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2.
Front Public Health ; 12: 1384308, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38721542

RESUMO

Background: Scrub typhus has become widespread across various regions in China in recent decades, causing a considerable burden on residents. While meteorological variables significantly impact the spread of scrub typhus, there is insufficient quantitative evidence illustrating this association in known high-endemic areas. Methods: A distributed lag non-linear model was applied to explore the relationship between meteorological parameters and scrub typhus incidence from 2010 to 2019 in Baoshan City, western Yunnan Province, China. Results: High monthly mean (20°C) and maximum (30°C) temperatures were associated with a peak risk of scrub typhus in the current month. Higher minimum temperatures and higher relative humidity were followed by increasing cumulative risks over the ensuing 3 months. Higher precipitation was followed by increasing cumulative risk over the ensuing 2-month period, peaking at around 30 cm. Conclusion: The non-linear lag associations between meteorological parameters and scrub typhus incidence suggest that higher monthly minimum temperature and relative humidity could be associated with an increased risk of scrub typhus in the subsequent several months, while warm temperature is more likely to impact the occurrence of scrub typhus in the current month.


Assuntos
Umidade , Conceitos Meteorológicos , Tifo por Ácaros , Tifo por Ácaros/epidemiologia , Humanos , China/epidemiologia , Incidência , Temperatura , Dinâmica não Linear , Estações do Ano , Fatores de Risco
3.
J Med Virol ; 96(5): e29666, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38738569

RESUMO

Acute encephalitis syndrome (AES) in children poses a significant public health challenge in India. This study aims to explore the utility of host inflammatory mediators and neurofilament (NfL) levels in distinguishing etiologies, assessing disease severity, and predicting outcomes in AES. We assessed 12 mediators in serum (n = 58) and 11 in cerebrospinal fluid (CSF) (n = 42) from 62 children with AES due to scrub typhus, viral etiologies, and COVID-associated multisystem inflammatory syndrome (MIS-C) in Southern India. Additionally, NfL levels in serum (n = 20) and CSF (n = 18) were examined. Clinical data, including Glasgow coma scale (GCS) and Liverpool outcome scores, were recorded. Examining serum and CSF markers in the three AES etiology groups revealed notable distinctions, with scrub typhus differing significantly from viral and MIS-C causes. Viral causes had elevated serum CCL11 and CCL2 compared with scrub typhus, while MIS-C cases showed higher HGF levels than scrub typhus. However, CSF analysis showed a distinct pattern with the scrub typhus group exhibiting elevated levels of IL-1RA, IL-1ß, and TNF compared with MIS-C, and lower CCL2 levels compared with the viral group. Modeling the characteristic features, we identified that age ≥3 years with serum CCL11 < 180 pg/mL effectively distinguished scrub typhus from other AES causes. Elevated serum CCL11, HGF, and IL-6:IL-10 ratio were associated with poor outcomes (p = 0.038, 0.005, 0.02). Positive CSF and serum NfL correlation, and negative GCS and serum NfL correlation were observed. Median NfL levels were higher in children with abnormal admission GCS and poor outcomes. Measuring immune mediators and brain injury markers in AES provides valuable diagnostic insights, with the potential to facilitate rapid diagnosis and prognosis. The correlation between CSF and serum NfL, along with distinctive serum cytokine profiles across various etiologies, indicates the adequacy of blood samples alone for assessment and monitoring. The association of elevated levels of CCL11, HGF, and an increased IL-6:IL-10 ratio with adverse outcomes suggests promising avenues for therapeutic exploration, warranting further investigation.


