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PubMed2005

Structural features of lipopolysaccharide from Rickettsia typhi: the causative agent of endemic typhus.

Rickettsia typhi causes endemic typhus, a relatively mild, acute febrile illness characterized by headache and macular rash. It is maintained in rodents and transmitted to humans by flea Xenopsylla cheopis. R. typhi contains a lipopolysaccharide thought to display a noticeable antigenic activity. We examined its structural features and it appears that the O-specific chain of the R. typhi LPS is composed mainly of the alternating Glc and QuiNAc residues linked by 1-->4 bonds.

Animals↗
PubMed2006

The foci of scrub typhus and strategies of prevention in the Spring in Pingtan Island, Fujian Province.

This study investigates the foci of tsutsugamushi disease on Pingtan Island, China, with emphasis on cases of illness that occur in the spring. The investigation of the physical and medical geography in the endemic area and detection of 141 sera samples in the population of Pingtan Island is described. The serum samples were taken from 102 soldiers and 39 residents and were tested by the indirect immunofluorescence assay. An island resident's history of illness inquiry was also conducted, and the results are discussed. We were able to determine the most prevalent types of rats and mites from the rat bodies. We isolated the DNA from the spleen of 40 rats and from five groups of mites by polymerase chain reaction. Orientia tsutsugamushi was isolated by perctoneally injecting KM mice with the patient's untreated blood along with ground rat viscera (R. losea) and ground mites (L. deliense), respectively. The isolates were typed at the molecular level. This study will then present direct prevention strategies that emphasize personal hygiene, methods of personal protection, keeping living environments clean, and it will provide strategies to eliminate rats and mites. As a result of adopting these strategies, no case of scrub typhus occurred in this region in approximately 2003-2004.

Animals↗
PubMed1993

Two-step polymerase chain reaction for diagnosis of scrub typhus and identification of antigenic variants of Rickettsia tsutsugamushi.

Two-step polymerase chain reaction (nested PCR) method was examined for the diagnosis of scrub typhus. Primers were derived from the type-specific antigen (TSA) gene DNA sequences of Rickettsia tsutsugamushi, Gilliam strain. These primers served to produce rickettsia-specific products in the amplification of template DNA prepared from all serovariants, Gilliam, Karp, Kato, Kawasaki, Kuroki and Shimokoshi strains, and the fragments of product after digestion with several kinds of restriction endonuclease showed the respective patterns to strain in acrylamide or agarose gel electrophoresis. The rickettsia-specific DNAs were also derived, by this nested PCR, by amplifying DNA from patients' bloods and mites from endemic areas, and the serotype of rickettsiae infected to these hosts could be identified from fragment patterns of the amplified products observed after endonuclease treatment. These results indicate that this PCR is sensitive and specific method not only for detection of rickettsial DNA in patient specimens and in mites, but also for the typing of rickettsiae infected to these hosts.

Animals↗
PubMed1985

Medicine as social science: Rudolf Virchow on the typhus epidemic in Upper Silesia.

Rudolf Virchow's Report on the 1848 typhus epidemic is one of the neglected classics of "social medicine"--a term he did much to popularize. His analysis of the epidemic emphasized the economic, social, and cultural factors involved in its etiology, and clearly identified the contradictory social forces that prevented any simple solution. Instead of recommending medical changes (i.e., more doctors or hospitals), he outlined a revolutionary program of social reconstruction; including full employment, higher wages, the establishment of agricultural cooperatives, universal education, and the disestablishment of the Catholic Church. This article includes the first English translation of these long-term recommendations. It also locates Virchow's Report within the context of the Medical Reform Movement of 1848 and traces his influence on the subsequent development of social medicine. Parallels are drawn between Virchow's attempts to reform health care and current developments in the political economy of health.

Germany↗
PubMed1990

Ciprofloxacin treatment of murine typhus.

A 31-year-old woman developed fever, severe headache, myalgia and rash 3 weeks after a visit to Cyprus where she experienced insect bites in her bed. Treatment with ciprofloxacin resulted in a remarkable and rapid effect. Endemic typhus was proved by serology.

