Rickettsiosis importadas en viajeros e inmigrantes en +Redivi, una red colaborativa en España.

Abstract

La rickettsiosis está reconocida como causa de fiebre importada en estudios previos basados en datos de sistemas de vigilancia. No existen, en la literatura hasta la fecha, análisis descriptivos sobre los casos de rickettsiosis importados en España. Por ello, hemos desarrollado un estudio observacional retrospectivo y multicéntrico, anidado en la red colaborativa española de consultas de atención al viajero e inmigrante +REDIVI, con el objetivo de describir las características demográficas, clínicas, epidemiológicas y microbiológicas de una cohorte de 56 casos de rickettsiosis importadas en viajero e inmigrantes, anidada en dicha red.

Rickettsiosis is recognized as a cause of imported fever in previous studies based on data from surveillance systems. There are no descriptive analyzes of rickettsiosis cases imported into Spain in the literature to date. To know the countries from where rickettsiosis cases are imported and the type of rickettsiosis imported from each country in travelers and immigrants included in the database of the collaborative network + Redivi, and describe the clinical and microbiological characteristics of said cases. Retrospective and multicenter observational study, nested in + REDIVI. Epidemiological, clinical and microbiological information on the cases identified as rickettsiosis in the network registry were requested from the collaborating centers from the beginning until December 2020. Subsequently, an analysis of the data was carried out using SSPS. 35/54 (64.8%) were men and 19/54 (35.2%) were women. The mean age was 39.3 [± 16.79] years. 47/54 (87%) were in travelers, 4/54 (7.5%) were in VFR (travelers visiting friends or family) and 3/54 (5.6%) were in immigrants. The most frequent place of origin was the Republic of South Africa with 21/54 cases (38.9%). 90.7% were related to risky activities. 50% of the patients began with symptoms after their return. The most frequent causes of consultation were febrile syndrome in 30/54 (55.6%) and skin manifestations in 15/54 (27.8%). The diagnosis was confirmed in 35/54 (64.81%), the most used test was the serological immunodiagnosis. The species could only be determined in 24 patients (20 R. conorii subspecies Conorii, 1 R. conorii subspecies Indica, 2 R. typhi, 1 R. slovaca). 5/54 (9.3%) required hospital admission. The most used treatment was doxycycline and the median duration of treatment was 7 days. 100% of the cases progressed to a cure. Most of the rickettsiosis imported into our country occur in male travelers, mostly from southern African countries, mainly the Republic of South Africa, and are associated with activities in rural areas and natural parks. Less than 10% of cases required hospital admission; all were cured.