Assuntos
Encefalopatia Aguda Febril , Biomarcadores , COVID-19 , Tifo por Ácaros , Síndrome de Resposta Inflamatória Sistêmica , Humanos , Índia/epidemiologia , Criança , Masculino , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Feminino , COVID-19/complicações , COVID-19/sangue , COVID-19/diagnóstico , Pré-Escolar , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/sangue , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/complicações , Tifo por Ácaros/sangue , Tifo por Ácaros/líquido cefalorraquidiano , Encefalopatia Aguda Febril/sangue , Encefalopatia Aguda Febril/etiologia , Encefalopatia Aguda Febril/diagnóstico , Adolescente , Lactente , Citocinas/sangue , Citocinas/líquido cefalorraquidiano
4.
Sci Rep ; 14(1): 10895, 2024 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-38740885

RESUMO

Scrub typhus, a neglected disease, is a significant health concern in the Tsutsugamushi triangle of the Asia-Pacific and has raised global concerns due to recent cases occurring outside this region. To estimate the global prevalence of scrub typhus, we conducted a systematic review and meta-analysis. We conducted a systematic search of PubMed, Scopus, and Embase databases for observational studies on scrub typhus. Using a random-effects model, we combined the prevalence estimates with inverse-variance weights while also evaluating heterogeneity and publication bias. Among 3551 reports screened, we identified 181 studies with 1,48,251 samples for inclusion in our synthesis. The overall pooled seroprevalence (95% confidence intervals) of scrub typhus infections was 24.93% (23.27-26.60). Gender-wise pooled prevalence was estimated to be 50.23% (47.05-53.40) for males and 48.84% (45.87-51.80) for females. Eschar prevalence was observed to be 30.34% (22.54-38.15) among the positive cases. One-fourth of all the samples tested positive for scrub typhus and eschar was present in one-third of these total positive cases, encompassing regions beyond the Tsutsugamushi triangle. This estimation underlines the importance of this neglected disease as a public health problem. Strengthening surveillance and implementing disease control measures are needed in the affected regions.


Assuntos
Tifo por Ácaros , Tifo por Ácaros/epidemiologia , Humanos , Estudos Soroepidemiológicos , Feminino , Masculino , Prevalência , Orientia tsutsugamushi/imunologia , Saúde Global
5.
PLoS One ; 19(4): e0301841, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38626103

RESUMO

The number of people suffering from scrub typhus, which is not of concern, is increasing year by year, especially in Yunnan Province, China. From June 1, 2021 to August 15, 2022, a total of 505 mammalian samples were collected from farm, forest, and residential habitats with high incidence of scrub typhus in Yunnan, China, for nPCR (nested PCR) and qPCR (quantitative real-time PCR) detection of Orientia tsutsugamushi. A total of 4 orders of murine-like animals, Rodentia (87.52%, n = 442), Insectivora (10.29%, n = 52), Lagomorpha (1.79%, n = 9) and Scandentia (0.40%, n = 2) were trapped. Comparing the qPCR infection rates in the three habitats, it was no significant difference that the infection rate of residential habitat (44.44%) and that of the farm habitat (45.05%, P>0.05), which is much larger than that of the forest habitat (3.08%) (P<0.001). Three genotypes (Karp-like, Kato-like and TA763-like) of O. tsutsugamushi were found from Yunnan, China in this study.


Assuntos
Orientia tsutsugamushi , Tifo por Ácaros , Humanos , Animais , Camundongos , Tifo por Ácaros/diagnóstico , Fazendas , China/epidemiologia , Orientia tsutsugamushi/genética , Roedores/genética , Reação em Cadeia da Polimerase em Tempo Real , Estudos Epidemiológicos , Florestas , Eulipotyphla/genética
6.
Front Public Health ; 12: 1347183, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38660358

RESUMO

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging zoonotic disease in the tropics with considerable morbidity and mortality rates. This disease, which is mostly prevalent in rural areas, remains underdiagnosed and underreported because of the low index of suspicion and non-specific clinical presentation. Limited access to healthcare, diagnostics, and treatment in rural settings further makes it challenging to distinguish it from other febrile illnesses. While easily treatable, improper treatment leads to severe forms of the disease and even death. As there is no existing public health program to address scrub typhus in India, there is an urgent need to design a program and test its effectiveness for control and management of the disease. With this backdrop, this implementation research protocol has been developed for a trial in few of the endemic "pockets" of Odisha, an eastern Indian state that can be scalable to other endemic areas of the country, if found effective. The main goal of the proposed project is to include scrub typhus as a differential diagnosis of fever cases in every tier of the public health system, starting from the community level to the health system, for the early diagnosis among suspected cases and to ensure that individuals receive complete treatment. The current study aimed to describe the protocol of the proposed Scrub Typhus Control Program (STCP) in detail so that it can receive valuable views from peers which can further strengthen the attempt.


