Abstract
In 2007, 19 cases of a scrub typhus epidemic occurred within a week at a sports school in Mingguang County, Anhui Province, where no previous incidence of this mite borne disease had been reported. Sero-surveillance in 2009 indicated that 10 of the 100 school students possessed anti-Orientia tsutsugamushi antibodies. From 2009 to 2013, 60 small animals and 2250 mites were collected in the vicinity of the school. 5 of the Apodemus agrarius samples and 1 group of Leptotrombidium linhuaikongense tested positive via PCR for O. tsutsugamushi. Two strains of O. tsutsugamushi were identified by injecting Kun Ming (KM) mice peritoneally with the organs of either Apodemus agrarius or Leptotrombidium linhuaikongense. Apart from sharing 98% homology with the O. tsutsugamushi Yongworl strain, genes encoding the membrane protein from the two O. tsutsugamushi isolates shared >99% sequence homology with each other, reflecting the consistency of the pathogen in both the vector and the host. In addition, we also characterized a chronic scrub typhus infection in a local patient. The membrane protein gene fragment from the patient’s blood shared 99% homology with O. tsutsugamushi Gilliam strain, suggesting that more than one O. tsutsugamushi strain is present at this location.
Highlights
Scrub typhus is a mite borne disease caused by the parasite O. tsutsugamushi, transmitted to humans and small animals by the bite of infected mites
A scrub typhus epidemic consisting of 19 cases broke out in 2007 in a sports school in the Anhui province of northern China
In total 60 small animals were captured; 38 Apodemus agrarius, 16 R. norvegicus, 2 Microtus fortis and 4 Neomys fodiens, indicating that Apodemus agrarius was the dominant species, accounting for 63.3% of the total small animals captured (Table 1). 2250 mites were collected from the ears of the trapped small animals, consisting of 1980 Leptotrombidium linhuaikongense and 270 Odontacarus majesticus, indicating that Leptotrombidium linhuaikongense was the dominant mite species
Summary
Scrub typhus is a mite borne disease caused by the parasite O. tsutsugamushi, transmitted to humans and small animals by the bite of infected mites. Since 1948, when Orientia tsutsugamushi was first identified in Guangzhou, China[1], the outbreaks of scrub typhus have been frequently reported. Scrub typhus has since been an emerging infectious disease in the Anhui Province of northern China. No cases of scrub typhus had previously been reported in this region suggesting a new epidemic focus. As an investigation into the natural foci of scrub typhus in this province hasn’t previously been conducted, this study was designed to investigate scrub typhus transmission in the vicinity of the sports school at which the epidemic of scrub typhus was reported in 2007. A focused investigation designed to identify O. tsutsugamushi genotypes, vector species and host animals present in Mingguang[13] was conducted in order to highlight the features of scrub typhus at this location and to implement measures for preventing further dissemination of the disease
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