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Volume 32, Number 9—September 2026
Research
Reemergence of Scrub Typhus Associated with Leptotrombidium akamushi Mites and Karp-Like Orientia tsutsugamushi Genotype Bacteria, Japan, 2024–2025
Figure 5

Figure 5. Phylogenetic relationships of Orientia tsutsugamushi strains detected in field mice, mites, and a human patient from a study of reemergence of scrub typhus associated with Leptotrombidium akamushi mites and Karp-like O. tsutsugamushi genotype bacteria, Japan, 2024–2025. Phylogenetic analysis was performed using the neighbor-joining method on the basis of an ≈420-bp region of the 56-kDa type–specific antigen gene. Sequences obtained from the placenta specimen, patient serum, 1 field mouse, and 3 L. akamushi mite larvae clustered together within the Karp-like lineage and were identical within the analyzed region. The placenta sequence (GenBank accession no. LC912005) was also identical over a 959-bp region to 2 L. akamushi mite–derived sequences (GenBank accession nos. LC912009 and LC912010). Reference strains representing major genotypes, including Kato and Karp-related strains, are included for comparison. O. tsutsugamushi bacterial sequences from rodents were all obtained from large Japanese field mice (Apodemus speciosus). Scale bar indicates nucleotide substitutions per site.