Foley Janet, López-Pérez Andrés M, Álvarez-Hernández Gerardo, Labruna Marcelo B, Angerami Rodrigo Nogueira, Zazueta Oscar E, Bermudez Sergio, Rubino Francesca, Salzer Johanna S, Brophy Maureen, Pinter Adriano, Paddock Christopher D
School of Veterinary Medicine, University of California-Davis, Davis, CA.
Red De Biología y Conservación De Vertebrados, Instituto De Ecología, Veracruz, México.
Am J Vet Res. 2025 Feb 4;86(3). doi: 10.2460/ajvr.24.11.0368. Print 2025 Mar 1.
RMSF, a tickborne infection caused by Rickettsia rickettsii, produces severe and fatal disease in humans and dogs. Since the beginning of the 21st century, cases have risen dramatically, most notably in Mexico and Brazil, where outbreaks occur in urban centers including cities with populations of > 1,000,000 persons. Reported case fatality rates can exceed 50%. Factors consistent with high case fatality include lack of awareness of disease ecology, limited capacity for diagnosis, and delay in appropriate antimicrobial treatment. The emergence of urban hyperendemic foci has been leveraged by 2 distinct but similar anthropogenic events that create disproportionately high numbers of vertebrate amplifiers of R rickettsii, as well as the tick species that transmit this pathogen in proximity with dense human populations. This often occurs in neighborhoods with a highly marginalized at-risk population that includes persons in poverty and particularly children, and health management systems that are under-resourced. We discuss strategies to reduce host dog populations, particularly in Mexico, and capybaras in Brazil. We review challenges to the control of tick populations in these settings. Robust systems are required to enhance awareness of RMSF among medical practitioners and people at risk of RMSF. Public health campaigns should incorporate innovative behavioral science (eg, diverse learning models, motivational interviews, and gamification) to increase prevention and understanding within communities. While anti-Rickettsia or anti-tick vaccines will be necessary to resolve this One Health crisis, impactful implementation will require data-driven and multiple-target innovations to address challenges with hosts, ticks, medical systems, and public welfare. The companion Currents in One Health by Foley, Backus, and López-Pérez, JAVMA, March 2025, addresses helpful information for the practicing veterinarian.
落基山斑疹热是由立氏立克次体引起的一种蜱传感染病，可导致人类和犬类患上严重的致命疾病。自21世纪初以来，病例数急剧上升，最显著的是在墨西哥和巴西，在包括人口超过100万的城市在内的城市中心爆发疫情。报告的病死率可能超过50%。与高病死率相关的因素包括对疾病生态缺乏认识、诊断能力有限以及适当抗菌治疗的延迟。城市高流行病灶的出现是由两种不同但相似的人为事件导致的，这些事件造成了数量极多的立氏立克次体脊椎动物扩增宿主，以及在密集人群附近传播这种病原体的蜱种。这种情况经常发生在高危人群高度边缘化的社区，这些人群包括贫困人口，尤其是儿童，以及资源不足的卫生管理系统。我们讨论了减少宿主犬数量的策略，特别是在墨西哥，以及巴西的水豚。我们回顾了在这些环境中控制蜱虫数量所面临的挑战。需要强大的系统来提高医疗从业者和有落基山斑疹热风险的人群对该病的认识。公共卫生运动应纳入创新的行为科学（如多样化的学习模式、动机访谈和游戏化），以增强社区内的预防意识和理解。虽然解决这一“同一健康”危机需要抗立克次体或抗蜱疫苗，但有效的实施将需要数据驱动的多目标创新，以应对宿主、蜱虫、医疗系统和公共福利方面的挑战。Foley、Backus和López-Pérez于2025年3月发表在《美国兽医医学协会杂志》上的同期“同一健康”专题文章，为执业兽医提供了有用的信息。
