NAME: Rickettsia rickettsii
SYNONYM OR CROSS REFERENCE: Rocky Mountain Spotted Fever (RMSF), New World spotted fever, Tick-borne typhus fever, Sao Paulo fever
CHARACTERISTICS: Pleomorphic gram-negative obligate intracellular bacterium 0.3-1.5 µm in size
PATHOGENICITY: Sudden onset with moderate to high fever persisting 2 to 3 weeks, malaise, deep muscle pain, severe headache, chills and conjunctival injection; maculopapular rash appears on extremities 3rd day and spreads rapidly; hemorrhages are common; 15-20% case fatality rate in absence of therapy but with treatment death is uncommon; clinical syndrome may be confused with atypical measles, ehrlichiosis, meningococcemia and enteroviral infection
EPIDEMIOLOGY: Occurs through USA during spring, summer and fall; many cases along eastern seaboard and the Rocky Mountain region; adult males infected most frequently in western USA and in East, incidence is higher in children; some infections in Canada, Central and South America
HOST RANGE: Humans, dogs, rodents, various other small animals
INFECTIOUS DOSE: < 10 organisms
MODE OF TRANSMISSION: Ordinarily by bite of an infected tick; several hours of attachment are required before the rickettsiae become reactivated to infect humans; by contamination of skin with crushed tissues or feces of tick
INCUBATION PERIOD: From 3 to 14 days
COMMUNICABILITY: Not directly transmitted from person-to-person; tick remains infectious for life, approximately 18 months
RESERVOIR: Maintained in nature in ticks by transovarian and transstadial passage; transmitted to humans, dogs, various rodents and animals
ZOONOSIS: Yes - bite from ticks from infected animals; contamination of broken skin or mucous membranes with feces or internal contents of crushed tick from infected animal
VECTORS: Ticks - East and South USA - dog tick,
Dermancentor variabilis
Northwest USA - wood tick, D.andersoni
Southwest USA - Lone Star tick, Amyblyomma
americanum
Latin America - A. cajennense
DRUG SUSCEPTIBILITY: Sensitive to tetracyclines and chloramphenicol
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite, 70% ethanol, glutaraldehyde, formaldehyde
PHYSICAL INACTIVATION: Sensitive to moist heat (121° C for at least 15 min) and dry heat (160-170° C for at least 1 hour)
SURVIVAL OUTSIDE HOST: Organism is stable in tick tissues or blood under ambient environmental conditions, surviving up to 1 year; sensitive to drying-feces of infected ticks quickly lose their infectivity on drying
SURVEILLANCE: Monitor for febrile illness and report symptoms immediately; confirm with IF, IgG does not appear until 7 to 10 days after onset
FIRST AID/TREATMENT: Appropriate antibiotic therapy in the early stages of infection should be initiated on clinical and epidemiologic considerations without waiting for laboratory confirmation of the diagnosis
IMMUNIZATION: None licensed; but may be available as killed experimental product from U.S. CDC
PROPHYLAXIS: Early antibiotic treatment lead to delayed onset of illness or relapse (tetracyclines and chloramphenicol do not kill Rickettsia)
LABORATORY-ACQUIRED INFECTIONS: Documented hazard to laboratory personnel; 63 cases reported up to 1976, 11 of which were fatal; one report of 9 cases occurring over a 6-year period in one laboratory (exposure to infectious aerosols)
SOURCES/SPECIMENS: Naturally and experimentally infected mammals, their ectoparasites, and their infected tissues
PRIMARY HAZARDS: Accidental parenteral inoculation and exposure to infectious aerosols (successful aerosol transmission documented in non-human primates)
SPECIAL HAZARDS: None
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment and facilities for all non-propagative laboratory procedures including serological and fluorescent antibody tests, and staining of impression smears; biosafety level 3 for all other manipulations of known or potentially infectious materials, including necropsy of infected animals and trituration of their tissues, and inoculation, incubation and harvesting of embryonated eggs or tissue culture
PROTECTIVE CLOTHING: Gloves and gown (tight wrists and ties in back) when working with agent
OTHER PRECAUTIONS: Animal biosafety level 2 practices and facilities are recommended for holding of experimentally infected rodents, however, all necropsy and manipulation of tissue should be conducted at Biosafety level 3
SPILLS: Allow aerosols to settle; wearing protective clothing; gently cover spill with paper towels and apply 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontaminate all wastes before disposal: incineration, steam sterilization
STORAGE: In sealed containers that are appropriately labelled
Date prepared: January, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001
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