Assuntos
Diagnóstico Precoce , Orientia tsutsugamushi , Saúde Pública , Tifo por Ácaros , Tifo por Ácaros/diagnóstico , Humanos , Índia , Orientia tsutsugamushi/isolamento & purificação
7.
BMC Genomics ; 25(1): 380, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38632506

RESUMO

BACKGROUND: Trombiculid mites are globally distributed, highly diverse arachnids that largely lack molecular resources such as whole mitogenomes for the elucidation of taxonomic relationships. Trombiculid larvae (chiggers) parasitise vertebrates and can transmit bacteria (Orientia spp.) responsible for scrub typhus, a zoonotic febrile illness. Orientia tsutsugamushi causes most cases of scrub typhus and is endemic to the Asia-Pacific Region, where it is transmitted by Leptotrombidium spp. chiggers. However, in Dubai, Candidatus Orientia chuto was isolated from a case of scrub typhus and is also known to circulate among rodents in Saudi Arabia and Kenya, although its vectors remain poorly defined. In addition to Orientia, chiggers are often infected with other potential pathogens or arthropod-specific endosymbionts, but their significance for trombiculid biology and public health is unclear. RESULTS: Ten chigger species were collected from rodents in southwestern Saudi Arabia. Chiggers were pooled according to species and screened for Orientia DNA by PCR. Two species (Microtrombicula muhaylensis and Pentidionis agamae) produced positive results for the htrA gene, although Ca. Orientia chuto DNA was confirmed by Sanger sequencing only in P. agamae. Metagenomic sequencing of three pools of P. agamae provided evidence for two other bacterial associates: a spirochaete and a Wolbachia symbiont. Phylogenetic analysis of 16S rRNA and multi-locus sequence typing genes placed the spirochaete in a clade of micromammal-associated Borrelia spp. that are widely-distributed globally with no known vector. For the Wolbachia symbiont, a genome assembly was obtained that allowed phylogenetic localisation in a novel, divergent clade. Cytochrome c oxidase I (COI) barcodes for Saudi Arabian chiggers enabled comparisons with global chigger diversity, revealing several cases of discordance with classical taxonomy. Complete mitogenome assemblies were obtained for the three P. agamae pools and almost 50 SNPs were identified, despite a common geographic origin. CONCLUSIONS: P. agamae was identified as a potential vector of Ca. Orientia chuto on the Arabian Peninsula. The detection of an unusual Borrelia sp. and a divergent Wolbachia symbiont in P. agamae indicated links with chigger microbiomes in other parts of the world, while COI barcoding and mitogenomic analyses greatly extended our understanding of inter- and intraspecific relationships in trombiculid mites.


Assuntos
Borrelia , Microbiota , Orientia tsutsugamushi , Tifo por Ácaros , Trombiculidae , Wolbachia , Animais , Tifo por Ácaros/epidemiologia , Tifo por Ácaros/microbiologia , Trombiculidae/genética , Trombiculidae/microbiologia , Wolbachia/genética , Filogenia , Borrelia/genética , Tipagem de Sequências Multilocus , RNA Ribossômico 16S/genética , Arábia Saudita , Orientia tsutsugamushi/genética , Roedores/genética , DNA , Orientia
8.
BMC Neurol ; 24(1): 137, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664621

RESUMO

BACKGROUND: Scrub typhus is an acute infectious disease caused by Orientia tsutsugamushi. Guillain-Barre syndrome (GBS) is an autoimmune-mediated peripheral neuropathy with a frequent history of prodromal infections, but GBS associated with scrub typhus is very rare. CASE PRESENTATION: We report a 51-year-old male patient who developed dysarthria and peripheral facial paralysis following the cure of scfrub typhus. CSF examination and electrophysiological findings suggested a diagnosis of GBS. After treatment with intravenous immunoglobulin, the patient's neurological condition improved rapidly. CONCLUSIONS: Scrub typhus infection is likely to be a potential predisposing factor in GBS, while scrub typhus-associated GBS has a favorable prognosis.


