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Ann Indian Acad Neurol 2019 Apr-Jun;22(2):237-240

Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.

Scrub typhus, a mite-borne zoonotic disease, is endemic in several parts of India. It may cause multisystemic disease involving lungs, heart, spleen, liver, hematological system, and nervous system. Neurological involvement may include meningoencephalitis, cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, muscle dysfunction, neuroleptic malignant syndrome, parkinsonian syndrome, and Guillain-Barre syndrome. Read More

Ann Indian Acad Neurol 2019 Apr-Jun;22(2):153-158

Department of Infectious Diseases, Christian Medical College Hospital, Vellore, Tamil Nadu, India.

Context: Opsoclonus, a rare neurological manifestation in scrub typhus, causes significant distress and disability. There is a paucity of clinical data and outcomes in these patients.

Aim: This study aims to describe the clinical and laboratory profile and longitudinal outcomes in a scrub typhus patient cohort with opsoclonus. Read More

J Lab Physicians 2019 Jan-Mar;11(1):82-86

Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India.

Purpose: Scrub typhus an acute febrile illness has diverse clinical manifestations, which overlap with other febrile illnesses. Due to this reason, it is misdiagnosed, leading to inappropriate treatment, sometimes resulting in fatality. Thus, accurate diagnosis of scrub typhus is important for appropriate treatment. Read More

J Lab Physicians 2019 Jan-Mar;11(1):11-16

Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Context: To the best of our knowledge, there are no reports of serological evidence of human leptospirosis from Uttarakhand state in India.

Aims: The aim of this study was to screen for serological evidence of leptospirosis in patients with acute undifferentiated febrile illness at a tertiary care teaching hospital in Uttarakhand.

Settings And Design: A pilot study was conducted from March to November 2017. Read More

BMC Pediatr 2019 Apr 10;19(1):102. Epub 2019 Apr 10.

Second Affiliated Hospital of Wenzhou Medical University, Wen Zhou, China.

Background: This study sought to analyze the cases of clinical misdiagnosis of scrub typhus complicated by hemophagocytic syndrome.

Methods: We retrospectively reviewed the medical records for diagnoses, clinical course, chest X-ray findings, laboratory data, and antibiotic therapy.

Results: All nine patients were misdiagnosed at the outpatient department between 07/2009 and 07/2017. Read More

Med Pharm Rep 2019 Jan 15;92(1):36-42. Epub 2019 Jan 15.

Internal Medicine Department, Pt. BD Sharma PGIMS, Rohtak, India.

Introduction: Scrub typhus is an acute febrile illness caused by . It is characterised by fever, rash, myalgia and diffuse lymphadenopathy. Most common complications are sepsis, shock, acute respiratory distress syndrome (ARDS), hepatitis, pre renal azotemia and multi organ dysfunction syndrome (MODS). Read More

Infect Chemother 2019 Mar;51(1):73-76

Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.

Scrub typhus is an acute febrile disease caused by , and the clinical course varies from mild and self-limiting to fatal. We describe a rare case of a pulmonary artery thrombosis associated with scrub typhus. Vasculitis via endothelial dysfunction caused by scrub typhus could be considered as the main mechanism. Read More

Immunol Med 2018 Jun 17;41(2):82-84. Epub 2018 Aug 17.

a Department of Rheumatology , Kawasaki Medical School , Kurashiki , Japan.

Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which is found mainly in East and Southeast Asia and in Australia. The disease presents with a variety of non-specific symptoms, including fever, headache, cough, myalgia, and rash. Delay in starting appropriate antimicrobial therapy may lead to serious complications and even death. Read More

Trop Med Infect Dis 2019 Mar 29;4(2). Epub 2019 Mar 29.

School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand.

Scrub typhus (ST) is a vector-borne rickettsial infection causing acute febrile illness. The re-emergence of ST in the Asia-Pacific region represents a serious public health threat. ST was first detected in Bhutan in 2008. Read More

Am J Trop Med Hyg 2019 Mar 25. Epub 2019 Mar 25.

Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea.

A 56-year-old female goat herder had scrub typhus that persisted after receiving doxycycline for 5 days. Her symptoms continued, prompting us to perform further examinations that revealed coinfection of Q fever and scrub typhus via molecular and serological testing. We also isolated using BALB/c mice and L929 cells. Read More

J Korean Med Sci 2019 Mar 12;34(11):e87. Epub 2019 Mar 12.

Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome. Read More

BMC Infect Dis 2019 Mar 25;19(1):283. Epub 2019 Mar 25.

Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea.

