Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus

Abstract

To determine prevalence of severe fever with thrombocytopenia syndrome in South Korea, we examined serum samples from patients with fever and insect bite history in scrub typhus–endemic areas. During the 2013 scrub typhus season, prevalence of this syndrome among patients suspected of having scrub typhus was high (23.0%), suggesting possible co-infection.

Mixed Infection with Severe Fever with Thrombocytopenia Syndrome Virus and Two Genotypes of Scrub Typhus in a Patient, South Korea, 2017

“…Severe fever with thrombocytopenia syndrome is a tick-borne viral disease with a high mortality rate that infects humans primarily through tick bites. 2,[6][7][8]10 Transmission from person-toperson has been confirmed in close contact person such as family members and health-care workers, and asymptomatic infection via person-to-person close contact has also been reported. [6][7][8] Scrub typhus is an acute febrile illness caused by O. tsutsugamushi, a bacterium transmitted to humans through chigger mite (Acari: Trombiculiidae) bites.…”

“…[6][7][8] Scrub typhus is an acute febrile illness caused by O. tsutsugamushi, a bacterium transmitted to humans through chigger mite (Acari: Trombiculiidae) bites. 10,11 The vectors of SFTSV and O. tsutsugamushi are different; H. longicornis is a major vector of SFTSV and Leptotrombidium spp. mites are vectors of O. tsutsugamushi.…”

“…2,6,9 The disease is characterized by fever, gastrointestinal signs and symptoms, leukopenia, thrombocytopenia, and a high mortality rate. 2,[6][7][8]10 Scrub typhus is a life-threatening bacterial disease caused by Orientia tsutsugamushi and is transmitted primarily by the bite of the Leptotrombidium spp. mite (Acari: Trombiculiidae) infected with Orientia species and endemic in the "tsutsugamushi triangle" within the Asia-Pacific region.…”

“…mite (Acari: Trombiculiidae) infected with Orientia species and endemic in the "tsutsugamushi triangle" within the Asia-Pacific region. 10,11 However, patients were documented in the Middle East and South America in 2016. 11 SFTS is endemic to South Korea and is a major public health concern between May and October; scrub typhus, also a major public health problem, is mostly present between October and November.…”

“…11 SFTS is endemic to South Korea and is a major public health concern between May and October; scrub typhus, also a major public health problem, is mostly present between October and November. 10 The clinical presentations of SFTS and scrub typhus are similar: signs and symptoms typically develop within 1-2 weeks of infection and include fever, headache, malaise, and gastrointestinal symptoms, but SFTS exhibits a higher mortality rate than dose scrub typhus. 2,[6][7][8]10,11 In this study, we report the first confirmed case of mixed infection with SFTSV and two genotypes of O. tsutsugamushi in a patient.…”