Infect Chemother.  2019 Jun;51(2):196-209. 10.3947/ic.2019.51.2.196.

History of Tsutsugamushi Disease in Korea

Affiliations
  • 1Department of Internal Medicine, Seogwipo Medical Center, Jeju, Korea. mhchungid@daum.net
  • 2Department of Microbiology, Inha University School of Medicine, Incheon, Korea.

Abstract

Tsutsugamushi disease or scrub typhus in Korea was first officially reported in foreign soldiers in 1951 and in indigenous persons in 1986. However, the history is further prolonged. The book Dong Ui Bo Gam, published in 1613, described "Soo Dok" (water poisoning), which is similar to tsutsugamushi disease. Further, the term was mentioned in the book Hyang Yak Gu Geup Bang, first published in 1232-1251. During the Japanese colonial rule (1910-1945), Trombicula akamushi was identified in Suwon, Korea, in 1917. Although cases of tsutsugamushi disease in Korea with a murine typhus-like illness and OXK-positivity were reported in 1935, such atypical presentation was not recognized as tsutsugamushi disease. During the Korean War, in 1951, tsutsugamushi disease developed in two British soldiers stationed in the Imjin River, who presented typical features and positive OXK reactions. Indigenous cases have re-emerged since 1986. Thereafter, there were many studies on various aspects of tsutsugamushi disease: epidemiology, vector, small mammals, clinical features and complications, diagnosis, and treatment. Persistence of Orientia tsutsugamushi and its possible recrudescence with pneumonia were reported in 2012 and 2014, respectively.

Keyword

History; Korea; Orientia tsutsugamushi; Scrub typhus; Tsutsugamushi disease

MeSH Terms

Animals
Asian Continental Ancestry Group
Cattle
Diagnosis
Epidemiology
Gyeonggi-do
Humans
Korea*
Korean War
Mammals
Military Personnel
Orientia tsutsugamushi
Pneumonia
Recurrence
Rivers
Scrub Typhus*
Trombiculidae

Figure

  • Figure 1 Annual number of tsutsugamushi disease reported to the Korea Centers for Disease Control and Prevention.

  • Figure 2 Incidence rates of tsutsugamushi disease in Korea, by area and year. SE, Seoul; GG, Gyeonggi-do; GW, Gangwon-do; CB, Chungcheongbuk-do; CN, Chungcheongnam-do; JB, Jeollabuk-do; JN, Jeollanam-do; GB, Gyeongsangbuk-do; GN, Gyeongsangnam-do; JJ, Jeju Special self-governing Province. Cited from Lee HW, et al. Current situation of scrub typhus in South Korea from 2001-2013. Parasit Vectors 2015;8:238.


Cited by  1 articles

The Eschar Size and Early Inoculation Lesion of Tsutsugamushi Disease on Jeju Island, Korea
Young Hoon Kim, Woojin Hyun, Dong Pil Kim, Moon-Hyun Chung, Jae Hyoung Im, Ji-hyeon Baek, Jin-Soo Lee, Jae-Seung Kang
Infect Chemother. 2019;51(4):345-354.    doi: 10.3947/ic.2019.51.4.345.


