1
|
Choi S, Ahn DH, Yoo MG, Lee HJ, Cho SB, Park HB, Kim SS, Chu H. Urine Metabolite of Mice with Orientia tsutsugamushi Infection. Am J Trop Med Hyg 2023; 108:296-304. [PMID: 36623483 PMCID: PMC9896320 DOI: 10.4269/ajtmh.20-1608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/23/2022] [Indexed: 01/11/2023] Open
Abstract
Scrub typhus is an acute febrile, mite-borne disease endemic to the Asia-Pacific region. In South Korea, it is a seasonal disease that occurs frequently in the autumn, and its incidence has increased steadily. In this study, we used a liquid chromatography and flow injection analysis-tandem mass spectrometry-based targeted urine metabolomics approach to evaluate the host response to Orientia tsutsugamushi infection. Balb/c mice were infected with O. tsutsugamushi Boryong, and their urine metabolite profile was examined. Metabolites that differed significantly between the experimental groups were identified using the Kruskal-Wallis test. Sixty-five differential metabolites were identified. The principal metabolite classes were acylcarnitines, glycerophospholipids, biogenic amines, and amino acids. An ingenuity pathway analysis revealed that several toxic (cardiotoxic, hepatotoxic, and nephrotoxic) metabolites are induced by scrub typhus infection. This is the first report of urinary metabolite biomarkers of scrub typhus infection and it enhances our understanding of the metabolic pathways involved.
Collapse
Affiliation(s)
- Sangho Choi
- Division of Zoonotic and Vector Borne Disease Research, Center for Infectious Disease Research, National Institute of Infectious Disease, National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Do-Hwan Ahn
- Division of Healthcare and Artificial Intelligence, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Min-Gyu Yoo
- Division of Endocrine and Kidney Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Hye-Ja Lee
- Division of Endocrine and Kidney Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Seong Beom Cho
- Division of Healthcare and Artificial Intelligence, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Hee-Bin Park
- Division of Zoonotic and Vector Borne Disease Research, Center for Infectious Disease Research, National Institute of Infectious Disease, National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Sung Soon Kim
- Division of Zoonotic and Vector Borne Disease Research, Center for Infectious Disease Research, National Institute of Infectious Disease, National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| | - Hyuk Chu
- Division of Zoonotic and Vector Borne Disease Research, Center for Infectious Disease Research, National Institute of Infectious Disease, National Institute of Health, Korea Disease Control and Prevention Agency, Osong-eup, Cheongju-si, Chungcheongbuk-do, 28160, Republic of Korea
| |
Collapse
|
2
|
Lin FH, Chou YC, Chien WC, Chung CH, Hsieh CJ, Yu CP. Epidemiology and Risk Factors for Notifiable Scrub Typhus in Taiwan during the Period 2010-2019. Healthcare (Basel) 2021; 9:1619. [PMID: 34946346 PMCID: PMC8701143 DOI: 10.3390/healthcare9121619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 11/22/2022] Open
Abstract
Scrub typhus is a zoonotic disease caused by the bacterium Orientia tsutsugamushi. In this study, the epidemiological characteristics of scrub typhus in Taiwan, including gender, age, seasonal variation, climate factors, and epidemic trends from 2010 to 2019 were investigated. Information about scrub typhus in Taiwan was extracted from annual summary data made publicly available on the internet by the Taiwan Centers for Disease Control. From 2010 to 2019, there were 4352 confirmed domestic and 22 imported cases of scrub typhus. The incidence of scrub typhus ranged from 1.39 to 2.30 per 100,000 from 2010-2019, and peaked in 2013 and 2015-2016. Disease incidence varied between genders, age groups, season, and residence (all p < 0.001) from 2010 to 2019. Risk factors were being male (odds ratio (OR) =1.358), age 40 to 64 (OR = 1.25), summer (OR = 1.96) or fall (OR = 1.82), and being in the Penghu islands (OR = 1.74) or eastern Taiwan (OR = 1.92). The occurrence of the disease varied with gender, age, and place of residence comparing four seasons (all p < 0.001). Weather, average temperature (°C) and rainfall were significantly correlated with confirmed cases. The number of confirmed cases increased by 3.279 for every 1 °C (p = 0.005) temperature rise, and 0.051 for every 1 mm rise in rainfall (p = 0.005). In addition, the total number of scrub typhus cases in different geographical regions of Taiwan was significantly different according to gender, age and season (all p < 0.001). In particular, Matsu islands residents aged 20-39 years (OR = 2.617) and residents of the Taipei area (OR = 3.408), northern Taiwan (OR = 2.268) and eastern Taiwan (OR = 2.027) were affected during the winter. Males and females in the 50-59 age group were at high risk. The total number of imported cases was highest among men, aged 20-39, during the summer months, and in Taipei or central Taiwan. The long-term trend of local cases of scrub typhus was predicted using the polynomial regression model, which predicted the month of most cases in a high-risk season according to the seasonal index (1.19 in June by the summer seasonal index, and 1.26 in October by the fall seasonal index). The information in this study will be useful for policy-makers and clinical experts for direct prevention and control of chigger mites with O. tsutsugamushi that cause severe illness and are an economic burden to the Taiwan medical system. These data can inform future surveillance and research efforts in Taiwan.
