Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: A lack of consensus leads to a lot of confusion

Clinical Infectious Diseases

Volumn 44, Issue 3, 2007, Pages 391-401

  Blacksell, Stuart D ^a,b   Bryant, Naomi J ^c   Paris, Daniel H ^a   Doust, Jenny A ^d   Sakoda, Yoshihiro ^e   Day, Nicholas P J ^a,b  

^a MAHIDOL UNIVERSITY   (Thailand)

^b UNIVERSITY OF OXFORD   (United Kingdom)

^c LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE   (United Kingdom)

^d UNIVERSITY OF QUEENSLAND   (Australia)

^e HOKKAIDO UNIVERSITY   (Japan)

Author keywords

[No Author keywords available]

Indexed keywords

DIAGNOSTIC ACCURACY; DISEASE SEVERITY; EARLY DIAGNOSIS; EVIDENCE BASED MEDICINE; HUMAN; IMMUNOFLUORESCENCE TEST; ORIENTIA TSUTSUGAMUSHI; PRIORITY JOURNAL; REVIEW; SCRUB TYPHUS; SERODIAGNOSIS; SEROPREVALENCE; SYSTEMATIC REVIEW;

FLUORESCENT ANTIBODY TECHNIQUE, INDIRECT; HUMANS; ORIENTIA TSUTSUGAMUSHI; REFERENCE VALUES; REPRODUCIBILITY OF RESULTS; SCRUB TYPHUS; SENSITIVITY AND SPECIFICITY; SEROEPIDEMIOLOGIC STUDIES; SEROLOGIC TESTS;

EID: 33846445321     PISSN: 10584838     EISSN: None     Source Type: Journal    
DOI: 10.1086/510585     Document Type: Review

References (124)

