Kong WS, Shin EH, Lee HI, Hwang TS, Kim HH, Lee NY, Sung JH, Lee SG, Yoon GH, 2007. Time-spatial distribution of scrub typhus and its environmental ecology. J Korean Geogr Soc 42: 863–878.
Chang WH, 1995. Current status of tsutsugamushi disease in Korea. J Korean Med Sci 10: 227–238.
Gunduz A, Turkmen S, Turedi S, Nuhoglu I, Topbas M, 2008. Tick attachment sites. Wilderness Environ Med 19: 4–6.
Derne B, Weinstein P, Musso D, Lau C, 2015. Distribution of rickettsioses in Oceania: past patterns and implications for the future. Acta Trop 143: 121–133.
Kim KH, Yi J, Kim G, Choi SJ, Jun KI, Kim NH, Choe PG, Kim NJ, Lee JK, Oh MD, 2013. Severe fever with thrombocytopenia syndrome, South Korea, 2012. Emerg Infect Dis 19: 1892–1894.
Korea Centers for Disease Control and Prevention (CDC), 2005–2014. Infectious Disease Statistics System. Available at: http://is.cdc.go.kr/dstat/jsp/stat/stat0001.jsp. Accessed January 11, 2016.
Kim KH, Yi J, Oh WS, Kim NH, Choi SJ, Choe PG, Kim NJ, Lee JK, Oh MD, 2014. Human granulocytic anaplasmosis, South Korea, 2013. Emerg Infect Dis 20: 1708–1711.
Kim DM, Won KJ, Park CY, Yu KD, Kim HS, Yang TY, Lee JH, Kim HK, Song HJ, Lee SH, Shin H, 2007. Distribution of eschars on the body of scrub typhus patients: a prospective study. Am J Trop Med Hyg 76: 806–809.
Kawamura A, Tanaka H, Tamura A, 1995. Tsutsugamushi Disease. Tokyo, Japan: University of Tokyo Press, 275–307.
Roh JY, Song BG, Park WI, Shin EH, Park C, Park MY, Chang KS, Lee WG, Lee HI, Shin EH, 2014. Coincidence between geographical distribution of Leptotrombidium scutellare and scrub typhus incidence in South Korea. PLoS One 9: e113193.
Park JH, Kim SJ, Youn SK, Park K, Gwack J, 2014. Epidemiology of scrub typhus and the eschars patterns in South Korea from 2008 to 2012. Jpn J Infect Dis 67: 458–463.
Choi MS, Chang WJ, Park SK, Huh MS, Kim HR, Han TH, Kim IS, 1997. Seroepidemiological survey of scrub typhus in Korea, 1995–1996. J Korean Soc Microbiol 32: 219–226.
Yi KS, Chong Y, Chun CH, Suto T, 1987. Importance of clinical findings in the early diagnosis of tsutsugamushi disease. J Korean Med Assoc 30: 1009–1016.
Koss T, Carter EL, Grossman ME, Silvers DN, Rabinowitz AD, Singleton J Jr, Zaki SR, Paddock CD, 2003. Increased detection of rickettsial pox in a New York City hospital following the anthrax outbreak of 2001: use of immunohistochemistry for the rapid confirmation of cases in an era of bioterrorism. Arch Dermatol 139: 1545–1552.
Kim DM, Park CJ, Lim SC, Park KH, Jang WJ, Lee SH, 2008. Diagnosis of scrub typhus by immune histochemical staining of Orientia tsutsugamushi in cutaneous lesions. Am J Clin Pathol 130: 543–551.
Wie SH, Chang UI, Kim HW, Hur JA, Kim SI, Kim YR, Kang MW, 2008. Clinical features of 212 cases of scrub typhus in southern region of Gyeonggi-Do and the significance of initial simple chest X-ray. Infect Chemother 40: 40–45.
Kar S, Dervis E, Akın A, Ergonul O, Gargili A, 2013. Preferences of different tick species for human hosts in Turkey. Exp Appl Acarol 61: 349–355.
Valenzuela JG, 2004. Exploring tick saliva: from biochemistry to ‘sialomes’ and functional genomics. Parasitology 129: S83–S94.
Park SW, Song BG, Shin EH, Yun SM, Han MG, Park MY, Park C, Ryou J, 2014. Prevalence of severe fever with thrombocytopenia syndrome virus in Haemaphysalis longicornis ticks in South Korea. Ticks Tick Borne Dis 5: 975–977.
