Scrub typhus strikes back: Are we ready?

Abstract

Scrub typhus has struck back, albeit with renewed vigour, impacting areas with previously known endemicity as also impressing newer expanses. It is not surprising, therefore, that Scrub typhus has emerged as a leading cause of public health concern globally as well as in India, but are we ready to take on the challenge? Over the last decade, there has been a global increase in the number of outbreaks of Scrub typhus, be it the military occupied areas or the civil population at large. The innumerable outbreaks of Scrub typhus, although disconcerting, have nonetheless contributed phenomenally towards better understanding of the dynamics of scrub typhus. There have been significant contributions to awareness of the disease amongst medical professionals, scrub typhus as a cause of Acute Undifferentiated Febrile Illness (AUFI) and newer clinical manifestation e Acute Encephalitis Syndrome (AES), availability and advances in diagnostics and management, man-vector-pathogen interactions, new records of Leptotrombidium species, newer vectors and Orientia species.Antigenic diversity and the varied clinical presentation of scrub typhus, absence of scrub typhus surveillance system and a lack of political will to recognize the disease as one of the important reemerging public health problem are areas seeking concerted deliberations and actions so that the challenges posed by scrub typhus can be addressed.

Representative Genotyping, Recombination and Evolutionary Dynamics Analysis of TSA56 Gene Segment of Orientia tsutsugamushi

“…At present, while its endemic areas continue to broaden in Asian regions, strong molecular, serological and clinical evidence suggested that this disease has spread in Africa and South America (Diaz et al, 2018 ). And the incidence of this disease is increasing worldwide (Yang and Zhao, 2008 ; Tilak and Kunte, 2019 ). Currently, cases of vertical transmission through the mother to the baby have been observed (Suntharasaj et al, 1997 ).…”

“…More than 40 serotypes or antigenic strains of O. tsutsugamushi been isolated worldwide (Tilak and Kunte, 2019 ). The most common genotype is Karp, following by Gilliam (Kelly et al, 2009 ; Tilak and Kunte, 2019 ).…”

“…More than 40 serotypes or antigenic strains of O. tsutsugamushi been isolated worldwide (Tilak and Kunte, 2019 ). The most common genotype is Karp, following by Gilliam (Kelly et al, 2009 ; Tilak and Kunte, 2019 ). Approximately 50 and 25% of human infections are related to Karp and Gilliam strain infections, respectively (Soong, 2018 ).…”

An Unusual Clinical Presentation of Scrub Typhus

“…Scrub typhus, also known as tsutsugamushi disease, is a bacterial infection transmitted by larval trombiculid mites from rodents often during cooler months. The causative organism is Orientia tsutsugamushi , an obligatory intracellular bacterium that leads to the formation of eschar at the inoculation site followed by fever, headache, myalgia, generalized lymphadenopathy, cough, gastrointestinal symptoms, transient hearing loss, and rash [1]. Further progression of the disease may manifest as acute respiratory distress syndrome, meningoencephalitis, gastrointestinal bleeding, acute renal failure, and coagulopathy [2].…”

Medical Journal Armed Forces India: 75 years young!

“…Look out for a reality check on scrub typhus as an emerging threat in this issue! 7 Entering 75 years of regular publishing, MJAFI will celebrate 2019 as a Platinum jubilee year. This will be an occasion to reflect, remodel and rededicate us to the challenges ahead.…”