Assuntos
Síndrome de Guillain-Barré , Tifo por Ácaros , Humanos , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/tratamento farmacológico , Tifo por Ácaros/complicações , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Imunoglobulinas Intravenosas/uso terapêutico
9.
J Vector Borne Dis ; 61(1): 5-22, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38648402

RESUMO

Rickettsial infections are emerging and/or re-emerging disease that poses a serious global threat to humans and animals. Transmission to humans and animals is through the bite of the ectoparasites including ticks, fleas and chigger mites. Most of the rickettsial diseases are endemic in India, but underdiagnosed. This review is aimed at analyzing the prevalence of rickettsiosis in India and the advancement of rickettsial diagnosis. We have conducted a systematic review on the prevalence of rickettsial disease in India ranging from 1.3% to 46.6% for spotted fever, 2.4% to 77.8% for scrub typhus and 1% to 46.4% for Q fever, based on the literature published with the evidence of isolation, serological, and molecular diagnostics. Search engines Medline/PubMed, Science Direct, ProQuest, and EBSCO were used to retrieve the articles from electronic databases by using appropriate keywords to track the emergence of these rickettsial diseases in India for the period of 1865 to till date. We retrieved 153 published rickettsial articles on hospital-based studies from India that were purely made on the basis of prevalence and the laboratory parameters viz., Weil-Felix test (WF) and Rapid Immunochromatographic tests (RICT) with reference to the gold standard IFA and ELISA. More epidemiological studies are required for epidemic typhus to know the exact prevalence status of this louse-borne rickettsiosis in India. Currently, there is no confirmed specific inflammatory marker for rickettsial diseases. Moreover, serological cross-reactivity is an important aspect, and it should be investigated in endemic areas, there is also a need to include molecular diagnostic techniques for further confirmation in healthcare settings.


Assuntos
Infecções por Rickettsia , Animais , Humanos , Índia/epidemiologia , Prevalência , Rickettsia/isolamento & purificação , Rickettsia/imunologia , Infecções por Rickettsia/epidemiologia , Infecções por Rickettsia/diagnóstico , Tifo por Ácaros/epidemiologia , Tifo por Ácaros/diagnóstico , Carrapatos/microbiologia
10.
Viruses ; 16(4)2024 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-38675971

RESUMO

The majority of cases of undifferentiated acute febrile illness (AFI) in the tropics have an undefined etiology. In Thailand, AFI accounts for two-thirds of illnesses reported to the Ministry of Public Health. To characterize the bacterial and viral causes of these AFIs, we conducted molecular pathogen screening and serological analyses in patients who sought treatment in Chum Phae Hospital, Khon Kaen province, during the period from 2015 to 2016. Through integrated approaches, we successfully identified the etiology in 25.5% of cases, with dengue virus infection being the most common cause, noted in 17% of the study population, followed by scrub typhus in 3.8% and rickettsioses in 6.8%. Further investigations targeting viruses in patients revealed the presence of Guadeloupe mosquito virus (GMV) in four patients without other pathogen co-infections. The characterization of four complete genome sequences of GMV amplified from AFI patients showed a 93-97% nucleotide sequence identity with GMV previously reported in mosquitoes. Nucleotide substitutions resulted in amino acid differences between GMV amplified from AFI patients and mosquitoes, observed in 37 positions. However, these changes had undergone purifying selection pressure and potentially had a minimal impact on protein function. Our study suggests that the GMV strains identified in the AFI patients are relatively similar to those previously reported in mosquitoes, highlighting their potential role associated with febrile illness.


