Abstract
Scrub typhus, caused by Orientia tsutsugamushi, has emerged recently in Jingjiang City, China where the disease had not been known to exist. We analyzed epidemiological data, clinical characteristics and risk factors of scrub typhus outbreak in Jingjiang City, 2013. The 271 clinically diagnosed patients were predominantly farmers 50 to 69 years old and the peak of onset was early to mid-November. For the 187 laboratory-confirmed cases, the major clinical manifestations of the patients were fever (100%), eschar (88.2%), rash (87.7%), chills (87.7%), and headache (66.8%). A community-based case-control study was carried out to investigate the risk factors of the scrub typhus outbreak. Bundling or moving waste straw (OR=9.0, 95%CI 4.6-17.8) and living at the edge of village (OR=0.6, 95%CI 0.4-0.9) posed the highest risks through single- and multi-variable conditional logistic regression. Phylogenetic analysis of the 56-kDa TSA gene showed that the new cluster (GB-C2) and the previously reported cluster (GB-C1) of O. tsutsugamushi were associated with this outbreak. These findings are useful for the establishment of a detailed control strategy for scrub typhus infection in previously unrecognized areas of Jiangsu Province, China.
Highlights
Scrub typhus is an acute, febrile and potentially fatal disease, caused by infection with the obligate intracellular bacterium Orientia tsutsugamushi, following the bite of an infected trombiculid mite [1]
The 271 cases of scrub typhus that occurred from 18 October to 11 December in 2013 were characterized by a peak of onset in early to mid- November (Fig 2), an incidence of 39.6/ 100,000, and a lack of mortalities following antibiotic treatment. 38.4% of patients were male; and 61.6% were female
The epidemiological data of scrub typhus outbreak in Jingjiang City showed that the majority of patients were female farmers 50 to 69-years-old, which might be explained by the fact that most young, male individuals of rural families work in urban areas to alleviate their economic burden, and that the elderly and women are left to do farm work
Summary
Scrub typhus is an acute, febrile and potentially fatal disease, caused by infection with the obligate intracellular bacterium Orientia tsutsugamushi (formerly Rickettsia tsutsugamushi), following the bite of an infected trombiculid mite [1]. This disease can account for up to 23% of PLOS ONE | DOI:10.1371/journal.pone.0125999. The first case of scrub typhus in China was in the city of Guangzhou, in 1948[5]. Since 1990, it has rapidly expanded its region of infection, spreading to the north of Yangtze River [6]. Jingjiang City, on the north bank of the Yangtze River, had heretofore never reported scrub typhus. In light of the outbreak of scrub typhus in 2013, we launched an investigation on scrub typhus in Jingjiang City, in order to describe its epidemiological and clinical characteristics, identify risk factors and provide a basis for taking scientific countermeasures
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
