J Korean Med Sci.  2023 May;38(20):e156. 10.3346/jkms.2023.38.e156.

Coinfection of Severe Fever With Thrombocytopenia Syndrome Virus and Coxiella burnetii in Developmental Stage of Hard Ticks in Subtropical Region of Korea

• Yoo JR
• Heo ST
• Kim M
• Kim M
• Kang MJ
• Kim ET
• Kang SY
• Lee KH

• KMID: 2542595
• DOI: http://doi.org/10.3346/jkms.2023.38.e156

Abstract

Background
Severe fever with thrombocytopenia syndrome virus (SFTSV) is transmitted through tick bites. Ticks are potential vectors for the bacterium Coxiella burnetii that causes Query fever. Here, we analyzed SFTSV and C. burnetii co-infection rates in ticks in rural areas of Jeju Island, South Korea.
Methods
Free ticks were collected from the natural environment of the island between 2016 and 2019, and SFTSV RNA was extracted. Additionally, ribosomal RNA gene sequencing was used to identify Coxiella species.
Results
Haemaphysalis longicornis was the most common tick species followed by H. flava. Tick number gradually increased from April, peaked in August, and was lowest in March. Of all the collected ticks, 82.6% (2,851/3,458) were nymphs, 17.9% (639/3,458) adults, and 0.1% (4/3,458) larvae. SFTSV-infected ticks comprised 12.6% of all ticks; their numbers were the lowest in November–December, increased from January, and were mostly identified in the adult stage during June–August. C. burnetii infections were detected in 4.4% of the SFTSVinfected H. longicornis ticks. C. burnetii co-infection was mainly observed in the nymph stage of H. longicornis, with the highest infection rate in January, followed by December and November.
Conclusion
Our findings suggest that Jeju Island has a high SFTSV and potential C. burnetii infection in ticks. This study provides important insights regarding SFTS and Q fever risk to humans in South Korea.

Keyword

Severe Fever With Thrombocytopenia Syndrome Virus; Coxiella burnetii; Q Fever; Ticks; Hemaphysalis longicornis; Jeju-do; South Korea

Figure

• 

  Fig. 1 Monthly trend according to the tick developmental stage and monthly number of patients with SFTSV and Coxiella burnetii in Jeju Island, South Korea.SFTSV = severe fever with thrombocytopenia syndrome virus.aNumber of patients with SFTSV between 2013 and 2022; bNumber of patients with C. burnetii between 2006 and 2022.

• 

  Fig. 2 Monthly IR of SFTSV and Coxiella burnetii in Jeju Island. The blue line indicates SFTSV IR, and the red dot line indicates C. burnetii IR.aC. burnetii infection in tick was only identified in the female adult stage.SFTSV = severe fever with thrombocytopenia syndrome virus, Jan = January, Feb = February, Mar = March, Apr = April, Aug = August, Sep = September, Oct = October, Nov = November, Dec = December, M = male, F = female, IR = infection rate.

• 

  Fig. 3 Phylogenetic trees of SFTSV and Coxiella burnetii in Jeju Island, South Korea. (A) Phylogenetic tree based on partial SFTSV S segment sequences. The partial S sequences were obtained from ticks collected between June 2016 and January 2019. The partial S sequence data for SFTSV identified in China, South Korea, and Japan were obtained from NCBI/BLAST. (B) Phylogenetic tree based on clone XCP-1 16S rRNA gene sequencing of C. burnetii.SFTSV = severe fever with thrombocytopenia syndrome virus.

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