Adult↗
PubMedDate not supplied

New Orientia tsutsugamushi strain from scrub typhus in Australia.

In a recent case of scrub typhus in Australia, Orientia tsutsugamushi isolated from the patient's blood was tested by sequence analysis of the 16S rDNA gene. The sequence showed a strain of O. tsutsugamushi that was quite different from the classic Karp, Kato, and Gilliam strains. The new strain has been designated Litchfield.

Adult↗
PubMedDate not supplied

Murine typhus in travelers returning from Indonesia.

We report the first three documented cases of murine typhus imported into Europe from Indonesia, discuss clues for the diagnosis of the disease, and urge that murine fever be considered in the diagnosis of febrile disease in travelers.

Adult↗
PubMed2003

Scrub typhus in the Torres Strait islands of north Queensland, Australia.

Scrub typhus, caused by Orientia tsutsugamushi, occurs throughout Southeast Asia. We descript ten cases that occurred in the Torres Strait islands of northern Australia during 2000 and 2001. Preceding heavy rain may have contributed to the outbreak. The successful use of azithromycin in two pediatric patients is also reported.

Adolescent↗
PubMed2003

Scrub typhus reemergence in the Maldives.

In summer 2002, an outbreak of febrile illness began in the Maldives in the Indian Ocean. Through April 2003, officials recorded 168 cases with 10 deaths. The Armed Forces Research Institute of Medical Sciences in Bangkok confirmed Orientia tsutsugamushi and conducted a joint investigation with the Ministry of Health, Maldives. These cases of scrub typhus were the first in the Maldives since World War II.

Animals↗
PubMed2004

Scrub typhus in the Republic of Palau, Micronesia.

In October 2001, an outbreak of febrile illness began in the southwest islands group of the Republic of Palau. Through October 2003, a total of 15 southwest islanders experienced fever >39.5 degrees C and abdominal distress, both lasting >7 days. Orientia tsutsugamushi, the agent of scrub typhus, was subsequently identified as the cause.

Adolescent↗
PubMed2006

Orientia tsutsugamushi in eschars from scrub typhus patients.

To verify the value of eschars for the diagnosis of scrub typhus and to characterize genotypes of Orientia tsutsugamushi in patients, we examined eschars and blood specimens of 7 patients from Shandong Province, People's Republic of China, for O. tsutsugamushi by polymerase chain reaction targeting the Sta56 gene. All 7 eschars and acute-phase blood samples were positive, while no specific DNA amplicons were obtained from the 7 convalescent-phase blood samples collected after antimicrobial drug therapy. The findings indicate that patients' eschars can be used for detection and genetic characterization of O. tsutsugamushi during the convalescent phase.

Adult↗
PubMed1990

A case of laboratory-acquired murine typhus.

We encountered a 32-year-old Korean woman who developed murine typhus in a laboratory. She worked as a technician in a laboratory for rickettsial disease. Immunofluorescence test with rickettsial antigen (R. typhi) was positive at 1: 320 on admission and 1: 1280 after 4 weeks. A dose of 200 mg of doxycycline for 7 days proved to be effective for her condition.

Adult↗
PubMed1975

Serologic classification of scrub typhus isolates from Pakistan.

Detailed serologic characterization of 79 isolates of Rickettsia tsutsugamushi from Pakistan was performed by using complement fixation and direct immunofluorescence techniques for comparison with three prototype strains. Seventy-one were of the Karp serotype and one was of a Gilliam serotype. Seven isolates were multiply-reactive: one with Karp and Gilliam, 3 with Karp and Kato, and 3 with Karp, Gilliam and Kato, No strain failed to react with at least 1 of the 3 prototype antisera. No correlation of antigenic types with local geographic factors, animal hosts, vecotr mites, or specific strain virulence was observed. These findings suggest the possibility that antigenic heterogeneity may be more restricted in areas peripheral to the geographic epicenter of scrub typhus endemicity, that the serotypes are relatively stable genetically and that new geographic variants are probably infrequent. The importance of these findings to the practical problems of immunoprophylaxis and serodiagnosis are discussed.

