Humoral and Cellular Responses in Scrub Typhus Patients Reflecting Primary Infection and Reinfection with Rickettsia Tsutsugamushi

Al, Bourgeois; Jg, Olson; Rc, Fang; Huang, Jiansheng; Cl, Wang; Chow, L; Bechthold, D; Dt, Dennis; Jc, Coolbaugh; Weiss, Emil

doi:10.4269/ajtmh.1982.31.532

Cited by 59 publications

(50 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given that none of the patients had a history of scrub typhus, it is crucial that further studies be conducted to investigate when and how patients with this illness may have acquired O. tsutsugamushi infections when younger. The overall features of recrudescent O. tsutsugamushi pneumonia in our cases were similar to those of type 2 antibody responders, i.e., reinfection type, as described by Bourgeois et al (13). Patients with this type of infection show a lower incidence of eschar, rash, and conjunctivitis, a higher incidence of generalized lymphadenopathy, quicker response to antibiotics, and a lower recurrence rate than those with primary infections.…”

supporting

confidence: 63%

A Case Series of Possibly Recrudescent Orientia tsutsugamushi Infection Presenting as Pneumonia

Baek

Lee

et al. 2014

Jpn J Infect Dis

View full text Add to dashboard Cite

SUMMARY: Orientia tsutsugamushi remains latent in humans after scrub typhus. Pneumonia occurs as a complication of scrub typhus in the late-phase disease. However, pneumonia may also occur as a presenting manifestation of O. tsutsugamushi infection. We reviewed the cases of 3 patients with atypical pneumonia who presented at our hospital and were later confirmed to have O. tsutsugamushi infection by serology, nested polymerase chain reaction (PCR), and cell culture. All patients were young adults with no history of scrub typhus, and none claimed to have recently been exposed to areas where scrub typhus is endemic. Two cases occurred in non-outbreak seasons. Furthermore, eschar was not observed. Pneumonia was documented within 4 days after fever onset. The immunoglobulin (Ig) G antibody titers against O. tsutsugamushi were higher than the IgM titers, although the serologic test results were less helpful in the diagnosis. Nested PCR and cell culture of blood specimens confirmed the diagnosis of O. tsutsugamushi infection. These findings suggest that pneumonia can occur as a result of recrudescence of latent O. tsutsugamushi infection.

show abstract

supporting

confidence: 63%

A Case Series of Possibly Recrudescent Orientia tsutsugamushi Infection Presenting as Pneumonia

Baek

Lee

et al. 2014

Jpn J Infect Dis

View full text Add to dashboard Cite

show abstract

“…The phenomenon of reinfection, which does not lead to detectable disease in endemic areas, has been reported for scrub typhus. 4,10 Generalized lymphadenopathy and lymphocytosis were more common than either eschar or rash among febrile American serviceman in Vietnam. 11 In the Pescadores Islands of Taiwan, the rather mild clinical manifestations of scrub typhus among the population were attributed to O. tsutsugamushi strains that were highly immunogenic and of low virulence for humans.…”

Section: Resultsmentioning

confidence: 99%

Seroepidemiologic survey of Orientia tsutsugamushi, Rickettsia typhi, and TT118 spotted fever group rickettsiae in rubber estate workers in Malaysia.

