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PubMed1979

Changing risk of scrub typhus in relation to socioeconomic development in the Pescadores islands of Taiwan.

Long term changes in risk of Rickettsia tsutsugamushi infection among civilian residents of the Pescadores Islands of Taiwan were associated with changing social conditions. Age specific incidence rates of scrub typhus in the Pescadores before 1940 were highest among children under 5 years of age. Rickettsiae can be demonstrated in vectors, wild animals continue to be infected and scrub typhus occurs in military personnel. A serologic survey for antibody to R. tsutsugamushi was conducted during 1975 and 1977 and failed to show evidence of previous infection among children. Two events appear to be associated with the decreased incidence of rickettsial infection in the young: increased urbanization and increased enrollment in schools. Both changes accompanied socioeconomic development which took place in the islands during the past 50 years. Prevalence of antibody to R. tsutsugamushi continues to be equal in the sexes and is undoubtedly due to similar occupational exposure of both sexes in fields and farms where vectors are numerous. The absence of apparent morbidity due to scrub typhus among the civilian populace was attributed to the mild nature of the disease caused by Pescadores strains, misdiagnosis and a lack of obligatory reporting.

Adolescent↗
PubMedDate not supplied

Scrub typhus pneumonitis acquired through the respiratory tract in a laboratory worker.

We report a case of scrub typhus pneumonitis in a laboratory worker who apparently acquired it through the respiratory tract. The patient was suffering from fever, cough and dyspnea. He had both cervical and axillary lymphadenopathy, and hepatomegaly. A chest X-ray showed interstitial infiltrates. A diagnosis of scrub typhus was established upon isolation of Orientia tsutsugamushi. 12 days before the patient showed symptoms, he had purified O. tsutsugamushi proteins from infected cells using an ultrasonication method which could generate aerosols containing O. tsutsugamushi.

Adult↗
PubMed2002

Afebrile scrub typhus (Tsutsugamushi disease) with acute respiratory distress syndrome.

A 74-year-old Japanese man with scrub typhus presented without the typical symptom of high fever and subsequently developed the complication of acute respiratory distress syndrome. It was suspected that exposure occurred at the river side of Kinugawa, Tochigi Prefecture, Japan. His body temperature was below 38.0 degrees C. After intensive supportive care and minocycline therapy, he dramatically recovered. With the increase in popularity of outdoor recreation, scrub typhus can be found in clinics all over Japan. Physicians should therefore be aware of the manifestations of the disease and the necessity of early treatment in suspected cases.

Aged↗
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↗
PubMedDate not supplied

Scrub typhus: an imported Rickettsial disease.

A case of scrub typhus due to Rickettsia tsutsugamushi is reported. This imported rickettsial disease was contracted by a 30-year-old woman while traveling in Thailand, and was transmitted by an infected mite's bite. Diagnosis was confirmed by specific serology and resolution was obtained by tetracycline therapy. Current concepts of the disease are reviewed.

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↗
PubMed1991

Atypical lymphocytes with a multilobated nucleus from a patient with tsutsugamushi disease (scrub typhus) in Japan.

A case of tsutsugamushi disease (scrub typhus) with atypical lymphocytes with a multilobated nucleus is reported. Although this type of atypical lymphocyte has been reported in patients with viral infections such as adult T-cell leukemia, infectious mononucleosis, human immunodeficiency virus (HIV) infection, this is the first reported case of atypical lymphocyte with a multilobated nucleus in a patient with rickettsial infection. This type of atypical lymphocyte seems to exist in a broad spectrum of infectious diseases.

Cell Nucleus↗
PubMed1995

Development and preliminary evaluation of an IgM dot-immunobinding assay (IgM-DIA) for rapid serodiagnosis of scrub typhus infection.

