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Molecular Epidemiology of an Orientia tsutsugamushi Gene Encoding a 56-kDa Type-Specific Antigen in Chiggers, Small Mammals, and Patients from the Southwest Region of Korea

Jung Wook ParkDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Sun Hee KimDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Duck Woong ParkDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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So Hyang JungDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Hye Jung ParkDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Mi Hee SeoDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Hyeon Je SongClinical Pathology, Gwangju Health University, Gwangju, Korea;

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Jung Yoon LeeClinical Pathology, Gwangju Health University, Gwangju, Korea;

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Dong Min KimDepartments of Internal Medicine, School of Medicine, Chosun University, Gwangju, Korea;

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Choon-Mee KimPremedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea;

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Byong Chul GillDivision of Zoonoses, Korea Centers for Disease Control and Prevention, Cheongju, Korea

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Hang Jin JeongDivision of Zoonoses, Korea Centers for Disease Control and Prevention, Cheongju, Korea

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Jeong Min LeeDivision of Zoonoses, Korea Centers for Disease Control and Prevention, Cheongju, Korea

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Dong Ryong HaDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Eun Sun KimDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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Jae Keun ChungDivision of Infectious disease investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea;

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A phylogenetic analysis of Orientia tsutsugamushi was performed to elucidate its antigenic diversity in chiggers, small mammals, and patients. Between September 2014 and December 2016, a total of 3,816 chiggers were identified within nine species of four genera in the southwest region of Korea: Leptotrombidium scutellare (49.9%; 1,907/3,816), Leptotrombidium orientale (21.1%; 804/3,816), Leptotrombidium pallidum (12.4%; 474/3,816), Euchoengastia koreaensis (7.2%; 273/3,816), Leptotrombidium palpale (6.7%; 256/3,816), Neotrombicular gardellai (1.3%; 50/3,816), Leptotrombidium zetum (0.8%; 32/3,816), Walchia fragilis (0.5%; 18/3,816), and Neotrombicular japonica (> 0.1%; 2/3,816). Twelve chiggers (11 L. scutellare and one L. palpale) tested positive for O. tsutsugamushi by polymerase chain reaction and, except for 1 chigger (KY266830), were part of the Boryong strain cluster. Of the 413 small mammals that were analyzed for O. tsutsugamushi, Apodemus agrarius was the most common rodent species (89.5%; 370/413), followed by Crocidura lasiura (6.8%; 28/413) and Myodes regulus (3.6%; 15/413). The sequence identity of an O. tsutsugamushi sample obtained from the A. agrarius sample population belonged to the Saitama strain cluster. Furthermore, a phylogenetic analysis in 125 patients revealed four clusters (Boryong cluster: 82.4% [103/125], Karp: 13.6% [17/125], Kawasaki: 3.2% [4/125], and Saitama: 0.8% [1/125]). This study clarified the phylogenetic relationship for O. tsutsugamushi in chiggers, small mammals, and patients. The Boryong strain was the most common strain in chiggers and patients. In addition, various strains were identified, except for the Boryong strain, in the southwest region of Korea. Overall, the data presented here will be helpful for the establishment of prevention strategies for scrub typhus.

Author Notes

Address correspondence to Jae Keun Chung, Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju 61986, Korea. E-mail: jkchung@korea.kr

Authors’ addresses: Jung Wook Park, Sun Hee Kim, Duck Woong Park, So Hyang Jung, Hye Jung Park, Mi Hee Seo, Dong Ryong Ha, Eun Sun Kim, and Jae Keun Chung, Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Korea, E-mails: jwpvet@korea.kr, sunny1989@korea.kr, vetpo2005@korea.kr, mist324@korea.kr, chj0103@korea.kr, mihee0105@korea.kr, dongryongha@korea.kr, keunsun@korea.kr, and jkchung@korea.kr. Hyeon Je Song and Jung Yoon Lee, Clinical Pathology, Gwangju Health University, Gwangju, Korea, E-mails: songha1@ghc.ac.kr and kumho_ljr@hanmail.net. Dong Min Kim, Departments of Internal Medicine, School of Medicine, Chosun University, Gwangju, Korea, E-mail: drongkim@hanmail.net. Choon-Mee Kim, Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea, E-mail: choonmee@hanmail.net. Byong Chul Gill, Hang Jin Jeong, and Jeong Min Lee, Division of Zoonoses, Korea Centers for Disease Control and Prevention, Cheongju, Korea, E-mails: gilri@korea.kr, jhjin9035@korea.kr, and jeongminlee@korea.kr.

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