Collapse
Affiliation(s)
- Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; (F.-H.L.); (Y.-C.C.); (W.-C.C.); (C.-H.C.)
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; (F.-H.L.); (Y.-C.C.); (W.-C.C.); (C.-H.C.)
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; (F.-H.L.); (Y.-C.C.); (W.-C.C.); (C.-H.C.)
- Department of Medical Research, Tri-Service General Hospital, Taipei City 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City 11490, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; (F.-H.L.); (Y.-C.C.); (W.-C.C.); (C.-H.C.)
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei City 11490, Taiwan
| | - Chi-Jeng Hsieh
- Department of Health Care Administration, Asia Eastern University of Science and Technology, New Taipei City 22061, Taiwan;
| | - Chia-Peng Yu
- School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; (F.-H.L.); (Y.-C.C.); (W.-C.C.); (C.-H.C.)
- Department of Medical Research, Tri-Service General Hospital, Taipei City 11490, Taiwan
| |
Collapse
|
3
|
Han MA, Kim CM, Yun NR, Kim DM, Park SM, Kim H, Shin HH. The Effect of Long-lasting Permethrin Impregnated Socks on Tick Bite in Korea. J Korean Med Sci 2021; 36:e49. [PMID: 33619917 PMCID: PMC7900532 DOI: 10.3346/jkms.2021.36.e49] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 12/10/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The risk of tick-borne diseases is decreased by increasing awareness and knowledge through prevention education. The aim of the present study was to evaluate the effect of long-lasting permethrin impregnated (LLPI) socks for tick bites. METHODS A randomized open label study was conducted to determine the effectiveness of LLPI socks for prevention of tick bites among 367 adults living in a rural area. Participants completed questionnaires at the start of follow-up (July 2014) and at the end of follow-up (December 2014), and tick bites were reported. RESULTS A total of 332 subjects completed the follow-up survey. The tick bite rate of the two groups was not significantly different (3.6% vs. 3.1%). But the tick bite rate of lower extremities of subjects wearing LLPI socks was significantly lower compared to that of subjects wearing general socks. CONCLUSION The tick bite rate was not different between the two groups, but the tick bite rate of lower extremities of LLPI was significantly lower than general groups. Further study is needed to investigate the effect of LLPI clothes with larger populations.
Collapse
Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Choon Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Korea
| | - Na Ra Yun
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea
| | - Dong Min Kim
- Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea.
| | - Sun Mi Park
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Hyoju Kim
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Hwan Ho Shin
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea
- Department of Clinical Pathology, Seoyeong University, Gwangju, Korea
| |
Collapse
|
4
|
Watanabe Y, Mashimo S, Ichige H, Nagata H, Kojima M. Scrub typhus mimicking the clinical course of infectious mononucleosis: a case report. J Rural Med 2021; 16:62-66. [PMID: 33442438 PMCID: PMC7788302 DOI: 10.2185/jrm.2020-037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/11/2020] [Indexed: 01/22/2023] Open
Abstract
Objective: Scrub typhus is a relatively common life-threating disease; its
symptoms are non-specific and similar to those of other viral infections. Therefore, scrub
typhus might be underdiagnosed. Patient: Herein, we report a patient with scrub typhus whose clinical course
mimicked that of infectious mononucleosis. A 63-year-old male patient with hypertension
presented to our hospital complaining of symptoms including prolonged fever, pharyngeal
discomfort, and a mild headache. He showed the appearance of a rash after amoxicillin
administration. At the same time, he did not show a crusted rash on his body surface. Results: After a comprehensive examination, Epstein-Barr virus and
cytomegalovirus infections were ruled out. We suspected that this patient suffered from
scrub typhus on the basis of his usual lifestyle. Finally, polymerase chain reaction
analysis showed a positive result for deoxyribonucleic acid of Orientia
tsutsugamushi in his blood sample. Fortunately, he recovered naturally with
only supportive treatment during his hospitalization. Conclusion: We should observe and monitor patients with infectious
mononucleosis-like symptoms and emphasize the importance of a clinical interview.