Assuntos
Dengue , Febre , Humanos , Tailândia/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Dengue/virologia , Dengue/epidemiologia , Febre/virologia , Adulto Jovem , Adolescente , Filogenia , Idoso , Criança , Tifo por Ácaros/microbiologia , Tifo por Ácaros/epidemiologia , Tifo por Ácaros/virologia , Bactérias/genética , Bactérias/isolamento & purificação , Bactérias/classificação , Pré-Escolar , Coinfecção/virologia , Coinfecção/microbiologia , Coinfecção/epidemiologia , Vírus/genética , Vírus/classificação , Vírus/isolamento & purificação , Culicidae/virologia , Culicidae/microbiologia , Animais , Vírus da Dengue/genética , Vírus da Dengue/classificação , Vírus da Dengue/isolamento & purificação , Infecções por Rickettsia/epidemiologia , Infecções por Rickettsia/microbiologia , Infecções por Rickettsia/virologia
11.
Am J Trop Med Hyg ; 110(4): 768-778, 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38471176

RESUMO

Murine typhus is a flea-borne disease caused by Rickettsia typhi infection. The disease is a notifiable infectious disease in Taiwan. Specimens from suspected cases are required to be sent to the Taiwan Centers for Disease Control and Prevention for laboratory diagnosis. In this study, 204 cases of murine typhus were identified by bacterial isolation, real-time polymerase chain reaction, or indirect immunofluorescence assay between 2013 and 2020. The average incidence rate was 0.11/100,000 person-years (95% CI: 0.08-0.13). Murine typhus occurred throughout the year, but it was most prevalent in summer (May to August). The majority of patients were males (75%), residents of Kaohsiung city (31%), and worked in agriculture, forestry, fishing, and animal husbandry (27%). Fever was the most common symptom, present in 95.6% of patients, followed by headache (41%), myalgia (33%), and liver dysfunction (33%). Only 13% of patients had a rash. Up to 80% of cases were among hospitalized patients, and 43% of patients developed severe manifestations. Serological assays also indicated coinfection events. Seven patients showed a 4-fold increase in antibody titers against Orientia tsutsugamushi (N = 2), Coxiella burnetii (n = 2), and Leptospira (N = 3). In conclusion, murine typhus is an endemic and important zoonotic rickettsial disease in Taiwan that cannot be ignored. Further epidemiological surveillance and clinical characteristics should be continuously investigated to prevent and control murine typhus.


Assuntos
Orientia tsutsugamushi , Tifo por Ácaros , Tifo Endêmico Transmitido por Pulgas , Masculino , Animais , Camundongos , Humanos , Feminino , Tifo Endêmico Transmitido por Pulgas/diagnóstico , Taiwan/epidemiologia , Zoonoses/epidemiologia , Rickettsia typhi , Tifo por Ácaros/diagnóstico
12.
J Immunol Methods ; 528: 113653, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38430991

RESUMO

A fluorescent immunochromatographic test (FM-ICT) was developed for rapid detection of anti-Orientia tsutsugamushi antibodies in serum samples. The FM-ICT was constructed based on the dual-antigen sandwich method. Truncated 56 kDa outer membrane protein of O. tsutsugamushi strain SJ, was expressed in E. coli and mixed with those of Ptan and Gillam strains. A thin line of the protein mixture was precisely sprayed across a nitrocellulose membrane making this the "Test" line. Polyclonal antibodies (pAbs) to O.tsutsugamushi were sprayed in another line across the membrane making this the "Control" line. Fluorescent microspheres conjugated 56 kDa proteins reacting with sample serum will be captured on the "Test" line if the sample contains antibodies to O.tsutsugamushi. Several experimental parameters were optimized. After optimizing the reaction procedure, the results are visible, within 6 min, with the naked eye under ultraviolet light. The limit of detection (LOD) was determined to be 7.63 ng/mL with prepared polyclonal antibodies. No cross-reaction was observed with sera samples from other febrile diseases. In clinical evaluations, the strips showed 94.92% sensitivity (106/112) and 93.75% specificity (56/60). The FM-ICT we developed will provide a new tool for on-site diagnosis of scrub typhus.


