, Vol II. Boca Raton, CRC Press, pp 135–155Google Scholar
  61. 61.
    McDonald GA, Anacker RL, Garjian K (1987) Cloned gene of Rickettsiaa rickettsii surface antigen: candidate vaccine for Rocky Mountain spotted fever. Science 235: 83–85PubMedCrossRefGoogle Scholar
  62. 62.
    Brown GW, Shirai A, Jegathesan M, Burke DS, Twartz JC, Saunders JP, Huxsoll DL (1984) Febrile illness in Malaysia- an analysis of 1,629 hospitalized patients. Am J Trop Med Hyg 33: 311–315PubMedGoogle Scholar
  63. 63.
    Smadel JE, Ley HL Diercks FH, Traub R (1950) Immunity in scrub typhus: resistance to induced reinfection. Arch Pathol 50: 847–861Google Scholar
  64. 64.
    Twartz JC, Shirai A, Selvaraju G, Saunders JP, Huxsoll DL, Groves MG (1982) Doxycycline prophylaxis for human scrub typhus. J Infect Dis 146: 811–818PubMedCrossRefGoogle Scholar
  65. 65.
    Eng TR, Harkess JR, Fishbein DB, Dawson JE, Greene CN, Redus MA, Satalowich FT (1990) Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States. JAMA 264: 2251–258PubMedCrossRefGoogle Scholar
  66. 66.
    Uhaa IJ, Sanchez JL Dawson JE, Greene CR, Kardatzke JT, Fishbein DB (1991) Epidemiologic, clinical, and serologic investigation of patients with suspected tick-borne illnesses. Abstract from the American Society for Rickettsiology and Rickettsial Diseases Sesqui-Annual Meeting, May 1–5, 1991, abstract 61Google Scholar
  67. 67.
    Dawson J, Anderson B, Fishbein D, Sanchez J, Goldsmith C, Wilson K, Duntley C (1991) Isolation and characterization of an Ehrlichia sp. from a patient diagnosed with human ehrlichiosis. J Clin Microbiol 29: 2741–2745PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • David H. Walker
    • 1
  1. 1.Department of PathologyThe University of Texas Medical BranchGalvestonUSA

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