Follow-up analysis on the epidemic strains of Orientia tsutsugamushi in the first outbreak of scrub typhus in Henan Province, China.

To obtain knowledge of the genetic characteristics and types of the epidemic strains of Orientia tsutsugamushi in the first outbreak of scrub typhus in Henan Province, genus and type-specific primers were employed to amplify a fragment of the gene of 56 kDa protein. Serotyping demonstrated that, of the 19 patients [15 patients in recovery phase (10-40 days) and 4 of patients in acute phase (1-7 days)], 4 were infected with Gilliam type, 8 with Kato type, 6 with Karp type, and 1 with an unknown type. Successful genotyping was obtained for only 3 patients, indicating that 2 were infected with Karp type and 1 with Taiwan Kato type. Thus the outbreak of scrub typhus in Henan Province was caused by at least two epidemic strains.

In vitro demonstration of the hemolytic, cytotoxic activities and induction of apoptosis in Orientia tsutsugamushi infected L929 mouse fibroblast cells.

Using cultured mouse fibroblast L929 cells, this study demonstrated the hemolytic and cytotoxic activities and induction of apoptosis in cells infected with Orientia tsutsugamushi. Low levels of hemolytic activity were detected using heavily infected cells. No hemolysin or cytotoxin were detected in the infected culture fluid regardless of the pathogenicity of the O. tsutsugamushi strains in mice. Using propidium iodide uptake assay, acridine orange/ethidium bromide staining and terminal deoxynucleotide transferase-mediated dUTP-digoxigenin nick-end labeling assay, apoptosis was observed in L929 cells infected with Karp and Gilliam strains.

Virulence of Malaysian isolates of Orientia tsutsugamushi in mice.

The pathogenicity of Malaysian isolates of Orientia tsutsugamushi was investigated by a mouse virulence assay. The isolates could be differentiated as low (4 isolates), moderately (3 isolates) and highly virulent (2 isolates) based on the different responses in infected mice. No direct correlation between severity of human scrub typhus infections and virulence of the O. tsutsugamushi in mice was observed. Mice infected with virulent strains of O. tsutsugamushi showed splenomegaly, ascitis accumulation and enlargement of kidneys and livers whereas avirulent O. tsutsugamushi strains were asymptomatic and exhibited ruffled fur for a short period after infection. There was low antibody response in mice infected with isolates of low pathogenicity as compared with those of highly virulent isolates. Upon dissection of the infected mice, enlargement of mouse organs such as spleen, kidney and liver was noted. Presence of rickettsemia in mice was confirmed by the growth of O. tsutsugamushi in the L929 cells when inoculated with blood from infected mice. O. tsutsugamushi was also cultured from the peritoneal exudates of the infected mice. However, DNA of O. tsutsugamushi was only detected in the peritoneal exudates (by PCR) and blood (by cell culture) and not from other tissue samples.

Protection against scrub typhus infection engendered by the passive transfer of immune sera.

The passive transfer of convalescent sera did not protect the majority of mice against challenge with the homologous strain and was completely ineffective against challenge with strains unrelated by fluorescent antibody techniques. When the immune sera was incubated with the rickettsia in vitro and then inoculated into the mice a dramatic increase occurred in the number of surviving mice. The importance of these data in relation to published results with other species of rickettsia is discussed.