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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 Feb 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 Jan 21. Epub 2019 Jan 21.

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 2018 Dec 17. Epub 2018 Dec 17.

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 2018 Dec 10. Epub 2018 Dec 10.

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 IgM and 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 Dec 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):22-25

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):36-38

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 Dec;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

BMC Infect Dis 2018 Nov 7;18(1):551. Epub 2018 Nov 7.

Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea.

Background: Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, a gram-negative intracellular bacterium. Myocarditis and rhabdomyolysis are rare complications of scrub typhus.

Case Presentation: We report a case of scrub typhus, which was simultaneously complicated with myocarditis and rhabdomyolysis. Read More

Curr Med Chem 2018 Nov 5. Epub 2018 Nov 5.

Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan 46241. Korea.

Vectors are living organisms that transmit infectious diseases from an infected animal to humans or another animal. Biological vectors such as mosquitoes, ticks, and sand flies carry pathogens that multiply within their bodies prior to delivery to a new host. The increased prevalence of vector-borne diseases (VBDs) such as Aedes-borne dengue, Chikungunya (CHIKV), Zika (ZIKV), malaria, tick-borne disease (TBD), and scrub typhus has a huge impact on the health of both humans and livestock worldwide. Read More

Int J Infect Dis 2019 Feb 2;79:195-198. Epub 2018 Nov 2.

Indian Council of Medical Research, New Delhi, India.

Background: The aim of this study was to estimate the seroprevalence of spotted fever group (SFG) and typhus group (TG) rickettsiae among individuals with acute febrile illness (AFI) in the scrub typhus endemic district of Gorakhpur in India. This district is one of the worst affected by annual seasonal acute encephalitis syndrome (AES) outbreaks.

Methods: Antibodies against SFG and TG rickettsiae and the associated risk factors were determined in 294 individuals presenting with an AFI, encountered during a community-based survey conducted during the AES outbreak period October-November 2016. Read More

Microb Genom 2018 Oct;4(10)

1​Northern Arizona University, Flagstaff, AZ, USA.

Indian J Med Res 2018 Aug;148(2):215-224

Institute of Medical Sciences, Tzu Chi University, Chia Yi, Taiwan.

Background & Objectives: Scrub typhus is a chigger-borne disease caused by Orientia tsutsugamushi. The immunological reactions to O. tsutsugamushi infection are not completely understood. Read More

Neurologist 2018 Nov;23(6):183-184

Department of Neurology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Korea.

Introduction: Aquaporin-4 antibody (AQP4-Ab) is specific for neuromyelitis optica spectrum disorder (NMOSD) and so is helpful to distinguish NMOSD from other autoimmune diseases. Several viral infections may play a role in the onset of NMOSD.

Case Report: We describe a case of a previous healthy 82-year-old woman who presented with acute visual loss occurring 3 weeks after scrub typhus. Read More

Trop Doct 2018 Oct 26:49475518804696. Epub 2018 Oct 26.

4 Director Professor and Head, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of unchecked activation of the immune system leading to phagocytosis of blood cells and proliferation of histiocytes in solid organs. HLH can be primary or secondary to infective, autoimmune and malignant conditions. Scrub typhus is an infective illness caused by Orientia tsutsugamushi, transmitted by mite. Read More

J Mol Recognit 2018 Oct 21:e2766. Epub 2018 Oct 21.

ICAR-Indian Veterinary Research Institute, Regional Station, Palampur, Himachal Pradesh, India.

Orientia tsutsugamushi (Ott) is a causative agent of chigger-borne zoonosis, scrub typhus which is life threatening and highly pervasive illness in humans. In this report, we have mined and classified the proteins involved in pathways unique to Ott by using high-throughput computational techniques. The 12 metabolic pathways were found to be unique to the pathogen. Read More

J Cell Biochem 2018 Oct 15. Epub 2018 Oct 15.

Sri Sakthi Amma Institute of Biomedical Research, Sri Narayani Hospital and Research Centre, Vellore, Tamil Nadu, India.

Orientia tsutsugamushi, a cause of scrub typhus is emerging as an important pathogen in several parts of the tropics. The control of this infection relies on rapid diagnosis, specific treatment, and prevention through vector control. Development of a vaccine for human use would be very important as a public health measure. Read More

Am J Trop Med Hyg 2018 Dec;99(6):1386-1389

Department of Clinical Medicine, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

Scrub typhus and Japanese spotted fever-both rickettsial diseases-are endemic and notifiable in Japan and may cause a fatal outcome without prompt treatment. Here we present the first case of a concurrent sympatric infection of both diseases with grade II evidence. A 67-year-old woman, after a single event of potential exposure to the pathogens, presented with a 12-day history of fever, pharyngeal pain, papulo-erythematous rash, and pronounced fatigue. Read More

J Antimicrob Chemother 2019 Jan;74(1):74-81

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.

Objectives: To develop a method to enable the large-scale antimicrobial susceptibility screening of Orientia tsutsugamushi clinical isolates, using one timepoint and one concentration of antibiotics to considerably speed up the time to result.

Methods: Growth, harvesting, multiplicity of infection (moi) and the day to determine the MICs were optimized using five O. tsutsugamushi reference strains [susceptible (Karp, Kato and Gilliam) and putatively resistant (AFC-3 and AFSC-4)], one clinical isolate (UT76) and one rodent isolate (TA763). Read More

J Clin Microbiol 2018 Dec 27;56(12). Epub 2018 Nov 27.