1. 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; 45:589-91.
2. Shirai A, Wisseman CL. Serologic classification of scrub typhus isolates from Pakistan. Am J Trop Med Hyg 1975; 24:145-53.
3. Isaac R, Varghese GM, Mathai E, J M, Joseph I. Scrub typhus: prevalence and diagnostic issues in rural Southern India. Clin Infect Dis 2004; 39:1395-6.
4. Mathai E, Rolain JM, Verghese GM, et al. Outbreak of scrub typhus in southern India during the cooler months. Ann NY Acad Sci 2003; 990:359-64.
5. Richards AL, Soeatmadji DW, Widodo MA, et al. Seroepidemiologic evidence for murine and scrub typhus in Malang, Indonesia. Am J Trop Med Hyg 1997; 57:91-5.
6. Currie B, O'Connor L, Dwyer B. A new focus of scrub typhus in tropical Australia. Am J Trop Med Hyg 1993; 49:425-9.
7. Graves S, Wang L, Nack Z, Jones S. Rickettsia serosurvey in Kimberley, Western Australia. Am J Trop Med Hyg 1999; 60:786-9.
8. Ogawa M, Hagiwara T, Kishimoto T, et al. Scrub typhus in Japan: epidemiology and clinical features of cases reported in 1998. Am J Trop Med Hyg 2002; 67:162-5.
9. Chong Y. Application of serologic diagnosis of tsutsugamushi disease (scrub typhus) in Korea where the disease was recently recognized to be endemic. Yonsei Med J 1989; 30:111-7.
10. Yi KS, Chong Y, Covington SC, et al. Scrub typhus in Korea: importance of early clinical diagnosis in this newly recognized endemic area. Mil Med 1993; 158:269-73.
11. World Health Organization. Recommended surveillance standards WHO/CDS/CDR/ISR/99.2, second edition. Available at: http://www .who.int/csr/resources/publications/surveillance/whocdscsrisr992.pdf. Accessed 24 September 2006.
12. Bozeman FM, Elisberg BL. Serological diagnosis of scrub typhus by indirect immunofluorescence. Proc Soc Exp Biol Med 1963; 112:568-73.
13. Ohashi N, Koyama Y, Urakami H, et al. Demonstration of antigenic and genotypic variation in Orientia tsutsugamushi which were isolated in Japan, and their classification into type and subtype. Microbiol Immunol 1996; 40:627-38.
14. La Scola B, Raoult D. Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases. J Clin Microbiol 1997; 35:2715-27.
15. Jensenius M, Fournier PE, Raoult D. Rickettsioses and the international traveler. Clin Infect Dis 2004; 39:1493-9.
16. Gan E, Cadigan FC, Walker JS. Filter paper collection of blood for use in a screening and diagnostic test for scrub typhus using the IFAT. Trans R Soc Trop Med Hyg 1972; 66:588-93.
17. Robinson DM, Brown G, Gan E, Huxsoll DL. Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 1976; 25:900-5.
18. Bossuyt PM, Reitsma JB, Bruns DE, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. British Medical Journal 2003; 326:41-3.
19. Cuzick J. A Wilcoxon-type test for trend. Stat Med 1985; 4:87-90.
20. Dupon M, Rogues AM, Malou M, d'Ivernois C, Lacut JY. Scrub typhus: an imported rickettsial disease. Infection 1992; 20:153-4.
21. Edlinger E, Navarro P. Rickettsioses: a disease of tourism. Sem Hop 1983; 59:2053-4.
22. McDonald JC, MacLean JD, McDade JE. Imported rickettsial disease: clinical and epidemiologic features. Am J Med 1988; 85:799-805.
23. Cracco C, Delafosse C, Baril L, et al. Multiple organ failure complicating probable scrub typhus. Clin Infect Dis 2000; 31:191-2.
24. Thiebaut MM, Bricaire F, Raoult D. Scrub typhus after a trip to Vietnam. N Engl J Med 1997; 336:1613-4.
25. Brown AE, Meek SR, Maneechai N, Lewis GE. Murine typhus among Khmers living at an evacuation site on the Thai-Kampuchean border. Am J Trop Med Hyg 1988; 38:168-71.
