Scrub typhus seroprevalence from an eastern state of India: findings from the state-wide serosurvey

Abstract

Background Scrub typhus is a mite-borne infectious disease caused primarily by the obligate intracellular bacteria Orientia tsutsugamushi, which is transmitted by chigger mites. The objective of this study was to determine the prevalence of scrub typhus among adults in Odisha, an eastern state of India. Methods A descriptive cross-sectional study was conducted to analyse 1840 serum samples from five districts (Khordha, Cuttack, Ganjam, Malkangiri and Sundargarh) of Odisha collected during 2020–2021. Both immunoglobulin G (IgG) and IgM antibodies against scrub typhus were tested using commercial enzyme-linked immunosorbent assay kits. Point estimates of the 95% confidence interval and adjusted odds ratio were calculated. Results Of 1840 participants, the prevalence of IgG positivity was 1034 (56.19%) and that of IgM was 523 (28.42%). The majority of participants were in the 18–45 y age group (53.7%). Cuttack had the highest IgG positivity (64.54%) and Malkangiri had the lowest (29.32%). The highest and lowest positivity for IgM were found in Malkangiri (40.84%) and Cuttack (25.30%), respectively. Conclusions With an increasing number of infections detected in the state, scrub typhus is emerging as a public health threat. Increasing awareness among the general public and healthcare professionals through health education campaigns regarding scrub typhus is essential. Early detection of the disease through the establishment of a laboratory surveillance system is required to control the transmission of scrub typhus.

An interesting case of scrub typhus meningoencephalits

“…More common during the Rainy Season, as rainy and humid conditions favor the vector growth that's why it is more common during this period of year with many outbreaks reported in above countries in last few decades more on the eastern coast of India. 4,5 It is a diverse group of species, mainly divided into 3 -typhus, spotted fever, and scrub typhus. Among them, scrub typhus caused by Orienta tsutsugamushi is found to be most notorious for neurological manifestations.…”

“…Scrub typhus mostly presents as fever, headache, myalgias, and a pathognomic eschar. 5 In an Indian setting, with darkcolored skin, the presence of eschar is difficult to elicit, and its incidence varies from 10%-92%. 6 In the absence of eschar, the diagnosis of scrub typhus is difficult.…”

Odisha tribal family health survey: methods, tools, and protocols for a comprehensive health assessment survey

“…The tests include liver function tests (direct and total bilirubin, serum albumin, alkaline phosphatase, SGOT and SGPT), kidney function tests (serum urea, creatinine), lipid profile (cholesterol, lipoproteins), iron profile (serum iron and total iron binding capacity). Tests to assess the seroprevalence of scrub typhus (IgG) and hepatitis B (HBsAg) infections will also be performed using enzyme-linked immunosorbent assay ( 16 , 17 ).…”