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Clinical characteristics and risk factors of an outbreak with scrub typhus in previously unrecognized areas, Jiangsu province, China 2013.
PLoS One. 2015; 10(5):e0125999.Plos

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.

Authors+Show Affiliations

Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Tongren Municipal Center for Disease Control and Prevention, Tongren, China.Taizhou Municipal Center for Disease Control and Prevention, Taizhou, China.Taizhou Municipal Center for Disease Control and Prevention, Taizhou, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Taizhou Municipal Center for Disease Control and Prevention, Taizhou, China.Jingjiang County Center for Disease Control and Prevention, Jingjiang, China.Jingjiang County Center for Disease Control and Prevention, Jingjiang, China.Jingjiang County Center for Disease Control and Prevention, Jingjiang, China.Taizhou Municipal Center for Disease Control and Prevention, Taizhou, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Taizhou Municipal Center for Disease Control and Prevention, Taizhou, China.The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.Huadong Research Institute for Medicine and Biotechnics, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.

Pub Type(s)

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

Language

eng

PubMed ID

25954814

Citation

Hu, Jianli, et al. "Clinical Characteristics and Risk Factors of an Outbreak With Scrub Typhus in Previously Unrecognized Areas, Jiangsu Province, China 2013." PloS One, vol. 10, no. 5, 2015, pp. e0125999.
Hu J, Tan Z, Ren D, et al. Clinical characteristics and risk factors of an outbreak with scrub typhus in previously unrecognized areas, Jiangsu province, China 2013. PLoS One. 2015;10(5):e0125999.
Hu, J., Tan, Z., Ren, D., Zhang, X., He, Y., Bao, C., Liu, D., Yi, Q., Qian, W., Yin, J., Xu, Z., Yu, C., Wang, S., Wu, B., Yang, H., Yue, M., Zhang, Y., Liu, W., Zhu, Y., ... Tang, F. (2015). Clinical characteristics and risk factors of an outbreak with scrub typhus in previously unrecognized areas, Jiangsu province, China 2013. PloS One, 10(5), e0125999. https://doi.org/10.1371/journal.pone.0125999
Hu J, et al. Clinical Characteristics and Risk Factors of an Outbreak With Scrub Typhus in Previously Unrecognized Areas, Jiangsu Province, China 2013. PLoS One. 2015;10(5):e0125999. PubMed PMID: 25954814.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and risk factors of an outbreak with scrub typhus in previously unrecognized areas, Jiangsu province, China 2013. AU - Hu,Jianli, AU - Tan,Zhongming, AU - Ren,Dafei, AU - Zhang,Xiang, AU - He,Yilin, AU - Bao,Changjun, AU - Liu,Dapeng, AU - Yi,Qianhua, AU - Qian,Weijuan, AU - Yin,Jun, AU - Xu,Zhen, AU - Yu,Chunxia, AU - Wang,Shenjiao, AU - Wu,Bin, AU - Yang,Haiyu, AU - Yue,Ming, AU - Zhang,Yun, AU - Liu,Wendong, AU - Zhu,Yefei, AU - Zhou,Minghao, AU - Tang,Fenyang, Y1 - 2015/05/08/ PY - 2014/10/29/received PY - 2015/03/27/accepted PY - 2015/5/9/entrez PY - 2015/5/9/pubmed PY - 2016/4/30/medline SP - e0125999 EP - e0125999 JF - PloS one JO - PLoS One VL - 10 IS - 5 N2 - 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/25954814/Clinical_characteristics_and_risk_factors_of_an_outbreak_with_scrub_typhus_in_previously_unrecognized_areas_Jiangsu_province_China_2013_ L2 - https://dx.plos.org/10.1371/journal.pone.0125999 DB - PRIME DP - Unbound Medicine ER -