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    1 OF 41

    Renal Manifestation in Scrub Typhus during a Major Outbreak in Central Nepal.
    Indian J Nephrol 2017 Nov-Dec;27(6):440-445
    Health Services Research, United Health Group, OptumInsight, CT, USA.
    Renal involvement and acute kidney injury (AKI) are common clinical manifestations seen in scrub typhus, a vector-borne tropical disease. There are no data on renal manifestation in scrub typhus in Nepal. We conducted a prospective study to analyze the incidence, urinary abnormalities, course, severity, outcome, and the predictors of AKI in patients with scrub typhus during a major outbreak in Central Nepal. Read More

    Rapid Diagnosis of Tick-Borne Illnesses by Use of One-Step Isothermal Nucleic Acid Amplification and Bio-Optical Sensor Detection.
    Clin Chem 2017 Dec 5. Epub 2017 Dec 5.
    Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;
    Background: Scrub typhus and severe fever with thrombocytopenia syndrome (SFTS) are the most common tick-borne illnesses in South Korea. Early differentiation of SFTS from scrub typhus in emergency departments is essential but difficult because of their overlapping epidemiology, shared risk factors, and similar clinical manifestations.

    Methods: We compared the diagnostic performance of one-step isothermal nucleic acid amplification with bio-optical sensor detection (iNAD) under isothermal conditions, which is rapid (20-30 min), with that of real-time PCR, in patients with a confirmed tick-borne illness. Read More

    Guillain-Barre Syndrome with Falciparum Malaria and Scrub Typhus Mixed Infection-An Unusual Combination.
    J Clin Diagn Res 2017 Sep 1;11(9):OD10-OD11. Epub 2017 Sep 1.
    Professor, Department of Medicine, Kasturba Hospital, Manipal University, Manipal, Karnataka, India.
    Guillain-Barre Syndrome is very rare in parasitic and rickettsial infection. Here we report a case of Plasmodium falciparum and scrub typhus mixed infection, presented with quadriparesis. Clinical, Serological, CSF analysis and Nerve Conduction Studies were consistent with Acute Inflammatory Demyelinating Polyneuropathy (variant of GBS). Read More

    Seroprevalence of rickettsial infections and Q fever in Bhutan.
    PLoS Negl Trop Dis 2017 Nov 27;11(11):e0006107. Epub 2017 Nov 27.
    Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.
    Background: With few studies conducted to date, very little is known about the epidemiology of rickettsioses in Bhutan. Due to two previous outbreaks and increasing clinical cases, scrub typhus is better recognized than other rickettsial infections and Q fever.

    Methodology: A descriptive cross-sectional serosurvey was conducted from January to March 2015 in eight districts of Bhutan. Read More

    Epidemiological, clinical and laboratory profile of scrub typhus cases detected by serology and RT-PCR in Kumaon, Uttarakhand: a hospital-based study.
    Trop Doct 2017 01 1:49475517743891. Epub 2017 Jan 1.
    6 Assistant Professor, Department of Microbiology, Government Medical College, Haldwani, Nainital, Uttarakhand, India.
    We analysed the epidemiology, clinical and laboratory data of the 168 scrub typhus cases confirmed by a combination of any one of the following: real time polymerase chain reaction (RT-PCR) and/or immunofluorescence assay (IFA) (IgM and/or IgG). The peak season for scrub typhus is from July to October. By multivariate binary logistic regression analysis, the risk of scrub typhus was about four times in those working in occupation related to forest work. Read More

    Differences in agricultural activities related to incidence of scrub typhus between Korea and Japan.
    Epidemiol Health 2017 Nov 9. Epub 2017 Nov 9.
    Wonkwang University, Iksan, Korea.
    Objectives: The purpose of this study is 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 both countries.