Assuntos
Tifo por Ácaros , Humanos , Tifo por Ácaros/diagnóstico , Escherichia coli , Sensibilidade e Especificidade , Antígenos de Bactérias , Anticorpos Antibacterianos
14.
Eur J Clin Microbiol Infect Dis ; 43(5): 905-914, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38472518

RESUMO

BACKGROUND: The existing literature lacks studies examining the epidemiological link between scrub typhus and deep vein thrombosis (DVT) or pulmonary embolism (PE), and the long-term outcomes. The objective of this study is to explore the potential association between scrub typhus and the subsequent risk of venous thromboembolism, and long-term mortality. METHOD: This nationwide cohort study identified 10,121 patients who were newly diagnosed with scrub typhus. Patients with a prior DVT or PE diagnosis before the scrub typhus infection were excluded. A comparison cohort of 101,210 patients was established from the general population using a propensity score matching technique. The cumulative survival HRs for the two cohorts were calculated by the Cox proportional hazards model. RESULT: After adjusting for sex, age, and comorbidities, the scrub typhus group had an adjusted HR (95% CI) of 1.02 (0.80-1.30) for DVT, 1.11 (0.63-1.93) for PE, and 1.16 (1.08-1.25) for mortality compared to the control group. The post hoc subgroup analysis revealed that individuals younger than 55 years with a prior scrub typhus infection had a significantly higher risk of DVT (HR: 1.59; 95% CI: 1.12-2.25) and long-term mortality (HR: 1.75; 95% CI, 1.54-1.99). CONCLUSION: The scrub typhus patients showed a 16% higher risk of long-term mortality. For those in scrub typhus cohort below 55 years of age, the risk of developing DVT was 1.59 times higher, and the risk of mortality was 1.75 times higher. Age acted as an effect modifier influencing the relationship between scrub typhus and risk of new-onset DVT and death.


Assuntos
Tifo por Ácaros , Tromboembolia Venosa , Humanos , Tifo por Ácaros/complicações , Tifo por Ácaros/epidemiologia , Tifo por Ácaros/mortalidade , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/mortalidade , Tromboembolia Venosa/etiologia , Fatores de Risco , Estudos de Coortes , Modelos de Riscos Proporcionais , Idoso de 80 Anos ou mais , Embolia Pulmonar/mortalidade , Embolia Pulmonar/epidemiologia , Embolia Pulmonar/etiologia , Adulto Jovem
15.
Indian J Med Res ; 159(2): 180-192, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38494626

RESUMO

BACKGROUND OBJECTIVES: Scrub typhus, caused by Orientia tsutsugamushi present in small mammals harbouring the ectoparasites. A study was undertaken to detect the pathogen present in small mammals and its ectoparasites in the scrub typhus-reported areas. METHODS: The small mammals (rodents/shrews) and its ectoparasites were screened for O. tsutsugamushi using nested PCR amplification of the groEL gene. Small mammals were collected by trapping and screened for ectoparasites (mites, ticks and fleas) by combing method. RESULTS: All the chigger mites collected were tested negative for O. tsutsugamushi . Interestingly, adult non-trombiculid mites ( Oribatida sp., Dermanyssus gallinae ), fleas ( Xenopsylla astia, X. cheopis, Ctenophalides felis and Ctenophalides sp.) and ticks ( Rhipicephalus sanguineus , R. haemaphysaloides ) screened were found to be positive for O. tsutsugamushi , which the authors believe is the first report on these species globally. Bandicota bengalensis with O. tsutsugamushi infection is reported for the first time in India. The O. tsutsugamushi groEL sequences from the positive samples were similar to the reference strains, Karp and Ikeda and phylogenetically clustered in clade IV with less evolutionary divergence. The blood samples of Rattus rattus , Suncus murinus and B. bengalensis collected from this area were tested positive for O. tsutsugamushi ; interestingly, the sequence similarity was much pronounced with their ectoparasites indicating the transmission of the pathogen to host or vice versa . INTERPRETATION CONCLUSIONS: The outcome of the present investigations widened our scope on the pathogens present in ectoparasites and rodents/shrews from this area. This will help to formulate the required vector control methods to combat zoonotic diseases.


