Co-Infection of Scrub Typhus and Human Granulocytic Anaplasmosis in Korea, 2006

Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable over...

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Published inJournal of Korean Medical Science Vol. 34; no. 39; pp. e257 - 9
Main Authors Kim, Jeong-Han, Lee, Chang-Seop, Moon, Chisook, Kwak, Yee Gyung, Kim, Baek-Nam, Kim, Eu Suk, Kang, Jae Myung, Park, Wan Beom, Oh, Myoung-don, Park, Sang-Won
Format Journal Article
LanguageEnglish
Published Korea (South) Korean Academy of Medical Sciences 14.10.2019
The Korean Academy of Medical Sciences
대한의학회
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ISSN1011-8934
1598-6357
1598-6357
DOI10.3346/jkms.2019.34.e257

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Abstract Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections. The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of . Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described. One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV. We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
AbstractList Background: Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections. Methods: The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described. Results: One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV. Conclusion: We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea. KCI Citation Count: 0
Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections. The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of . Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described. One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV. We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections.BACKGROUNDScrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections.The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described.METHODSThe study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described.One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV.RESULTSOne-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV.We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.CONCLUSIONWe found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
Author Jeong Han Kim
Yee Gyung Kwak
Myoung Don Oh
Jae Myung Kang
Baek-Nam Kim
Wan Beom Park
Sang Won Park
Chisook Moon
Chang-Seop Lee
Eu Suk Kim
AuthorAffiliation 2 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3 Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
6 Department of Internal Medicine, Pohang St. Mary's Hospital, Pohang, Korea
5 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
4 Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
1 Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
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Issue 39
Keywords Anaplasma phagocytophilum
Scrub Typhus
Human Granulocytic Anaplasmosis
Severe Fever with Thrombocytopenia Syndrome
Co-Infection
Language English
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Snippet Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in...
Background: Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious...
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SubjectTerms Adolescent
Adult
Aged
Aged, 80 and over
Anaplasma phagocytophilum
Anaplasma phagocytophilum - classification
Anaplasma phagocytophilum - genetics
Anaplasma phagocytophilum - isolation & purification
Anaplasmosis
Anaplasmosis - diagnosis
Anaplasmosis - microbiology
Coinfection
Coinfection - diagnosis
Female
Humans
Male
Middle Aged
Original
Original Article
Phlebovirus
Phlebovirus - genetics
Phlebovirus - isolation & purification
Phylogeny
Polymerase Chain Reaction
Republic of Korea
Retrospective Studies
RNA, Ribosomal, 16S
RNA, Ribosomal, 16S - genetics
RNA, Ribosomal, 16S - metabolism
RNA, Viral
RNA, Viral - genetics
RNA, Viral - metabolism
Scrub Typhus
Scrub Typhus - diagnosis
Scrub Typhus - virology
Young Adult
의학일반
Title Co-Infection of Scrub Typhus and Human Granulocytic Anaplasmosis in Korea, 2006
URI https://cir.nii.ac.jp/crid/1874242817467954048
https://www.ncbi.nlm.nih.gov/pubmed/31602827
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Volume 34
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