Collapse
Affiliation(s)
- Yusuke Watanabe
- Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, Japan
| | - Shouta Mashimo
- Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, Japan
| | - Hiroyuki Ichige
- Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, Japan
| | - Hiroyuki Nagata
- Department of Internal Medicine, Hitachiomiya Saiseikai Hospital, Japan
| | - Masayuki Kojima
- Department of Surgery, Hitachiomiya Saiseikai Hospital, Japan
| |
Collapse
|
5
|
Banerjee A, Kulkarni S. Orientia tsutsugamushi: The dangerous yet neglected foe from the East. Int J Med Microbiol 2020; 311:151467. [PMID: 33338890 DOI: 10.1016/j.ijmm.2020.151467] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 10/06/2020] [Accepted: 11/25/2020] [Indexed: 01/22/2023] Open
Abstract
Orientia tsutsugamushi (OT), the causative agent of the vector-borne Scrub typhus zoonotic disease in humans, is a unique microorganism that exists in the Asia-Pacific region since a long time. In spite of its occurrence, the organism had been neglected until recent years. Humans are the accidental dead-end hosts of O. tsutsugamushi and display manifestations which are both severe and misleading. The vast antigenic diversity of OT and non-pathognomic symptoms of Scrub typhus, create hurdles in the clinical management of the disease and impede the OT-research. Many countries in the Asia-Pacific region have reported the resurgence of OT- infections and have raised concerns for its expanding distribution. This has triggered the development of advanced techniques for diagnosis and research on exploring a successful vaccine candidate to reduce the burden of the disease. Thus, the aim of this systematic review is to provide an update on the recent advances in the OT-research and highlight the key areas that have remained obscure and demand attention.
Collapse
Affiliation(s)
- Anwesha Banerjee
- ICMR-National AIDS Research Institute, Bhosari, Pune, 411026, India
| | - Smita Kulkarni
- ICMR-National AIDS Research Institute, Bhosari, Pune, 411026, India.
| |
Collapse
|
6
|
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
|
7
|
Bahk YY, Jun H, Park SH, Jung H, Jegal S, Kim-Jeon MD, Roh JY, Lee WG, Ahn SK, Lee J, Joo K, Gong YW, Kwon MJ, Kim TS. Surveillance of Chigger Mite Vectors for Tsutsugamushi Disease in the Hwaseong Area, Gyeonggi-do, Republic of Korea, 2015. THE KOREAN JOURNAL OF PARASITOLOGY 2020; 58:301-308. [PMID: 32615743 PMCID: PMC7338901 DOI: 10.3347/kjp.2020.58.3.301] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/20/2020] [Indexed: 11/25/2022]
Abstract
Owing to global climate change, the global resurgence of vector-borne infectious diseases and their potential to inflict widespread casualties among human populations has emerged as a pivotal burden on public health systems. Tsutsugamushi disease (scrub typhus) in the Republic of Korea is steadily increasing and was designated as a legal communicable disease in 1994. The disease is a mite-borne acute febrile disease most commonly contracted from October to December. In this study, we tried to determine the prevalence of tsutsugamushi disease transmitted by chigger mites living on rodents and investigated their target vector diversity, abundance, and distribution to enable the mapping of hotspots for this disease in 2015. A total of 5 species belonging to 4 genera (109 mites): Leptotrombidium scutellare 60.6%, L. pallidum 28.4% Neotrombicula tamiyai 9.2%, Euschoengastia koreaensis/0.9%), and Neoschoengastia asakawa 0.9% were collected using chigger mite collecting traps mimicking human skin odor and sticky chigger traps from April to November 2015. Chigger mites causing tsutsugamushi disease in wild rodents were also collected in Hwaseong for the zoonotic surveillance of the vector. A total of 77 rodents belonging to 3 genera: Apodemus agrarius (93.5%), Crocidura lasiura (5.2%), and Micromys minutus (1.3%) were collected in April, October, and November 2015. The most common mite was L. pallidum (46.9%), followed by L. scutellare (18.6%), and L. orientale (18.0%). However, any of the chigger mite pools collected from rodent hosts was tested positive for Orientia tsutsugamushi, the pathogen of tsutsugamushi disease, in this survey.
