Severe Fever with Thrombocytopenia Syndrome Virus Infection or Mixed Infection with Scrub Typhus in South Korea in 2000–2003

Nguyen Thi Hai Yen,1,2 Chaewon Kim,1,2 Seonyoung Jeong,2 Kyeongseok Jeon,1,2 Hooncheol Choi,1,2 Hyo-Jin Ro,1,2 Hong-Il Kim,1,2 Yuri Kim,1,2,3 Jun-Gu Kang,1,2,3 Dahee Park,4 Myung-Sik Choi,1 Keun Hwa Lee,4 *† and Nam-Hyuk Cho1,2,3*† 1 Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, South Korea; 2 Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea; 3 Institute of Endemic Disease, Seoul National University Medical Research Center and Bundang Hospital, Seoul, South Korea; 4 Department of Microbiology and Immunology, College of Medicine, Jeju National University, Jeju, South Korea

Abstract. Severe fever with thrombocytopenia syndrome is a tick-borne viral disease, with a high mortality rate that was first reported in China in 2009. Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi, a bacterium transmitted to humans through chigger mite bites. Severe fever with thrombocytopenia syndrome and scrub typhus are endemic to South Korea. To investigate evidence of severe fever with thrombocytopenia syndrome virus (SFTSV) infection or mixed infection with scrub typhus in South Korea, we examined 2,329 sera samples collected from patients presenting from November 1, 2000, to November 1, 2003, for the diagnosis of rickettisal diseases at Seoul National University, Seoul, South Korea. We found retrospective evidence of SFTSV infection or mixed infection with scrub typhus in South Korea in 2000–2003. Severe fever with thrombocytopenia syndrome virus infections in South Korea occurred before previously reported cases and were more concurrent with those in China. It is important to consider SFTSV infection in patients with scrub typhus

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