Reference

1. Kim DJ. The history of medicine in Korea. Seoul: Tamgudang Co.;1966.
2. Miki S. The history of medicine and disease in Chosun. Kyoto: Shibunkaku Publishing Co.;1991.
3. Ro BH, Choi SH. Clinical and statistical observation of epidemic typhus. Korean Med J. 1947; 1:27–37.
4. Chun CH. Overview of acute infectious disease in Korea. 3rd edition. Seoul: Newest Publishing Co.;1975.
5. Hatori J. On the endemic tsutsugamushi disease of Formosa. Ann Trop Med Parasit. 1919; 13:233–258.
Article
6. Weir HH. A continued fever of Korea. China Med J. 1915; 29:307–315.
7. Kodama R. On murine typhus and epidemic typhus. Tokyo Med J. 1932; 1795–1797.
8. Goto Y. A study on the construction of street network in Heijo (Pyongyang; at present) under Japanese rule. Hist Stud Civil Eng. 1994; 14:1–14.
Article
9. Noh DS. Clinical observation of murine typhus in Pyeongyang, Chosun. Japan J Infect Dis. 1937; 11:683–710.
10. Nakamura K, Noh DS. 1935.
11. Miyajima M, Okumura T. A comparative study of akamushi and related species in Japan, Korea and Formosa. Saikingaku Zasshi. 1917; 893–908.
12. Ueno Y. Studies on tsutsugamushi and tsutsugamushi-disease of Hachijo Island. Med Entomol Zool. 1956; 7:231–253.
Article
13. Shishido A, Hikita M, Kitaka M. Studies on inapparent scrub typhus infection. III. On the relation of mild febrile diseases of unknown origin to inapparent scrub typhus infection. Nihon Densenbyo Gakkai Zasshi. 1963; 130–135.
14. Simmons JS, Whayne TF, Anderson GW, Horack HM. Global epidemiology. A geography of disease and sanitation. Philadelphia: J.B. Lippincott Co.;1944.
15. Chang WH. Tsutsugamushi disease in Korea. Seoul: Seo Heung Publishing Co.;1994.
16. Chang WH. Current status of tsutsugamushi disease in Korea. J Korean Med Sci. 1995; 10:227–238.
Article
17. United States. Navy Depart. Epidemiology of the diseases of naval importance in Korea. Washington: U. S. Govt. Print. Off;1948.
18. Munro-Faure AD, Andrew R, Missen GA, Mackay-Dick J. Scrub typhus in Korea. J R Army Med Corps. 1951; 97:227–229.
19. Department of the Army. Annual historical report, 406th medical general laboratory. Washington, DC: Office of the Surgeon General;1951. p. 13–14.
20. Department of the Army. Annual historical report, 406th medical general laboratory. Washington, DC: Office of the Surgeon General;1953. p. 22–23.
21. Ley HL, Markelz RA. Scrub typhus: occurrence in United Nations' personnel in Korea. Mil Med. 1961; 126:834–837.
Article
22. Jackson EB, Danauskas JX, Smadel JE, Fuller HS, Coale MC, Bozeman FM. Occurrence of Rickettsia tsutsugamushi in Korean rodents and chiggers. Am J Hyg. 1957; 66:309–320.
23. Chun CH, Chung HY, Lee YJ. Preliminary studies on tsutsugamushi disease in Korea (Report 1). Jong Hap Eui Hak. 1965; 10:1248–1252.
24. Jameson EW Jr, Toshioka S. Notes on some chiggers (Acarina: Thrombiculidae) from Southern Korea. Pac Sci. 1954; 8:11–22.
25. Paik SH, Lee HW. A scrub typhus and leptospirosis epidemic among Republic of Korea troops in the Republic of Vietnam, Summer 1969. Korea Univ Med J. 1974; 11:789–795.
26. Inada S, Kono Y, Hamada M, Shimamoto J, Nishida T, Hukuhara T. Tsutsugamushi disease. J Hiroshima Med Assoc. 1986; 39:163–164.
27. Yi KS, Chong Y, Kwon OH, Lee SY, Kim KY, Ujiiye A. Tsutsugamushi disease in Chinhae area confirmed by serology. J Korea Soc Microbiol. 1986; 21:113–120.