Collapse
Affiliation(s)
- Young Yil Bahk
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju 27478, Korea
| | - Hojong Jun
- Department of Tropical Medicine, Inha University College of Medicine, Incheon 22212, Korea
| | - Seo Hye Park
- Department of Tropical Medicine, Inha University College of Medicine, Incheon 22212, Korea
| | - Haneul Jung
- Department of Tropical Medicine, Inha University College of Medicine, Incheon 22212, Korea
| | - Seung Jegal
- Department of Infectious Diseases Diagnosis, Incheon Metropolitan City Institute of Public Health and Environment, Incheon 22320, Korea
| | - Myung-Deok Kim-Jeon
- Department of Infectious Diseases Diagnosis, Incheon Metropolitan City Institute of Public Health and Environment, Incheon 22320, Korea
| | - Jong Yul Roh
- Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Osong 28159, Korea
| | - Wook-Gyo Lee
- Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Osong 28159, Korea
| | - Seong Kyu Ahn
- Department of Tropical Medicine, Inha University College of Medicine, Incheon 22212, Korea
| | - Jinyoung Lee
- Department of Tropical Medicine, Inha University College of Medicine, Incheon 22212, Korea
| | - Kwangsig Joo
- Department of Infectious Diseases Diagnosis, Incheon Metropolitan City Institute of Public Health and Environment, Incheon 22320, Korea
| | - Young Woo Gong
- Department of Infectious Diseases Diagnosis, Incheon Metropolitan City Institute of Public Health and Environment, Incheon 22320, Korea
| | - Mun Ju Kwon
- Department of Infectious Diseases Diagnosis, Incheon Metropolitan City Institute of Public Health and Environment, Incheon 22320, Korea
| | - Tong-Soo Kim
- Department of Tropical Medicine, Inha University College of Medicine, Incheon 22212, Korea
| |
Collapse
|
8
|
Ma CJ, Oh GJ, Kang GU, Lee JM, Lee DU, Nam HS, Ryu SY, Lee YH. Differences in agricultural activities related to incidence of scrub typhus between Korea and Japan. Epidemiol Health 2017; 39:e2017051. [PMID: 29121711 PMCID: PMC5790984 DOI: 10.4178/epih.e2017051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/09/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The purpose of this study was to establish a basis for improving or strengthening the preventive strategy against scrub typhus in Korea by comparing and analyzing the difference of prevention behaviors contributing to the occurrence of scrub typhus in Japan and Korea. METHODS The survey was carried out in Jeollabuk-do, which is a high risk and high incidence area, and Fukuoka Prefecture, which is a high risk and low incidence area. The study included 406 Korean farmers and 216 Japanese farmers. Data were collected through face-to-face surveys by interviewers who had completed standardized education. RESULTS Korean farmers have a higher percentage of agricultural working posture that involved contact with weeds than Japanese farmers (p<0.05). The frequency and proportion of weeding were lower in Korean farmers than in Japanese farmers (p<0.05). The level of knowledge about scrub typhus was significantly higher among Korean farmers than among Japanese farmers (p<0.05). Mostly, the behavior of agriculture work was more appropriate for Japanese farmers than for Korean farmers (p<0.05). The total average level of agricultural work was lower in Korea than in Japan, lower in men than women, and lower in part-time farmers than full-time farmers (p<0.05). CONCLUSIONS This study suggests that it is reasonable to develop and provide a program that can improve the level of preventive behavior taking into consideration the characteristics of the subject in order to reduce the incidence of diseases in high-risk areas for scrub typhus.
