The Foci of Scrub Typhus and Strategies of Prevention in the Spring in Pingtan Island, Fujian Province

: This study investigates the foci of tsutsugamushi disease on Pingtan Island, China, with emphasis on cases of illness that occur in the spring. The investigation of the physical and medical geography in the endemic area and detection of 141 sera samples in the population of Pingtan Island is described. The serum samples were taken from 102 soldiers and 39 residents and were tested by the indirect immunofluorescence assay. An island resident's history of illness inquiry was also conducted, and the results are discussed. We were able to determine the most prevalent types of rats and mites from the rat bodies. We isolated the DNA from the spleen of 40 rats and from five groups of mites by polymerase chain reaction. Orientia tsutsugamushi was isolated by perctoneally injecting KM mice with the patient's untreated blood along with ground rat viscera (R. losea) and ground mites (L. deliense), respectively. The isolates were typed at the molecular level. This study will then present direct prevention strategies that emphasize personal hygiene, methods of personal protection, keeping living environments clean, and it will provide strategies to eliminate rats and mites. As a result of adopting these strategies, no case of scrub typhus occurred in this region in approximately 2003–2004.