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[Clinical manifestations and epidemic factors of autumn-winter type scrub typhus in children from northern new endemic area].
Zhonghua Er Ke Za Zhi. 2008 Feb; 46(2):128-31.ZE

Abstract

OBJECTIVE

Scrub typhus is an infectious disease due to Orientia tsutsugamushi transmitted by infected chigger mites. Scrub typhus has long been recognized to occur in southern areas of China, but has recently been increasingly often reported from the north since the first case was reported in Mengyin County, Shandong Province in 1986. The key objectives of the present study were to investigate the clinical manifestations and epidemic factors of scrub typhus in children from the northern new natural foci.

METHODS

The case records of 56 children with scrub typhus who were admitted to the 5 hospitals of Fei County from September 1993 to January 2004 were reviewed. Orientia tsutsugamushi (Ot) was isolated from the cases. Based on ecological observations on the composition, seasonal fluctuation of animal hosts and chigger mites, Ot was isolated from rodents and chiggers. IgG antibodies to Ot was detected by IFA. Genotypes of the Ot isolates were also identified by nested PCR.

RESULTS

Among 56 children scrub typhus cases, 46 were male, 10 were female; 96% exhibited typical eschars or ulcers, 100% cases had high fever, skin rashes were observed in 55 cases (98%), and regional lymphadenopathy occurred in 48 cases (86%). All cases came from countryside, and all had histories of exposure to the crop field. fifty-one serum samples of suspected patients with scrub typhus were collected, 48 were positive for antibodies to Ot. The serotypes were Gilliam types. The cases only appeared in September to December with the peak at mid and late October. Leptotrombidium (L.) scutellare was the most important vector causing scrub typhus in the foci. Apodemus (A.) agrarius was the main host animals of Ot in the crop field. Totally 26 strains were isolated from patients, rodents, and chigger mites. The serotypes of 24 out of the 26 isolates were Gilliam types, while the genotypes of these isolates were Kawasaki types. The serotypes of the other 2 isolates were identical and both were Karp types.

CONCLUSION

Children scrub typhus patients were frequently seen in the new natural foci of Shandong province. Exposure history, typical eschars or ulcers, and presence of IgG antibody were the important indexes to diagnose the disease.

Authors+Show Affiliations

Liu YX
Department of Nosocomial Infection Management and Disease Control, Institute of Hospital Management, General Hospital of the People's Liberation Army, Beijing 100853, China.
Zhao ZT
No affiliation info available
Feng PT
No affiliation info available
Ma SB
No affiliation info available
Min JS
No affiliation info available
Qin DT
No affiliation info available
Yuan YE
No affiliation info available
Wei H
No affiliation info available
Suo JJ
No affiliation info available
Xing YB
No affiliation info available
Jia N
No affiliation info available
Gao Y
No affiliation info available

MeSH

AdolescentAnimalsChildChild, PreschoolChinaFemaleHumansInfantInfant, NewbornMaleMiceOrientia tsutsugamushiScrub TyphusSeasonsTrombiculidae

Pub Type(s)

English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

19099688

Citation

Liu, Yun-xi, et al. "[Clinical Manifestations and Epidemic Factors of Autumn-winter Type Scrub Typhus in Children From Northern New Endemic Area]." Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics, vol. 46, no. 2, 2008, pp. 128-31.
Liu YX, Zhao ZT, Feng PT, et al. [Clinical manifestations and epidemic factors of autumn-winter type scrub typhus in children from northern new endemic area]. Zhonghua Er Ke Za Zhi. 2008;46(2):128-31.
Liu, Y. X., Zhao, Z. T., Feng, P. T., Ma, S. B., Min, J. S., Qin, D. T., Yuan, Y. E., Wei, H., Suo, J. J., Xing, Y. B., Jia, N., & Gao, Y. (2008). [Clinical manifestations and epidemic factors of autumn-winter type scrub typhus in children from northern new endemic area]. Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics, 46(2), 128-31.
Liu YX, et al. [Clinical Manifestations and Epidemic Factors of Autumn-winter Type Scrub Typhus in Children From Northern New Endemic Area]. Zhonghua Er Ke Za Zhi. 2008;46(2):128-31. PubMed PMID: 19099688.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical manifestations and epidemic factors of autumn-winter type scrub typhus in children from northern new endemic area]. AU - Liu,Yun-xi, AU - Zhao,Zhong-tang, AU - Feng,Pei-tian, AU - Ma,Shu-bin, AU - Min,Jing-si, AU - Qin,De-tai, AU - Yuan,Yun-e, AU - Wei,Hua, AU - Suo,Ji-jiang, AU - Xing,Yu-bin, AU - Jia,Ning, AU - Gao,Yan, PY - 2008/12/23/entrez PY - 2008/12/23/pubmed PY - 2010/12/14/medline SP - 128 EP - 31 JF - Zhonghua er ke za zhi = Chinese journal of pediatrics JO - Zhonghua Er Ke Za Zhi VL - 46 IS - 2 N2 - OBJECTIVE: Scrub typhus is an infectious disease due to Orientia tsutsugamushi transmitted by infected chigger mites. Scrub typhus has long been recognized to occur in southern areas of China, but has recently been increasingly often reported from the north since the first case was reported in Mengyin County, Shandong Province in 1986. The key objectives of the present study were to investigate the clinical manifestations and epidemic factors of scrub typhus in children from the northern new natural foci. METHODS: The case records of 56 children with scrub typhus who were admitted to the 5 hospitals of Fei County from September 1993 to January 2004 were reviewed. Orientia tsutsugamushi (Ot) was isolated from the cases. Based on ecological observations on the composition, seasonal fluctuation of animal hosts and chigger mites, Ot was isolated from rodents and chiggers. IgG antibodies to Ot was detected by IFA. Genotypes of the Ot isolates were also identified by nested PCR. RESULTS: Among 56 children scrub typhus cases, 46 were male, 10 were female; 96% exhibited typical eschars or ulcers, 100% cases had high fever, skin rashes were observed in 55 cases (98%), and regional lymphadenopathy occurred in 48 cases (86%). All cases came from countryside, and all had histories of exposure to the crop field. fifty-one serum samples of suspected patients with scrub typhus were collected, 48 were positive for antibodies to Ot. The serotypes were Gilliam types. The cases only appeared in September to December with the peak at mid and late October. Leptotrombidium (L.) scutellare was the most important vector causing scrub typhus in the foci. Apodemus (A.) agrarius was the main host animals of Ot in the crop field. Totally 26 strains were isolated from patients, rodents, and chigger mites. The serotypes of 24 out of the 26 isolates were Gilliam types, while the genotypes of these isolates were Kawasaki types. The serotypes of the other 2 isolates were identical and both were Karp types. CONCLUSION: Children scrub typhus patients were frequently seen in the new natural foci of Shandong province. Exposure history, typical eschars or ulcers, and presence of IgG antibody were the important indexes to diagnose the disease. SN - 0578-1310 UR - https://www.unboundmedicine.com/medline/citation/19099688/[Clinical_manifestations_and_epidemic_factors_of_autumn_winter_type_scrub_typhus_in_children_from_northern_new_endemic_area]_ L2 - http://www.diseaseinfosearch.org/result/7277 DB - PRIME DP - Unbound Medicine ER -