26. Dasch GA, Halle S, Bourgeois AL. Sensitive microplate enzyme-linked immunosorbent assay for detection of antibodies against the scrub typhus rickettsia, Rickettsia tsutsugamushi. J Clin Microbiol 1979; 9:38-48.
27. Kularatne SA, Edirisingha JS, Gawarammana IB, Urakami H, Chenchittikul M, Kaiho I. Emerging rickettsial infections in Sri Lanka: the pattern in the hilly Central Province. Trop Med Int Health 2003; 8:803-11.
28. Takada N, Khamboonruang C, Yamaguchi T, Thitasut P, Vajrasthira S. Scrub typhus and chiggers in northern Thailand. Southeast Asian J Trop Med Public Health 1984; 15:402-6.
29. Parola P, Miller RS, McDaniel P, et al. Emerging rickettsioses of the Thai-Myanmar border. Emerg Infect Dis 2003; 9:592-5.
30. Lewis MD, Yousuf AA, Lerdthusnee K, Razee A, Chandranoi K, Jones JW. Scrub typhus reemergence in the Maldives. Emerg Infect Dis 2003; 9:1638-41.
31. Kende M, Graves S. Survey of rickettsial antibodies at two local sites and review of rickettsiosis in Papua New Guinea. P N G Med J 2003; 46:53-62.
32. Crum JW, Hanchalay S, Eamsila C. New paper enzyme-linked immunosorbent technique compared with microimmunofluorescence for detection of human serum antibodies to Rickettsia tsutsugamushi. J Clin Microbiol 1980; 11:584-8.
33. Ching WM, Rowland D, Zhang Z, et al. Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi. Clin Diagn Lab Immunol 2001; 8:409-14.
34. Nakagawa Y, Huruie H, Satou H, Matsumoto Y. A case of severe tsutsugamushi disease without eruption. Kansenshogaku Zasshi 1994; 68:1433-6.
35. Weddle JR, Chan TC, Thompson K, et al. Effectiveness of a dot-blot immunoassay of anti-Rickettsia tsutsugamushi antibodies for serologic analysis of scrub typhus. Am J Trop Med Hyg 1995; 53:43-6.
36. Brown GW, Shirai A, Rogers C, Groves MG. Diagnostic criteria for scrub typhus: probability values for immunofluorescent antibody and Proteus OXK agglutinin titers. Am J Trop Med Hyg 1983; 32:1101-7.
37. Bourgeois AL, Olson JG, Ho CM, Fang RC, Van Peenen PF. Epidemiological and serological study of scrub typhus among Chinese military in the Pescadores islands of Taiwan. Trans R Soc Trop Med Hyg 1977; 71:338-42.
38. Dennis DT, Hadi TR, Brown RJ, Sukaeri S, Leksana B, Cholid R. A survey of scrub and murine typhus in the Ancol section of Jakarta, Indonesia. Southeast Asian J Trop Med Public Health 1981; 12:574-80.
39. Olson JG, Bourgeois AL. Changing risk of scrub typhus in relation to socioeconomic development in the Pescadores islands of Taiwan. Am J Epidemiol 1979; 109:236-43.
40. Taylor A, Sivarajah A, Kelly DJ, Lewis EG Jr. An analysis of febrile illnesses among members of the Malaysian Police Field Force. Mil Med 1986; 151:442-5.
41. Coleman RE, Sangkasuwan V, Suwanabun N, et al. Comparative evaluation of selected diagnostic assays for the detection of IgG and IgM antibody to Orientia tsutsugamushi in Thailand. Am J Trop Med Hyg 2002; 67:497-503.
42. Kelly DJ, Wong PW, Gan E, Lewis GE. Comparative evaluation of the indirect immunoperoxidase test for the serodiagnosis of rickettsial disease. Am J Trop Med Hyg 1988; 38:400-6.
43. Ben RJ, Feng NH, Ku CS. Meningoencephalitis, myocarditis and disseminated intravascular coagulation in a patient with scrub typhus. J Microbiol Immunol Infect 1999; 32:57-62.
44. Chayakul P, Panich V, Silpapojakul K. Scrub typhus pneumonitis: an entity which is frequently missed. Q J Med 1988; 68:595-602.
