Table Of ContentInfectious Blood Diseases
of Man and Animals
Diseases Caused by Protista
Edited by
DAVID WEINMAN
Department of Microbiology
Yale University
New Haven, Connecticut
MIODRAG RISTIC
College of Veterinary Medicine
University of Illinois
Urbana, Illinois
VOLUME II
The Pathogens, The Infections, and The Consequences
1968
ACADEMIC PRESS New York and London
COPYRIGHT © 1968, BY ACADEMIC PRESS, INC.
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List of Contributors
Numbers in parentheses indicate the pages on which the authors'
contributions begin.
S. F. BARNETT (269), Cambridge University School of Veterinary Medi-
cine, Cambridge, England
RUDOLF GEIGY (175), Swiss Tropical Institute, Basel, Switzerland
J. P. KREIER (387), Department of Microbiology, Ohio State University,
Columbus, Ohio
W. H. R. LUMSDEN (329), Veterinary Field Station, Royal (Dick) School
of Veterinary Medicine, Midlothian, Scotland
REGINALD D. MANWELL (25), Department of Zoology, Syracuse Uni-
versity, Syracuse, New York
R. F. RIEK (219), Veterinary Research and Development Laboratory, Merck
Sharp and Dohme, Campbelltown, Australia
MIODRAG RISTIC (387, 473), College of Veterinary Medicine, Uni-
versity of Illinois, Urbana, Illinois
DAVID WEINMAN (3, 97), Department of Microbiology, Yale Uni-
versity, New Haven, Connecticut
E. A. WELLS (329), Veterinary Field Station, Royal {Dick) School of Veter-
inary Medicine, Midlothian, Scotland
v
Foreword
Reader: "I wish to congratulate you on your monograph. It is invaluable."
Author: "Thank you. It is very pleasant of you to say so."
Reader: "But why did you write it?"
Author: "What do you mean?"
Reader: "Well, now that it is published, everyone will know as much
about the subject as you do."
This book is intended to be useful. It will have accomplished its aims if :
(1) it provides a critical review of the subject matter, (2) it provokes the
solution of unsolved problems, and (3) it can assist in overcoming the
amputation of microbiology into the various heads, arms, and legs which
today characterize it.
The protistan blood diseases are here defined as that group caused by
microorganisms which pass a major portion of their lifetime in the blood.
Viruses are excluded as not being protista, which is the consensus of virolo-
gists today.
The group has not been reviewed for many years. It is hoped that this
book will provide a source of pertinent material and literature with empha-
sis on new acquisitions, insights, and syntheses. Suggestions for productive
lines of research have been solicited and, if these volumes are successful,
the surest evidence will be that they become rapidly outdated.
vii
Preface
This book is intended to be a modern critical source of material and
literature on the protistan blood diseases. It is anticipated that the book
will provide a unique source of information for professional microbiologists,
graduate students in the medical and microbiological fields, and others
interested in the biological and medical sciences.
The first volume consists of a summary and critical analysis of metabolic,
immunopathologic, taxonomic, ultrastructural, locomotor, écologie,
zoonotic, and other aspects of the protistan blood diseases. The second
volume includes pertinent disease aspects as they occur in man and animals
infected with the pathogens belonging to this group.
There are interesting features associated with the protistan blood dis-
eases. All are transmitted by arthropod vectors, some are zoonotic in
nature. Certain of these diseases cause devastating losses to the livestock
industry throughout the world, and others are of great importance to human
health, e.g., malaria, still considered a major disease problem. Attempts to
develop immunologie rather than chemotherapeutic control measures have
been greatly handicapped by inadequate information about immune mecha-
nisms as well as other aspects of the host-parasite relationships in these
diseases.
The last decade has witnessed great expansion in the application of im-
munologie principles and techniques to the study of the agents of these
diseases and in an understanding of their interactions with the host they
invade. We are now beginning to comprehend that factors other than the
parasite per se may cause the extensive erythrocyte destruction which is a
striking feature of many of these diseases.
Specialists with varied scientific backgrounds are interested in studying
these diseases, and their number has increased tremendously in recent
years. The efforts of protozoologists and microbiologists are now being
added to by the contributions of biophysicists, biochemists, immunologists,
and molecular geneticists using modern research tools for the analysis of
hitherto unsolved problems. It is with these new approaches and results in
mind that we have undertaken the task of assembling these volumes.
ix
X PREFACE
It is a pleasure to be able to express our appreciation to the authors whose
contributions have made the two volumes possible. For their editorial
assistance beyond any mere call of duty our thanks go to Elizabeth G.
Weinman and Mrs. Alys von Lehmden-Maslin. The staff of Academic
Press has participated helpfully at all stages, and their comprehension,
their skill, and their standards of excellence are reflected throughout.
