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Fleas are known vectors of several important zoonotic pathogens. One of these, Rickettsia felis, the causative agent of flea borne spotted fever (FBSF), has been documented as a cause of human disease in Australia. There is also serological evidence of high levels of exposure to this pathogen in Australian veterinarians. Such findings reinforce the need for increased awareness among the veterinary profession of emerging zoonoses, and highlight the importance of educating clients on the importance of flea control, not only for the wellbeing of their pets, but also as a measure to help minimise zoonotic disease.
Like many rickettsial organisms, R. felis is transmitted by arthropod vectors; primarily the cat flea (Ctenocephalides felis). Given the ubiquitous distribution of C. felis in companion animals across Australia, the risk of human exposure to R. felis is likely considerably greater than to other zoonotic rickettsial organisms that are associated with arthropods infesting primarily native or non-domesticated species. The reported prevalence of R. felis in fleas parasitising cats and dogs in Australia is high, with studies demonstrating rates up to 36%. Both domestic dogs and cats have been shown to be infected with R. felis, however infection appears not to be associated with clinical signs in these species.
In humans, the clinical signs associated with rickettsial infections include pyrexia, myalgia and arthralgia, maculopapular rash, and fatigue. The disease course may be protracted, and at least in some cases can result in long term sequelae. Disease due to R. felis has been reported to be less severe than that seen with other rickettsial infections, with patients generally presenting with typical flu-like symptoms, however more severe manifestations, including neurological and multi-systemic disease, have been recorded. The first confirmed human cases of FBSF in Australia were reported in 2011 and involved a cluster of five patients exposed to a common source of infection through exposure to two flea infested kittens. Since this study, additional cases have been documented across Australia.
There is no information about the degree of exposure to R. felis in the general Australian population, however data is available from one cohort regularly exposed to the vector—veterinarians. In this study, 16% of Australian veterinarians were seropositive to R. felis and a further 35.1% positive for rickettsial exposure which was unable to be differentiated to a particular species. Veterinarians who reported that they recommended flea control measures to their clients had a statistically significant reduction in the risk of exposure to R. felis in this study.
C. felis, an unwelcome and regular visitor in our workplaces and homes, is not only a cause of pruritus and dermatological disease in our pets and patients, but may also transmit zoonotic pathogens. Recognition of exposure to this pathogen among veterinarians and cases of clinical disease among the public in Australia should serve as a reminder of the importance of maintaining good ectoparasite control in companion animals. With the availability of newer generation, safe and efficacious parasiticides such as NexGard SPECTRA®, providing this protection is easier than ever.
References available on request.
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