Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 19, Number 2—February 2013
Dispatch

Human Granulocytic Anaplasmosis, Japan

Norio Ohashi1Comments to Author , Gaowa1, Wuritu, Fumihiko Kawamori, Dongxing Wu, Yuko Yoshikawa, Seizou Chiya, Kazutoshi Fukunaga, Toyohiko Funato, Masaaki Shiojiri2, Hideki Nakajima3, Yoshiji Hamauzu, Ai Takano, Hiroki Kawabata, Shuji Ando, and Toshio Kishimoto

Author affiliations: University of Shizuoka and Global Center of Excellence Program, Shizuoka City, Japan (N. Ohashi, Gaowa, Wuritu, F. Kawamori, D. Wu, Y. Yoshikawa); Kochi Institute of Health, Kochi City, Japan (S. Chiya, K. Fukunaga); Shizuoka Institute of Environment and Hygiene, Shizuoka City (F. Kawamori); Muroto Hospital, Muroto, Japan (T. Funato); Kochi Prefectural Aki Hospital, Aki City, Japan (M. Shiojiri, H. Nakajima); Chu-gei Clinic, Aki District, Japan (Y. Hamauzu); National Institute of Infectious Diseases, Tokyo, Japan (A. Takano, H. Kawabata, S. Ando); Okayama Prefectural Institute for Environmental Science and Public Health, Okayama, Japan (T. Kishimoto)

Main Article

Table 1

Results of PCR for select rickettsial organisms for 2 men with human granulocytic anaplasmosis, Kochi Prefecture, Japan*

Days after symptom onset† Nested PCR result‡
SFG rickettsia 16S rDNA Orientia tsutsugamushi 16S rDNA Anaplasma phagocytophilum p44/msp2 Ehrlichia sp. p28/omp-1
Case-patient 1
3 Negative Negative Positive Negative
19
 Negative
 Negative
 Negative
 Negative
Case-patient 2
4 Positive Negative Positive Negative
11 NA NA NA NA

*SFG, spotted fever group; NA, not available.
†After in-hospital treatment with minocycline (200 mg/d), both case-patients improved clinically and were discharged on days 20 and 12, respectively, after symptom onset.
‡Before being used in PCR, blood clots from the patients were homogenized by using BioMasher (Nippi Inc., Tokyo, Japan) and treated overnight with 100 U of streptokinase (WAKO Pure Chemical Industries Ltd, Osaka, Japan). DNA then was extracted by using the QIAamp DNA Mini Kit (QIAGEN, Valencia, CA, USA). Multiplex nested first-step PCR for SFG rickettsiae and O. tsutsugamushi was performed by using the following primers: RO-1F (5'-CCGTAAACGATGAGTGCTAGA-3') and RO-R1 (5'-CCGAGAACGTATTCACCGC-3'). Multiplex nested second-step PCR for SFG rickettsiae 16S rDNA was performed by using the following primers: R-2F (5'-GAAGATTCTCTTTCGGTTTCGC-3') and R-2R (5'-GTCTTGCTTCCCTCTGTAAAC-3'). Multiplex nested second-step PCR for O. tsutsugamushi 16S rDNA was performed by using the following primers: O-2F (5'-GACATGGTAGTCGCGAAAAATG-3') and O-2R (5'-TGCAATCCGAACTGAGATACC-3'). A. phagocytophilum p44/msp2 was amplified by using primers p3726, p4257, p3761, and p4183, and Ehrlichia spp. p28/omp-1 was amplified by using primers conP28-F1, conP28-R1, conP28-F2, and conP28-R2, as described (3,9).

