1
|
Musa TH, Ahmad T, Wana MN, Li W, Musa HH, Sharun K, Tiwari R, Dhama K, Chaicumpa W, Campbell MC, Wei P. The epidemiology, diagnosis and management of scrub typhus disease in China. Hum Vaccin Immunother 2021; 17:3795-3805. [PMID: 34124995 DOI: 10.1080/21645515.2021.1934355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Thirty-nine years ago, scrub typhus (ST), a disease, was not among the China's notifiable diseases. However, ST has reemerged to become a growing public health issue in the southwest part of China. The major factors contributing to an increased incidence and prevalence of this disease include rapid globalization, urbanization, expansion of humans into previously uninhabited areas, and climate change. The clinical manifestation of ST also consists of high fever, headache, weakness, myalgia, rash, and an eschar. In severe cases, complications (e.g. multi-organ failure, jaundice, acute renal failure, pneumonitis, myocarditis, and even death) can occur. The diagnosis of ST is mainly based on serological identification by indirect immunofluorescence assay and other molecular methods. Furthermore, several groups of antibiotics (e.g. tetracycline, chloramphenicol, macrolides, and rifampicin) are currently effective in treating this disease. This fact suggests the need for robust early diagnostic techniques, increased surveillance, and prompt treatment, and develop future vaccine.
Collapse
Affiliation(s)
- Taha Hussein Musa
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Biomedical Research Institute (BRI), Darfur College, Nyala, Sudan
| | - Tauseef Ahmad
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Mohammed Nasiru Wana
- Department of Biological Sciences, Faculty of Science, Abubakar Tafawa Balewa University, Bauchi, Nigeria
| | - Wei Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Hassan Hussein Musa
- Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, UP Deen Dayal Upadhayaya Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU), Mathura, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Pingmin Wei
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| |
Collapse
|
2
|
AuNPs/CNF-modified DNA biosensor for early and quick detection of O. tsutsugamushi in patients suffering from scrub typhus. 3 Biotech 2020; 10:446. [PMID: 33014689 DOI: 10.1007/s13205-020-02432-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/08/2020] [Indexed: 01/20/2023] Open
Abstract
A novel approach has been developed for the detection of 56 kDa tissue-specific antigen (TSA) gene of Orientia tsutsugamushi a causative agent of scrub typhus disease. The approach was developed by immobilization of 5' NH2 labeled ssDNA probe selective to 56 kDa TSA gene, to the surface of AuNPs/CNF modified screen-printed electrode. An electrochemical response was recorded with single stranded genomic DNA (ssDNA) of O. tsutsugamushi isolated from patient sample, using cyclic voltammetry and electrochemical impedance spectroscopy. The electrode surface was characterized by Field-Emission Scanning electron microscope (FE-SEM), Fourier Transform Infrared Spectroscopy (FTIR) and Raman Spectroscopy at each step of fabrication. The DNA biosensor shows optimum response within 50-60 s at room temperature (25 ± 3 °C). The sensor shows higher sensitivity [7849 (µA/cm2)/ng DNA], fast response time (60 s), wider linear range (0.04-2.6 ng) with limit of detection of 0.02 ng/µl of ssDNA sample.
Collapse
|
3
|
Kala D, Gupta S, Nagraik R, Verma V, Thakur A, Kaushal A. Diagnosis of scrub typhus: recent advancements and challenges. 3 Biotech 2020; 10:396. [PMID: 32834918 PMCID: PMC7431554 DOI: 10.1007/s13205-020-02389-w] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Scrub typhus is a mite-borne, acute febrile illness caused by the bacterium Orientia tsutsugamushi. It is a re-emerging infectious disease of the tsutsugamushi triangle. Scrub typhus is transmitted through bites of contaminated chiggers (larval stage). Diagnosis of scrub typhus is challenging as its symptoms mimic with other acute febrile illnesses. Several methods are effectual for diagnosis of scrub typhus that includes enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), immunochromatographic test (ICT), Weil-Felix, polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). Weil-Felix test was initially used for the diagnosis of scrub typhus in underdeveloped countries but not preferred due to a lack of both specificity and sensitivity. Other immuno-based methods like IFA and ELISA are most outrank for detection of scrub typhus due to their higher sensitivity and specificity, but not vigorous to lay bare the infection at early stages and need the convalescent sampling for verification of positive samples. On another deed, PCR based methods becoming acceptable over era due to its dexterity of early-stage diagnosis with higher specificity and sensitivity but lack its applicability in circumstances of scrub typhus due to the variegated genetic makeup of Orientia tsutsugamushi among its serotypes. The present review focused on various detection methods along with their advantages and disadvantages used in the diagnosis of scrub typhus. A comparison between available methods of diagnosis with challenges in the detection of scrub typhus is also summarized.