Collapse
Affiliation(s)
- Chang-Jin Ma
- Department of Environmental Science, Fukuoka Women's University, Fukuoka, Japan
| | - Gyung-Jae Oh
- Department of Preventive Medicine and Public Health, Wonkwang University School of Medicine, Iksan, Korea
| | - Gong-Unn Kang
- Department of Medical Administration, Wonkwang Health Science University, Iksan, Korea
| | - Jeong Mi Lee
- Graduate School of Public Health, Wonkwang University, Iksan, Korea
| | - Da-Un Lee
- Department of Korean History Education, Wonkwang University College of Education, Iksan, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine and Public Health, Wonkwang University School of Medicine, Iksan, Korea
| |
Collapse
|
9
|
Xu G, Walker DH, Jupiter D, Melby PC, Arcari CM. A review of the global epidemiology of scrub typhus. PLoS Negl Trop Dis 2017; 11:e0006062. [PMID: 29099844 PMCID: PMC5687757 DOI: 10.1371/journal.pntd.0006062] [Citation(s) in RCA: 251] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/15/2017] [Accepted: 10/21/2017] [Indexed: 12/18/2022] Open
Abstract
Scrub typhus is a serious public health problem in the Asia-Pacific area. It threatens one billion people globally, and causes illness in one million people each year. Caused by Orientia tsutsugamushi, scrub typhus can result in severe multiorgan failure with a case fatality rate up to 70% without appropriate treatment. The antigenic heterogeneity of O. tsutsugamushi precludes generic immunity and allows reinfection. As a neglected disease, there is still a large gap in our knowledge of the disease, as evidenced by the sporadic epidemiologic data and other related public health information regarding scrub typhus in its endemic areas. Our objective is to provide a systematic analysis of current epidemiology, prevention and control of scrub typhus in its long-standing endemic areas and recently recognized foci of infection.
Collapse
Affiliation(s)
- Guang Xu
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - David H. Walker
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Daniel Jupiter
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Peter C. Melby
- Department of Internal Medicine, Division of Infectious Diseases, The University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Christine M. Arcari
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas, United States of America
| |
Collapse
|
10
|
Choi S, Jeong HJ, Hwang KJ, Gill B, Ju YR, Lee YS, Lee J. A Recombinant 47-kDa Outer Membrane Protein Induces an Immune Response against Orientia tsutsugamushi Strain Boryong. Am J Trop Med Hyg 2017; 97:30-37. [PMID: 28719308 PMCID: PMC5508880 DOI: 10.4269/ajtmh.15-0771] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/04/2016] [Indexed: 11/10/2022] Open
Abstract
We investigated the 47-kDa outer membrane protein (OMP), which is a periplasmic serine protease and an antigenic major surface protein of Orientia tsutsugamushi, as a vaccine candidate. We developed a conventional subunit vaccine expressing recombinant 47-kDa OMP (rec47) and a DNA vaccine (p47). In mouse immunization experiments, intranasal immunization with rec47 alone or with rec47 plus heat-labile enterotoxin B subunit from Escherichia coli or plus cholera toxin (CT) as adjuvants induced a higher amount of rec47-specific antibodies than intramuscular immunization with p47 alone or with p47 plus pBOOST2-samIRF7/3 (pB) as adjuvant. Moreover, the combination of rec47 and CT induced a strong cellular immune response to 47-kDa OMP, as demonstrated by a spleen cell proliferation assay, and also induced Th1- and Th2-type cytokine production, as demonstrated by a cytokine enzyme-linked immunosorbent assay. Intranasal immunization with rec47 plus CT was the most effective method for the induction of humoral and cell-mediated immune responses. Furthermore, relatively strong protection against homologous O. tsutsugamushi strain Boryong challenge was observed in mice immunized with rec47 plus CT. Therefore, 47-kDa OMP is an attractive candidate for developing a prophylactic vaccine against scrub typhus by O. tsutsugamushi infection.
Collapse
Affiliation(s)
- Sangho Choi
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Hang Jin Jeong
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Kyu-Jam Hwang
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Byoungchul Gill
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Young Ran Ju
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Yeong Seon Lee
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Jeongmin Lee
- Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| |
Collapse
|
11
|
Meteorological factors affecting scrub typhus occurrence: a retrospective study of Yamagata Prefecture, Japan, 1984–2014. Epidemiol Infect 2016; 145:462-470. [DOI: 10.1017/s0950268816002430] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
SUMMARYClimate change, by its influence on the ecology of vectors might affect the occurrence of vector-borne diseases. This study examines the effects of meteorological factors in Japan on the occurrence of scrub typhus, a mite-borne zoonosis caused byOrientia tsutsugamushi. Using negative binomial regression, we analysed the relationships between meteorological factors (including temperature, rainfall, snowfall) and spring–early summer cases of scrub typhus in Yamagata Prefecture, Japan, during 1984–2014. The average temperature in July and August of the previous year, cumulative rainfall in September of the previous year, snowfall throughout the winter, and maximum depth of snow cover in January and February were positively correlated with the number of scrub typhus cases. By contrast, cumulative rainfall in July of the previous year showed a negative relationship to the number of cases. These associations can be explained by the life-cycle ofLeptotrombidium pallidum, a predominant vector of spring–early summer cases of scrub typhus in northern Japan. Our findings show that several meteorological factors are useful to estimate the number of scrub typhus cases before the endemic period. They are applicable to establish an early warning system for scrub typhus in northern Japan.