45. Park JS, Jee YK, Lee KY, Kim KY, Myong NH, Seo PW. Acute respiratory distress syndrome associated with scrub typhus: diffuse alveolar damage without pulmonary vasculitis. J Korean Med Sci 2000; 15:343-5.
46. Ting KS, Lin JC, Chang MK. Brachial plexus neuropathy associated with scrub typhus: report of a case. J Formos Med Assoc 1992; 91:110-2.
47. Brown GW, Shirai A, Jegathesan M, et al. Febrile illness in Malaysiaan analysis of 1,629 hospitalized patients. Am J Trop Med Hyg 1984; 33:311-5.
48. Eamsila C, Buranakitjaroen P, Tanskul P, Watcharapichat P. Scrub typhus in suburban Bangkok: first cases. J Med Assoc Thai 1990; 73:585-91.
49. Pradutkanchana J, Silpapojakul K, Paxton H, Pradutkanchana S, Kelly DJ, Strickman D. Comparative evaluation of four serodiagnostic tests for scrub typhus in Thailand. Trans R Soc Trop Med Hyg 1997; 91:425-8.
50. World Health Organization Regional Office for the Western Pacific. Report of meeting of the task force on the serological diagnosis of Tsutusgamushi disease (scrub typhus). Manila: World Health Organization, 1987.
51. Asai S, Kawarano M. The first case of tsutsugamushi disease in 20 years infected in a rural region of Osaka. Kansenshogaku Zasshi 1989; 63:654-8.
52. Kaiho I, Tokieda M, Ohtawara M, Uchiyama T, Uchida T. Occurrence of rickettsiosis of spotted fever group in Chiba Prefecture of Japan. Jpn J Med Sci Biol 1988; 41:69-71.
53. Fujii T, Sakata S, Mori N, et al. Five cases of tsutsugamushi disease. Kansenshogaku Zasshi 1994; 68:1057-62.
54. Kajinami K, Fujita H, Hirata M, et al. A case of tsutsugamushi disease in the urban area of Komatsu City. Kansenshogaku Zasshi 1991; 65:749-53.
55. Kato T, Watanabe K, Katori M, Terada Y, Hayasaka S. Conjunctival injection, episcleral vessel dilation, and subconjunctival hemorrhage in patients with new tsutsugamushi disease. Jpn J Ophthalmol 1997; 41:196-9.
56. Matsumoto I, Shiroguchi T, Murakami S, Kobayashi Y, Kanemitsu N, Tange Y. The first case of tsutsugamushi disease in Ehime Prefecture. Kansenshogaku Zasshi 1989; 63:262-7.
57. Murata M, Nogami S, Shirasaka A, et al. Tsutsugamushi disease in the foothills of Mt. Fuji. Kansenshogaku Zasshi 1980; 54:291-8.
58. Nagaki Y, Hayasaka S, Kadoi C, Matsumoto M, Sakagami T. Branch retinal vein occlusion in the right eye and retinal hemorrhage in the left in a patient with classical Tsutsugamushi disease. Jpn J Ophthalmol 2001; 45:108-10.
59. Nagasaka S, Imagawa Y, Murata M. The first two cases of tsutsugamushi disease found in Toshima Island, Tokyo Metropolis. Kansenshogaku Zasshi 1991; 65:591-6.
60. Okada N. Tsutsugamushi disease found in the northern districts of Awaji Island-epidemiological study of the outbreak season temperature. Kansenshogaku Zasshi 2003; 77:60-7.
61. Watanabe H, Saito T, Misawa K, et al. Direct cytopathic liver injury and acute respiratory distress syndrome associated with gilliam-type tsutsugamushi disease. J Gastroenterol Hepatol 2005; 20:969-71.
62. Furuya Y, Katayama T, Hara M, Yoshida Y, Imai M, Hagiwara T. Occurrence of scrub typhus (Tsutsugamushi) in Kanagawa Prefecture and types of Orientia tsutsugamushi involved. Jpn J Infect Dis 2000; 53:77-8.
63. Yamamoto S, Kizoe K, Yoshino S, Hagiwara T. Annual incidence of tsutsugamushi disease caused by different serotypes of Orientia tsutsugamushi in Miyazaki Prefecture in 1991-1999. Jpn J Infect Dis 2000; 53:126-7.
