Multiplex 5′ nuclease-quantitative PCR for diagnosis of relapsing fever in a large Tanzanian cohort

Megan E. Reller, Emily G. Clemens, Steve E. Schachterle, George A. Mtove, David J. Sullivan, J. Stephen Dumler

Research output: Contribution to journalArticle

Abstract

Relapsing fever (RF) is caused by tick- and louse-borne Borrelia spp., is characterized by recurrent fever, and is often misdiagnosed as malaria. Because of submicroscopic bacteremia, microscopy can be insensitive between febrile bouts. We designed a multiplex quantitative PCR (qPCR) assay to distinguish RF Borrelia from Plasmodium falciparum and P. vivax. The assay specifically (100%) amplified pathogenic RF Borrelia (1 copy/reaction). We then tested blood from participants within a Tanzanian cohort assessed at scheduled intervals and with fever. Among 8,617 blood samples from 2,057 participants surveyed routinely, 7 (0.08%) samples and 7 (0.3%) participants had RF DNA (median, 4.4 x 10 3 copies/ml). Of 382 samples from 310 febrile persons, 15 (3.9%) samples from 13 (4.2%) participants had RF DNA (median, 7.9 x 10 2 copies/ml). Five (1.3%) samples from 4 (1.3%) participants were found to harbor Borrelia by microscopy. We conclude that multiplex qPCR holds promise for improved clinical diagnosis and epidemiologic assessment of RF.

Original languageEnglish (US)
Pages (from-to)3245-3249
Number of pages5
JournalJournal of clinical microbiology
Volume49
Issue number9
DOIs
StatePublished - Sep 1 2011

ASJC Scopus subject areas

  • Microbiology (medical)

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