Collapse
|
12
|
Rana A, Mahajan SK, Sharma A, Sharma S, Verma BS, Sharma A. Neurological manifestations of scrub typhus in adults. Trop Doct 2016; 47:22-25. [PMID: 27059055 DOI: 10.1177/0049475516636543] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In order to study the neurological manifestations in adult patients suffering from scrub typhus, 323 patients aged over 18 years, admitted with a positive diagnosis, were screened for neurological dysfunction; 37 patients with symptoms and/or signs suggestive of neurological dysfunction were included in the study. Of these, 31 (84%) patients had altered sensorium, four (11%) had cerebellitis, one (2%) patient had acute transverse myelitis and one (2%) had bilateral papilloedema without focal neurological deficit. Of the 31 patients with altered sensorium, 15 (40%) had meningoencephalitis, three (8%) had seizures, two (5%) had cerebral haemorrhages, one (2%) had a presentation likened to neuroleptic malignant syndrome (NMS) and one (2%) had a 6th nerve palsy with inflammation of the right cavernous sinus. Cerebrospinal fluid (CSF) analysis was abnormal in 23 patients (raised lymphocytes in 68%, raised protein in 80%). All patients improved with anti-rickettsial therapy.
Collapse
Affiliation(s)
- Abhinav Rana
- Resident, I.G. Medical College, Shimla, Himachal Pradesh, India
| | - Sanjay K Mahajan
- Associate Professor, I.G. Medical College, Shimla, Himachal Pradesh, India
| | - Arindam Sharma
- Resident, I.G. Medical College, Shimla, Himachal Pradesh, India
| | - Sudhir Sharma
- Department of Neurology, I.G. Medical College, Shimla, Himachal Pradesh, India
| | - Balbir S Verma
- Professor, I.G. Medical College, Shimla, Himachal Pradesh, India
| | - Ashok Sharma
- Professor and Head Department of Medicine, I.G. Medical College, Shimla, Himachal Pradesh, India
| |
Collapse
|
13
|
Park SW, Ha NY, Ryu B, Bang JH, Song H, Kim Y, Kim G, Oh MD, Cho NH, Lee JK. Urbanization of scrub typhus disease in South Korea. PLoS Negl Trop Dis 2015; 9:e0003814. [PMID: 26000454 PMCID: PMC4441427 DOI: 10.1371/journal.pntd.0003814] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/05/2015] [Indexed: 01/19/2023] Open
Abstract
Background Scrub typhus is an endemic disease in Asia. It has been a rural disease, but indigenous urban cases have been observed in Seoul, South Korea. Urban scrub typhus may have a significant impact because of the large population. Methods Indigenous urban scrub typhus was epidemiologically identified in Seoul, the largest metropolitan city in South Korea, using national notifiable disease data from 2010 to 2013. For detailed analysis of clinical features, patients from one hospital that reported the majority of cases were selected and compared to a historic control group. Chigger mites were prospectively collected in the city using a direct chigger mite-collecting trap, and identified using both phenotypic and 18S rDNA sequencing analyses. Their infection with Orientia tsutsugamushi was confirmed by sequencing the 56-kDa antigen gene. Results Eighty-eight cases of urban scrub typhus were determined in Seoul. The possible sites of infection were mountainous areas (56.8%), city parks (20.5%), the vicinity of one’s own residence (17.0%), and riversides (5.7%). Eighty-seven chigger mites were collected in Gwanak mountain, one of the suspected infection sites in southern Seoul, and seventy-six (87.4%) of them were identified as Helenicula miyagawai and eight (9.2%) as Leptotrombidium scutellare. Pooled DNA extracted from H. miyagawai mites yielded O. tsutsugamushi Boryong strain. Twenty-six patients from one hospital showed low APACHE II score (3.4 ± 2.7), low complication rate (3.8%), and no hypokalemia. Conclusions We identified the presence of indigenous urban scrub typhus in Seoul, and a subgroup of them had mild clinical features. The chigger mite H. miyagawai infected with O. tsutsugamushi within the city was found. In endemic area, urban scrub typhus needs to be considered as one of the differential febrile diseases and a target for prevention. Scrub typhus is one of the high burdened infectious diseases in endemic rural areas. Our study showed that the disease could be endemic in urban areas. Indigenous urban scrub typhus may also have significant impact in terms of a disease burden and differential diagnosis. A