64. Ishikura M, Watanabe M, Matsuura K, et al. Epidemiological studies on the background of the endemic occurrence of tsutsugamushi disease in Toyama Prefecture. II. Anti-Rickettsia tsutsugamushi antibody-positive rate in inhabitants of endemic and nonendemic areas. Microbiol Immunol 1987; 31:985-99.
65. Kaiho I, Tokieda M, Yoshida Y, et al. Epidemiology of Tsutsugamushi disease and typing of isolated Rickettsia in Chiba Prefecture. Kansenshogaku Zasshi 1993; 67:196-201.
66. Miyairi T, Kijima H, Murata M, et al. Shichito fever in Izu Shichito Islands. 4. Incidence of anti-R. tsutsugamushi antibody among inhabitant's sera. Kansenshogaku Zasshi 1980; 54:284-90.
67. Suzuki T, Suto T. Observations on the new type tsutsugamushi disease in Akita Prefecture. Kansenshogaku Zasshi 1980; 54:755-65.
68. Yamashita T, Morishita T, Tsuzuki H, et al. Analysis of prevalent Orientia tsutsugamushi in Aichi Prefecture. Kansenshogaku Zasshi 1999; 73:1194-8.
69. Furuya Y, Yamamoto S, Otu M, et al. Use of monoclonal antibodies against Rickettsia tsutsugamushi Kawasaki for serodiagnosis by enzyme-linked immunosorbent assay. J Clin Microbiol 1991; 29:340-5.
70. Murai K, Okayama A, Horinouchi H, Oshikawa T, Tachibana N, Tsubouchi H. Eradication of Rickettsia tsutsugamushi from patients' blood by chemotherapy, as assessed by the polymerase chain reaction. Am J Trop Med Hyg 1995; 52:325-7.
71. Sugita Y, Yamakawa Y, Takahashi K, Nagatani T, Okuda K, Nakajima H. A polymerase chain reaction system for rapid diagnosis of scrub typhus within six hours. Am J Trop Med Hyg 1993; 49:636-40.
72. Suzuki H. Diagnosis of tsutsugamushi disease by immunofluorescence. Nippon Densenbyo Gakkai Zasshi 1968; 41:407-11.
73. Urakami H, Yamamoto S, Tsuruhara T, Ohashi N, Tamura A. Serodiagnosis of scrub typhus with antigens immobilized on nitrocellulose sheet. J Clin Microbiol 1989; 27:1841-6.
74. Yamamoto S, Minamishima Y. Serodiagnosis of tsutsugamushi fever (scrub typhus) by the indirect immunoperoxidase technique. J Clin Microbiol 1982; 15:1128-32.
75. 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 1977; 70:444-8.
76. Brown GW, Robinson DM, Huxsoll DL. Serological evidence for a high incidence of transmission of Rickettsia tsutsugamushi in two Orang Asli settlements in Peninsular Malaysia. Am J Trop Med Hyg 1978; 27:121-3.
77. Brown GW, Shirai A, Groves MG. Development of antibody to Rickettsia tsutsugamushi in soldiers in Malaysia. Trans R Soc Trop Med Hyg 1983; 77:225-7.
78. Cadigan FC, Andre RG, Bolton M, Gan E, Walker JS. The effect of habitat on the prevalence of human scrub typhus in Malaysia. Trans R Soc Trop Med Hyg 1972; 66:582-7.
79. Shirai A, Brown GW, Gan E, Huxsoll DL, Groves MG. Rickettsia tsutsugamushi antibody in mother/cord pairs of sera. Jpn J Med Sci Biol 1981; 34:37-9.
80. Taylor AC, Hii J, Kelly DJ, Davis DR, Lewis GE. A serological survey of scrub, tick, and endemic typhus in Sabah, East Malaysia. Southeast Asian J Trop Med Public Health 1986; 17:613-9.
81. Bozeman FM, Elisberg BL. Studies of the antibody response in scrub typhus employing indirect immunofluorescence. Acta Med Biol (Niigata) 1967; 15:105-11.
82. Saunders JP, Brown GW, Shirai A, Huxsoll DL. The longevity of antibody to Rickettsia tsutsugamushi in patients with confirmed scrub typhus. Trans R Soc Trop Med Hyg 1980; 74:253-7.
83. Needy CF. The indirect fluorescent antibody technique in scrub typhus studies. Med J Malaysia 1964; 19:65-6.
