Mahara F , 1997. Japanese spotted fever: report of 31 cases and review of the literature. Emerg Infect Dis 3: 105–111.
National Institute of Infectious Diseases , 2020. Japanese spotted fever 1999–2019. Infect Agents Surveill Rep 41: 133–135.
Kodama K , Senba T , Yamauchi H , Nomura T , Chikahira Y , 2003. Clinical study of Japanese spotted fever and its aggravating factors. J Infect Chemother 9: 83–87.
Sakabe S , Tanaka H , Nakanishi Y , Toyoshima H , 2022. The clinical course of 239 cases of Japanese spotted fever in Ise Red Cross Hospital, 2006–2019. J Infect Chemother 28: 211–216.
National Institute of Infectious Diseases , 2017. Scrub typhus and Japanese spotted fever in Japan 2007–2016. Infect Agents Surveill Rep 38: 109–112.
Wakayama City Infectious Disease Surveillance Center , 2022. Infectious Diseases Transmitted by Ticks. Available at: http://www.kansen-wakayama.jp/. Accessed May 1, 2022.
Matsuyama H , Taira M , Suzuki M , Sando E , 2020. Associations between Japanese spotted fever (JSF) cases and wildlife distribution on the Boso Peninsula, central Japan (2006–2017). J Vet Med Sci 82: 1666–1670.
Londoño AF , Arango-Ferreira C , Acevedo-Gutiérrez LY , Paternina LE , Montes C , Ruiz I , Labruna MB , Díaz FJ , Walker DH , Rodas JD , 2019. A cluster of cases of Rocky Mountain spotted fever in an area of Colombia not known to be endemic for this disease. Am J Trop Med Hyg 101: 336–342.
Keysary A , Potasman I , Itzhaki A , Finkelstein R , Yitzhaki S , Strenger C , Rzotkiewicz S , Leitner M , 2007. Clusters of Mediterranean spotted fever in Israel. Vector Borne Zoonotic Dis 7: 143–146.
Matsuura H , Yokota K , 2018. Case report: family cluster of Japanese spotted fever. Am J Trop Med Hyg 98: 835–837.
Takano A , Fujita H , Kadosaka T , Takahashi M , Yamauchi T , Ishiguro F , Takada N , Yano Y , Oikawa Y , Honda T , 2014. Construction of a DNA database for ticks collected in Japan: application of molecular identification based on the mitochondrial 16S rDNA gene. Jpn J Sanit Zool 65: 13–21.
Anderson JF , Magnarelli LA , 2008. Biology of ticks. Infect Dis Clin North Am 22: 195–215.
Mediannikov OY , Sidelnikov Y , Ivanov L , Mokretsova E , Fournier P-E , Tarasevich I , Raoult D , 2004. Acute tick-borne rickettsiosis caused by Rickettsia sibirica in the Russian Far East. Emerg Infect Dis 10: 810–817.
Noda H , Munderloh UG , Kurtti TJ , 1997. Endosymbionts of ticks and their relationship to Wolbachia spp. and tick-borne pathogens of humans and animals. Appl Environ Microbiol 63: 3926–3932.
Buczek A , Zając Z , Woźniak A , Kulina D , Bartosik K , 2017. Locomotor activity of adult Dermacentor reticulatus ticks (Ixodida: Ixodidae) in natural conditions. Ann Agric Environ Med 24: 271–275.
Tribaldos M , Zaldivar Y , Bermudez S , Samudio F , Mendoza Y , Martinez AA , Villalobos R , Eremeeva ME , Paddock CD , Page K , 2011. Rocky Mountain spotted fever in Panama: a cluster description. J Infect Dev Ctries 5: 737–741.
Renvoisé A , Delaunay P , Blanchouin E , Cannavo I , Cua E , Socolovschi C , Parola P , Raoult D , 2012. Urban family cluster of spotted fever rickettsiosis linked to Rhipicephalus sanguineus infected with Rickettsia conorii subsp. caspia and Rickettsia massiliae. Ticks Tick Borne Dis 3: 389–392.
Hidalgo M , Miranda J , Heredia D , Zambrano P , Vesga JF , Lizarazo D , Mattar S , Valbuena G , 2011. Outbreak of Rocky Mountain spotted fever in Córdoba, Colombia. Mem Inst Oswaldo Cruz 106: 117–118.
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Japanese spotted fever (JSF) is a tick-borne rickettsiosis caused by Rickettsia japonica. Although the number of JSF cases has been increasing, exceeding 300 per year since 2017, clusters of cases are rare. Here, we report a cluster of seven JSF cases, the first nonfamilial cluster of the disease documented in the Japanese literature, and describe the management of the outbreak through prompt investigation and control-and-prevention measures performed collaboratively by members from the clinical, laboratory, and public health fields. All seven cases in the cluster had visited a cemetery in September or October of 2019. R. japonica was detected in whole-blood and/or skin samples from six patients and in the larvae of Haemaphysalis hystricis collected in a field survey. The evidence suggested that this cluster of cases was caused by the conjunction of two circumstances within a short period of time: an increase in the number of visitors to a cemetery during a Buddhist event and an increase in the number of infectious tick larvae in the cemetery through hatching (vertical transmission from infected females). Delays in the treatment of JSF can lead to severe manifestations. Early interventions through collaborative efforts among members from the clinical, laboratory, and public health fields are important for controlling outbreaks, raising the awareness of the public, and diagnosing and treating patients.
Disclosure: Patient data were collected from the notifiable disease-reporting form for JSF submitted by the physician to the local health center, one of the diseases subject to public health surveillance under the Infectious Diseases Control Law in Japan. Therefore, no review by an ethics committee was required.
Authors’ addresses: Ken-ichiro Kobayashi, Kenji Kubo, and Nobuhiro Komiya, Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Nobuko Utatsu, Chisa Kanbe, and Tetsuya Niu, Section of Health Crisis Management, Wakayama City Public Health Center, Wakayama, Japan, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Fumio Terasoma, Public Health Research Division, Wakayama Prefectural Research Center of Environment and Public Health, Wakayama, Japan, E-mail: email@example.com. Shuji Ando, Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan, E-mail: firstname.lastname@example.org.