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Volume 26, Number 8—August 2020
Dispatch

Genotypic Heterogeneity of Orientia tsutsugamushi in Scrub Typhus Patients and Thrombocytopenia Syndrome Co-infection, Myanmar

Aye Marlar Win1, Yen Thi Hai Nguyen1, Yuri Kim1, Na-Young Ha, Jun-Gu Kang, Hongil Kim, Bo San, Okkar Kyaw, Wah Win Htike, Dong-Ok Choi, Keun-Hwa Lee2Comments to Author , and Nam-Hyuk Cho2Comments to Author 
Author affiliations: University of Medicine 1, Yangon, Myanmar (A.M. Win, O. Kyaw, W.W. Htike); Seoul National; University College of Medicine, Seoul, South Korea (Y.T.H. Nguyen, Y. Kim, N.-Y. Ha, J.-G. Kang, H. Kim, N.-H. Cho); Private practitioner, Sagaing, Myanmar (B. San); Bore Da Biotech, Seongnam, South Korea (D.-O. Choi); Hanyang University College of Medicine, Seoul (K.-H. Lee); Seoul National University Medical Research Center and Bundang Hospital, Seoul (N.-H. Cho)

Main Article

Figure 2

Phylogenetic tree constructed on the basis of Orientia tsutsugamushi tsa56 gene sequences for scrub typhus patients in Myanmar (black dots) and reference sequences. The tree was constructed using the maximum likelihood method with MEGA7 (http://www.megasoftware.net). The tsa56 gene sequences identified in this study are indicated by black circles and compared with 17 representative genotype sequences reported by a previous study (1). The percentage of replicate trees in which the associated geno

Figure 2. Phylogenetic tree constructed on the basis of Orientia tsutsugamushi tsa56 gene sequences for scrub typhus patients in Myanmar (black dots) and reference sequences. The tree was constructed using the maximum likelihood method with MEGA7 (http://www.megasoftware.net). The tsa56 gene sequences identified in this study are indicated by black circles and compared with 17 representative genotype sequences reported by a previous study (1). The percentage of replicate trees in which the associated genotypes clustered together in the bootstrap test (1,000 replicates) is shown next to the branches.

Main Article

References
  1. Kim  G, Ha  NY, Min  CK, Kim  HI, Yen  NTH, Lee  KH, et al. Diversification of Orientia tsutsugamushi genotypes by intragenic recombination and their potential expansion in endemic areas. PLOS Neglect Trop Dis. 2017;11:e0005408.
  2. Davis  GE, Austrian  RC, Bell  EJ. Observations on tsutsugamushi disease (scrub typhus) in Assam and Burma: the recovery of strains of Rickettsia orientalis. Am J Hyg. 1947;46:268–86.PubMedGoogle Scholar
  3. Parola  P, Miller  RS, McDaniel  P, Telford  SR III, Rolain  JM, Wongsrichanalai  C, et al. Emerging rickettsioses of the Thai-Myanmar border. Emerg Infect Dis. 2003;9:592–5. DOIPubMedGoogle Scholar
  4. Brummaier  T, Kittitrakul  C, Choovichian  V, Lawpoolsri  S, Namaik-Larp  C, Wattanagoon  Y. Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border. J Infect Dev Ctries. 2017;11:407–13. DOIPubMedGoogle Scholar
  5. Liu  S, Chai  C, Wang  C, Amer  S, Lv  H, He  H, et al. Systematic review of severe fever with thrombocytopenia syndrome: virology, epidemiology, and clinical characteristics. Rev Med Virol. 2014;24:90–102. DOIPubMedGoogle Scholar
  6. Hu  J, Shi  C, Li  Z, Guo  X, Qian  Y, Tan  W, et al. A cluster of cases of severe fever with thrombocytopenia syndrome bunyavirus infection in China, 1996: A retrospective serological study. PLoS Negl Trop Dis. 2018;12:e0006603. DOIPubMedGoogle Scholar
  7. Thi Hai Yen  N, Kim  C, Jeong  S, Jeon  K, Choi  H, Ro  HJ, et al. Severe fever with thrombocytopenia syndrome virus infection or mixed infection with scrub typhus in South Korea in 2000–2003. Am J Trop Med Hyg. 2019;101:1096–9. DOIPubMedGoogle Scholar
  8. Takahashi  T, Maeda  K, Suzuki  T, Ishido  A, Shigeoka  T, Tominaga  T, et al. The first identification and retrospective study of Severe Fever with Thrombocytopenia Syndrome in Japan. J Infect Dis. 2014;209:816–27. DOIPubMedGoogle Scholar
  9. Tran  XC, Yun  Y, Van An  L, Kim  SH, Thao  NTP, Man  PKC, et al. Endemic severe fever with thrombocytopenia syndrome, Vietnam. Emerg Infect Dis. 2019;25:1029–31. DOIPubMedGoogle Scholar
  10. Ra  SH, Kim  JY, Cha  HH, Kwon  JS, Lee  HJ, Jeon  NY, et al. Coinfection of severe fever with thrombocytopenia syndrome and scrub typhus in patients with tick-borne illness. Am J Trop Med Hyg. 2019;101:1259–62. DOIPubMedGoogle Scholar
  11. Watthanaworawit  W, Turner  P, Turner  C, Tanganuchitcharnchai  A, Jintaworn  S, Hanboonkunupakarn  B, et al. Diagnostic accuracy assessment of immunochromatographic tests for the rapid detection of antibodies against Orientia tsutsugamushi using paired acute and convalescent specimens. Am J Trop Med Hyg. 2015;93:1168–71. DOIPubMedGoogle Scholar
  12. Paris  DH, Dumler  JS. State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus. Curr Opin Infect Dis. 2016;29:433–9. DOIPubMedGoogle Scholar
  13. Yoo  JR, Heo  ST, Kang  JH, Park  D, Kim  JS, Bae  JH, et al. Mixed infection with severe fever with thrombocytopenia syndrome virus and two genotypes of scrub typhus in a patient, South Korea, 2017. Am J Trop Med Hyg. 2018;99:287–90. DOIPubMedGoogle Scholar
  14. Kim  DM, Lee  YM, Back  JH, Yang  TY, Lee  JH, Song  HJ, et al. A serosurvey of Orientia tsutsugamushi from patients with scrub typhus. Clin Microbiol Infect. 2010;16:447–51. DOIPubMedGoogle Scholar
  15. Yun  SM, Park  SJ, Kim  YI, Park  SW, Yu  MA, Kwon  HI, et al. Genetic and pathogenic diversity of severe fever with thrombocytopenia syndrome virus (SFTSV) in South Korea. JCI Insight. 2020;5:e129531;5:129531. DOIPubMedGoogle Scholar

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1These first authors contributed equally to this article.

2These authors were co–principal investigators.

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Page updated: July 19, 2020
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