Tick-Borne Rickettsiosis and Tsutsugamushi Disease Recorded in 313.

Infect Chemother

Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.

Published: June 2024

AI Article Synopsis

  • * The disease Zhongxidu is less understood but is thought to be another infection occurring in mountainous areas, also presenting with an eschar; it predates Shashidu by about five centuries.
  • * Shegongdu, observed in ancient texts, is believed to result from bites of an insect called Shegong, which may actually indicate a tick, linking the condition to a tick-borne illness that hasn't been fully acknowledged due to historical gaps

Article Abstract

Tsutsugamushi disease was first described in China by Hong Ge in 313. In his book , three eschar-associated febrile diseases were described: Shashidu, Zhongxidu, and Shegongdu. Shashidu was identified as being identical to tsutsugamushi disease in Japan: it occurred in riverside areas, exhibited an eschar, and was transmitted by tiny red "sand lice". The nature of Zhongxidu remains unknown, but we propose that it is another type of infection: it occurred in mountainous areas, an eschar was observed, and the causative vector was not identified. Moreover, Zhongxidu would have predated Shashidu by five centuries; thus, the first documentation of tsutsugamushi disease would date back 2.2 millennia. infection without eschar has not been identified in ancient Chinese literature and may be included in Shanghan. Several ancient Chinese books describe that Shegongdu occurs following a Shegong bite. Shegong is described as a bug resembling a cockroach or cicada with a crossbow-like structure, possibly the hypostome and unfolded palps of tick, in its mouth. Thus, Shegong refers to an engorged tick and Shegongdu is a tick-borne rickettsiosis. However, due to a lack of entomological knowledge, these findings have not been recognized for the past 1.7 millennia.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224035PMC
http://dx.doi.org/10.3947/ic.2023.0105DOI Listing

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