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1/4. Isolation of rickettsia prowazekii from blood by shell vial cell culture.

    A blood sample from a patient who returned from algeria with a fever inoculated on human embryonic lung fibroblasts by the shell vial cell culture technique led to the recovery of rickettsia prowazekii. The last clinical strain was isolated 30 years ago. Shell vial cell culture is a versatile method that could replace the classic animal and/or embryonated egg inoculation.
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2/4. Possible typhus-group infection in new york State: presentation of four suspect cases.

    Epidemiologic investigations were recently conducted on four cases which were reported in new york State in 1986 and 1987, three of which were within one family. These included hospital chart reviews, case or family interviews, animal trappings, and ectoparasite surveys. serologic tests and immunoblots were performed on blood samples obtained from these patients. All four patients had acute febrile illnesses; two required hospitalization and one died. Microimmunofluorescence test results using rickettsia typhi and R. prowazekii antigens showed a greater than or equal to 4-fold increase in titer with paired sera from three patients. The remaining patient had a single serum titer of 4096 with both antigens. In addition, sera from all patients reacted with R. typhi in the immunoblot test and, from the three patients for whom sera were available, also with R. prowazekii. Results suggest that the four patients were exposed to the typhus-group rickettsiae or to an organism which shares a common epitope(s).
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3/4. epidemiology and ecology of rickettsial diseases in the People's Republic of china.

    Since 1949, information on rickettsial diseases in the People's Republic of china has been virtually nonexistent in the West. This is the first comprehensive review of the ecology and epidemiology of Chinese rickettsial diseases to be published outside the People's Republic. At least five rickettsioses exist in china: scrub typhus, murine typhus, epidemic typhus, q fever, and one or more spotted fever-group (SFG) rickettsioses. Although epidemic typhus has been controlled and scrub typhus has abated in many areas, murine typhus, q fever, and SFG rickettsiosis are important public health problems. Serologic surveys indicate high prevalences of antibodies to coxiella burnetii, Rickettsia tsutsugamushi, and SFG rickettsiae in some regions; these rickettsiae have been isolated from humans, arthropods, and animals. doxycycline has emerged as the best treatment for murine typhus, epidemic typhus, and scrub typhus. china offers both opportunities and challenges for the investigation and alleviation of the problems of rickettsial diseases.
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4/4. Epidemic typhus in the united states associated with flying squirrels.

    Between July 1977 and January 1980, seven cases of sporadic, nonepidemic "epidemic" typhus (rickettsia prowazekii) were discovered in Virginia, west virginia, and north carolina. The reservoir seemed to be the southern flying squirrel (Glaucomys volans), an animal indigenous to the eastern united states; however, the vector or mode of acquisition was not evident. diagnosis was established principally through complement fixation, indirect immunofluorescence, and toxin neutralization tests. patients' ages were 11 to 81 years. Most were white women. Six had abrupt onset of illness. Headaches, fever, myalgias, and exanthems were among the presenting complaints. The disease seemed milder than classic louse-born epidemic typhus, but in some instances, it was life-threatening. All patients responded to tetracycline or chloramphenicol. This entity probably is more common than reported, is difficult to recognize, and is produced by an organism seemingly identical to that producing louse-born epidemic typhus.
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