Assuntos
Orientia tsutsugamushi , Tifo por Ácaros , Carrapatos , Trombiculidae , Ratos , Animais , Tifo por Ácaros/epidemiologia , Orientia tsutsugamushi/genética , Musaranhos , Índia/epidemiologia , Roedores/parasitologia , Trombiculidae/genética
16.
PLoS Negl Trop Dis ; 18(3): e0011963, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38442086

RESUMO

The reported cases of scrub typhus (ST) have continued to escalate, with outbreaks occurring regionally in China. These pose an increasing public health threat at a time when public health has been overwhelmed. During the period from July to August 2022, in Rongjiang County, Guizhou Province, China, 13 out of 21 fever patients were diagnosed with scrub typhus, based on epidemiological investigation and blood test analysis. The major clinical symptoms of these patients showed fever, chills, headache, eschar, fatigue and pneumonia, which were accompanied by a rise in C-reactive protein, neutrophils, alanine transaminase (ALT) and aspartate aminotransferase (AST). Furthermore, nearly half of them exhibited abnormal electrocardiogram activity. Through semi-nested PCR, Sanger sequencing and phylogenetic tree construction, the Karp strain of Orientia tsutsugamushi (O. tsutsugamushi) was confirmed as the pathogen causing ST in Rongjiang County, which shared the same evolutionary branch with O. tsutsugamushi isolated from wild mouse liver or spleen, indicating that the wild mouse plays an important role in transmitting the disease. In contrast to the sporadic cases in the past, our study is the first to disclose an epidemic and the corresponding clinical characteristics of ST in Guizhou province, which is of great significance for the prevention and treatment of regional illnesses.


Assuntos
Tifo por Ácaros , Humanos , Animais , Camundongos , Tifo por Ácaros/epidemiologia , Filogenia , Surtos de Doenças , Saúde Pública , China/epidemiologia , Febre
17.
Sao Paulo Med J ; 142(4): e20230142, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38477775

RESUMO

CONTEXT: Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. CASE REPORT: A 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17. CONCLUSION: This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient's clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance.


Assuntos
Hipopotassemia , Tifo por Ácaros , Choque Séptico , Feminino , Humanos , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos , Eletrólitos
18.
PLoS One ; 19(3): e0297373, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38452006

RESUMO

Rickettsiosis is caused by Orientia spp. and Rickettsia spp., arthropod-borne zoonotic intracellular bacteria. The close relationships between pet dogs, cats and owners increase the risk of rickettsial transmission, with limited studies on the seroprevalence in pets. This study investigated the prevalence of rickettsia exposure among dogs and cats in Bangkok and neighboring provinces. The samples from 367 dogs and 187 cats used in this study were leftover serum samples from routine laboratory testing stored at the Veterinary Teaching Hospital. In-house Enzyme-linked immunosorbent assay (ELISA) tests included IgG against the scrub typhus group (STG), typhus group (TG), and spotted fever group (SFG). The seroprevalence in pet dogs was 30.25% (111/367), including 21.53% for STG, 4.36% for TG, and 1.09% for SFG. Co-seroprevalence consisted of 2.72% for STG and TG, 0.27% for STG and SFG, and 0.27% for pangroup infection. The prevalence in cats was 62.56% (117/187), including 28.34% for STG, 4.28% for TG, and 6.42% for STG. Co-seroprevalence in cats consisted of STG and TG (4.28%), STG and SFG (5.35%), TG and SFG (3.21%), and three-group infection (10.69%). No significant difference in seroprevalence for the three serogroups was observed in any of the 64 districts sampled. The mean hematocrit level significantly decreased in seropositive dogs (P<0.05). Seropositive dogs and cats were detected in significantly greater numbers of anemia cases than nonanemia cases (P<0.05) (odds ratio: 7.93, 0.44, p = 0.00, p = 0.01). A significantly higher number of seropositive cats had decreased hemoglobin levels (P<0.05) (odds ratio: 3.63, p = 0.00). The seropositive samples significantly differed among older cats (P<0.05). These high exposures in pet dogs and cats could constitute important relationship dynamics between companion animals and rickettsial vectors. Significantly decreased hematocrit and hemoglobin levels indicated anemia in the exposed dogs and cats. The study findings will raise awareness of this neglected disease among pet owners and veterinary hospital personnel and aid in future public health preventative planning.


