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Orientia tsutsugamushi, an obligate intracellular Gram-negative bacterium, is the causative agent of scrub typhus, a vector-borne disease transmitted by infected chiggers (trombiculid mite larvae). In 2002, an outbreak of scrub typhus occurred among Royal Thai Army troops during the annual field training at a military base in Bothong district, Chonburi province, central Thailand. This report describes the outbreak investigation including its transmission cycle. Results showed that 33.9% of 174 trained troops had scrub typhus-like signs and symptoms and 9.8% of those were positive for O. tsutsugamushi-specific antibodies by indirect fluorescence antibody assay. One hundred thirty-five rodents were captured from this training area, 43% of them had antibodies against O. tsutsugamushi. Six new O. tsutsugamushi isolates were obtained from captured rodent tissues and successfully established in cell culture. Phylogenetic studies showed that these six isolates were either unique or related to a native genotype of previously described isolates from Thailand.
Financial support: This work was supported by Thanphuying Viraya Chavakul Foundation for Medical Armed Forces Research Grant (2008), the Department of Biology, Faculty of Science and the Graduate school, Chiang Mai University Thailand, the Armed Forces Research Institute of Medical Science (AFRIMS) Royal Thai Army, Bangkok Thailand, and GEIS/AFHSC work unit number 847705.82000.25GB.A0074 for the financial support of this project.
Authors' addresses: Wuttikon Rodkvamtook, Toon Ruang-areerate, and Jariyanart Gaywee, Department of Epidemiology, Research Division Armed Forces Research Institute of Medical Science (AFRIMS), Royal Thai Army, Ratchathawee, Bangkok, Thailand, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Allen L. Richards, Naval Medical Research Center, Viral and Rickettsial Diseases Department, Silver Spring, MD, E-mail: Allen.Richards@med.navy.mil. Pimmada Jeamwattanalert, Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Ratchathawee, Bangkok, Thailand, E-mail: email@example.com. Dharadhida Bodhidatta, Research Division, Armed Forces Research Institute of Medical Sciences (AFRIMS), Royal Thai Army, Ratchathawee, Bangkok, Thailand, E-mail: firstname.lastname@example.org. Noppadon Sangjun, Department of Laboratory Animal, Analysis Division, Armed Forces Research Institute of Medical Sciences (AFRIMS), Royal Thai Army, Ratchathawee, Bangkok, Thailand, E-mail: email@example.com. Anchana Prasartvit, Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand, E-mail: A_Pasartvit@yahoo.com. Araya Jatisatienr and Chaiwat Jatisatienr, Department of Biology, Faculty of Science, Chiang Mai University, Muang District, Chiang Mai, Thailand, E-mails: Arayarj@yahoo.com and Jchaiwat@chiangmai.ac.th.