    Methods: The survey area selected Jeonbuk province, which is a high risk and high incidence area, and Fukuoka prefecture, which is a high risk and low incidence area. The subjects were 406 in Korea and 216 in Japanese farmers. Read More

    Orientia tsutsugamushi modulates endoplasmic reticulum-associated degradation to benefit its growth.
    Infect Immun 2017 Nov 6. Epub 2017 Nov 6.
    Department of Microbiology and Immunology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0678, USA
    Orientia tsutsugamushi, an obligate intracellular bacterium that is auxotrophic for the aromatic amino acids and histidine, causes scrub typhus, a potentially deadly infection that threatens one billion people. O. tsutsugamushi growth is minimal during the first 24 to 48 h of infection, but becomes logarithmic thereafter. Read More

    Chigger Mite (Acari: Trombiculidae) Survey of Rodents in Shandong Province, Northern China.
    Korean J Parasitol 2017 Oct 31;55(5):555-559. Epub 2017 Oct 31.
    Shandong Academy of Medicine Sciences, Shandong Institute of Parasitic Diseases, Jining, Shandong Province 272033, People's Republic of China.
    Chigger mites are parasites of rodents and other vertebrates, invertebrates, and other arthropods, and are the only vectors of scrub typhus, in addition to other zoonoses. Therefore, investigating their distribution, diversity, and seasonal abundance is important for public health. Rodent surveillance was conducted at 6 districts in Shandong Province, northern China (114-112°E, 34-38°N), from January to December 2011. Read More

    A review of the global epidemiology of scrub typhus.
    PLoS Negl Trop Dis 2017 Nov 3;11(11):e0006062. Epub 2017 Nov 3.
    Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas, United States of America.
    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. Read More

    Differential diagnosis of scrub typhus meningitis from tuberculous meningitis using clinical and laboratory features.
    Clin Neurol Neurosurg 2017 Dec 23;163:76-80. Epub 2017 Oct 23.
    Department of Internal Medicine, Malabar Institute of Medical Sciences, Calicut, Kerala, India.
    Objectives: The involvement of the central nervous system in the form of meningitis or meningoencephalitis is common in scrub typhus and is an important differential diagnosis of other lymphocytic meningitis like tuberculous meningitis (TBM). The aim of this study was to identify the clinical and laboratory parameters that may be helpful in differentiating scrub typhus meningitis from TBM.

    Patients And Methods: We compared of the clinical and laboratory features of 57 patients admitted with scrub typhus meningitis or TBM during a 3-year period. Read More

    Relative Bradycardia in Scrub Typhus.
    Am J Trop Med Hyg 2017 Nov 10;97(5):1316-1318. Epub 2017 Oct 10.
    Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.
    To investigate the relationship between heart rate and temperature, we examined 493 febrile patients with documented disease. These patients were diagnosed serologically and analyzed retrospectively: 337 (68.4%) responded to fever with increased heart rate < 10 beats/minute/°C (relative bradycardia [RB]), and 156 patients had a heart rate response ≥ 10 beats/minute/°C (general heart rate increase [GHRI]). Read More

    Immune thrombocytopenia with multi-organ dysfunction syndrome as a rare presentation of scrub typhus: a case report.
    BMC Res Notes 2017 Oct 6;10(1):496. Epub 2017 Oct 6.
    M.O.S.C Medical College & Hospital, Ernakulam District, Kolenchery, Kerala, 682311, India.
    Background: Scrub typhus is an acute infectious illness caused by Orientia tsutsugamushi. It is endemic to a part of the world known as the "tsutsugamushi triangle". Humans are accidental hosts in this zoonotic disease. Read More

    New Record of the Scrub Typhus Vector, Leptotrombidium rubellum, in Southwest China.
    J Med Entomol 2017 Nov;54(6):1767-1770
    Vector Laboratory, Institute of Pathogens and Vectors, Dali University, and the Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali, Yunnan Province 671000, P. R. China.
    There are several main vectors of scrub typhus in China, and Leptotrombidium rubellum Wang et Liao, 1984 is one of them, which was previously considered to be restricted to the coastal regions of Changle to Xiamen, Fujian province of east China. Ecological investigation of chigger mites in recent years demonstrated the presence of L. rubellum also in Yunnan province. Read More

    Scrub Typhus in Southern Districts of West Bengal.
    Indian J Dermatol 2017 Sep-Oct;62(5):512-514
    Department of Dermatology, R G Kar Medical College, Kolkata, West Bengal, India.
    Scrub typhus has been previously reported from north and eastern Indian states and areas such as Kashmir, Himachal Pradesh, Assam, Sikkim, and Darjeeling district of West Bengal. It has also been known to be endemic in some parts of South India (Eastern and Western Ghats). However, no cases have ever been reported from the southern districts of West Bengal. Read More