Background: Scrub typhus is an acute disease, characterized by symptoms of fever, which occurs due to infection by Orientia tsutsugamushi. In most cases, patients recover from the disease with appropriate treatment, but serious and fatal complications may occur. The present study examined laboratory findings and tumor necrosis factor-alpha (TNF-α) levels of scrub typhus patients to identify the prognostic predictors of disease severity. Read More

Hum Immunol 2019 Mar 20. Epub 2019 Mar 20.

Medical Entomology, Arbovirology and Rickettsial Disease Division, Indian Council of Medical Research- Regional Medical Research Centre, N.E. Region, Post box no. 105, Dibrugarh-786001, Assam, India. Electronic address:

Scrub typhus (ST), caused by a gram negative intracellular bacteria- Orientia tsutsugamushi, is one among the leading causes of febrile illness across Southeast Asia, including India. Clinical presentation can vary from asymptomatic to severely fatal. Th1-cell mediated immunity has been suggested to play an important role against ST infection in animal models. Read More

Trop Doct 2019 Mar 21:49475519836038. Epub 2019 Mar 21.

3 Consultant, Department of Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.

Guillain-Barré syndrome (GBS) is a potentially life-threatening immune-mediated acute inflammatory polyneuropathy associated with several antecedent infections. We report a 20-year-old man with GBS associated with concurrent leptospirosis and scrub typhus infection. GBS was confirmed with clinical examination and nerve conduction studies. Read More

Emerg Infect Dis 2019 Apr;25(4)

Rickettsioses are endemic to Vietnam; however, only a limited number of clinical studies have been performed on these vectorborne bacteria. We conducted a prospective hospital-based study at 2 national referral hospitals in Hanoi to describe the clinical characteristics of scrub typhus and murine typhus in northern Vietnam and to assess the diagnostic applicability of quantitative real-time PCR assays to diagnose rickettsial diseases. We enrolled 302 patients with acute undifferentiated fever and clinically suspected rickettsiosis during March 2015-March 2017. Read More

Emerg Microbes Infect 2019 ;8(1):130-138

a National Institute of Virology, Microbial Containment Complex , Pune , India.

Seasonal outbreaks of acute encephalitis syndrome (AES) at Gorakhpur, India have been recognized since 2006. So far, the causative agent has not been identified. Use of next generation sequencing identified human parvovirus 4 (HPARV4) sequences in a CSF/plasma pool. Read More

J Pediatric Infect Dis Soc 2019 Mar 13. Epub 2019 Mar 13.

Department of Medicine, Swiss Tropical and Public Health Institute and Faculty of Medicine, University of Basel, Switzerland.

Background: Scrub typhus, caused by Orientia tsutsugamushi, is a major cause of acute febrile illness in children in the rural tropics.

Methods: We recruited 60 febrile pediatric patients with a positive scrub typhus rapid diagnostic test result and 40 healthy controls from Chiang Rai Province in northern Thailand. Diagnosis was confirmed by the detection of (1) O. Read More

Front Microbiol 2019 26;10:319. Epub 2019 Feb 26.

Department of Entomology, US Army Medical Directorate of the Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS), Bangkok, Thailand.

In this study, we used a metagenomic approach to analyze bacterial communities from diverse populations (humans, animals, and vectors) to investigate the role of these microorganisms as causative agents of disease in human and animal populations. Wild rodents and ectoparasites were collected from 2014 to 2018 in Nan province, Thailand where scrub typhus is highly endemic. Samples from undifferentiated febrile illness (UFI) patients were obtained from a local hospital. Read More

Am J Trop Med Hyg 2019 Mar 11. Epub 2019 Mar 11.

Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom.

In this diagnostic accuracy study, we evaluated data from 135 febrile patients from Chiang Rai, to determine the optimal optical density (OD) cutoffs for an in-house scrub typhus IgM ELISA. Receiver operating characteristic curves were generated using a panel of reference assays, including an IgM immunofluorescence assay (IFA), PCR, in vitro isolation, presence of an eschar, or a combination of these. Altogether, 33 patients (24. Read More

Emerg Infect Dis 2019 Jun 17;25(6). Epub 2019 Jun 17.

Endemic scrub typhus was recently detected on Chiloé Island in southern Chile. We report a series of cases, acquired over a wide geographical range in continental Chile during 2016-2018, demonstrating that this emerging rickettsial infection is also found on the mainland of South America. Read More

PLoS Negl Trop Dis 2019 02 25;13(2):e0007160. Epub 2019 Feb 25.

Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

Background: The burden of scrub typhus in endemic areas is poorly understood. This study aimed at estimating the proportion of hospitalisations and outpatient visits for undifferentiated fever in the community that may be attributable to scrub typhus.

