Scrub Typhus in Previously Unrecognized Areas of Endemicity in China

Scrub typhus, caused by Orientia tsutsugamushi, has emerged recently in areas of northern China where the disease had not been known to exist. We analyzed epidemiological, clinical, and laboratory data for 104 patients who were admitted to a hospital in Fuyang City between 26 September and 1 Novembe...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2010-04, Vol.48 (4), p.1241-1244
Main Authors: Zhang, Shouyin, Song, Hongbin, Liu, Yan, Li, Qun, Wang, Yong, Wu, Jiabin, Wan, Junfeng, Li, Guolan, Yu, Changjun, Li, Xiuyong, Yin, Wenwu, Xu, Zhen, Liu, Bo, Zhang, Qian, Wan, Kanglin, Li, Guichang, Fu, Xiuping, Zhang, Jingshan, He, Jinrong, Hai, Rong, Yu, Dongzheng, Walker, David H, Xu, Jianguo, Yu, Xue-Jie
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Bacterial - blood
Child
China - epidemiology
DNA, Bacterial - chemistry
DNA, Bacterial - genetics
Endemic Diseases
Epidemiology
Female
Fluorescent Antibody Technique, Indirect
Humans
Immunoglobulin M - blood
Male
Middle Aged
Molecular Sequence Data
Orientia tsutsugamushi
Orientia tsutsugamushi - isolation & purification
Polymerase Chain Reaction
Scrub Typhus - epidemiology
Scrub Typhus - microbiology
Scrub Typhus - pathology
Sequence Analysis, DNA
Young Adult
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Summary:Scrub typhus, caused by Orientia tsutsugamushi, has emerged recently in areas of northern China where the disease had not been known to exist. We analyzed epidemiological, clinical, and laboratory data for 104 patients who were admitted to a hospital in Fuyang City between 26 September and 1 November 2008. We showed that the major clinical manifestations of the patients were fever (100%), headache (82%), myalgias (77%), eschar (67%), rash (52%), and unusual facial flushing (62%). Among the 104 patients, the sera of 98% contained IgM antibodies to O. tsutsugamushi detected by indirect immunofluorescence assays (IFA), and DNA of the O. tsutsugamushi 56-kDa gene was amplified by PCR from the blood of 36 patients. We conclude that 104 patients were infected with scrub typhus in Fuyang City, Anhui Province. Our study indicates that physicians need to consider the diagnosis of scrub typhus for febrile patients living in northern China, where scrub typhus had not been considered to exist in the past.
ISSN:0095-1137
1098-660X
DOI:10.1128/JCM.01784-09