    Scrub Typhus: An Emerging Threat.
    Indian J Dermatol 2017 Sep-Oct;62(5):478-485
    Department of Dermatology, Dr. B. C. Roy Postgraduate Institute of Pediatric Science, Kolkata, West Bengal, India.
    Scrub typhus is caused by Orientia tsutsugamushi (formerly Rickettsia) and is transmitted to humans by an arthropod vector of the Trombiculidae family (Leptotrombidium deliense and L. akamushi). It is the most common re-emerging Rickettsial infection in India and many other South East Asian countries. Read More

    Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy.
    BMC Infect Dis 2017 Oct 4;17(1):665. Epub 2017 Oct 4.
    Infectious Diseases Training and Research Centre, Department of Medicine, Christian Medical College, Vellore, India.
    Background: The objectives of this study were to determine the proportion of malaria, bacteraemia, scrub typhus, leptospirosis, chikungunya and dengue among hospitalized patients with acute undifferentiated fever in India, and to describe the performance of standard diagnostic methods.

    Methods: During April 2011-November 2012, 1564 patients aged ≥5 years with febrile illness for 2-14 days were consecutively included in an observational study at seven community hospitals in six states in India. Malaria microscopy, blood culture, Dengue rapid NS1 antigen and IgM Combo test, Leptospira IgM ELISA, Scrub typhus IgM ELISA and Chikungunya IgM ELISA were routinely performed at the hospitals. Read More

    Scrub Typhus in a New Born.
    J Clin Diagn Res 2017 Aug 1;11(8):SD05-SD06. Epub 2017 Aug 1.
    Senior Resident, Department of Paediatrics, Chacha Nehru Bal Chikitsalaya, Delhi, India.
    Scrub typhus is an acute febrile mite-born rickettsial infection caused by Orientia tsutsugamushi (formely called Rickettsiatsutsugamushi). This infection is very uncommon in neonates. We report a case of 19-day-old newborn presenting with clinical features mimicking severe sepsis but was subsequently diagnosed with primary scrub typhus infection. Read More

    Improving the Diagnosis of Scrub Typhus by Combining groEL Based Polymerase Chain Reaction and IgM ELISA.
    J Clin Diagn Res 2017 Aug 1;11(8):DC27-DC31. Epub 2017 Aug 1.
    Senior Technical officer, Department of Statistics, Regional Medical Research Centre, Belagavi, Karnataka, India.
    Introduction: Scrub typhus, an acute febrile illness, caused by Orientia tsutsugamushi, is an important cause of pyrexia of unknown origin in regions of endemicity. This disease is mostly underdiagnosed or misdiagnosed, the reasons for this being a combination of factors which include clinical manifestations that can mimic other infections, lack of easy and reliable diagnostic methods and variation among strains in endemic areas. Hence, easy and reliable methods of diagnosis will contribute to rapid identification and treatment of the infection. Read More

    Estimating the burden of scrub typhus: A systematic review.
    PLoS Negl Trop Dis 2017 Sep 25;11(9):e0005838. Epub 2017 Sep 25.
    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
    Background: Scrub typhus is a vector-borne zoonotic disease that can be life-threatening. There are no licensed vaccines, or vector control efforts in place. Despite increasing awareness in endemic regions, the public health burden and global distribution of scrub typhus remains poorly known. Read More

    Prevalence and Phylogenetic Analysis of Orientia tsutsugamushi in Rodents and Mites from Central India.
    Vector Borne Zoonotic Dis 2017 Nov 21;17(11):749-754. Epub 2017 Sep 21.
    1 Centre for Zoonoses, Department of Veterinary Public Health, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University , Nagpur, India .
    Orientia tsutsugamushi, the causative agent of scrub typhus in humans, is an obligate intracytosolic bacterium transmitted among animals and to humans by some species of larval trombiculid mites (chiggers) and is hosted mainly by rodents. In this study, we attempted detection of O. tsutsugamushi from blood and tissue samples of rodents trapped from different locations in Central India using PCR targeting the 56 kDa outer membrane protein gene and the 47 kDa high temperature transmembrane protein gene. Read More

    Zoonotic surveillance for rickettsiae in rodents and mapping of vectors of rickettsial diseases in India: A multi-centric study.
    Indian J Public Health 2017 Jul-Sep;61(3):174-181
    Junior Scientific Assistant, Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
    Background: The global resurgence of rickettsial diseases and their potential to impact the fitness of military personnel and inflict widespread casualties amongst civil populations has emerged as a major cause of public health concern. Absence of surveillance system, lack of awareness amongst medical fraternity to rickettsial activity along with the difficulty in diagnosis because of their protean clinical manifestations are reasons for the outbreaks of these diseases.