84. Aung-Thu, Supanaranond W, Phumiratanaprapin W, Phonrat B, Chinprasatsak S, Ratanajaratroj N. Gastrointestinal manifestations of septic patients with scrub typhus in Maharat Nakhon Ratchasima Hospital. Southeast Asian J Trop Med Public Health 2004; 35:845-51.
85. Phupong V, Srettakraikul K. Scrub typhus during pregnancy: a case report and review of the literature. Southeast Asian J Trop Med Public Health 2004; 35:358-60.
86. Silpapojakul K, Varachit B, Silpapojakul K. Paediatric scrub typhus in Thailand: a study of 73 confirmed cases. Trans R Soc Trop Med Hyg 2004; 98:354-9.
87. Sirisanthana V, Puthanakit T, Sirisanthana T. Epidemiologic, clinical and laboratory features of scrub typhus in thirty Thai children. Pediatr Infect Dis J 2003; 22:341-5.
88. Suntharasaj T, Janjindamai W, Krisanapan S. Pregnancy with scrub typhus and vertical transmission: a case report. J Obstet Gynaecol Res 1997; 23:75-8.
89. Leelarasamee A, Chupaprawan C, Chenchittikul M, Udompanthurat S. Etiologies of acute undifferentiated febrile illness in Thailand. J Med Assoc Thai 2004; 87:464-72.
90. Pradutkanchana J, Pradutkanchana S, Kemapanmanus M, Wuthipum N, Silpapojakul K. The etiology of acute pyrexia of unknown origin in children after a flood. Southeast Asian J Trop Med Public Health 2003; 34:175-8.
91. Thap LC, Supanaranond W, Treeprasertsuk S, Kitvatanachai S, Chinprasatsak S, Phonrat B. Septic shock secondary to scrub typhus: characteristics and complications. Southeast Asian J Trop Med Public Health 2002; 33:780-6.
92. Chanyasanha C, Kaeburong K, Chenchittikul M, Sujirarat D. Seroprevalence of scrub typhus infection in patients with pyrexia at some malaria clinics in three western provinces of Thailand. Asian Pac J Allergy Immunol 1998; 16:119-25.
93. Eamsila C, Singsawat P, Duangvaraporn A, Strickman D. Antibodies to Orientia tsutsugamushi in Thai soldiers. Am J Trop Med Hyg 1996; 55:556-9.
94. Johnson DE, Crum JW, Hanchalay S, Saengruchi C. Sero-epidemiological survey of Rickettsia tsutsugamushi infection in a rural Thai village. Trans R Soc Trop Med Hyg 1982; 76:1-3.
95. Manosroi J, Chutipongvivate S, Auwanit W, Manosroi A. Early diagnosis of scrub typhus in Thailand from clinical specimens by nested polymerase chain reaction. Southeast Asian J Trop Med Public Health 2003; 34:831-8.
96. Saisongkorh W, Chenchittikul M, Silpapojakul K. Evaluation of nested PCR for the diagnosis of scrub typhus among patients with acute pyrexia of unknown origin. Trans R Soc Trop Med Hyg 2004; 98:360-6.
97. Wongchotigul V, Waicharoen S, Riengrod S, Chimsumang S, Rattanadakul J, Chinprasatsak S. Development and evaluation of a latex agglutination test for the rapid diagnosis of scrub typhus. Southeast Asian J Trop Med Public Health 2005; 36:108-12.
98. Chien RN, Liu NJ, Lin PY, Liaw YF. Granulomatous hepatitis associated with scrub typhus. J Gastroenterol Hepatol 1995; 10:484-7.
99. Fang CT, Ferng WF, Hwang JJ, et al. Life-threatening scrub typhus with meningoencephalitis and acute respiratory distress syndrome. J Formos Med Assoc 1997; 96:213-6.
100. Hsu GJ, Young T, Peng MY, Chang FY, Chou MY, Sheu LF. Acute renal failure associated with scrub typhus: report of a case. J Formos Med Assoc 1993; 92:475-7.
101. Lee ML, Lin MT. Scrub typhus-one case report. Zhonghua Yi Xue Za Zhi (Taipei) 1989; 44:274-8.
102. Lee WS, Wang FD, Wang LS, et al. Scrub typhus complicating acute respiratory distress syndrome: a report of two cases. Zhonghua Yi Xue Za Zhi (Taipei) 1995; 56:205-10.