Assuntos
Anemia , Doenças do Gato , Doenças do Cão , Rickettsia , Tifo por Ácaros , Animais , Gatos , Cães , Estudos Soroepidemiológicos , Doenças do Gato/epidemiologia , Hospitais Veterinários , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Hospitais de Ensino , Tailândia , Tifo por Ácaros/epidemiologia , Hemoglobinas
19.
BMC Infect Dis ; 24(1): 268, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38424500

RESUMO

INTRODUCTION: Rickettsia spp. and Orientia spp. are the causes of neglected infections that can lead to severe febrile and systemic illnesses in humans. Implementing proper biosafety practices when handling these pathogens is crucial to ensure a safe and sustainable work environment. It is essential to assess the current knowledge and identify any potential gaps to develop effective measures that minimise the risk of exposure to these pathogens. By doing so, we can establish a comprehensive framework that promotes safety, mitigates hazards, and safeguards the well-being of personnel and the surrounding community. METHODS AND RESULTS: This review aimed to synthesise and determine the evidence base for biosafety precautions for Rickettsia spp. and Orientia spp. pathogens. Enhancing our understanding of the relative infectious risk associated with different strains of Rickettsia and Orientia spp. requires identifying the infectious dose of these pathogens that can cause human disease. The application of risk groups for Rickettsia and Orientia spp. is inconsistent across jurisdictions. There is also incomplete evidence regarding decontamination methods for these pathogens. With regards to Orientia spp. most of the available information is derived from experiments conducted with Rickettsia spp. CONCLUSIONS: Rickettsia and Orientia spp. are neglected diseases, as demonstrated by the lack of evidence-based and specific biosafety information about these pathogens. In the case of Orientia spp., most of the available information is derived from Rickettsia spp., which may not be appropriate and overstate the risks of working with this pathogen. The advent of effective antibiotic therapy and a better understanding of the true hazards and risks associated with pathogen manipulation should inform decisions, allowing a sustainable and safe work environment.


Assuntos
Orientia tsutsugamushi , Rickettsia , Tifo por Ácaros , Humanos , Contenção de Riscos Biológicos , Biosseguridade
20.
Infect Dis Now ; 54(2): 104865, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38350558

RESUMO

OBJECTIVES: To identify the potential target genes for detection of Orientia tsutsugamushi (OT) in pediatric acute encephalitis syndrome (pAES). METHODS: DNA was extracted from whole blood of 100 pAES cases having tested positive (n = 41) and negative (n = 59) for scrub typhus (ST) by IgM ELISA. These samples were subjected to standard PCR for 56 kDa, 47 kDa, 16 s rRNA, groEL, traD genes and the newly identified 27 kDa gene. RESULTS: Among the selected gene targets, 56 kDa demonstrated its superiority for OT detection over the other tested genes. The presence of OT was confirmed via PCR targeting 56 kDa gene in 17 out of the 41 (41.4 %) IgM-positive ST AES cases and 38 out of the 59 (64.4 %) ST IgM negative cases. None of the other gene targets were amplified. CONCLUSION: Integration of serological diagnosis with molecular diagnostics targeting the 56 kDa gene for routine testing of AES patients would facilitate detection of OT in AES endemic regions.


Assuntos
Encefalopatia Aguda Febril , Tifo por Ácaros , Criança , Humanos , Tifo por Ácaros/diagnóstico , Encefalopatia Aguda Febril/diagnóstico , Ensaio de Imunoadsorção Enzimática , Imunoglobulina M , Reação em Cadeia da Polimerase
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