low rate of characteristic eschar and skin rash may make the clinical suspicion more troublesome. Scrub typhus is the 3rd most frequent notifiable infectious disease in South Korea. Seoul is a densely populated capital city located in northwestern South Korea. We epidemiologically identified indigenous urban cases. A subgroup of them showed mild clinical characteristics. Direct mite collection from a suspected infection site, Mt. Gwanak in Seoul, showed that Helenicula miyagawai (87.4%) and Leptotrombidium scutellare (9.2%) were the dominant species. In addition, O. tsutsugamushi-specific gene, tsa56, was identified in a fraction of the collected H. miyagawai. The 18S rDNA sequencing of the chigger mites was complementarily helpful for the differentiation of species. Our data are from one region, but urban scrub typhus is likely a scenario in endemic areas. Urban areas should be included as possible locations for scrub typhus.
Collapse
Affiliation(s)
- Sang-Won Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Boramae Medical Center, Seoul, Republic of Korea
| | - Na-Young Ha
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Science, Seoul National University College of Medicine and Bundang Hospital, Seoul, Republic of Korea
| | - Boyeong Ryu
- Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul Center for Infectious Disease Control, Seoul, Republic of Korea
| | - Ji Hwan Bang
- Department of Internal Medicine, Boramae Medical Center, Seoul, Republic of Korea
- Seoul Center for Infectious Disease Control, Seoul, Republic of Korea
| | - Hoyeon Song
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Science, Seoul National University College of Medicine and Bundang Hospital, Seoul, Republic of Korea
| | - Yuri Kim
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Science, Seoul National University College of Medicine and Bundang Hospital, Seoul, Republic of Korea
| | - Gwanghun Kim
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Science, Seoul National University College of Medicine and Bundang Hospital, Seoul, Republic of Korea
| | - Myoung-don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Seoul Center for Infectious Disease Control, Seoul, Republic of Korea
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Science, Seoul National University College of Medicine and Bundang Hospital, Seoul, Republic of Korea
- * E-mail: (NHC); (JkL)
| | - Jong-koo Lee
- Seoul Center for Infectious Disease Control, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail: (NHC); (JkL)
| |
Collapse
|
14
|
Epidemic characteristics and spatio-temporal patterns of scrub typhus during 2006–2013 in Tai'an, Northern China. Epidemiol Infect 2014; 143:2451-8. [DOI: 10.1017/s0950268814003598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYTai'an, a famous cultural tourist district, is a new endemic foci of scrub typhus in northern China. Frequent reports of travel-acquired cases and absence of effective vaccine indicated a significant health problem of scrub typhus in Tai'an. Thus, descriptive epidemiological methods and spatial-temporal scan statistics were used to describe the epidemic characteristics and detect the significant clusters of the high incidence of scrub typhus at the town level in Tai'an. Results of descriptive epidemiological analysis showed a total of 490 cases were reported in Tai'an with the annual average incidence ranging from 0·48 to 2·27/100 000 during 2006–2013. Females, the elderly and farmers are the high-risk groups. Monthly changes of scrub typhus cases indicated an obvious epidemic period in autumn. Spatial-temporal distribution analysis, showed significant clusters of high incidence mainly located in eastern and northern Tai'an. Our study suggests that more effective, targeted measures for local residents should be implemented in the eastern and northern areas of Tai'an in autumn. Meanwhile, it may prove beneficial for health policy makers to advise travellers to take preventive measures in order to minimize the risk of infection of scrub typhus in Tai'an.
Collapse
|
15
|
Cho HW. The Geographical and Economical Impact of Scrub Typus, the Fastest-growing Vector-borne Disease in Korea. Osong Public Health Res Perspect 2013; 4:1-3. [PMID: 24159522 PMCID: PMC3747677 DOI: 10.1016/j.phrp.2013.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|