{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:14:29Z","timestamp":1784740469490,"version":"3.55.0"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["2022R1C1C1002741"],"award-info":[{"award-number":["2022R1C1C1002741"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["2020R1C1C1007297"],"award-info":[{"award-number":["2020R1C1C1007297"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Chonnam National University Hospital Biomedical Research Institute","award":["BCRI21013"],"award-info":[{"award-number":["BCRI21013"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Due to environmental and ecological changes and suitable habitats, the occurrence of vector-borne diseases is increasing. We investigated the seroprevalence of four major vector-borne pathogens in human patients with febrile illness who were clinically suspected of having Scrub Typhus (ST) caused by<jats:italic>Orientia tsutsugamushi<\/jats:italic>. A total of 187 samples (182 patient whole blood and sera samples, including 5 follow-up) were collected. Antibodies to<jats:italic>Anaplasma phagocytophilum<\/jats:italic>,<jats:italic>Ehrlichia chaffeensis<\/jats:italic>,<jats:italic>Borrelia burgdorferi<\/jats:italic>, and<jats:italic>Bartonella henselae<\/jats:italic>were tested by using indirect immunofluorescence assays. Molecular diagnoses were performed using real-time PCR. Of the 182 cases, 37 (20.3%) cases were designated as confirmed cases of ST, and the remaining 145 (79.7%) cases as other febrile diseases (OFDs). The seroprevalence of<jats:italic>A<\/jats:italic>.<jats:italic>phagocytophilum<\/jats:italic>,<jats:italic>E<\/jats:italic>.<jats:italic>chaffeensis<\/jats:italic>,<jats:italic>B<\/jats:italic>.<jats:italic>burgdorferi<\/jats:italic>, and<jats:italic>B<\/jats:italic>.<jats:italic>henselae<\/jats:italic>was 51.4% (19\/37), 10.8% (4\/37), 86.5% (32\/37), and 10.8% (4\/37) among the ST group, and 42.8% (62\/145), 10.4% (19\/145), 57.7% (105\/145), and 15.9% (29\/145) among the OFD group, respectively. There were no significant differences in the seroprevalence between the ST and the OFD groups. Considering the co-occurrence, 89.0% (162\/182) had at least one antibody to tick-borne pathogens, 37.0% (60\/162) were positive for two pathogens, 17.3% (28\/162) for three pathogens, and 6.2% (10\/162) for four pathogens. In real-time PCR,<jats:italic>O<\/jats:italic>.<jats:italic>tsutsugamushi<\/jats:italic>was positive in 16 cases [15 (40.5%) in ST group and 1 (2.2%) in OFD group], and the four other pathogens were negative in all cases except one confirmed as anaplasmosis. In evaluating the five follow-up samples, the appearance of new antibodies or an increase in the pre-existing antibody titers was detected. Our data highlighted that acute febrile illness and manifestations suggestive of a vector-borne infection must be recognized and further considered for coinfections in clinical practice and the laboratory.<\/jats:p>","DOI":"10.1371\/journal.pone.0286631","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T18:08:29Z","timestamp":1685729309000},"page":"e0286631","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Under-diagnosis of vector-borne diseases among individuals suspected of having Scrub Typhus in South Korea"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8750-4257","authenticated-orcid":true,"given":"Eun Jeong","family":"Won","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeong Hwan","family":"Byeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chae-Hyeon","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Ji","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo-Heon","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Jung","family":"Kee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9438-1603","authenticated-orcid":true,"given":"Hyun-Woo","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"pone.0286631.ref001","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1146\/annurev-ento-052720-094533","article-title":"The impacts of climate change on ticks and tick-borne disease risk","volume":"66","author":"L. 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