Mission & Objectives
ESCAR, formerly EUWOG, is the acronym for the ESCMID Study Group for Coxiella, Anaplasma, Rickettsia and Bartonella. What are the rationale and objectives for a Study Group in this field of infectious diseases and microbiology?
Rickettsiosis and related diseases are not only classical infectious diseases that caused thousands of deaths in previous eras. Currently, rickettsioses are emerging and re-emerging infections that cause many health problems not only in poorer countries but also in developed nations. The recent epidemic of typhus in Burundi with thousands of affected people, exemplifies re-emerging rickettsiosis. In some areas other classical rickettsioses as Mediterranean Spotted Fever, or Rocky Mountain Spotted Fever are endemic. Other infections are being spread all over the world such as those caused by Rickettsia felis, closely tied to humans due to their transmission by the cat flea. In the last 10 years, thanks to the use of new molecular tools, for instance PCR, numerous species of the spotted fever group of Rickttsiae have been implicated as human pathogens. Using PCR the Marseille Group (Didier Raoult et al.) has described human infections by R. mongolotimonae, R. aeschelimani, or R. slovaca among others. An important Rickettsiosis, known as TIBOLA or DEBONEL, is distributed all around Europe and is a frequent cause of scar and lymphadenopathy in people bitten by ticks in cool months. Another emerging health problem is infection caused by R. africae. This illness affects a large number of travellers to South Africa and other southern African countries.
We also study infections caused by Ehrlichia sp. and Anaplasma sp. (ehrlichiosis), which have been recognised pathogens in mammals since the beginning of the 20th century in Europe. After the first European descriptions in humans, human granulocytic ehrlichiosis or human anaplasmosis was described Europe-wide, and we know that a large percentage of Ixodes ricinus ticks is infected by the etiologic agent Anaplasma phagocytophilum. Recently, a new species found in northern Italy has been described that could be a human pathogen (E. walkerii).
Bartonella infections are currently a significant problem worldwide. It has been demonstrated that B. quintana is the cause of new cases of “Trench Fever” now called “Urban Trench Fever” because it affects urban homeless populations. This is an example of a re-emerging infection. We also know that B. henselae is one of the main etiologic agents of lymphadenopathy in children and young people and that Bartonella sp. are the main pathogens of culture-negative endocarditis. Sadly enough Rickettsia sp. and Coxiella burnetti are also “fashionable” bio-terrorism threats. Although these agents are not easy to employ as biological weapons, they are still classified as Class B agents.
Obviously, almost all pathogens that we study in ESCAR also cause disease in other mammals, and they are of interest not only to physicians and microbiologists but also to veterinarians and other specialists.
The aim of ESCAR is to encourage basic and applied research in the field of rickettsiology and related diseases. ESCAR has approximately 300 members (medical doctors, microbiologists, scientists, veterinarians, pharmacists, etc.) from most European countries and many other countries around the world, including the USA, Japan, and Russia. Our main research fields are: epidemiology, genomics, taxonomy, diagnosis, physiopathology, immunology and therapy of rickettsiosis, bartonellosis, anaplasmosis, and coxiellosis in humans and animals.
We make recommendations on research issues related to rickettsiae and rickettsial diseases in order to advance basic understanding and knowledge in this field. ESCAR also advises government health agencies, if necessary, on important aspects of these diseases.