. 2020 Aug 18;10(9):396. doi: 10.1007/s13205-020-02389-w

Table 2.

Reported outbreaks of scrub typhus from different countries with prevalent serotypes and methods used for diagnosis

S. no	Year	Region	Out break	Method of diagnosis	Antibody/marker gene	Prevalent strain	References
India
1	2018	Kerala	8 samples	ELISA	IgM	Karp-like Kawasaki like strain	Biswal et al. (2018)
1	2018	Kerala	8 samples	Nested PCR	56-kDa tsa	Karp-like Kawasaki like strain	Biswal et al. (2018)
2	2016	North-India	228 cases	ELISA	IgM	Boryong-like a prototype	Sharma et al. (2016)
3	2015	South India (Vellore), Northern India (Shimla) and Northeast India (Shillong)	263 eschar samples	ELISA	IgM	Kato-like strain (61.5%), Karp-like strain (27.7%) and Gilliam and Ikeda strain (2.3% each)	Varghese et al. (2015)
3	2015		263 eschar samples	PCR	56-kDa tsa		Varghese et al. (2015)
4	2013	South India	154 cases	Weil–Felix test	OX-K	Kato (65%) Karp (30.7%)	Paris et al. (2015)
5	2011	Vellore	87 cases	ELISA	IgM	99% homology with strain Taitung-2 and TW461	Prakash et al. (2011)
5	2011	Vellore	87 cases	ELISA	IgM	99% homology with strain Taitung-2 and TW461	Prakash et al. (2011)
6	2006	Himachal Pradesh	21 cases	Nested PCR	56-kDa tsa	Two different genotypes were identified with similarity in between Karp and JP-1, Saitama and JG type respectively	Mahajan et al. (2006)
				Weil–Felix test	OX19, OX2, OXK
				MIF assay	IgG, IgM
				Real-time PCR	47-kDa HtrA
China
7	2015	Shandong province	49 cases	Nested- PCR	56-kDa tsa	Most prevalent is the Kawasaki strain. STA-07 is the second most common	Zheng et al. (2015)
8	2015	Northern China	43 cases	Nested- PCR	56-kDa tsa	Kawasaki	Zhang et al. (2015)
9	2013	Shandong province	3134 chiggers and 89 ticks	PCR	56-kDa tsa	Kawasaki	Zhang et al. (2013a, b)
10	2009	Northern China	36 cases	PCR	56-kDa tsa	Kawasaki	Liu et al. (2009)
Taiwan
11	2011	–	130 mites	Nested PCR	56-kDa tsa	Karp and Gilliam like	Lin et al. (2011)
12	2010	–	116 cases	Nested PCR	56-kDa tsa	Karp like strain	Lu et al. (2010)
South Korea
13	2012	–	44 eschar samples	PCR	56-kDa tsa	Boryong followed by Kawasaki	Jeong et al. (2012)
14	2011	–	69 cases	PCR	56-kDa tsa	Boryong	Lee et al. (2011)
15	2010	–	153 cases	PCR	56-kDa tsa	Boryong	Park et al. (2010)
Thailand
16	2013	–	430 samples	PCR	56-kDa tsa	Karp	Unsworth et al. (2007)
17	2011	–		PCR	56-kDa tsa	Karp-like and Ikeda-like strain	Ruang-areerate et al. (2011)
18	2008	–	195 cases	PCR	56-kDa tsa	Karp	Fournier et al. (2008)
Vietnam
19	2017	–	32 patients	IFA qPCR	IgG and IgM 56-kDa tsa	Karp (70.4%), Gilliam (11.1%) TA763 and Kawasaki (7.4%) and TA716 (3.7%)	Le Viet et al. (2017)
20	2013	–	41 cases	PCR	56-kDa tsa	Karp	Blacksell et al. (2008)
Sri Lanka
21	2017	Ragama and Balapitiya	28 cases	Real-time PCR	47-kDa HtrA	JP-1(Karp related) followed by Kato Close homology with Kuroki-Boryong L04956	Premaratna et al. (2017)
21	2017	Ragama and Balapitiya	28 cases	Nested PCR	56-kDa tsa		Premaratna et al. (2017)

The study concluded that in most of the countries the karp like strains are most prevalent and other strains are mostly region specific like Kato in India, Kawasaki in China and Boryong in South Korea

56 kDa tsa 56 kDa tissue specific antigen encoding gene, 47 kDa HtrA 47 kDa high temperature requirement A, Proteus antigens OX-19, OX2, OX-K OX-19, OX₂—Proteus vulgaris, OX-K—Proteus mirabilis, qPCR quantitative polymerase chain reaction, IFA immunofluorescence assay, ELISA enzyme linked immunosorbent assay