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Volume 18, Number 1—January 2012

Letter

Bartonella quintana Transmission from Mite to Family with High Socioeconomic Status

Oto MelterComments to Author , Mardjan Arvand, Jiří Votýpka, and Dagmar Hulínská
Author affiliations: Charles University, Prague, Czech Republic (O. Melter); Zentrum für Gesundheitsschutz, Dillenburg, Germany (M. Arvand); National Institute of Public Health, Prague (J. Votýpka, D. Hulínská)

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Table

Patient and microbiologic data from a study of Bartonella quintana transmission from mites to a family with high socioeconomic status, Czech Republic, 2007*

Day after symptom onset† Date of specimen collection Specimen type‡ Case-patient Main symptoms Specimen testing
Incubation period, d
IgG titer§ PCR¶
1 NA NA Daughter, son Papular rash, pruritic lesions NA NA 14
3 2007 Jul 5 Serum Son Rash, vesicles, fever (temperature 39°C) Neg Neg/ND 14
Serum Daughter Rash, vesicles, fever (temperature 39.5°C) Neg Neg/ND 14
4 2007 Jul 6 Serum Father Recurrent fever (temperature 38.5°C), tibialgia, headache 256 Pos/pos 15
5 2007 Jul 7 Serum Mother Vesicles, tibialgia 512 Neg/ND 16
6 2007 Jul 11 Mites NA NA NA Pos/pos NA
28 2007 Aug 2 Serum Epidemiologist Malaise, arthralgia, headache 256 Neg/ND 16
35 2007 Aug 9 Serum Grandfather Malaise, arthralgia, rash, headache Neg Neg/ND 14
Serum Grandmother 1 Fatigue, malaise 256 Neg/ND 14
Serum Grandmother 2 Fatigue, malaise 64 Neg/ND 14
41 2007 Aug 15 Serum Son Recurrent fever 256 Neg/ND 14
Serum Daughter Recurrent fever 64 Neg/ND 14
Serum Father Malaise and intense headache 256 Neg/ND 15
Serum Mother Malaise and intense headache 512 Neg/ND 16
Serum Grandfather Recurrent fatigue and malaise Neg Neg/ND 14
Serum Grandmother 1 Recurrent fatigue and malaise 256 Neg/ND 14
68 2007 Sep 11 Mites NA NA NA Pos/pos NA
74 2007 Aug 17 Serum Epidemiologist Recurrent fever; fatigue and intense headache 512 Neg/ND 16
163 2007 Dec 13 Serum, B, H Epidemiologist Poor concentration, headache 256 Neg/ND 16
197 2008 Jan 17 Serum, B, H Son None Neg Neg/ND 14
Serum, B, H Daughter None Neg Neg/ND 14
Serum, B, H Father Poor concentration, headache 128 Neg/ND 15
Serum, B, H Mother None 128 Neg/ND 16
Serum, B, H Grandmother 1 None Neg Neg/ND 14

*NA, not applicable; neg, negative; ND, not done; pos, positive; B, blood with anticoagulant EDTA; H, hemoculture. During August 9–19, 2007, children and adult case-patients received oral clarithromycin and oral doxycycline, respectively. On August 9 and 19, 2007, the apartment building in which the case-patients lived was treated with insecticide.
†Days after symptom onset do not correlate with incubation period in last column.
‡Specimens were analyzed as follows: serum by serologic testing, EDTA blood by PCR, hemoculture by culture. Patient serum samples were negative for Anaplasma phagocytophilum (by immunofluorescence assay [IFA], IgM, and IgG); Borrelia bugdorferi (by ELISA and Western blot, IgM, and IgG); Coxiella burnetii, Rickettsia connorii, and R. prowazekii (IFA, total immunoglobulin).
§Determined by IFA.
¶Detected by 16S rRNA and by htrA amplification.

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