Tee¹,

Kamalanathan²,

Suan³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. The seroprevalence of Orientia tsutsugamushi, Rickettsia typhi, and TT118 spotted fever group (SFG) rickettsiae in 300 rubber estate workers in Slim River, Malaysia was determined in December 1996 and March 1997. In December, which was the wet season, 23.3%, 3.0%, and 57.3% of the population had antibodies detected against the three rickettsiae, respectively. The highest seropositive rate of 40% was detected for single infection with SFG rickettsiae, followed by a rate of 15.3% for both O. tsutsugamushi and SFG rickettsiae among the rubber estate workers. Subjects less than 21 years old had a lower seroprevalence of SFG rickettsiae compared with the other age groups. Indians had a higher seroprevalence of O. tsutsugamushi compared with other ethnic groups. Rubber tappers had a higher seroprevalence of SFG rickettsiae compared with other occupational groups. During the dry season in March 1997, there was a significant increase in the seroprevalence of R. typhi. The seroconversion rates for IgM against O. tsutsugamushi, R. typhi, and SFG rickettsiae were 5.7%, 12.3%, and 15.1%, respectively, during the fourmonth period. Significant variations of antibody titers towards the three rickettsiae was noted among subjects who were bled twice. This suggests a significant and continual exposure of rubber estate workers to the three rickettsiae.Rickettsial infections are major causes of febrile illnesses throughout the Asia-Pacific region. 1 The gram-negative, obligate intracellular bacteria that cause these infections are transmitted by arthropods and infect vertebrates. Rickettsiae can be grouped into three antigenically defined groups: scrub typhus, typhus, and spotted fever. Scrub typhus infection, which is caused by Orientia tsutsugamushi (previously known as Rickettsia tsutsugamushi), 2 is endemic in the western Pacific region and has been reported as the most frequent infection (19.3%) among febrile hospitalized patients in rural areas of Malaysia. 3 Murine typhus is caused by infection with a typhus group rickettsiae, Rickettsia typhi, and was once considered a sporadic and uncommon cause of illness in Malaysia. 4,5 However, in 1977, a high prevalence of this infection in the human and rodent population was reported. 6 The seroprevalence of spotted fever group (SFG) rickettsiae TT118 among febrile patients was 0.3% in Mentakab Hospital 3 and 16% in a study conducted in Sabah. 5 There is no information on the etiologic agent of tick typhus in Malaysia.In a serologic survey conducted in 1994-1995, it was shown that sera from a large proportion of febrile outpatients at a health center in Slim River, a small town located on the middle-northern west coast of Peninsular Malaysia, were reactive to antigens of O. tsutsugamushi, R. typhi, and SFG rickettsiae. 7 The majority of these patients were agricultural workers: mostly rubber tappers, oil palm plantation workers, and farmers. The objectives of the present study were to assess in more detail the seroprevalence of O. tsutsugamushi, R. typhi, and SFG rickettsia...

show abstract

“…Reinfection of O. tsutsugamushi is not uncommon in areas to which scrub typhus is endemic. 15 In this study, 17 (16.7%) of 102 patients with scrub typhus were diagnosed by a four-fold increase in IgG titer or by a high initial IgG titer. The kinetic pattern of antibody response of Orientia re-infection mimics those who had re-infection of dengue virus.…”

Section: Discussionmentioning

confidence: 99%

Development of New, Broadly Reactive, Rapid IgG and IgM Lateral Flow Assays for Diagnosis of Scrub Typhus

Silpasakorn¹,

Srisamut²,

Ekpo³

et al. 2012

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. We evaluated the diagnostic accuracy of two broadly reactive rapid immunochromatographic tests (ICTs) for detection of IgM and IgG against Orientia tsutsugamushi by using archived acute-phase serum samples from 102 patients with laboratory-confirmed scrub typhus, and from 62 archived serum samples from patients with other causes of fever as a negative control. These ICTs were constructed by using a mixture of recombinant proteins: 1) C1, a chimeric protein containing epitopes of the 56-kD antigen from Karp and TA763 strains; 2) Ktr56; and 3) Gmr56. Sensitivities of the ICTs for detection of IgM and IgG were 90.2% (95% confidence interval [CI] = 84.4-96.0%) and 86.3% (95% CI = 80.9-93.8%), respectively. Specificities were 85.5% (95% CI = 73.9-92.2%) and 96.8% (95% CI = 90.3-100%), respectively. Both assays were more sensitive and specific than the standard immune immunofluorescence assay for the early diagnosis of scrub typhus.

show abstract

Humoral and Cellular Responses in Scrub Typhus Patients Reflecting Primary Infection and Reinfection with Rickettsia Tsutsugamushi

Cited by 59 publications

References 0 publications

A Case Series of Possibly Recrudescent Orientia tsutsugamushi Infection Presenting as Pneumonia

A Case Series of Possibly Recrudescent Orientia tsutsugamushi Infection Presenting as Pneumonia

Seroepidemiologic survey of Orientia tsutsugamushi, Rickettsia typhi, and TT118 spotted fever group rickettsiae in rubber estate workers in Malaysia.

Development of New, Broadly Reactive, Rapid IgG and IgM Lateral Flow Assays for Diagnosis of Scrub Typhus

Contact Info

Product

Resources

About