28. Lee JS, Ahn C, Kim YK, Lee M. Thirteen cases of rickettsial infection including nine cases of tsutsugamushi disease first confirmed in Korea. J Korean Med Assoc. 1986; 29:430–438.
29. Chang WH, Kang JS. Isolation of Rickettsia tsutsugamushi from Korean patients. J Korean Med Assoc. 1987; 30:999–1008.
30. Tamura A, Ohashi N, Urakami H, Miyamura S. Classification of Rickettsia tsutsugamushi in a new genus, Orientia gen. nov., as Orientia tsutsugamushi comb. nov. Int J Syst Bacteriol. 1995; 45:589–591.
Article
31. Chang WH, Kang JS, Lee WK, Choi MS, Lee JH. Serological classification by monoclonal antibodies of Rickettsia tsutsugamushi isolated in Korea. J Clin Microbiol. 1990; 28:685–688.
Article
32. Seong SY, Park SG, Kim HR, Han TH, Kang JS, Choi MS, Kim IS, Chang WH. Isolation of a new Orientia tsutsugamushi serotype. Microbiol Immunol. 1997; 41:437–443.
33. Park SW, Lee CK, Kwak YG, Moon C, Kim BN, Kim ES, Kang JM, Lee CS. Antigenic drift of Orientia tsutsugamushi in South Korea as identified by the sequence analysis of a 56-kDa protein-encoding gene. Am J Trop Med Hyg. 2010; 83:930–935.
Article
34. Cho NH, Kim HR, Lee JH, Kim SY, Kim J, Cha S, Kim SY, Darby AC, Fuxelius HH, Yin J, Kim JH, Kim J, Lee SJ, Koh YS, Jang WJ, Park KH, Andersson SG, Choi MS, Kim IS. The Orientia tsutsugamushi genome reveals massive proliferation of conjugative type IV secretion system and host-cell interaction genes. Proc Natl Acad Sci U S A. 2007; 104:7981–7986.
Article
35. Lee IY, Kim HC, Lee YS, Seo JH, Lim JW, Yong TS, Klein TA, Lee WJ. Geographical distribution and relative abundance of vectors of scrub typhus in the Republic of Korea. Korean J Parasitol. 2009; 47:381–386.
Article
36. Ree HI, Cho MK, Lee IY, Jeon SH. Comparative epidemiological studies on vector/reservoir animals of tsutsugamushi disease between high and low endemic areas in Korea. Korean J Parasitol. 1995; 33:27–36.
Article
37. Lee HW, Cho PY, Moon SU, Na BK, Kang YJ, Sohn Y, Youn SK, Hong Y, Kim TS. Current situation of scrub typhus in South Korea from 2001-2013. Parasit Vectors. 2015; 8:238.
Article
38. Jang KM, Kang MH, Yang YS, Hwang HG, Lee KP, Lee JS, Tomiyama T, Chu YK, Lee HW. The twenty cases of serologically confirmed tsutsugamushi disease. J Korean Med Assoc. 1987; 30:638–646.
39. Bourgeois AL, Olson JG, Fang RC, Huang J, Wang CL, Chow L, Bechthold D, Dennis DT, Coolbaugh JC, Weiss E. Humoral and cellular responses in scrub typhus patients reflecting primary infection and reinfection with Rickettsia tsutsugamushi. Am J Trop Med Hyg. 1982; 31:532–540.
Article
40. Brown GW, Robinson DM, Huxsoll DL, Ng TS, Lim KJ. Scrub typhus: a common cause of illness in indigenous populations. Trans R Soc Trop Med Hyg. 1976; 70:444–448.
Article
41. Fox JP. The long persistence of Rickettsia orientalis in the blood and tissues of infected animals. J Immunol. 1948; 59:109–114.
42. Hayashi H, Watanabe M. On the possibility of appearance of rickettsiae in the circulating blood after the recovery of rickettsiosis. Kitasato Arch Exp Med. 1948; 21:135–141.
43. Smadel JE, Ley HL Jr, Diercks RH, Cameron JA. Persistence of Rickettsia tsutsugamushi in tissues of patients recovered from scrub typhus. Am J Hyg. 1952; 56:294–302.
Article
44. Chung MH, Lee JS, Baek JH, Kim M, Kang JS. Persistence of Orientia tsutsugamushi in humans. J Korean Med Sci. 2012; 27:231–235.