Yun SM, Lee WG, Ryou J, Yang SC, Park SW, Roh JY, Lee YJ, Park C, Han MG, 2014. Severe fever with thrombocytopenia syndrome virus in ticks collected from humans, South Korea, 2013. Emerg Infect Dis 20: 1358–1361.
Korea National Institute of Health (NIH), 1996. Guidelines for Laboratory Diagnosis of Statutory Communicable Diseases. Lee JS, Kim OJ, 328–336.
Kim DM, 2009. Clinical features and diagnosis of scrub typhus. Infect Chemother 41: 315–322.
Robinson DM, Brown G, Gan E, Huxsoll DL, 1976. Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 25: 900–905.
Lee YM, Kim DM, Lee SH, Jang MS, Neupane GP, 2011. Phylogenetic analysis of the 56 kDa protein genes of Orientia tsutsugamushi in south west area of Korea. Am J Trop Med Hyg 84: 250–254.
Kim DM, Yun NR, Yang TY, Lee JH, Yang JT, Shim SK, Choi EN, Park MY, Lee SH, 2006. Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study. Am J Trop Med Hyg 75: 542–545.
Karaer Z, Guven E, Nalbantoglu S, Kar S, Orkun O, Ekdal K, Kocak A, Akcay A, 2011. Ticks on humans in Ankara, Turkey. Exp Appl Acarol 54: 85–91.
Ree HI, Kim TE, Lee IY, Jeon SH, Hwang UW, Chang WH, 2001. Determination and geographical distribution of Orientia tsutsugamushi serotypes in Korea by nested polymerase chain reaction. Am J Trop Med Hyg 65: 528–534.
Park CH, Park CW, Sim SS, Jung M, Lee YM, Ryeu HS, Kim JW, 1993. A clinical study of 218 cases of tsutsugamushi disease. Korean J Med 45: 497–506.
Kweon SS, Choi JS, Lim HS, Kim JR, Kim KY, Ryu SY, Yoo HS, Park O, 2009. Rapid increase of scrub typhus, South Korea, 2001–2006. Infect Dis 15: 1127–1129.
Chae KS, Gang H, Lee DW, Byun DG, Cho BK, Park CW, Suh JK, Lee KB, Kim HJ, 2000. Tick bites. Korean J Dermatol 38: 111–116.
Chang WH, Cha CY, Choi MS, Lee WK, Choi IH, Kang JS, Park JK, Lee JH, Park JW, Kim SY, Song KY, Ryu Y, Kim YS, Young TY, Song IS, Yoon KH, 1989. Seroepidemiology, serotype of the causative agent, and clinical features of tsutsugamushi disease in Chungcheung area. Infect Chemother 21: 67–82.
Angeloni VL, Keller RA, Walker DH, 1997. Rickettsial pox-like illness in a traveler. Mil Med 162: 636–639.
Rees DJ, Dioli M, Kirkendalla LR, 2003. Molecules and morphology: evidence for cryptic hybridization in African Hyalomma (Acari: Ixodidae). Mol Phylogenet Evol 27: 131–142.
Elston DM, 2010. Tick bites and skin rashes. Curr Opin Infect Dis 23: 132–138.
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Identification of mite and tick bite sites provides important clinical information. The predominant mite species in Korea associated with scrub typhus are Leptotrombidium pallidum and Leptotrombidium scutellare. The most abundant tick species is Haemaphysalis longicornis. To date, there has been no comparative study on preferred bite sites between mites and ticks in humans. This study included a review of medical records and a field study. For mite bite sites, eschars were checked on 506 patients with scrub typhus, confirmed by indirect immunofluorescence assay or nested polymerase chain reaction on the 56-kDa type-specific antigen gene of Orientia tsutsugamushi. Tick bite sites were identified and marked on a diagram for 91 patients who experienced tick bites within the previous year through a field epidemiological investigation. The mite and tick bite sites in Koreans were compared. The most frequently observed mite bite sites were the anterior chest, including the axillae (29.1%) and the abdominal region, including the inguinal area (26.1%). Tick bite sites were most frequent on the lower extremities (33.0%), followed by the abdominal region, including the inguinal area (26.4%), and upper extremities (26.4%). The distribution was significantly different between mite and tick bite sites (P < 0.001). There was a statistically significant difference in the mite bite (P = 0.001), but not tick bite sites (P = 0.985), between men and women. This is the first report on the differences between tick and mite bite sites, and may help clinicians reach a rapid diagnosis of mite- or tick-borne infection.