An IgM dot-immunobinding assay (IgM-DIA) was developed for the diagnosis of scrub typhus infection. The whole cell antigens of Karp, Kato and Gilliam strains of Rickettsia tsutsugamushi were immobilized onto nitrocellulose paper and reacted with patients sera. The presence of IgM R. tsutsugamushi specific antibody in the patient sera could be detected by the observation of a visible brown dot on the nitrocellulose paper. The IgM-DIA has a sensitivity of 90.4% and specificity of 81.4% as compared to the indirect immunoperoxidase test. The IgM-DIA is rapid, simple, cost-effective, does not require microscope or incubator. It is recommended as a rapid screening test for the diagnosis of scrub typhus infection in the field or rural area within the hyperendemic region.

Antibodies, Bacterial↗
PubMed2004

Mite vectors (Acari: Trombiculidae) of scrub typhus in a new endemic area in northern Kyoto, Japan.

Between 1983 and 1999, 27 human cases of scrub typhus (two fatal) occurred in the Nodagawa River basin of northern Kyoto, Japan, an area where no cases had been previously reported. Antibody screening of infected patients' sera showed that nine of 15 patients had high titers against the Gilliam type of Orientia tsutsugamushi (Hayashi). To determine the vector mite transmitting the disease, we studied rodent and chigger populations in and near a rice field alongside the Nodagawa River between 1996 and 1999. The most common rodent species was Microtus montebelli (Milne-Edwards), representing 73.3% (33/45) of the population. The mite index (average number of mites per infested host) was highest (190.8) in Leptotrombidium pallidum Nagayo, Mitamura & Tamiya parasitizing on M. montebelli, followed by Leptotrombidium intermedium (Nagayo, Mitamura & Tamiya) (174.9) on the same host species. Orientia tsutsugamushi was isolated from 60.5% (23/38) of rodents and from 71.2% (37/52) of pools of engorged L. pallidum. The Gilliam type of O. tsutsugamushi was most prevalent in rodents, and in engorged L. pallidum and it was the only type recovered from 10 isolates inoculated into L 929 cells for indirect immunofluorescence examination. Orientia tsutsugamushi infected 14.3% (181/1263) and 14.8% (306/2066) of engorged and unfed L. pallidum larvae, respectively, and was also detected in 0.055% (2/3634) of unfed L. intermedium, although previous studies suggest that this mite rarely bites humans. These results show that L. pallidum is the primary vector species of scrub typhus in this new endemic area in Japan.

Animals↗
PubMed1989

Serodiagnosis of scrub typhus with antigens immobilized on nitrocellulose sheet.

This study was designed to develop a simple method for serodiagnosis of scrub typhus. The basis of the method is detection of anti-Rickettsia tsutsugamushi antibody in patient serum by reaction with antigens dot blotted on a nitrocellulose sheet (NCS). The final evaluation of the reaction is performed by observing the color intensity which develops as a result of sequential treatments of the NCS with peroxidase-conjugated anti-human immunoglobulin G or immunoglobulin M antibody and with the substrate of the enzyme. After various trials, we found that the best results were obtained by using a purified antigen which adhered to an NCS at 0.2 to 2 micrograms of protein per dot and a test serum diluted 1,000- to 4,000-fold. Under these conditions, almost all antibody-positive sera showed a distinct color at the dot on the NCS, so that a positive reaction could be distinguished by the naked eye from a negative reaction with antibody-negative sera, which developed only a faint color. A comparison of the results of screening of antibody-positive and -negative sera by this method and the immunofluorescence test showed that both methods produced similar results. From these results, it is concluded that this dot immunoassay can be useful for the serodiagnosis of scrub typhus.

Antibodies, Bacterial↗
PubMed1995

Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial.

To assess the clinical efficacy of short-course doxycycline in the treatment of scrub typhus, we compared conventional 7-day tetracycline therapy with 3-day doxycycline therapy in 116 patients. Patients were randomized to receive either tetracycline (500 mg four times daily; n = 50) or doxycycline (100 mg twice daily; n = 66) and were followed for 4 weeks after the completion of treatment. The cure rate was 100% in the tetracycline group and 93.9% in the doxycycline group (P > .05). The two groups did not differ significantly in terms of the interval required for defervescence or for the alleviation of symptoms. There were no relapses in either group. These data suggest that 3-day doxycycline therapy is as effective as conventional 7-day tetracycline therapy for the cure of scrub typhus and the prevention of relapses.

