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. 2019 Apr;25(4):633-641.
doi: 10.3201/eid2504.180691.

Clinical Manifestations and Molecular Diagnosis of Scrub Typhus and Murine Typhus, Vietnam, 2015-2017

Nguyen Vu Trung, Le Thi Hoi, Vu Minh Dien, Dang Thi Huong, Tran Mai Hoa, Vu Ngoc Lien, Phan Van Luan, Sonia Odette Lewycka, Marc Choisy, Juliet E Bryant, Behzad Nadjm, H Rogier van Doorn, Allen L Richards, Nguyen Van Kinh

Clinical Manifestations and Molecular Diagnosis of Scrub Typhus and Murine Typhus, Vietnam, 2015-2017

Nguyen Vu Trung et al. Emerg Infect Dis. 2019 Apr.

Abstract

Rickettsioses are endemic to Vietnam; however, only a limited number of clinical studies have been performed on these vectorborne bacteria. We conducted a prospective hospital-based study at 2 national referral hospitals in Hanoi to describe the clinical characteristics of scrub typhus and murine typhus in northern Vietnam and to assess the diagnostic applicability of quantitative real-time PCR assays to diagnose rickettsial diseases. We enrolled 302 patients with acute undifferentiated fever and clinically suspected rickettsiosis during March 2015-March 2017. We used a standardized case report form to collect clinical information and laboratory results at the time of admission and during treatment. We confirmed scrub typhus in 103 (34.1%) patients and murine typhus in 12 (3.3%) patients. These results highlight the need for increased emphasis on training for healthcare providers for earlier recognition, prevention, and treatment of rickettsial diseases in Vietnam.

Keywords: Scrub typhus; Vietnam; bacteria; clinical manifestations; molecular diagnosis; murine typhus; rickettsial diseases.

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Figures

Figure 1
Figure 1
Enrollment flow, qPCR results, and presence of eschar among enrollees in study of rickettsial patients, Vietnam, March 2015–March 2017. NS1, nonstructural protein 1; qPCR, quantitative PCR; SFG, scrub typhus group; SFG, spotted fever group; STG, scrub typhus group; +, positive; –, negative.
Figure 2
Figure 2
Distribution of 302 rickettsial patients, by province, in northern Vietnam, March 2015–March 2017. A) Provinces of northern Vietnam; inset shows location within Vietnam. B) Number of cases by province. BG, Bac Giang; BK, Bac Kan; BN, Bac Ninh; CB, Cao Bang; DB, Dien Bien; HG, Ha Giang; HB, Hoa Binh; HD, Hai Duong; HN, Ha Nam; HP, Hai Phong; HT, Ha Tinh; HY, Hung Yen; LS, Lang Son; NA, Nghe An; NB, Ninh Binh; ND, Nam Dinh; NHO, Hanoi; PT, Phu Tho; QN, Quang Ninh; SL, Son La; TB, Thai Binh; TH, Thanh Hoa; TN, Thai Nguyen; TQ, Tuyen Quang; VP, Vinh Phuc; YB, Yen Bai.
Figure 3
Figure 3
Frequency of all enrolled patients and those with confirmed scrub typhus or murine typhus in National Hospital for Tropical Diseases and Bach Mai Hospital, by month, Vietnam, March 2015–March 2017.
See this image and copyright information in PMC

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