Financial support: This study was supported by research funds from Chosun University, 2013.
Authors' addresses: Mi-Sun Jang, Dong-Min Kim, and Na Ra Yoon, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea, E-mails: sangkm3507@nate.com, drongkim@chosun.ac.kr, and shine@chosun.ac.kr. Choon-Mee Kim, Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea, E-mail: choonmee@chosun.ac.kr. Mi Ah Han, Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, South Korea, E-mail: mahan@Chosun.ac.kr. Hyun-Kuk Kim, Department of Pulmonary and Critical Care Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea, E-mail: khkmd1205@hanmail.net. Won Sup Oh, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea, E-mail: onesbi@gmail.com. Hee-Jung Yoon, Department of Infectious Diseases, Seoul Metropolitan Government Seobuk hospital, Seoul, Korea, E-mail: yhj822@medimail.co.kr. Seong-Heon Wie, Department of Internal Medicine, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea, Seoul, South Korea, E-mail: wiesh@chol.com. Jian Hur, Department of Internal Medicine, Yeungnam University, College of Medicine, Daegu, South Korea, E-mail: sarang7529@naver.com.
Kong WS, Shin EH, Lee HI, Hwang TS, Kim HH, Lee NY, Sung JH, Lee SG, Yoon GH, 2007. Time-spatial distribution of scrub typhus and its environmental ecology. J Korean Geogr Soc 42: 863–878.
Chang WH, 1995. Current status of tsutsugamushi disease in Korea. J Korean Med Sci 10: 227–238.
Gunduz A, Turkmen S, Turedi S, Nuhoglu I, Topbas M, 2008. Tick attachment sites. Wilderness Environ Med 19: 4–6.
Derne B, Weinstein P, Musso D, Lau C, 2015. Distribution of rickettsioses in Oceania: past patterns and implications for the future. Acta Trop 143: 121–133.
Kim KH, Yi J, Kim G, Choi SJ, Jun KI, Kim NH, Choe PG, Kim NJ, Lee JK, Oh MD, 2013. Severe fever with thrombocytopenia syndrome, South Korea, 2012. Emerg Infect Dis 19: 1892–1894.
Korea Centers for Disease Control and Prevention (CDC), 2005–2014. Infectious Disease Statistics System. Available at: http://is.cdc.go.kr/dstat/jsp/stat/stat0001.jsp. Accessed January 11, 2016.
Kim KH, Yi J, Oh WS, Kim NH, Choi SJ, Choe PG, Kim NJ, Lee JK, Oh MD, 2014. Human granulocytic anaplasmosis, South Korea, 2013. Emerg Infect Dis 20: 1708–1711.
Kim DM, Won KJ, Park CY, Yu KD, Kim HS, Yang TY, Lee JH, Kim HK, Song HJ, Lee SH, Shin H, 2007. Distribution of eschars on the body of scrub typhus patients: a prospective study. Am J Trop Med Hyg 76: 806–809.
Kawamura A, Tanaka H, Tamura A, 1995. Tsutsugamushi Disease. Tokyo, Japan: University of Tokyo Press, 275–307.
Roh JY, Song BG, Park WI, Shin EH, Park C, Park MY, Chang KS, Lee WG, Lee HI, Shin EH, 2014. Coincidence between geographical distribution of Leptotrombidium scutellare and scrub typhus incidence in South Korea. PLoS One 9: e113193.
Park JH, Kim SJ, Youn SK, Park K, Gwack J, 2014. Epidemiology of scrub typhus and the eschars patterns in South Korea from 2008 to 2012. Jpn J Infect Dis 67: 458–463.
Choi MS, Chang WJ, Park SK, Huh MS, Kim HR, Han TH, Kim IS, 1997. Seroepidemiological survey of scrub typhus in Korea, 1995–1996. J Korean Soc Microbiol 32: 219–226.
Yi KS, Chong Y, Chun CH, Suto T, 1987. Importance of clinical findings in the early diagnosis of tsutsugamushi disease. J Korean Med Assoc 30: 1009–1016.
Koss T, Carter EL, Grossman ME, Silvers DN, Rabinowitz AD, Singleton J Jr, Zaki SR, Paddock CD, 2003. Increased detection of rickettsial pox in a New York City hospital following the anthrax outbreak of 2001: use of immunohistochemistry for the rapid confirmation of cases in an era of bioterrorism. Arch Dermatol 139: 1545–1552.