    Objectives: To determine rickettsial activity amongst rodents and study vector diversity, abundance and their distribution to enable mapping of rickettsial hotspots. Read More

    Strong interferon-gamma mediated cellular immunity to scrub typhus demonstrated using a novel whole cell antigen ELISpot assay in rhesus macaques and humans.
    PLoS Negl Trop Dis 2017 Sep 11;11(9):e0005846. Epub 2017 Sep 11.
    Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
    Scrub typhus is a febrile infection caused by the obligate intracellular bacterium Orientia tsutsugamushi, which causes significant morbidity and mortality across the Asia-Pacific region. The control of this vector-borne disease is challenging due to humans being dead-end hosts, vertical maintenance of the pathogen in the vector itself, and a potentially large rodent reservoir of unclear significance, coupled with a lack of accurate diagnostic tests. Development of an effective vaccine is highly desirable. Read More

    Typhoid and Scrub Typhus Coinfection in a Returned Traveler.
    Glob Pediatr Health 2017 25;4:2333794X17726941. Epub 2017 Aug 25.
    KK Women's and Children's Hospital, Singapore, Singapore.
    This is a case report of a 12-year-old returned traveler with typhoid and scrub typhus coinfection. The diagnosis of typhoid was made early with blood cultures and Widal Weil Felix serology. Persistent fever despite appropriate antibiotics for typhoid fever prompted a search for concomitant infection, which led to the diagnosis of scrub typhus confirmed by Orientia tsutsugamushi serology. Read More

    Comparative effectiveness of azithromycin for treating scrub typhus: A PRISMA-compliant systematic review and meta-analysis.
    Medicine (Baltimore) 2017 Sep;96(36):e7992
    aDepartment of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City bDepartment of Pediatrics, MacKay Children's Hospital, Taipei cMacKay Medical College, New Taipei dDepartment of Medical Technology, Jen-Teh Junior college of Medicine, Nursing and Management, Miaoli eDivision of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan fDepartment of Medicine, National Yang-Ming University gBiobank Management Center of the Tri-Service General Hospital, National Defense Medical Center hDepartment of Pathology and Graduate Institute of Pathology and Parasitology, the Tri-Service General Hospital, National Defense Medical Center iGraduate Institute of Life Sciences, National Defense Medical Center, Taipei jDepartment of Pathology & Laboratory Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan kDivision of Infection and Pathway Medicine, College of Medicine and Veterinary Medicine, the University of Edinburgh, Scotland, UK.
    Background: Scrub typhus is a zoonotic disease that remains an important health threat in endemic areas. Appropriate anti-rickettsial treatment ensures a successful recovery. Doxycycline is a recommended drug, but it is contraindicated in pregnant women and young children. Read More

    Validation of Geno-Sen's Scrub Typhus Real Time Polymerase Chain Reaction Kit by its Comparison with a Serological ELISA Test.
    J Glob Infect Dis 2017 Jul-Sep;9(3):108-112
    Department of Genomics and Proteomics, Central Interdisciplinary Research Facility, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
    Background: In the recent past, scrub typhus (ST) has been reported from different parts of India, based on Weil-Felix/enzyme-linked immunosorbent assay (ELISA)/indirect immunofluorescence assay (IFA). Molecular tests are applied only by a few researchers.

    Aims: Evaluation of a new commercial real time polymerase chain reaction (PCR) kit for molecular diagnosis of ST by comparing it with the commonly used IgM ELISA is our aim. Read More

    Endoscopic characteristics of infection-associated peptic ulcers.
    Helicobacter 2017 Dec 18;22(6). Epub 2017 Aug 18.
    Chosun University College of Medicine Internal Medicine, Gwangju, Korea.
    Background: Aside from Helicobacter pylori, another cause for the development or worsening of gastrointestinal ulcers is scrub typhus, an acute febrile disease caused by Orientia tsutsugamushi. We aimed to compare the endoscopic characteristics of peptic ulcers caused by these infectious agents.