Methodology And Principal Findings: The study was a retrospective cohort with a nested case-control study conducted in the South Indian state of Tamil Nadu. Read More

Am J Trop Med Hyg 2019 Feb;100(2):235-236

Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea.

BMC Infect Dis 2019 Feb 19;19(1):174. Epub 2019 Feb 19.

Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, the Republic of Korea.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is emerging in Asian 3 countries, China, Japan and Korea, which are scrub typhus endemic areas, and its incidence is increasing. As the two infections overlap epidemiologically and clinically and the accessibility or sensitivity of diagnostic tests is limited, early clinical prediction may be useful for diagnostic and therapeutic purposes.

Methods: Patients aged ≥16 years who were clinically suspected and laboratory-confirmed to be infected with Orientia tsutsugamushi or the SFTS virus in South Korea were enrolled. Read More

Am J Trop Med Hyg 2019 Feb;100(2):399-404

Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea.

This study compared the frequency of abnormal electrocardiogram (ECG) types between scrub typhus patient group and age- and gender-matched health checkup group and their associations with disease severity in scrub typhus patient. Demographic characteristics and ECG and laboratory findings of patients with scrub typhus admitted to Chosun University Hospital, and normal subjects visiting the hospital for health checkup from January 2008 to December 2012 were retrospectively studied. Electrocardiogram abnormalities at admission were observed in 72 of 165 (43. Read More

J Genet Eng Biotechnol 2018 Dec 3;16(2):441-446. Epub 2018 Dec 3.

Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok 65000, Thailand.

Leptospirosis is a widespread zoonotic disease caused by . Symptoms of disease range from mild symptoms to serious complications including, jaundice, pulmonary hemorrhage, renal and hepatic failure, which may prove fatal. Clinical presentations of this disease are similar with other febrile illness. Read More

Trop Med Infect Dis 2019 Feb 2;4(1). Epub 2019 Feb 2.

Department of Microbiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu 44600 Nepal.

a zoonotic bacterial infection common in the region known as the tsutsugamushi triangle. This study aims to determine the seroprevalence, seasonal variation, and risk factors of scrub typhus among the acute febrile illness patients attending different hospitals of central Nepal. Blood samples were collected from hospitalized patients of acute febrile illness suspected of scrub typhus infection attending different hospitals of central Nepal from April 2017 to March 2018. Read More

PLoS Negl Trop Dis 2019 02 4;13(2):e0007158. Epub 2019 Feb 4.

Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Background: Scrub typhus is a neglected tropical disease that causes acute febrile illness. Diagnosis is made based upon serology, or detection of the causative agent-Orientia tsutsugamushi-using PCR or in vitro isolation. The enzyme-linked immunosorbent assay (ELISA) is an objective and reproducible means of detecting IgM or IgG antibodies. Read More

Med J Armed Forces India 2019 Jan 10;75(1):8-17. Epub 2019 Jan 10.

Professor & Head, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India.

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. Read More

Am J Trop Med Hyg 2019 Mar;100(3):635-638

Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.

Scrub typhus (ST, ), murine typhus (MT, ), and dengue virus (DENV) are important causes of childhood morbidity in Cambodia. This prospective, cross-sectional seroprevalence study determined the proportion of Cambodian children infected by these pathogens and the ages at which initial infection is likely to occur. A total of 993 patient serum samples were tested for MT- and ST-specific IgG, and 837 samples tested for DENV-specific IgG. Read More

Environ Monit Assess 2019 Jan 18;191(2):82. Epub 2019 Jan 18.

ICAR-National Research Centre on Meat, Hyderabad, 500092, India.

Orientia tsutsugamushi, the causative agent of scrub typhus, is an obligate intracytosolic bacterium transmitted among humans and small mammals by some species of larval trombiculid mites (chiggers). It has been recognized as a pathogen of major public health concern in the Asia-Pacific region. As disease is considered as a neglected, there exists a gap in our knowledge of the disease with regard to the sporadic epidemiologic data in endemic areas. Read More

Int J Infect Dis 2019 Jan 11. Epub 2019 Jan 11.

CDC India, New Delhi, India.

Background: Acute encephalitis syndrome (AES) surveillance in India has indicated that Japanese encephalitis virus (JEV) accounts for 5-35% of AES cases annually; the etiology remains unknown in the remaining cases. We implemented comprehensive AES surveillance to identify other etiological agents of AES, with emphasis on dengue virus.