April, 1968
DAVID WEINMAN
MlODRAG RlSTIC
Contents of Volume I
Parti
SPECIAL TOPICS
1. Ecology and Host-Parasite Relationship
NORMAN D. LEVINE
2. Basis of Host Cell-Parasite Specificity
AVIVAH ZUCKERMAN
3. Abrogation of Immunological Tolerance as a Model for Auto-
immunity
DIEGO SEGRE
4. Autoimmune Response and Pathogenesis of Blood Parasite
Diseases
WILLIAM F. SCHROEDER AND MIODRAG RISTIC
5. Blood Parasite Antigens and Antibodies
AVIVAH ZUCKERMAN AND MlODRAG RlSTIC
6. Zoonotic Potential of Blood Parasites
R. S. BRAY
XV
XVI CONTENTS OF VOLUME I
Part II
GENERAL CHARACTERISTICS OF THE BLOOD PROTISTS
7. Definition and Classification
JOHN 0. CORLISS
8. Cultivation and Nutritional Requirements
WILLIAM TRÄGER
9. Some Biological Leads to Chemotherapy of Blood Protitsa,
Especially Trypanosomatidae
S. H. HUTNER, HUGUETTE FROMENTIN, AND KATHLEEN M. O'CONNELL
10. The Fine Structure
MARIA A. RUDZINSKA AND KEITH VICKERMAN
11. Development and Reproduction (Vertebrate and Arthropod
Host)
R. BARCLAY MCGHEE
12. Preservation and Storage in Vitro
H. T. MERYMAN AND DAVID WEINMAN
13. Investigational Problems and the Mechanisms of Inheritance
in Blood Protozoa
PETER J. WALKER
14. Locomotion of Blood Protists
THEODORE L. JAHN AND EUGENE C. BOVEE
Author Index—Subject Index
15
Bartonellosis
DAVID WEINMAN
I. Introduction 3
II. Human Bartonella Infection 4
A. Definition and Characteristics 4
B. History 4
C. Geographical Distribution; Prevalence 6
D. Impact of Chemotherapy and Insecticides; Present Status 7
III. Bartonella bacilliformis; Bartonellosis 8
A. Synonyms 8
B. Morphology 8
C. Biology 11
D. Identification 14
E. Preservation 14
F. Action of Chemotherapeutic Agents 14
IV. Types of Human Infection 14
A. The Anemic Form 14
B. The Eruptive Form 15
C. Other Types of Infection 15
V. Pathology and Pathogenesis 16
A. Pathology 16
B. Pathogenesis 17
VI. Diagnosis 18
VII. Immunology 18
VIII. Chemotherapy 19
IX. Transmission and Epidemiology 20
X. Control 21
XI. Appendix—Thailand Febrile Anemia 22
References 23
I. INTRODUCTION
The "bartonella group" consists of microorganisms classified as Bar-
tonella, Haemobartonella, and Eperythrozoon. These genera have been
grouped because of common characteristics. All are insect-transmitted,
proved or presumptive; usually cause acute primary febrile infectious
anemias in their vertebrate host; have a characteristic position on the
3
4 DAVID WEINMAN
erythrocyte; and are carried as asymptomatic infections for long periods
of time.
Despite these similarities, Bartonella differs from the other genera in
structure, response to chemotherapy, and sites of major multiplication
in vivo; it alone causes a specific, granulomatous, cutaneous eruption in
its mammalian host, and for it, major control of multiplication by the
spleen has not been demonstrated (Weinman, 1935 ; Tyzzer and Weinman,
1935).
Bartonella is a monotypic genus. The single species, Bartonella bacilli-
jormis, is the cause of Carrion's disease in man. Haemobartonella and
Eperythrozoon, native to other animals, but not proved to cause human
infections, are discussed in Chapter 21.
II. HUMAN BARTONELLA INFECTION
A. DEFINITION AND CHARACTERISTICS
The unique and striking reactions to Bartonella bacilliformis which
occur in man individualize the microorganism better than the charac-
teristics thus far discovered in vitro. In addition to asymptomatic in-
fections of presumed epidemiological importance, B. bacilliformis causes
two very different and apparently unrelated conditions: (1) Oroya fever,
a febrile anemia, and (2) verruga peruana, a benign skin eruption.
These usually occur sequentially, in the order indicated. Each form has a
distinctive pathological substratum, and the two are linked immunolog-
ically. In Oroya fever, bartonella is found on the erythrocytes. In both
diseases it occurs within fixed tissue cells, notably those of the reticulo-
endothelial system. On the red cells it is unmistakable, and no other
proved human parasite resembles it even slightly (see Plate I). In the
tissues it is intracellular and during Oroya fever multiplies within the
cytoplasm of vascular endothelial cells as isolated elements or grouped in
rounded masses (see Fig. 3). A polymorphic bacillus, often flagellated in
culture, B. bacilliformis can be maintained by unlimited serial culture on
media containing serum and hemoglobin. Living cells are not required;
however, when grown in tissue culture, development is both intracyto-
plasmic and extracellular. In nature the microorganism occurs in phle-
botomus and in man.
B. HISTORY
The history of bartonellosis is in part a record of scientific documenta-
tion for one of the most improbable of the New World marvels. The ex-
cellent monograph of Odriozola (1898) drew attention to a disease
believed to occur only in western South America. There it was restricted to