Collapse
Affiliation(s)
- Deepak Kala
- Amity Center of Nanotechnology, Amity University, Haryana, 122413 India
| | | | | | | | - Atul Thakur
- Amity Center of Nanotechnology, Amity University, Haryana, 122413 India
| | - Ankur Kaushal
- Amity Center of Nanotechnology, Amity University, Haryana, 122413 India
| |
Collapse
|
4
|
Evans SM, Adcox HE, VieBrock L, Green RS, Luce-Fedrow A, Chattopadhyay S, Jiang J, Marconi RT, Paris D, Richards AL, Carlyon JA. Outer Membrane Protein A Conservation among Orientia tsutsugamushi Isolates Suggests Its Potential as a Protective Antigen and Diagnostic Target. Trop Med Infect Dis 2018; 3:E63. [PMID: 30274459 PMCID: PMC6073748 DOI: 10.3390/tropicalmed3020063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 01/28/2023] Open
Abstract
Scrub typhus threatens one billion people in the Asia-Pacific area and cases have emerged outside this region. It is caused by infection with any of the multitude of strains of the bacterium Orientia tsutsugamushi. A vaccine that affords heterologous protection and a commercially-available molecular diagnostic assay are lacking. Herein, we determined that the nucleotide and translated amino acid sequences of outer membrane protein A (OmpA) are highly conserved among 51 O. tsutsugamushi isolates. Molecular modeling revealed the predicted tertiary structure of O. tsutsugamushi OmpA to be very similar to that of the phylogenetically-related pathogen, Anaplasma phagocytophilum, including the location of a helix that contains residues functionally essential for A. phagocytophilum infection. PCR primers were developed that amplified ompA DNA from all O. tsutsugamushi strains, but not from negative control bacteria. Using these primers in quantitative PCR enabled sensitive detection and quantitation of O. tsutsugamushi ompA DNA from organs and blood of mice that had been experimentally infected with the Karp or Gilliam strains. The high degree of OmpA conservation among O. tsutsugamushi strains evidences its potential to serve as a molecular diagnostic target and justifies its consideration as a candidate for developing a broadly-protective scrub typhus vaccine.
Collapse
Affiliation(s)
- Sean M Evans
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.
| | - Haley E Adcox
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.
| | - Lauren VieBrock
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.
| | - Ryan S Green
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.
| | - Alison Luce-Fedrow
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA.
- Department of Biology, Shippensburg University, Shippensburg, PA 17257, USA.
| | - Suschsmita Chattopadhyay
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA.
| | - Ju Jiang
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA.
| | - Richard T Marconi
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.
| | - Daniel Paris
- Department of Medicine, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland.
| | - Allen L Richards
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA.
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
| | - Jason A Carlyon
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.
| |
Collapse
|
5
|
A Case of Scrub Typhus Related Encephalopathy Presenting as Rapidly Progressive Dementia. Dement Neurocogn Disord 2017; 16:83-86. [PMID: 30906376 PMCID: PMC6427984 DOI: 10.12779/dnd.2017.16.3.83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 11/27/2022] Open
Abstract
Background An infection known to be a major cause of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). Rapidly progressive dementia is a neurological condition in which dementia progresses in a short period of time. Case Report We report on a 78-year-old woman presenting with a rapid decline in cognitive function resulting from a scrub typhus infection. Diffusion weighted images showed a signal intensity at the splenium, and subcortical white matter of both hemispheres suggesting MERS. On the neuropsychological test, the patient showed frontal executive dysfunction. Conclusions This case suggests that diagnosticians should consider the possibility that a MERS patient with a rapidly cognitive decline could have a scrub typhus infection because early diagnosis of scrub typhus is very important in this aspect of the treatment.
Collapse
|
6
|
Zhao M, Wang T, Yuan X, Du W, Lin M, Shen Y. Comparison of minocycline and azithromycin for the treatment of mild scrub typhus in northern China. Int J Antimicrob Agents 2016; 48:317-20. [PMID: 27449540 DOI: 10.1016/j.ijantimicag.2016.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/24/2016] [Accepted: 05/28/2016] [Indexed: 11/28/2022]
Abstract
Scrub typhus, caused by Orientia tsutsugamushi, has recently emerged in northern China where the disease had not been known to exist. Although doxycycline and azithromycin are the recommended agents for the treatment of scrub typhus, clinical responses depend both on the susceptibilities of various O. tsutsugamushi strains and the severity of the disease. A retrospective analysis was conducted on patients diagnosed with mild scrub typhus from August 2013 to January 2016 in the Affiliated Hospital of Nantong University, northern China. A total of 40 patients who received minocycline treatment and 34 patients who received azithromycin treatment were included in the analysis. All patients except one defervesced within 120 h after initiating antimicrobial therapy. Kaplan-Meier curves in association with log-rank test showed that the median time to defervescence was significantly shorter for the minocycline-treated group than the azithromycin-treated group (P = 0.003). There were no serious adverse events during treatment. No relapse occurred in either group during the 1-month follow-up period. In conclusion, both minocycline and azithromycin are effective and safe for the treatment of mild scrub typhus, but minocycline is more active than azithromycin against O. tsutsugamushi infection acquired in northern China.
Collapse
Affiliation(s)
- Minxing Zhao
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu 226001, China
| | - Ting Wang
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu 226001, China
| | - Xiaoyu Yuan
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu 226001, China
| | - Weiming Du
- BDM Consulting Inc., 100 Franklin Square Drive, Suite 102, Somerset, NJ 08873, USA
| | - Miaoxin Lin
- Waksman Institute of Microbiology, Rutgers University, 190 Frelinghuysen Road, Piscataway, NJ 08854, USA
| | - Yanbo Shen
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu 226001, China.
| |
Collapse
|