---
title: "Reemergence of Summer Scrub Typhus in Japan Linked to Leptotrombidium akamushi and Karp-Like Orien"
id: "pubmed-42661144"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42661144"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42661144/"
doi: "10.3201/eid3209.260646"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Reemergence of Summer Scrub Typhus in Japan Linked to Leptotrombidium akamushi and Karp-Like Orien
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42661144
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42661144/)
- **DOI:** [10.3201/eid3209.260646](https://doi.org/10.3201%2Feid3209.260646)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Scrub typhus is a **miteborne** disease caused by **Orientia tsutsugamushi**. In Japan, cases typically occur in spring and autumn and are transmitted by **Leptotrombidium pallidum** and **L. scutellare**; summer transmission by **L. akamushi** is uncommon. - In August 2024 a pregnant woman developed scrub typhus after attending a fireworks event in Niigata Prefecture; the pregnancy ended in fetal death. - Molecular testing identified a **Vietnam-related Karp-like O. tsutsugamushi genotype** in patient samples. This genotype is distinct from the Kato type more commonly linked previously with **L. akamushi** mites. - Field investigations at the fireworks site documented seasonal predominance of **L. akamushi** mites during summer months. - Identical O. tsutsugamushi sequences to the patient’s strain were detected in three **L. akamushi** mite larvae and one large Japanese field mouse (Apodemus speciosus), supporting that infected **L. akamushi** were the likely source of human infection. - The findings indicate a reemergence of **summer scrub typhus** in Japan associated with infected **L. akamushi** carrying a locally novel genotype, raising concerns about seasonal and genotypic shifts in vector-host dynamics.
## Clinical Analysis & Structured Key Points
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Emerg Infect Dis. 2026 Sep. Free article Show details Display options Display options Format Abstract PubMed PMID Emerg Infect Dis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Emerg+Infect+Dis%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Emerg+Infect+Dis%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42661144/) . 2026 Sep;32(9):1463-1469. doi: 10.3201/eid3209.260646. ### Authors [Motohiko Ogawa](https://pubmed.ncbi.nlm.nih.gov/?term=Ogawa+M&cauthor_id=42661144), [Nobuhiro Takada](https://pubmed.ncbi.nlm.nih.gov/?term=Takada+N&cauthor_id=42661144), [Takashi Katayama](https://pubmed.ncbi.nlm.nih.gov/?term=Katayama+T&cauthor_id=42661144), [Yuki Hashimoto](https://pubmed.ncbi.nlm.nih.gov/?term=Hashimoto+Y&cauthor_id=42661144), [Kei Nagano](https://pubmed.ncbi.nlm.nih.gov/?term=Nagano+K&cauthor_id=42661144), [Hirotaka Komine](https://pubmed.ncbi.nlm.nih.gov/?term=Komine+H&cauthor_id=42661144), [Yukihiro Akeda](https://pubmed.ncbi.nlm.nih.gov/?term=Akeda+Y&cauthor_id=42661144) * PMID: **42661144** * DOI: [ 10.3201/eid3209.260646 ](https://doi.org/10.3201/eid3209.260646) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Scrub typhus is a miteborne infectious disease caused by Orientia tsutsugamushi bacteria. In Japan, most cases occur in spring and autumn and are transmitted by Leptotrombidium pallidum and L. scutellare mites; summer scrub typhus, transmitted by L. akamushi mites, is rarely reported. In August 2024, a pregnant woman had scrub typhus develop after attending a fireworks event in Niigata Prefecture, Japan, resulting in fetal death. A Vietnam-related Karp-like O. tsutsugamushi genotype, distinct from the Kato type usually associated with L. akamushi mites, was detected from patient samples. Field investigations at the site of the fireworks event revealed seasonal predominance of L. akamushi mites in summer. We detected O. tsutsugamushi sequences identical to the patient's strain in 3 L. akamushi mite larvae and 1 field mouse, suggesting that L. akamushi mites were the source of human infection. Our findings suggest reemergence of summer scrub typhus associated with infected L. akamushi mites carrying a locally novel genotype. **Keywords:** Apodemus speciosus; Japan; Leptotrombidium akamushi; Orientia tsutsugamushi; bacteria; large Japanese field mouse; rickettsia; scrub typhus; seasonal variation; vector-borne infections; zoonoses. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Epidemiology of Tsutsugamushi disease in relation to the serotypes of Rickettsia tsutsugamushi isolated from patients, field mice, and unfed chiggers on the eastern slope of Mount Fuji, Shizuoka Prefecture, Japan. ](https://pubmed.ncbi.nlm.nih.gov/1452653/) Kawamori F, Akiyama M, Sugieda M, Kanda T, Akahane S, Uchikawa K, Yamada Y, Kumada N, Furuya Y, Yoshida Y, et al.Kawamori F, et al.J Clin Microbiol. 1992 Nov;30(11):2842-6. doi: 10.1128/jcm.30.11.2842-2846.1992.J Clin Microbiol. 1992.PMID: 1452653Free PMC article. * [ Trombiculid mites (Acari: Trombiculidae) and Rickettsia tsutsugamushi isolated from wild rodents in a new endemic area of Japan. ](https://pubmed.ncbi.nlm.nih.gov/2117663/) Iwasa M, Kasuya S, Noda N, Hioki A, Ito A, Ohtomo H.Iwasa M, et al.J Med Entomol. 1990 Jul;27(4):501-8. doi: 10.1093/jmedent/27.4.501.J Med Entomol. 1990.PMID: 2117663 * [ Heterogeneity of Orientia tsutsugamushi genotypes in field-collected trombiculid mites from wild-caught small mammals in Thailand. ](https://pubmed.ncbi.nlm.nih.gov/30011267/) Takhampunya R, Korkusol A, Promsathaporn S, Tippayachai B, Leepitakrat S, Richards AL, Davidson SA.Takhampunya R, et al.PLoS Negl Trop Dis. 2018 Jul 16;12(7):e0006632. doi: 10.1371/journal.pntd.0006632. eCollection 2018 Jul.PLoS Negl Trop Dis. 2018.PMID: 30011267Free PMC article. * [ Occurrence of Orientia tsutsugamushi, the Etiological Agent of Scrub Typhus in Animal Hosts and Mite Vectors in Areas Reporting Human Cases of Acute Encephalitis Syndrome in the Gorakhpur Region of Uttar Pradesh, India. ](https://pubmed.ncbi.nlm.nih.gov/30016222/) Sadanandane C, Jambulingam P, Paily KP, Kumar NP, Elango A, Mary KA, Agatheswaran S, Sankari T, Mishra BB.Sadanandane C, et al.Vector Borne Zoonotic Dis. 2018 Oct;18(10):539-547. doi: 10.1089/vbz.2017.2246. 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