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 Original Articles |
| Murine Typhus and Scrub Typhus in Kangwon-do Korea |
| Yoon-Won Kim, Chang-Hong Min, Min Kee Cho, Chang-Soon Yoon, Su-Ik Cho, Moon-Kee, Choi*, Jae-Seung Kang**, Woo-Hyun Chang*** |
| Department of Microbiology and Internal Medicine*, Faculty of Medicine, Hallym University, Choonchun, Kangwon-do; Department of Microbiology, College of Medicine, Inha University, Inchon**, and Department of Microbiology, College of Medicine, Seoul Nation |
Vol.20 Num.2 (p105~116)
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In Korea, there has been an increasing concern on rickettsiosis as one of most prevailing acute febrile illness, since murine typhus and scrub typhus had not been reported for 2 decades until 1986 and thereafter a few studies were reported on these diseases. A microimmunofluorescence test was used to study antibodies to R. typhi and R. tsutsugamushi in urban and rural inhabitants, students, and patiants suspected of leptospirosis or rickettsiosis from 1986 to 1987 in Kangwon-do Korea.
43% of inhabitants and 17% of students reacted to R. typhi. Only one inhabitant among inhabitants and students reacted to R. tsutsugamushi. Among 169 patients, 43 (25%) reacted to R. typhi, 38(22%) to R. tsutsugamushi and 25(15%) to Leptospira interrogans.
Sexual rate(male: female) in murine typhus was 1.7:1, that in scrub typhus was 1:2.2 and that in leptospirosis was 1.5:1. The age ditribution of patients with murine typhus was generally even over 20 years old. But 71% of patients with scrub typhus were over 40 years old. Scrub typhus was most prevailing in female over 40 years old.
Murine typhus was relatively more prevailing in Choonchum city than rural area as compared with scrub typhus and leptospirosis. Most of scrub typhus occured in rural area. Most of each disease occurred between September and Novermber (murine typhus: 93%, scrub typhus: 95%, leptospirosis: 84%) with a peak in October. Scrub typhus considerably occurred not only October (58%) but also November(28%).
All patients with scrub typhus were immediately diagnosed by antibody when they visited hospital. 53% of patients with murine typhus were diagnosed when they visited hospital within 7 days after onset of illness, and others were done by second sera obtained 8 days after.
The patients in whom IgM was seronegative but antibodies of other class were seropsitive by 20 days after onset of illness, were 14% in murine typhus and 26% in scrub typhus. At least those patients were considered to be infected second. Murine typhus and scrub typhus were suggested to be endemic diseases in Kangwon-do as antibodies of inhabitants and characteristics of patients'sera were condidered.
By serologic finding of patients with scrub typhus in Kangwon-do, Gilliam was 59% of etiologic strain of scrub typhus Karp was 41% and Kato was none.
Most scrub typhus occurred in person to be related to agriculture, but murine typhus was not related to job and occurred more in small city than rural area. Rash was scarcely detected in murine typhus and scrub typhus and eschar was in 50% of scrub typhus only. Serum transaminase elevated in many patients with scrub typhus and murine typhus. Leukocytosis and abnormal finding in chest X-ray were showed in some patients with scrub typhus but were scarcely in murine typhus.
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