Animals↗
PubMed1984

Lack of transplacental infection with scrub typhus organisms in laboratory mice.

Female mice were inoculated with either a virulent or avirulent strain of Rickettsia tsutsugamushi before (1 month and 1 week) or after (approximately 10 days) impregnation. From each group, two pregnant mothers were killed on day 20 post-impregnation, and fetuses and placentas were examined for rickettsiae. Organisms were isolated from 80% of placentas but not from the fetuses. Immediately following parturition, litters from 50% of the infected mothers were exchanged with litters from uninfected mothers. In all cases, no scrub typhus rickettsiae were found in the litters examined on days 1, 7, and 30 postpartum, and no antibody was found in sera collected 1 and 2 months postpartum.

Animals↗
PubMed1988

Newborn rats in the murine typhus enzootic infection cycle: studies on transplacental infection and passively acquired maternal antirickettsial antibodies.

This study focused attention on the newborn rat as a possible significant participant in the highly successful enzootic cycle of murine typhus. We examined the influence of maternal Rickettsia typhi (R. mooseri) infection in rats on the offspring with respect to the possible vertical transmission of R. typhi and the passive transfer of maternal antirickettsial antibodies. Transmission of R. typhi by rickettsemic pregnant rats did not occur either transplacentally during gestation to their fetuses or postnatally through colostrum and milk to their newborn. The rickettsial burden of the placenta was sometimes greater than 10(6) plaque forming units per g tissue and undetectable in colostrum or milk. However, newborn rats were highly susceptible to infection per os. Transplacental passage of antirickettsial antibody to offspring was detectable only when the mother's antibody titer was high. Passive postpartum acquisition of antirickettsial antibodies by newborn rats from colostrum and milk of immune mothers occurred regardless of the height of the maternal antibody titer, rose to a maximum at about 3 weeks of age, and then declined rapidly, becoming undetectable 4 weeks after birth.

Animals↗
PubMed1990

Multi-laboratory evaluation of a scrub typhus diagnostic kit.

Scrub typhus is a major cause of febrile illness throughout the Asia-Pacific region. It is commonly undiagnosed, partly because of the lack of a simple, reliable diagnostic test which can be used in clinical laboratories. The indirect immunoperoxidase technique, configured into a test kit, was provided to technicians who were trained in its use. They used the kit during a 2 year field trial in their respective clinical hospital laboratories throughout Malaysia. In an evaluation using 1,722 consecutive sera tested in those laboratories, the kit was found to have a median sensitivity for IgG detection of 0.85 (range 0.33-0.95), a median specificity of 0.94 (range 0.88-1.00), reproducibility of 0.86, and efficiency of 0.92 when compared to the reference laboratory. In a proficiency survey in which 10 laboratories received 3 coded test samples, all but 2 laboratories had results within 1 dilution of the reference laboratory in quantitating specific IgG, whereas 7 laboratories were within 1 dilution in quantitating IgM. The shelf life of the kit was at least 1 year at 4 degrees C.

Antibodies, Bacterial↗
PubMed1993

A new focus of scrub typhus in tropical Australia.

A new focus of scrub typhus (Rickettsia tsutsugamushi) is described in a remote rain forest region of the Northern Territory of Australia. Five serologically confirmed cases, two near fatal with multisystem involvement, have occurred since the area became accessible to tourists. As tourism increases, other remote foci of vectors and organisms may also be recognized in tropical Australia.

Adult↗
PubMed1993

A polymerase chain reaction system for rapid diagnosis of scrub typhus within six hours.

A rapid diagnostic system for scrub typhus (tsutsugamushi disease) was established using the polymerase chain reaction (PCR) combined with microplate hybridization. With this system, diagnosis can be made within six hours without the need for radioisotopes, electrophoresis, or membrane hybridization. The use of a PCR processor and DNA-precoated enzyme-linked immunosorbent assay plates allows a rapid and precise diagnosis to be easily made even in primary medical care clinics.

Aged↗