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Rickettsioses and Q fever in Croatia

The aim. To analyze and present the data of the current knowledge about rickettsiae and rickettsioses in Croatia. Methods. Retrospective study based on the epidemiological reports and official data on rickettsiosis and Q fever cases from the Croatian Institute of Public Health, and a review the relevant literature (by computer-search of Pubmed). Results. From 1957 to 2011, a total of 174 epidemic typhus (ET) or Brill-Zinsser cases were recorded in Croatia. In 1969 the last case of ET was reported. The sporadic cases, of murine typhus occurred in or originated exclusively from the Croatian littoral and islands between Zadar and Split. Human cases of Mediterranean spotted fever (MSF) have been observed along the Croatian coast, mainly in the area from Zadar to Dubrovnik. Serological evidence of circulation of R.conorii among inhabitants was obtained in all the surveyed localities in southern Croatia. According to the study of ticks, Dermacentor marginatus ticks were infected with Rickettsia slovaca, whereas H. marginatum were infected with R. aeschlimannii, and R. hoogstraalii sp. nov. strain Croatica as a novel species of spotted fever group Rickettsia was found in Haemaphysalis sulcata ticks in southern Croatia. In northwestern Croatia D. reticulatus ticks were infected with Rickettsia helvetica, R. slovaca, and R. raoultii. In 1991 R. akari was isolated from blood of a patient diagnosed with MSF in Zadar. Subsequent study in the area found 24.8% seropositive persons to R. akari, but none case of rickettsialpox was reported. Q fever is an endemic disease in many parts of Croatia where the minor or major epidemics have been described every year. Conclusion. Rickettsiae, rickettsial diseases, and Q fever were, currently are and will be a significant health problem in Croatia. Further studies of the pathogenicity and the role of known and novel rickettsiae for human health in Croatia are warranted.

Rickettsiae; Rickettsial Diseases; Q fever; Croatia

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