Neorickettsia sennetsu as a Neglected Cause of Fever in South-East Asia

摘要: Neorickettsia sennetsu infection is rarely recognized, with less than 100 globally reported patients over the last 50 years. The disease thought to be contracted by eating raw fish, a staple of many South-East Asian cuisines. In 2009, first patient was identified in Lao PDR (Laos), raising question as how common this organism and related species are presenting fever. We investigated frequency N. at hospitals diverse areas Laos. Consenting febrile hospital inpatients from central (Vientiane: n = 1,013), northern (Luang Namtha: 453) southern (Salavan: 171) Laos were screened PCR for sennetsu, if no previous positive direct diagnostic test available. A PCR-restriction fragment length polymorphism assay developed differentiate between Ehrlichia chaffeensis Anaplasma phagocytophilum. To allow more detailed studies culture successfully established using reference strain (ATCC VR-367), identifying canine-macrophage cell line (DH82) most suitable visually identify infection. After screening, sequence confirmed four (4/1,637; 0.2%) patients. Despite previously high seroprevalence antibodies population (~17%), acute sufficient clinical signs prompt hospitalization appears rare. reservoir, zoonotic cycle pathogenicity remain unclear require further investigations.