Centre for Research in Tropical Medicine (CRTM), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Wilderness Environ Med. 2021 Dec;32(4):499-502. doi: 10.1016/j.wem.2021.05.003. Epub 2021 Jul 29.
Tea plantations in Sri Lanka cover the central hills of the island, where spotted fever group (SFG) rickettsial infection is common. In most cases, the history of tick bite is obscure and eschars are not present. A 45-y-old female experienced massive tick bites while working in her tea plantation. She developed fever 2 d after exposure, but the diagnosis of SFG infection was not considered until a skin rash appeared on the eighth day. She had a very high titer of antirickettsial antibodies detected by immunofluorescence assay and responded to doxycycline. Here, we highlight the high risk of exposure to ticks and tick bites within tea estates and its causal relationship to SFG infection, which is increasing in Sri Lanka. Active case detection, notification, surveillance, and community awareness are imperative. Possible preventative measures for tick bites have to be introduced. There is a need to explore the effectiveness of local remedies currently in use.
斯里兰卡的茶园覆盖了该岛的中部山区，那里常见斑点热群（SFG）立克次体感染。在大多数情况下，蜱虫叮咬的病史不明确，也没有出现焦痂。一名 45 岁女性在茶园工作时被大量蜱虫叮咬。她在接触后 2 天出现发热，但直到第 8 天出现皮疹时才考虑到 SFG 感染的诊断。她的抗立克次体抗体滴度通过免疫荧光检测非常高，对多西环素有反应。在这里，我们强调了在茶园中接触蜱虫和蜱虫叮咬的高风险及其与 SFG 感染的因果关系，这种感染在斯里兰卡正在增加。必须积极开展病例发现、报告、监测和社区意识。必须引入预防蜱虫叮咬的可能措施。需要探索目前正在使用的本地疗法的效果。