Kim DM, Park CJ, Lim SC, Park KH, Jang WJ, Lee SH, 2008. Diagnosis of scrub typhus by immune histochemical staining of Orientia tsutsugamushi in cutaneous lesions. Am J Clin Pathol 130: 543–551.
Wie SH, Chang UI, Kim HW, Hur JA, Kim SI, Kim YR, Kang MW, 2008. Clinical features of 212 cases of scrub typhus in southern region of Gyeonggi-Do and the significance of initial simple chest X-ray. Infect Chemother 40: 40–45.
Kar S, Dervis E, Akın A, Ergonul O, Gargili A, 2013. Preferences of different tick species for human hosts in Turkey. Exp Appl Acarol 61: 349–355.
Valenzuela JG, 2004. Exploring tick saliva: from biochemistry to ‘sialomes’ and functional genomics. Parasitology 129: S83–S94.
Park SW, Song BG, Shin EH, Yun SM, Han MG, Park MY, Park C, Ryou J, 2014. Prevalence of severe fever with thrombocytopenia syndrome virus in Haemaphysalis longicornis ticks in South Korea. Ticks Tick Borne Dis 5: 975–977.
Yun SM, Lee WG, Ryou J, Yang SC, Park SW, Roh JY, Lee YJ, Park C, Han MG, 2014. Severe fever with thrombocytopenia syndrome virus in ticks collected from humans, South Korea, 2013. Emerg Infect Dis 20: 1358–1361.
Korea National Institute of Health (NIH), 1996. Guidelines for Laboratory Diagnosis of Statutory Communicable Diseases. Lee JS, Kim OJ, 328–336.
Kim DM, 2009. Clinical features and diagnosis of scrub typhus. Infect Chemother 41: 315–322.
Robinson DM, Brown G, Gan E, Huxsoll DL, 1976. Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 25: 900–905.
Lee YM, Kim DM, Lee SH, Jang MS, Neupane GP, 2011. Phylogenetic analysis of the 56 kDa protein genes of Orientia tsutsugamushi in south west area of Korea. Am J Trop Med Hyg 84: 250–254.
Kim DM, Yun NR, Yang TY, Lee JH, Yang JT, Shim SK, Choi EN, Park MY, Lee SH, 2006. Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study. Am J Trop Med Hyg 75: 542–545.
Karaer Z, Guven E, Nalbantoglu S, Kar S, Orkun O, Ekdal K, Kocak A, Akcay A, 2011. Ticks on humans in Ankara, Turkey. Exp Appl Acarol 54: 85–91.
Ree HI, Kim TE, Lee IY, Jeon SH, Hwang UW, Chang WH, 2001. Determination and geographical distribution of Orientia tsutsugamushi serotypes in Korea by nested polymerase chain reaction. Am J Trop Med Hyg 65: 528–534.
Park CH, Park CW, Sim SS, Jung M, Lee YM, Ryeu HS, Kim JW, 1993. A clinical study of 218 cases of tsutsugamushi disease. Korean J Med 45: 497–506.
Kweon SS, Choi JS, Lim HS, Kim JR, Kim KY, Ryu SY, Yoo HS, Park O, 2009. Rapid increase of scrub typhus, South Korea, 2001–2006. Infect Dis 15: 1127–1129.
Chae KS, Gang H, Lee DW, Byun DG, Cho BK, Park CW, Suh JK, Lee KB, Kim HJ, 2000. Tick bites. Korean J Dermatol 38: 111–116.
Chang WH, Cha CY, Choi MS, Lee WK, Choi IH, Kang JS, Park JK, Lee JH, Park JW, Kim SY, Song KY, Ryu Y, Kim YS, Young TY, Song IS, Yoon KH, 1989. Seroepidemiology, serotype of the causative agent, and clinical features of tsutsugamushi disease in Chungcheung area. Infect Chemother 21: 67–82.
Angeloni VL, Keller RA, Walker DH, 1997. Rickettsial pox-like illness in a traveler. Mil Med 162: 636–639.
Rees DJ, Dioli M, Kirkendalla LR, 2003. Molecules and morphology: evidence for cryptic hybridization in African Hyalomma (Acari: Ixodidae). Mol Phylogenet Evol 27: 131–142.
Elston DM, 2010. Tick bites and skin rashes. Curr Opin Infect Dis 23: 132–138.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 1859 | 1677 | 39 |
Full Text Views | 628 | 12 | 0 |
PDF Downloads | 124 | 14 | 0 |