Detection of Immunoglobulin M and Immunoglobulin G Antibodies Against Orientia tsutsugamushi for Scrub Typhus Diagnosis and Serosurvey in Endemic Regions

Gupte, M. D.; Gupte, Manish; Kamble, Suchit; Mane, Arati; Sane, Suvarna; Bondre, Vijay P.; Deshpande, Jagadish M.; Gadkari, Deepak A.; Murhekar, Manoj

doi:10.1007/s13312-020-2067-4

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…In this study, patients with a positive PCR had a median duration of illness of 9 (IQR 5.75-12.25) days before clinical specimen sampling versus 11 (IQR 8.5-14.5) days for patients with a negative PCR result. Because IgM does not ordinarily cross the blood-CSF barrier, presence of those antibodies in CSF implies their production within the CNS (35) and higher certainty of association with the infection compared to serum IgM. Using CSF IgM ELISA increased the certainty of association from possible to probable in 23 patients who had simultaneous evidence of another pathogen.…”

Section: Treatmentmentioning

confidence: 99%

“…Using CSF IgM ELISA increased the certainty of association from possible to probable in 23 patients who had simultaneous evidence of another pathogen. Although the kit is recommended for (35). A cutoff OD value for IgM in CSF has not been determined in the southern states in India, so we used a higher cutoff (0.5), as used by Behera et al (21) for CSF of children with scrub typhus ME in eastern India.…”

Section: Treatmentmentioning

confidence: 99%

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Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India

Damodar¹,

Singh²,

Prabhu³

et al. 2023

Emerg. Infect. Dis.

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S crub typhus is an acute febrile illness caused by an obligate intracellular gram-negative bacterium, Orientia tsutsugamushi. It is transmitted through chigger mites and is considered endemic to the tsutsugamushi triangle (covering Asia, northern Australia, and islands in the Indian and Pacific Oceans), although scrub typhus caused by other Orientia species has also been reported in Africa, France, the Middle East, and South America (1). A recent systematic review from hospital-based studies in India reported 25% of acute undifferentiated febrile illness was caused by scrub typhus. Most studies included were from southern India, but only 20% of included patients were <15 years of age (2). Although scrub typhus illness is typically self-limiting, neurologic complications are seen in 20%-25% of patients admitted to the hospital and are associated with high mortality rates (3,4). Scrub typhus can result in myriad neurologic manifestations, including meningitis, meningoencephalitis, encephalopathy, seizures, stroke, neuropathy, optic neuritis, myositis, myelitis, involuntary movements, and Guillain-Barré syndrome, all of which are well recognized in adults (3,4).Recent studies in India have identified O. tsutsugamushi as a major cause of acute encephalitis syndrome (AES) outbreaks, especially in northern states of the country, such as Uttar Pradesh, Bihar, West Bengal, and Assam (5-7). Outbreaks of AES pose a major public health problem in India, predominantly affecting children (8). The definition of AES used for syndromic surveillance is broad and includes all patients experiencing acute onset of fever and altered mental state (9,10). The clinical manifestation might be caused by encephalitis or meningitis (direct invasion of the

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India

Damodar¹,

Singh²,

Prabhu³

et al. 2023

Emerg. Infect. Dis.

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“…A subsequent study found out the existence of antibodies against OT during AES epidemic period (July–November 2016) as well as during the lean period (December–June 2016), antibody titer being higher during the epidemic period ( Kamble et al, 2020 ). Apart from these studies, various other reports were based on either serological or molecular evidences but none involved isolation of pathogen in cell culture that is a definite method for diagnosis of any disease of unknown etiology ( Janardhanan et al, 2014 ; Varghese et al, 2015 ; Jain et al, 2017 ; Chunchanur et al, 2019 ; Kumar et al, 2019 ; Gupte et al, 2020 ; Kannan et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Genotypic Characterization of Orientia tsutsugamushi Isolated From Acute Encephalitis Syndrome and Acute Febrile Illness Cases in the Gorakhpur Area, Uttar Pradesh, India

Nanaware

Desai²,

Banerjee³

et al. 2022

Front. Microbiol.

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Scrub typhus infections caused by Orientiatsutsugamushi (OT), continue to remain underdiagnosed globally, due to the lack of distinctive symptoms. The elusive nature of the Acute Encephalitis Syndrome (AES) outbreak in Gorakhpur, Uttar Pradesh that claimed numerous pediatric lives was the driving force of this study which involved serological diagnosis (IgM–ELISA), isolation of OT in cell culture, confirmation by PCR, and characterization by Sanger sequencing. In total, 12 out of 36 patients were seropositive, of which 4 were positive by PCR. Upon enrichment in cell culture, additional 3 patients (including two seronegative) were detected positive by PCR. In total, three of these 7 patients were found to be infected with two strains of OT. Taken together, this study for the first time reports the occurrence of dual infections in addition to three circulating OT genotypes (Gilliam, Kato, and Karp-like) and highlights the significance of enriching OT in cell culture systems for efficient molecular detection.

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The Need for Geographic Location Specific Optical Density Cut-offs for IgM ELISA Serology to Diagnose Scrub Typhus in Children

Babu

Narayanasamy

2021

Indian Pediatr

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The aging of the immune system. Transpl Int.We read with great interest the research article by Meena, et al.[1] on screen time in children by 15-18 months of age. We wish to share our survey findings of 109 well children (12-36 months) at three hospitals in Bangalore between September, 2016 to April, 2017. We found that the mean (SD) screen time exposure was 120 (96.2) minutes (range 0-540 min) in this age group, similar to the study by Meena, et al. [1]. Television (69%), mobile phones (66%), tablet (27.5%) and laptop (22%) were the most common electronic media used in our study. We found rhymes (89%) commercial advertisements (62%), educational videos (36%), and cartoons (20%) constituted majority of the activities during screen time. Importantly, 73% of the parents used screen time to help the child in eating, 51% for entertain-ment, and 34.8% as a distraction to give the caregiver some free time. Contrary to their findings, we found that only 7% of the parents thought screen time was good for the child. We found that 26% of these children had delay in speech for their respective ages. An association with speech delay and screen time has also been reported earlier [2,3].

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Detection of Immunoglobulin M and Immunoglobulin G Antibodies Against Orientia tsutsugamushi for Scrub Typhus Diagnosis and Serosurvey in Endemic Regions

Cited by 4 publications

References 12 publications

Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India

Association of Scrub Typhus in Children with Acute Encephalitis Syndrome and Meningoencephalitis, Southern India

Genotypic Characterization of Orientia tsutsugamushi Isolated From Acute Encephalitis Syndrome and Acute Febrile Illness Cases in the Gorakhpur Area, Uttar Pradesh, India

The Need for Geographic Location Specific Optical Density Cut-offs for IgM ELISA Serology to Diagnose Scrub Typhus in Children

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