103. Yen TH, Chang CT, Lin JL, Jiang JR, Lee KF. Scrub typhus: a frequently overlooked cause of acute renal failure. Ren Fail 2003; 25:397-410.
104. Yu C. Report on first finding an epidemic of Scrub typhus in north rural areas. Zhonghua Liu Xing Bing Xue Za Zhi 1992; 13:212-5.
105. Gale JL, Irving GS, Wang HC, Lien JC, Chen WF, Cross JH. Scrub typhus in eastern Taiwan, 1970. Am J Trop Med Hyg 1974; 23:679-84.
106. Shieh GJ, Chen HL, Chen HY, Horng CB. Detection of Rickettsia tsutsugamushi specific DNA from the lymphocyte of patients by polymerase chain reaction. Proc Natl Sci Counc Repub China B 1995; 19:43-6.
107. Chang JH, Ju MS, Chang JE, et al. Pericarditis due to Tsutsugamushi disease. Scand J Infect Dis 2000; 32:101-2.
108. Jee HG, Chung MH, Lee SG, Kim IS, Chang WH. Transmission of scrub typhus by needlestick from a patient receiving pefloxacin. Scand J Infect Dis 1996; 28:411-2.
109. Kim DE, Lee SH, Park KI, Chang KH, Roh JK. Scrub typhus encephalomyelitis with prominent focal neurologic signs. Arch Neurol 2000; 57:1770-2.
110. Song SW, Kim KT, Ku YM, et al. Clinical role of interstitial pneumonia in patients with scrub typhus: a possible marker of disease severity. J Korean Med Sci 2004; 19:668-73.
111. Park JH, Heo EJ, Choi KS, Dumler JS, Chae JS. Detection of antibodies to Anaplasma phagocytophilum and Ehrlichia chaffeensis antigens in sera of Korean patients by western immunoblotting and indirect immunofluorescence assays. Clin Diagn Lab Immunol 2003; 10:1059-64.
112. Jang WJ, Huh MS, Park KH, Choi MS, Kim IS. Evaluation of an immunoglobulin M capture enzyme-linked immunosorbent assay for diagnosis of Orientia tsutsugamushi infection. Clin Diagn Lab Immunol 2003; 10:394-8.
113. Kim IS, Seong SY, Woo SG, Choi MS, Chang WH. High-level expression of a 56-kilodalton protein gene (bor56) of Rickettsia tsutsugamushi Boryong and its application to enzyme-linked immunosorbent assays. J Clin Microbiol 1993; 31:598-605.
114. Berman SJ, Kundin WD. Scrub typhus in South Vietnam: a study of 87 cases. Ann Intern Med 1973; 79:26-30.
115. Colwell EJ, Brown JD, Russell PK, Boone SC, Legters LJ, Catino D. Investigations on acute febrile illness in American servicemen in the Mekong Delta of Vietnam. Mil Med 1969; 134:1409-14.
116. Deller JJ, Russell PK. An analysis of fevers of unknown origin in American soldiers in Vietnam. Ann Intern Med 1967; 66:1129-43.
117. Faa AG, McBride WJ, Garstone G, Thompson RE, Holt P. Scrub typhus in the Torres Strait islands of north Queensland, Australia. Emerg Infect Dis 2003; 9:480-2.
118. McBride WJ, Taylor CT, Pryor JA, Simpson JD. Scrub typhus in north Queensland. Med J Aust 1999; 170:318-20.
119. Brown GW, Shirai A, Gan E, Bernthal P. Antibodies to typhus in Eastern Nepal. Trans R Soc Trop Med Hyg 1981; 75:586-7.
120. Hu ML, Liu JW, Wu KL, et al. Short report: abnormal liver function in scrub typhus. Am J Trop Med Hyg 2005; 73:667-8.
121. Lau SM, Yu WL, Wang JH. An unusual site of chigger bite in a patient with scrub typhus. Diagn Microbiol Infect Dis 1999; 35:159-61.
122. Tsay RW, Chang FY. Acute respiratory distress syndrome in scrub typhus. QJM 2002; 95:126-8.
123. Oh M, Kim N, Huh M, et al. Scrub typhus pneumonitis acquired through the respiratory tract in a laboratory worker. Infection 2001; 29:54-6.
124. Kawamura A, Tanaka H, Tamura A, eds. Tsutsugamushi disease. Tokyo: University of Tokyo Press, 1995.