Boutonneuse Fever in Romania between 2000–2008

Abstract

We describe the geographical and temporal distribution of boutonneuse fever ( MSF) cases in Romania in the 2000 to 2008 interval. All cases of boutonneuse fever recorded nationwide during the 2000 - 2008 interval came from the South of Romania and have exclusively evolved as sporadic cases. Highest incidence rate was registered in 2001 in Constanta (44.2% 000). Boutonneuse fever cases were recorded since May to October with a peak in August (38% of cases). Patients were living mainly in urban areas (80%). Most affected age group was 45-54 years (25%). The predominant clinical form of disease was the mild form (58%) and in 99.5% of cases, the outcome was favorable. In the studied interval there were two deaths from boutonneuse fever. Of reported cases, 96% recognized tick exposure by coming into contact with parasitized dogs (92%) or other domestic animals (3%). Exposure was most common at home (60%), but 4% of boutonneuse fever cases had professional exposure. The geographical distribution of boutonneuse fever cases reported in Southern Romania between 2000 – 2008 overlaps the distribution of the vectors, while temporal distribution respects the maximum activity interval of vectors. However, a trend of extending the reporting interval was noticed, as our case reporting interval was starting from May compared with the June- September previous pattern. Sporadic case pattern evolution of boutonneuse fever cases demonstrated persistent natural reservoirs (foci) of infected ticks in Southern Romania. Key words: cases, patients, Rickettsia conorii, geographical area.