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Molecular epidemiology of scrub typhus in Taiwan during 2006–2016
Authors:Hsiang-Fei Chen  Shih-Huan Peng  Kun-Hsien Tsai  Cheng-Fen Yang  Mei-Chun Chang  Yeou-Lin Hsueh  Chien-Ling Su  Ruo-Yu Wang  Pei-Yun Shu  Su-Lin Yang
Institution:1. Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taiwan, Republic of China;2. Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Republic of China;3. Department of Public Health, College of Public Health, National Taiwan University, Taipei, Republic of China; Seoul National University College of Medicine, REPUBLIC OF KOREA
Abstract:Scrub typhus is the most common endemic vector-borne disease in Taiwan. We identified a total of 4,857 laboratory-confirmed cases during 2006–2016 with hyperendemic foci on offshore islands, including Penghu (778 cases, 16.0%) and Kinmen (716 cases, 14.7%), and eastern Taiwan, including Taitung (628 cases, 12.9%) and Hualien (508 cases, 10.5%). Scrub typhus cases occur year-round throughout Taiwan, with a summer peak in June and July. A total of 545 O. tsutsugamushi isolates were successfully obtained from patients infected in diverse geographic areas, including Taiwan and three offshore islands, and the complete open reading frame of the 56 kDa type-specific antigen gene (tsa56) sequence of these isolates was examined. High phylogenetic diversity was found in these isolates, which could be grouped into 36 distinct sequence types. Most isolates belonged to the Karp (49.9%; 272/545), followed by the TW-22 (17.8%; 97/454) and Kawasaki (14.7%; 80/545) genotypes. In conclusion, our data indicate the widespread presence of tsa56 genotypes closely related to Thailand and Korean strains and the presence of the unique endemic strains TW-12, TW-22, TW-29, and TW-36 in Taiwan.
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