Methods: Serum and cerebrospinal fluid (CSF) specimens were collected from patients enrolled prospectively in AES surveillance from 2014-2017 at selected sites of three high burden states of India. Read More

Travel Med Infect Dis 2019 Jan 9. Epub 2019 Jan 9.

Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address:

J Adv Res 2019 Jan 18;15:111-116. Epub 2018 Jul 18.

Department of Pediatrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon and life-threatening disorder that may rarely complicate the clinical course of Orientia tsutsugamushi disease (scrub typhus). Here, we describe the clinical features, laboratory parameters, management, and outcome of 16 children with scrub typhus-associated HLH. All patients satisfied the HLH-2004 diagnostic criteria. Read More

BMJ Case Rep 2018 Dec 3;11(1). Epub 2018 Dec 3.

Paediatrics, Kasturba Medical College, Manipal, Karnataka, India.

Scrub typhus caused by is an important cause for fever of unknown origin in endemic areas including India. The vasculitis associated with the disease leads to a variety of clinical manifestations. However, the joint involvement is quite rare and not reported in children. Read More

Infect Immun 2019 Mar 21;87(3). Epub 2019 Feb 21.

Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, Virginia, USA

is an obligate intracellular bacterium that infects mononuclear and endothelial cells to cause the emerging global health threat scrub typhus. The ability of to survive in monocytes facilitates bacterial dissemination to endothelial cells, which can subsequently lead to several potentially fatal sequelae. As a strict intracellular pathogen that lives in the cytoplasm of host cells, has evolved to counter adaptive immunity. Read More

Clin Infect Dis 2018 Dec 10. Epub 2018 Dec 10.

State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.

Background: Substantial outbreaks of scrub typhus coupled with the discovery of this vector-borne disease in new areas suggest that the disease remains remarkably neglected. The objectives of this study were to map the contemporary and potential transmission risk zones of the disease and provide novel insights into the health burden imposed by scrub typhus in southern China.

Methods: Based on the assembled data sets of annual scrub typhus cases and maps of environmental and socioeconomic correlates, a boosted regression tree modeling procedure was used to identify the environmental niche of scrub typhus and to predict the potential infection zones of the disease. Read More

Am J Trop Med Hyg 2019 Mar;100(3):532-539

Center for Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Republic of China.

Scrub typhus is caused by the intracellular bacterium . The 56-kDa type-specific antigen (TSA) displays a significant antigenic variation across different strains. To minimize the influence of the antigenic diversity of TSA on assay sensitivity, we developed a mixed-TSA enzyme-linked immunosorbent assay (mixed-TSA ELISA) using a mixture of recombinant TSAs of prototype (Karp, Gilliam, and Kato) and local (TW-1, TW-10, TW-19, and TW-22) strains as antigens to detect immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against . Read More

PLoS One 2018 6;13(12):e0208327. Epub 2018 Dec 6.

Department of Entomology and Plant Pathology, North Carolina State University, Raleigh, North Carolina, United States of America.

Scrub typhus is a mites-borne rickettsiosis caused by the obligate intracellular Gram-negative bacterium Orientia tsutsugamushi. The disease is potentially life threatening and is prevalent in tropical Asia, islands of the western Pacific Ocean and northern Australia where an estimated one million cases occur annually. Orientia tsutsugamushi is transmitted by the bite of larval mites in the genus Leptotrombidium. Read More

Ticks Tick Borne Dis 2019 02 16;10(2):495-503. Epub 2018 Nov 16.

Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. Electronic address:

The vectors of scrub typhus are the larval stage of trombiculid mites, termed "chiggers". These vectors are very small - the larvae are approximately 0.2 mm in size - and therefore their morphological identification is difficult. Read More

J Transl Med 2018 12 3;16(1):333. Epub 2018 Dec 3.

Department of Medical Research, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan.

Background: Studies on the relationship between depression and scrub typhus are limited. We conducted a retrospective cohort study to investigate whether scrub typhus is a risk factor for depression.

Methods: Using Taiwan's National Health Insurance Research Database, this study investigated the incidence of depression, and its risk factors, in patients diagnosed with scrub typhus between 2000 and 2010. Read More

Sci Rep 2018 Nov 26;8(1):17373. Epub 2018 Nov 26.

Drug & Disease Target Team, Korea Basic Science Institute, Cheongju, 28119, South Korea.

Scrub typhus, which is caused by Orientia tsutsugamushi, is a public health problem in the Asian-Pacific region and is the third most frequently reported infectious disease in South Korea. While ultrastructural studies have been performed on O. tsutsugamushi in murine fibroblasts, its variable locations in patients have hampered similar studies in humans. Read More

J Assoc Physicians India 2018 May;66(5):22-5

Department of Medicine, VIMS, Kolkata, West Bengal.

