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Volume 9, Number 12—December 2003
Dispatch

Scrub Typhus Reemergence in the Maldives

Michael D. Lewis*Comments to Author , Abdul Azeez Yousuf†, Kriangkrai Lerdthusnee*, Ahmed Razee‡, Kirkvitch Chandranoi*, and James W. Jones*
Author affiliations: *Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; †Ministry of Health, Malé, Republic of Maldives; ‡Indira Gandhi Memorial Hospital, Malé, Republic of Maldives

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Table 2

Testing results performed at the Armed Forces Research Institute of Medical Sciences

IIPa IFAb ELISAc
IgM (+)
 14
 15
 14
IgG (+)
 24
 24
 24
IgM (+) + IgG (+)
 14
 15
 14
Total samples tested
 28
 28
 28
PCRe and agarose gel electrophoresis positive results: 2 of 4

aIndirect immunoperoxidase test (positive if titer was ≥1:400) (15).
b Indirect immunofluorescent antibody test (positive if titer was ≥1:50) (15).
cEnzyme-linked immunosorbent assay (positive if PanBio units >11) (15).
dPositive immunoglobulin (Ig) M plus IgG results indicate active Orientia tsustugamushi infection. IgG without IgM indicates the persistence of IgG after a primary infection but with no active infection. The absence of both IgG and IgM indicates no exposure or a very early stage of infection (15).
ePolymerase chain reaction for O. tsustugamushi DNA (13).

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References
  1. Audy  JR. A summary topographical account of scrub typhus 1908–1946. In: Bulletins from the Institute for Medical Research, Federation of Malaya, No.1 of 1949. Kuala Lumpur, Malaysia: Government Press; 1949.
  2. Kalra  SL. Progress in the knowledge of rickettsial diseases in India. Indian J Med Res. 1959;5:477–83.PubMedGoogle Scholar
  3. Watt  G. Scrub typhus. In: Ledingham JGG, Warrell DA, editors. Concise Oxford textbook of medicine. New York: Oxford University Press; 2000. p.1698–1700.
  4. Singharaj  P, Watt  G. Scrub typhus. J Trop Med Parasitol. 1997;20:23–7.
  5. Kelly  DJ, Richards  AL, Temenak  J, Strickman  D, Dasch  GA. The past and present threat of rickettsial diseases to military medicine and international public health. Clin Infect Dis. 2002;34(Suppl 4):S145–69. DOIPubMedGoogle Scholar
  6. Kawamura  A, Tanaka  H, Tamura  A, eds. Tsutsugamushi disease. Tokyo, Japan: University of Tokyo Press; 1995.
  7. Pinkerton  H, Strano  AJ. Rickettsial diseases. In: Binford CH, Connor DH, editors. Pathology of tropical and extraordinary diseases, an atlas, volume one. Washington: Armed Forces Institute of Pathology; 1976. p. 87–100.
  8. Suto  T. A ten years experience on diagnosis of rickettsial diseases using the indirect immunoperoxidase methods. Acta Virol. 1991;35:580–6.PubMedGoogle Scholar
  9. Land  MV, Ching  WM, Dasch  GA, Zhang  Z, Kelly  DJ, Graves  SR, Evaluation of a commercially available recombinant-protein enzyme-linked immunosorbent assay for detection of antibodies produced in scrub typhus rickettsial infections. J Clin Microbiol. 2000;38:2701–5.PubMedGoogle Scholar
  10. Bozeman  FM, Elisberg  BL. Serological diagnosis of scrub typhus by indirect immuno-fluorescence. Proc Soc Exp Biol Med. 1963;112:568–73.PubMedGoogle Scholar
  11. Robinson  DM, Brown  G, Gan  E, Huzsoll  DL. Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg. 1976;25:900–5.PubMedGoogle Scholar
  12. Tay  ST, Nazma  S, Rohani  MY. Diagnosis of scrub typhus in Malaysian aborigines using nested polymerase chain reaction. SE Asian J Trop Med Publ Hlth. 1996;27:580–3.PubMedGoogle Scholar
  13. Horinouchi  H, Murai  K, Okayama  A, Tachibana  N, Tsubouchi  H. Genotypic identification of Rickettsia tsutsugamushi by restriction fragment length polymorphism analysis of DNA amplified by the polymerase chain reaction. Am J Trop Med Hyg. 1996;54:647–51.PubMedGoogle Scholar
  14. Lerdthusnee  K, Khuntirat  B, Leepitakrat  W, Tanskul  P, Monkanna  T, Khlaimanee  N, Scrub typhus: vector competence of Leptotrombidium chiangraiensis chiggers and transmission efficacy and isolation of Orienta tsutsugamushi. Ann N Y Acad Sci. 2003;990:1–11.PubMedGoogle Scholar
  15. Coleman  RE, Sangkasuwan  V, Suwanabun  N, Eamsila  C, Mungviriya  S, Devine  P, Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orienta tsutsugamushi in Thailand. Am J Trop Med Hyg. 2002;67:497–503.PubMedGoogle Scholar

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