    Methods: This retrospective case-control study involved patients who underwent upper gastrointestinal endoscopy at Chosun University Hospital in Korea. Read More

    Epidemiologic characteristics of scrub typhus on Jeju Island.
    Epidemiol Health 2017 18;39:e2017039. Epub 2017 Aug 18.
    Jeju Special Self-Governing Provincial Office, Jeju, Korea.
    Objectives: Scrub typhus is the most common febrile disease in Korea during the autumn. Jeju Island is the largest island in South Korea and has a distinctive oceanic climate. This study aimed to identify epidemiologic characteristics of scrub typhus on Jeju Island. Read More

    Central Nervous System Infection Associated with Orientia tsutsugamushi in South Korea.
    Am J Trop Med Hyg 2017 Oct 18;97(4):1094-1098. Epub 2017 Aug 18.
    Department of Neurology, Seoul National University Hospital, Seoul, South Korea.
    Orientia tsutsugamushi is a major cause of vector-borne infection in Asia. Prompt recognition and appropriate treatment are crucial because of its potentially fatal complications and lack of response to beta-lactam antibiotics. The present study retrospectively evaluated the clinical characteristics and laboratory findings of 16 patients with scrub typhus-related central nervous system (CNS) infections. Read More

    Scrub Typhus as an Etiology of Acute Febrile Illness in Gorakhpur, Uttar Pradesh, India, 2016.
    Am J Trop Med Hyg 2017 Nov 18;97(5):1313-1315. Epub 2017 Aug 18.
    National Institute of Epidemiology, Chennai, India.
    Seasonal outbreaks of acute encephalitis syndrome (AES) with high mortality occur every year in Gorakhpur region of Uttar Pradesh, India. Earlier studies indicated the role of scrub typhus as the important etiology of AES in the region. AES cases were hospitalized late in the course of their illness. Read More

    Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India.
    Natl Med J India 2017 Mar-Apr;30(2):69-72
    Department of Internal Medicine, Government Medical College, Kota, Rajasthan, India.
    Background: Scrub typhus, a potentially fatal rickettsial infection, is common in India. It usually presents with acute febrile illness along with multi-organ involvement caused by Orientia tsutsugamushi. As there was an outbreak of scrub typhus in the Hadoti region of Rajasthan and there is a paucity of data from this region, we studied this entity to describe the diverse epidemiological, clinico-radiological, laboratory parameters and outcome profile of patients with scrub typhus in a tertiary care hospital. Read More

    Scrub Typhus - The Most Common Cause of Febrile Jaundice in a Tertiary Care Hospital of Himalayan State.
    J Assoc Physicians India 2017 Aug;65(8):47-50
    Senior Resident, Department of Medicine, IGMC, Shimla, Himachal Pradesh.
    Background: Most common cause of jaundice in south east Asia is of infective etiology. Combination of fever with jaundice can cause diagnostic problem as this duo is present in many infective diseases. Timely diagnosis by simple laboratory investigations can save a lot of time and prevent morbidity and mortality. Read More

    Rickettsial Infections in Goa-Not Just Scrub Typhus!
    J Assoc Physicians India 2017 Aug;65(8):24-27
    Professor and Head, Department of Microbiology, Goa Medical College, Bambolim, Goa.
    Background And Objective: Rickettsial infections are an important cause of undifferentiated febrile illness in tropics. While scrub typhus was reported from Goa, other rickettsial infections have not been reported earlier. The present study was planned to identify pattern of rickettsial infections in Goa. Read More

    Pneumonia in the tropics.
    Respirology 2018 Jan 1;23(1):28-35. Epub 2017 Aug 1.
    Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.
    Pneumonia in the tropics poses a heavy disease burden. The complex interplay of climate change, human migration influences and socio-economic factors lead to changing patterns of respiratory infections in tropical climate but also increasingly in temperate countries. Tropical and poorer countries, especially South East Asia, also bear the brunt of the global tuberculosis (TB) pandemic, accounting for almost one-third of the burden. Read More

    Increased level and interferon-γ production of circulating natural killer cells in patients with scrub typhus.
    PLoS Negl Trop Dis 2017 Jul 27;11(7):e0005815. Epub 2017 Jul 27.
    Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
    Background: Natural killer (NK) cells are essential immune cells against several pathogens. Not much is known regarding the roll of NK cells in Orientia tsutsugamushi infection. Thus, this study aims to determine the level, function, and clinical relevance of NK cells in patients with scrub typhus. Read More