Main Article

References
  1. National Institute of Infectious Diseases, Ministry of Health, Labour and Welfare. IASR (Infectious Agents Surveillance Report). Scrub typhus and Japanese spotted fever in Japan, 2006–2011 [cited 2012 May 31]. http://idsc.nih.go.jp/iasr/31/363/tpc363.html
  2. Ando  S, Kurosawa  M, Sakata  A, Fujita  H, Sakai  K, Sekine  M, Human Rickettsia heilongjiangensis infection, Japan. Emerg Infect Dis. 2010;16:1306–8. DOIPubMedGoogle Scholar
  3. Ohashi  N, Inayoshi  M, Kitamura  K, Kawamori  F, Kawaguchi  D, Nishimura  Y, Anaplasma phagocytophilum–infected ticks, Japan. Emerg Infect Dis. 2005;11:1780–3. DOIPubMedGoogle Scholar
  4. Wuritu , Kawamori  F, Aochi  M, Masuda  T, Ohashi  N. Characterization of p44/msp2 multigene family of Anaplasma phagocytophilum from two different tick species, Ixodes persulcatus and Ixodes ovatus, in Japan. Jpn J Infect Dis. 2009;62:142–5.PubMedGoogle Scholar
  5. Wuritu , Ozawa  Y, Gaowa , Kawamori  F, Masuda  T, Masuzawa  T, Structural analysis of a p44/msp2 expression site of Anaplasma phagocytophilum in naturally infected ticks in Japan. J Med Microbiol. 2009;58:1638–44. DOIPubMedGoogle Scholar
  6. Kawahara  M, Tajima  T, Torii  H, Yabutani  M, Ishii  J, Harasawa  M, Ehrlichia chaffeensis infection of sika deer, Japan. Emerg Infect Dis. 2009;15:1991–3. DOIPubMedGoogle Scholar
  7. Gaowa , Wuritu , Wu  D, Yoshikawa  Y, Ohashi  N, Kawamori  F, Detection and characterization of p44/msp2 transcript variants of Anaplasma phagocytophilum from naturally infected ticks and wild deer in Japan. Jpn J Infect Dis. 2012;65:79–83.PubMedGoogle Scholar
  8. Gaowa , Aoch i M, Ohashi  N, Wuritu , Wu  D, Yoshikawa  Y, Rickettsiae in Ticks, Japan, 2007–2011 [letter]. Emerg Infect Dis. 2013;19:338–40. DOIGoogle Scholar
  9. Inayoshi  M, Naitou  H, Kawamori  F, Masuzawa  T, Ohashi  N. Characterization of Ehrlichia species from Ixodes ovatus ticks at the foot of Mt. Fuji, Japan. Microbiol Immunol. 2004;48:737–45 .PubMedGoogle Scholar
  10. Heo  EJ, Park  JH, Koo  JR, Park  MS, Park  MY, Dumler  JS, Serologic and molecular detection of Ehrlichia chaffeensis and Anaplasma phagocytophila (human granulocytic ehrlichiosis agent) in Korean patients. J Clin Microbiol. 2002;40:3082–5. DOIPubMedGoogle Scholar
  11. Zhi  N, Ohashi  N, Rikihisa  Y, Horowitz  HW, Wormser  GP, Hechemy  K. Cloning and expression of the 44-kilodalton major outer membrane protein gene of the human granulocytic ehrlichiosis agent and application of the recombinant protein to serodiagnosis. J Clin Microbiol. 1998;36:1666–73 .PubMedGoogle Scholar
  12. Ohashi  N, Zhi  N, Zhang  Y, Rikihisa  Y. Immunodominant major outer membrane proteins of Ehrlichia chaffeensis are encoded by a polymorphic multigene family. Infect Immun. 1998;66:132–9 .PubMedGoogle Scholar
  13. Mahara  F. Japanese spotted fever: report of 31 cases and review of the literature. Emerg Infect Dis. 1997;3:105–11. DOIPubMedGoogle Scholar
  14. Lin  M, Kikuchi  T, Brewer  HM, Norbeck  AD, Rikihisa  Y. Global proteomic analysis of two tick-borne emerging zoonotic agents: Anaplasma phagocytophilum and Ehrlichia chaffeensis. Front Microbiol. 2011;2:24. Epub 2011 Feb 17. DOIGoogle Scholar

Main Article

1These authors contributed equally to this article.

2Current affiliation: Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.

3Current affiliation: Kochi Medical School, Nankoku, Kochi, Japan.

Page created: January 22, 2013
Page updated: January 22, 2013
Page reviewed: January 22, 2013
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external