Adult↗
PubMed1982

Population indices of chiggers (Leptotrombidium deliense) and incidence of scrub typhus in Chinese military personnel, Pescadores Islands of Taiwan, 1976-77.

Larval Leptotrombidium deliense were recovered from live-trapped Suncus murinus, Rattus rattus and R. norvegicus captured in the Pescadores Islands of Taiwan during 1976 and 1977. Weekly and monthly indices of chigger infestation expressed as a percentage of hosts infested and the number of chiggers per host for S. murinus and Rattus spp. were calculated. Close correlations were observed between monthly indices of L. deliense measured for S. murinus and Rattus spp. and the number of laboratory-confirmed cases of scrub typhus per month. Weekly indices from S. murinus correlated more closely with number of cases than did weekly indices from Rattus spp. The critical level of chigger infestation necessary for a single case of scrub typhus in a month was estimated at 0.69 chigger per S. murinus and 0.68 chigger per Rattus spp. The weekly index of chigger infestation necessary for a single case of scrub typhus during a week was calculated at 0.47 chiggers per shrew. Critical levels of chigger infestations expressed as percentages of hosts infested were not calculated.

Animals↗
PubMed1996

Transmission of scrub typhus by needlestick from a patient receiving pefloxacin.

A nurse experience a needlestick during the care of a patient with scrub typhus, treated with pefloxacin (400 mg twice daily) and cefazolin. Seven days after the needlestick, pain and erythematous swelling developed at the tip of her left fourth finger, the site of the needlestick. Fever and headache developed 10 days later, and her skin lesion became a small vesicle surrounded by a dark erythematous area. The diagnosis of scrub typhus was made by a rising indirect immunofluorescent antibody titre, and her illness was improved with doxycycline.

Adult↗
PubMed1981

Scrub Typhus antibody in cynomolgus monkeys (Macaca fascicularis) in Malaysia.

Using an indirect immunofluorescence technique, sera from 113 cynomolgus monkeys (Macaca fascicularis), trapped in Peninsular Malaysia, were screened for the presence of antibody to six prototype strains of Rickettsia tsutsugamushi combined into three polyvalent groupings: I--Karp, TA716, and TA763; II--Gilliam; and III--TA678 and TH1817. Fifteen percent (17/113) of the monkeys had antibody titers greater than or equal to 1:50 to one or more of the antigenic groups. Although a titer greater than or equal to 1:150 is generally considered indicative or prior Rickettsia tsutsugamushi infection, we selected a less than 1:25 titer as a conservative standard to insure non-infected animals. Using this criterion, 62 (55%) of the 113 monkeys were accepted for use in scrub typhus studies. The high prevalence of antibody to scrub typhus in the semi-arboreal cynomolgus monkey is in marked contrast to the low prevalence reported in the strictly arboreal silvered leaf monkeys (Presbytis cristatus). The results of this study indicate that cynomolgus monkeys should be rigorously screened for evidence of prior infection before they are included in experimental scrub typhus studies.

Animals↗
PubMed1992

Interferon-gamma in cerebrospinal fluid without pleocytosis in scrub typhus.

We detected immunoreactive interferon-gamma (IFN-gamma) both in cerebrospinal fluid (CSF) and in serum of 5 patients with scrub typhus, one with meningitis and 4 other cases with neither CSF pleocytosis nor blood-CSF barrier dysfunction. Our data suggest intrathecal synthesis of IFN-gamma without pleocytosis which implies occult cerebral involvement in scrub typhus.

Adult↗
PubMed1992

Scrub typhus and pregnancy: a case report and literature review.

Scrub typhus is still prevalent on Penghu Islands. We herein report a case in a pregnant woman who had been to Yi-Lan County in Taiwan. The patient responded well to Minocycline (Minocin) therapy without complication. Her newborn baby was found not complicated with the disease. The relative literature is reviewed.

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↗