45. Im JH, Baek JH, Lee JS, Chung MH, Lee SM, Kang JS. A case series of possibly recrudescent Orientia tsutsugamushi infection presenting as pneumonia. Jpn J Infect Dis. 2014; 67:122–126.
Article
46. Park SD, Chung MH, Lee HM, Kim MK, Kang JS. A case of scrub typhus in summer presenting as atypical pneumonia. Infect Chemother. 2008; 40:241–245.
Article
47. Kim IS, Seong SY, Woo SG, Choi MS, Kang JS, Chang WH. Rapid diagnosis of scrub typhus by a passive hemagglutination assay using recombinant 56-kilodalton polypeptides. J Clin Microbiol. 1993; 31:2057–2060.
Article
48. Kim YS, Yun HJ, Shim SK, Koo SH, Kim SY, Kim S. A comparative trial of a single dose of azithromycin versus doxycycline for the treatment of mild scrub typhus. Clin Infect Dis. 2004; 39:1329–1335.
Article
49. Kim YS, Lee HJ, Chang M, Son SK, Rhee YE, Shim SK. Scrub typhus during pregnancy and its treatment: a case series and review of the literature. Am J Trop Med Hyg. 2006; 75:955–959.
Article
50. Lee SM, Kwon HY, Im JH, Baek JH, Hwang SS, Kang JS, Chung MH, Lee JS. In vitro activity of tigecycline against Orientia tsutsugamushi . Yonsei Med J. 2016; 57:1034–1037.
Article
51. Brown GW, Saunders JP, Singh S, Huxsoll DL, Shirai A. Single dose doxycycline therapy for scrub typhus. Trans R Soc Trop Med Hyg. 1978; 72:412–416.
Article
52. Song JH, Lee C, Chang WH, Choi SW, Choi JE, Kim YS, Cho SR, Ryu J, Pai CH. Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial. Clin Infect Dis. 1995; 21:506–510.
Article
53. Watt G, Chouriyagune C, Ruangweerayud R, Watcharapichat P, Phulsuksombati D, Jongsakul K, Teja-Isavadharm P, Bhodhidatta D, Corcoran KD, Dasch GA, Strickman D. Scrub typhus infections poorly responsive to antibiotics in northern Thailand. Lancet. 1996; 348:86–89.
Article
54. Kim ES, Kim MK, Lee HM, Kil SH, Chung MH, Lee JS, Kang JS. Doxycycline resistance in Orientia tsutsugamushi isolated from Korean patients. Infect Chemother. 2008; 40:259–265.
Article
55. Chanta C, Chanta S. Clinical study of 20 children with scrub typhus at Chiang Rai Regional Hospital. J Med Assoc Thai. 2005; 88:1867–1872.
56. Harris PNA, Oltvolgyi C, Islam A, Hussain-Yusuf H, Loewenthal MR, Vincent G, Stenos J, Graves S. An outbreak of scrub typhus in military personnel despite protocols for antibiotic prophylaxis: doxycycline resistance excluded by a quantitative PCR-based susceptibility assay. Microbes Infect. 2016; 18:406–411.
Article
57. Phuklia W, Panyanivong P, Sengdetka D, Sonthayanon P, Newton PN, Paris DH, Day NPJ, Dittrich S. Novel high-throughput screening method using quantitative PCR to determine the antimicrobial susceptibility of Orientia tsutsugamushi clinical isolates. J Antimicrob Chemother. 2019; 74:74–81.
58. Kim MS, Baek JH, Lee JS, Chung MH, Lee SM, Kang JS. High in vitro infectivity of a doxycycline-insensitive strain of Orientia tsutsugamushi . Infect Chemother. 2013; 45:431–434.
Article
59. Kawamura R, Kasahara S, Toyama T, Nishinarita F, Tsubaki S. On the prevention of tsutsugamushi. Results of preventive inoculations for people in the endemic region, and laboratory tests with the Pescadores strain. Kitasato Arch Exp Med. 1939; 16:93–109.
60. Valbuena G, Walker DH. Approaches to vaccines against Orientia tsutsugamushi. Front Cell Infect Microbiol. 2013; 2:170.
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