Detection of Rickettsia parkeri from within Piura, Peru, and the first reported presence of Candidatus Rickettsia andeanae in the tick Rhipicephalus sanguineus

Domestic farm animals (n=145) were sampled for the presence of ectoparasites in northwestern Peru during March, 2008. Ninety domestic animals (62%) were positive for the presence of an ectoparasite(s) and produced a total collection of the following: 728 ticks [Amblyomma maculatum, Anocentor nitens, Rhipicephalus (Boophilus) microplus, Rhipicephalus sanguineus, and Otobius megnini], 12 lice (Haematopinus suis), and 3 fleas (Ctenocephalides felis). A Rickettsia genus-specific qPCR assay was performed on nucleic acid preparations of the collected ectoparasites that resulted in 5% (37/743, 35 ticks and 2 fleas) of the ectoparasites positive for the presence of Rickettsia. DNA from the positive individual ticks was tested with 2 other qPCR assays for the presence of the ompB gene in Candidatus Rickettsia andeanae or Rickettsia parkeri. Candidatus R. andeanae was found in 25 A. maculatum ticks and in two Rh. sanguineus ticks, whereas R. parkeri was detected in 6 A. maculatum ticks. Two A. maculatum were co-infected with both Candidatus R. andeanae and R. parkeri. Rickettsia felis was detected in 2 fleas, Ctenocephalides felis, by multilocus sequence typing of the 17-kD antigen and ompA genes. These findings expand the geographic range of R. parkeri to include Peru as well as expand the natural arthropod vector of Candidatus R. andeanae to include Rhipicephalus sanguineus.

[Concurrent infections by two dengue virus serotypes during an outbreak in northwestern Peru, 2008]

OBJECTIVES

To establish the existence of concurrent infections by different dengue virus (DENV) serotypes in an outbreak in the Northwestern in Peru during 2008.

MATERIAL AND METHODS

73 serum samples from patients with dengue were analyzed during an outbreak that occurred in Northwestern in Peru between May and June 2008. Molecular biology techniques were used to serotype the DENV, thus, firstly the viral RNA viral was extracted using Viral QIAamp RNA mini kit (Qiagen, Valencia, California, USA), then the viral cDNA fragments were reverse transcripted and amplified by means of the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and the RT-Nested PCR region techniques and finally, genetic sequencing of the viral cDNA fragments were performed using the Big Dye Terminator v.3,1 kit.

RESULTS

The 73 dengue cases presented infections by different serotypes: 34 (46.6%) by DENV-3, 29 (39.7%) by DENV-1, 4 (5.5%) by DENV-4, and 6 (8.2%) concurrent infections by DENV-1 and DENV-3. The most frequent clinical manifestations observed among dengue patients were fever and headache (100%), myalgia (94.5%), ocular pain (83.6%), arthralgia (78.1%), shivers (63.0%), nausea/vomiting (38.4%), positive tourniquet test (30.1%), and rash (20.5%). All patients with concurrent infections presented light clinical course of dengue fever (DF) except one patient who had moderate hemorrhagic manifestations.

CONCLUSION

This is the first Peruvian report of patients with concurrent infections of two DENV serotypes without severe clinical manifestations.

[Risk sexual behavior among people living with HIV/AIDS and receiving antiretroviral therapy in Piura, Peru]

OBJECTIVE

To explore opinions and beliefs about risky sexual behavior and HIH transmission in tow hospital of Piura.

MATERIAL AND METHODS

Qualitative study based on extensive interviews and focus groups of people over 15 years old of age living with HIV. Interviews were recorded as audio, and then transcribed as text in MS Word. Information was analyzed with AtlasTi.

RESULTS

Results indicate that people living with HIV and receive antiretrovirals practice risky sexual behavior. Those results agree with quantitative-epidemiological studies establishing that TARGA era is associated with continuation or increase of risky sexual behavior. Two reasons could explain such behavior; first there is a belief that HIV is innocuous by effect of the antiretrovirals. Second, there is belief that a medical confirmation of undetectable viral count means being healed from infection.

CONCLUSIONS

People living with HIV receiving antiretrovirals improving general health status maintain risky sexual behavior that may facilitate HIV transmission to their serodiscordant partners and increase the number of people infected. Until now, prevention activities mostly targeted people believed not to be infected, however, it is also necessary an intense secondary prevention effort that includes an explicit approach of sexuality in its entire dimension.