    Type 1-skewed neuroinflammation and vascular damage associated with Orientia tsutsugamushi infection in mice.
    PLoS Negl Trop Dis 2017 Jul 24;11(7):e0005765. Epub 2017 Jul 24.
    Department of Ophthalmology, Institute of Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America.
    Background: Scrub typhus is a life-threatening disease, due to infection with O. tsutsugamushi, a Gram-negative bacterium that preferentially replicates in endothelial cells and professional phagocytes. Meningoencephalitis has been reported in scrub typhus patients and experimentally-infected animals; however, the neurological manifestation and its underlying mechanisms remain poorly understood. Read More

    Serologic Evidence of Scrub Typhus in the Peruvian Amazon.
    Emerg Infect Dis 2017 08;23(8):1389-1391
    Using a large, passive, febrile surveillance program in Iquitos, Peru, we retrospectively tested human blood specimens for scrub typhus group orientiae by ELISA, immunofluorescence assay, and PCR. Of 1,124 participants, 60 (5.3%) were seropositive, and 1 showed evidence of recent active infection. Read More

    Scrub Typhus as a Cause of Acute Encephalitis Syndrome, Gorakhpur, Uttar Pradesh, India.
    Emerg Infect Dis 2017 08;23(8):1414-1416
    Outbreaks of acute encephalitis syndrome (AES) have been occurring in Gorakhpur Division, Uttar Pradesh, India, for several years. In 2016, we conducted a case-control study. Our findings revealed a high proportion of AES cases with Orientia tsutsugamushi IgM and IgG, indicating that scrub typhus is a cause of AES. Read More

    CD8+ T cells provide immune protection against murine disseminated endotheliotropic Orientia tsutsugamushi infection.
    PLoS Negl Trop Dis 2017 Jul 19;11(7):e0005763. Epub 2017 Jul 19.
    Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, United States of America.
    Scrub typhus, caused by a Gram-negative obligately intracellular coccobacillus, Orientia tsutsugamushi, is a long neglected but important tropical disease. Orientia tsutsugamushi causes illness in one million people each year, and 1 billion people are at risk. Without appropriate diagnosis and treatment, the disease can cause severe multiorgan failure with a case fatality rate of 7-15%. Read More

    Malaria-Associated Mortality in the Australian Defence Force during the Twentieth Century.
    Am J Trop Med Hyg 2017 Aug 19;97(2):544-547. Epub 2017 Jul 19.
    Department of Zoology, University of Oxford, Oxford, United Kingdom.
    Malaria has been a military problem throughout history capable of causing epidemics that stop military operations. Individual mortality was examined from records of the three major wars of the 20th century that involved Australia in which 133 (1914-1919), 92 (1943-1945), and two (1965-1967) soldiers are known to have died with malaria. Those dying were predominately enlisted soldiers with a mean age of 29 years often complicated by other infections such as influenza, pneumonia or scrub typhus. Read More

    A Recombinant 47-kDa Outer Membrane Protein Induces an Immune Response against Orientia tsutsugamushi Strain Boryong.
    Am J Trop Med Hyg 2017 Jul;97(1):30-37
    Division of Zoonoses, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
    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. Read More

    Characteristics of scrub typhus, murine typhus, and Q fever among elderly patients: Prolonged prothrombin time as a predictor for severity.
    J Microbiol Immunol Infect 2017 Jun 22. Epub 2017 Jun 22.
    School of Medicine, Kaohsiung Medical University, Taiwan; Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address:
    Background/purpose: The clinical manifestations of scrub typhus, murine typhus and acute Q fever in the elderly are not clear.

    Methods: We conducted a retrospective study to identify the characteristics of the elderly aged ≥65 years with a comparison group aged 18-64 years among patients with scrub typhus, murine typhus, or acute Q fever who were serologically confirmed at three hospitals in Taiwan during 2002-2011.

    Results: Among 441 cases, including 187 cases of scrub typhus, 166 acute Q fever, and 88 murine typhus, 68 (15. Read More

    Neuropsychiatric Manifestations of Scrub Typhus.
    J Neurosci Rural Pract 2017 Jul-Sep;8(3):421-426
    All India Institute of Medical Sciences, New Delhi, India.
    Scrub typhus is caused by Orientia tsutsugamushi characterized by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. It was thought to have been eradicated from India. Recently it is being reported from many areas of India. Read More

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