Trench fever

trench fever disease.

1. TRENCH FEVER PREPARED BY: Nurfarah ain limin (p74703)

2. Trench Fever An acute febrile illness caused by a gram-negative bacterium known as Bartonella quintana ( Relman , D. A., 1995) Trench fever first reported during World War 1, when approximately 1 million soldiers developed this disease ( Byam , W., 1919)

3. PATHOGEN OF TRENCH FEVER (http :// idsc.nih.go.jp/iasr/31/370/tpc370.html ) B. quintana has typical gram-negative cell wall but stains poorly with Gram’s stain B. quintana is an aerobic, non-motile, short bacillary organism . It’s able to survive for prolonged period in dried louse feces ( Relman , D. A., 1995)

4. PATHOPHYSIOLOGY

5. Laser confocal microscopy showing the intraerythrocytic location of Bartonella quintana Magnification × 400 Source: Emerging Infectious Diseases. 2006; Centers for Disease Control and Prevention (CDC)

6. VECTORS of B. quintana Body lice ( Pediculus humanus corporis ) are the vectors of B. quintana B.quintana is transmitted when an infected louse excretes the bacterium onto the host’s skin The excretion is then scratched or rubbed into the skin (Vinson, J. W ., et al. , 1969)

7. LIFE CYCLE of P.humanus http://www.cdc.gov/parasites/lice/body/biology.html

8. RISKY GROUP Infection with B.quintana is associated with: Homelessness Alcoholism in poor people Poor sanitation Crowded population ( Spach , D. H., et al ., 1995)

9. GEOGRAPHICAL DISTRIBUTION OF CASES Trench fever has appeared in every continent except Australia and Antartica since the first appearance in World War 1 ( Maurin , M., et al ., 1996) In 1997, an epidemic of trench fever erupted in refugee camps in Burundi, Africa ( Raoult , D., et al., 1998)

10. Prevalence of B.quintana infestation on homeless population in: Country Percentage (%) United States of America (San Francisco) 33.3% France 20.0% Japan 16.7% Russia 12.3% ( Brouqui , P., et al., 1999)

11. Some patients developed “classic trench fever symptoms” Headache Rash Mild fever Bone pain (mainly in shins) Neck and back pain Pain behind the eyes Other clinical manifestations: Relapsing febrile illness ( recurrent fever, usually every fifth day) Endocarditis (inflamed of endocardium usually involve heart valve) Lymphadenopathy (swollen lymph nodes ) Bacteremia (bloodstream infection) SYMPTOMS (Foucault, C., et al., 2006)

12. SYMPTOMS

13. TREATMENT B.quintana is sensitive to antibiotics such as: Penicillins Deoxycycline Tetracycline Gentamicin Erythromycin Aminoglycosides – 1 st line treatment for Bartonella infections because it has bactericidal effect ( http :// wwwnc.cdc.gov/eid/article/12/2/05-0874_article.htm ) (Myers, W. F., et al., 1984)

14. PREVENTION Avoid exposure to human body lice typically in crowded condition and limited access to proper personal hygiene Wear clean clothes and wash them regularly

15. REFERENCES Vinson, J. W., Varela, G. and Molina- Pasquel , C. (1969) Trench Fever. 111. Induction of clinical disease in volunteers inoculated with Rickettsia quintana propagated on blood agar . The American Journal of Tropical Medicine and Hygiene, 18, 713-722. Relman , D. A. (1995) Has trench fever returned? The New England Journal and Medicine, 332, 463-464. Spach , D.H., Kanter , A. S., Dougherty, M. J. et al. (1995) Bartonella ( Rochalimaea ) quintana bacteremia in inner-city patients with chronic alcoholism. The New England Journal of Medicine , 332, 424-428. Byam,W . (1919) Trench fever. London: Henry Frowde and Hodder & Stoughton. Raoult , D. Ndihokubwayo , J. B., Tissot-Dupont , H. et al. (1998). Outbreak of epidemic typhus associated with trench fever in Burundi. Lancet , 352, 353-358.

16. REFERENCES http:// wwwnc.cdc.gov/eid/article/12/2/05-0874_article.html http:// idsc.nih.go.jp/iasr/31/370/tpc370.html http:// www.cdc.gov/parasites/lice/body/biology.html http://www.businessinsider.com/homeless-shelter-photos-2012-1?IR=T& http://sniffandflehmen.tumblr.com/post/78993226/sanitation-in-Africa http://www.skinsight.com/atlas/trenchFever.htm http:// www.pharmacy-and-drugs.com/Heart_diseases/Endocarditis.html http://wwwnc.cdc.gov/eid/article/12/2/05-0874_article.htm http :// wwwnc.cdc.gov/eid/article/12/2/05-0874_article.htm

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