Background And Aims: Scrub typhus is the commonest of the rickettsial diseases in India and is difficult to diagnose. Untreated cases have fatality rates of 30-45%. Eschar is present in 7-97% cases. Read More

J Assoc Physicians India 2018 May;66(5):36-8

Professor, Department of Microbiology, IGMC, Shimla, Himachal Pradesh.

Background: Scrub typhus is a re-emerging zoonotic rickettsial infection. Mortality is approximately 15% in some areas due to missed or delayed diagnosis. There had been only few studies on the markers for the severity of the disease, so this study has been planned to provide the knowledge regarding various aspects of scrub typhus in adult age group to detect early signs of severity . Read More

Emerg Infect Dis 2018 12;24(12):2364-2367

Scrub typhus is associated with outbreaks of acute encephalitis syndrome in Uttar Pradesh, India. A case-control study indicated that children residing, playing, or visiting fields; living with firewood stored indoors; handling cattle fodder; and practicing open defecation were at increased risk for scrub typhus. Communication messages should focus on changing these behaviors. Read More

Geospat Health 2018 11 9;13(2). Epub 2018 Nov 9.

Department of Applied Statistics, Hanyang University, Seoul.

Scrub typhus, a bacterial, febrile disease commonly occurring in the autumn, can easily be cured if diagnosed early. However, it can develop serious complications and even lead to death. For this reason, it is an important issue to find the risk factors and thus be able to prevent outbreaks. Read More

Indian J Ophthalmol 2018 Dec;66(12):1840-1844

Resident, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Salem, Tamil Nadu, India.

Purpose: Among the major groups of rickettsiosis, the commonly reported diseases in India are: (a) Typhus group induced-scrub typhus, murine flea-borne typhus; (b) Spotted fever group induced-Indian tick typhus; and (c) Q fever. Though many scrub typhus outbreaks have been reported from India, only one outbreak of spotted fever-serologically proven Indian tick typhus (Rickettsia conorii)-has been reported. We report for the first time ocular manifestations of serologically proven R. Read More

Gigascience 2018 12 1;7(12). Epub 2018 Dec 1.

Institute of Infection & Global Health, University of Liverpool, L3 5RF, United Kingdom.

Background: Trombidid mites have a unique life cycle in which only the larval stage is ectoparasitic. In the superfamily Trombiculoidea ("chiggers"), the larvae feed preferentially on vertebrates, including humans. Species in the genus Leptotrombidium are vectors of a potentially fatal bacterial infection, scrub typhus, that affects 1 million people annually. Read More

Indian J Med Microbiol 2018 Jul-Sep;36(3):422-425

Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Scrub typhus caused by Orientia tsutsugamushi presents as an acute febrile illness with a varied presentation from mild illness to fatal disease in the absence of appropriate antibiotic treatment. Performing polymerase chain reaction (PCR) on eschar sample acts a rapid diagnostic tool in the early stage of scrub typhus when blood is negative. A total of eight patients from whom both whole blood and eschar samples were collected and tested by nested PCR targeting 56 kDa trichostatin A (TSA) gene to detect O. Read More

Korean J Parasitol 2018 Oct 31;56(5):521-525. Epub 2018 Oct 31.

International Development Group, School of Veterinary Science, Massey University, Palmerston North, New Zealand.

Rodents are well-known reservoirs and vectors of many emerging and re-emerging infectious diseases, but little is known about their role in zoonotic disease transmission in Bhutan. In this study, a cross-sectional investigation of zoonotic disease pathogens in rodents was performed in Chukha district, Bhutan, where a high incidence of scrub typhus and cases of acute undifferentiated febrile illness had been reported in people during the preceding 4-6 months. Twelve rodents were trapped alive using wire-mesh traps. Read More

Indian J Crit Care Med 2018 Oct;22(10):706-710

Department of Nephrology, PGIMER, Chandigarh, India.

Background And Aim: Scrub typhus (ST) is an acute infectious disease of variable severity caused by (formerly ) . The disease can be complicated by organ dysfunctions and the case fatality rate (CFR) is approximately 15%, which further rises with the development of severe complications. We studied the clinical features of the ST and the performance of critical illness scoring systems (CISSs) - Acute Physiology and Chronic Health Evaluation (APACHE) II, sequential organ failure assessment (SOFA), and quick SOFA (qSOFA) in predicting the clinical outcomes in complicated ST (cST) patients admitted to the emergency department. Read More