AN OVERVIEW OF THE PATHOGENESIS, TRANSMISSION, AND PREVENTION STRATEGIES OF RAT-BITE FEVER IN HUMANS

Abstract

Rat bite fever (RBF) is a zoonotic disease caused by the bacteria Spirillum minus, Streptobacillus moniliformis, and Streptobacillus notomytis. In 1926, an S. moniliformis outbreak in Haverhill, Massachusetts, linked to contaminated milk, caused “Haverhill Disease.” S. moniliformis is prevalent in the Americas, while S. minus is more common in Asia. In 2018, Okinawa, Japan, documented the first human case of RBF caused by S. notomytis (Fukushima et al., 2018). Key animal carriers include rodents such as black rats (Rattus rattus) and brown rats (Rattus norvegicus), which asymptomatically harbor these bacteria as part of their natural flora. The disease is transmitted to humans through wounds from bites or scratches. Infected individuals typically present with high fever, rash, and painful swelling in the joints. Without treatment, the mortality rate can reach up to 10%, with complications such as myocarditis, pericarditis, and meningitis being potential causes of death. High-risk groups include individuals whose occupations involve frequent contact with rodents or those working in environments prone to rodent infestations, such as food processing facilities that often attract rodents. Treatment involves antibiotics, which significantly reduce the mortality rate. Diagnosing RBF is challenging due to the need for specific environmental conditions to isolate and culture the bacteria. This restriction is a reflection of the present knowledge gaps on the disease's pathogenic mechanisms. Prevention and control strategies focus on maintaining strict hygiene practices and avoiding contact with rodents to minimize the risk of infection.