U.S. Army Medical Research Directorate-Kenya/Kenya Medical Research Institute, Kisumu, Kenya

We present data that concurs with the reported geographical expansion of scrub typhus outside the "Tsutsugamushi Triangle" and addition of as a second species in the genus. Wild rodents were caught in Marigat, Baringo County, Kenya, and ectoparasites, including chiggers, were recovered. Rodent and chigger species were identified by taxonomic features. Read More

J Vector Borne Dis 2018 Apr-Jun;55(2):165-167

Department of Microbiology, Government Medical College, Haldwani, India.

J Vector Borne Dis 2018 Apr-Jun;55(2):144-150

Department of General Medicine and Microbiology, Indira Gandhi Govt. General Hospital and Post Graduate Institute, Puducherry, India.

Background & Objectives: Rickettsial diseases are important re-emerging infections that mostly go unnoticed or are misdiagnosed. Though few case reports of Indian tick typhus have been reported in Indian literature in the past 10 yr, prevalence surveys are few and far between. The objective of this research was to study the seroprevalence of spotted fever (SF) group rickettsiosis and its coinfection with scrub typhus (ST) in Puducherry region of south India, as these two diseases may show similar clinical presentations. Read More

J Vector Borne Dis 2018 Apr-Jun;55(2):130-136

Department of Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.

Background & Objectives: In India, certain geographic regions witness simultaneous outbreaks of two or more diseases like scrub typhus, dengue fever, malaria, leptospirosis and chikungunya during monsoon and post-monsoon period, sharing common indication of acute febrile illness. The objective of the present study was to assess the prevalence of coinfections among patients with acute undifferentiated fevers (AUF) admitted in a tertiary care hospital in the northern hilly state of Himachal Pradesh, India.

Methods: This was a hospital based open cohort study conducted over a period of two months (September and October) in 2016. Read More

Trop Med Infect Dis 2018 Sep 1;3(3). Epub 2018 Sep 1.

Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithee Road, Bangkok 10400, Thailand.

Here we estimated the accuracy of the InBios Scrub Typhus Detect™ immunoglobulin M (IgM) ELISA to determine the optimal optical density (OD) cut-off values for the diagnosis of scrub typhus. Patients with undifferentiated febrile illness from Chittagong, Bangladesh, provided samples for reference testing using (i) qPCR using the spp. 47-kDa gene, (ii) IFA ≥1:3200 on admission, (iii) immunofluorescence assay (IFA) ≥1:3200 on admission or 4-fold rise to ≥3200, and (iv) combination of PCR and IFA positivity. Read More

Trop Med Infect Dis 2018 Jul 5;3(3). Epub 2018 Jul 5.

Mahara Institute of Medical Acarology, Tokushima 779-1510, Japan.

The rickettsial diseases Japanese spotted fever (JSF) and scrub typhus (ST) are caused by and , respectively. The diseases share clinical symptoms, such as fever, rash, and eschar. However, there are no systematical investigations of the serological cross-reactivity between and . Read More

Trop Med Infect Dis 2018 Jun 11;3(2). Epub 2018 Jun 11.

Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, School of Medicine, Richmond, VA 23298, USA.

Scrub typhus threatens one billion people in the Asia-Pacific area and cases have emerged outside this region. It is caused by infection with any of the multitude of strains of the bacterium . A vaccine that affords heterologous protection and a commercially-available molecular diagnostic assay are lacking. Read More

Trop Med Infect Dis 2018 Feb 14;3(1). Epub 2018 Feb 14.

Stroke Center, Jichi Medical University 3311-1, Yakushiji, Shimotsuke-city, Tochigi 329-0498, Japan;

Background: Scrub typhus is a mite-borne bacterial infection caused by . Hemophagocytic lymphohistiocytosis (HLH) is a potential severe complication. Most reported cases of HLH associated with scrub typhus were single cases or case series with a small sample sizes. Read More

Trop Med Infect Dis 2018 Jan 25;3(1). Epub 2018 Jan 25.

Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.

There is limited evidence of rickettsial diseases in Bhutan. We explored the contribution of rickettsioses as a cause of undifferentiated febrile illness in patients presenting to 14 Bhutanese hospitals from October 2014 to June 2015. Obvious causes of fever were excluded clinically. Read More

Trop Med Infect Dis 2018 Jan 25;3(1). Epub 2018 Jan 25.

Viral and Rickettsial Diseases Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.

Scrub typhus is the most important rickettsial disease in the world. Its previous endemic region was considered to be in Asia, Australia and islands in the Indian and Pacific Oceans; this area was referred to as the Tsutsugamushi Triangle. Accumulation of serological, molecular, genetic, and culture data have shown that not only is scrub typhus not limited to the Tsutsugamushi Triangle, but can be caused by orientiae other than . Read More

Trop Med Infect Dis 2018 Jan 17;3(1). Epub 2018 Jan 17.

Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA.

Scrub typhus and the rickettsial diseases represent some of the oldest recognized vector-transmitted diseases, fraught with a rich historical aspect, particularly as applied to military/wartime situations. The vectors of were once thought to be confined to an area designated as the Tsutsugamushi Triangle. However, recent reports of scrub typhus caused by species other than well beyond the limits of the Tsutsugamushi Triangle have triggered concerns about the worldwide presence of scrub typhus. Read More

Trop Med Infect Dis 2017 Dec 21;3(1). Epub 2017 Dec 21.

Institute of Environmental Health, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 100, Taiwan.

Rickettsial diseases, particularly vector-borne rickettsioses (VBR), have a long history in Taiwan, with studies on scrub typhus and murine typhus dating back over a century. The climatic and geographic diversity of Taiwan's main island and its offshore islands provide many ecological niches for the diversification and maintenance of rickettsiae alike. In recent decades, scrub typhus has re-emerged as the most prevalent type of rickettsiosis in Taiwan, particularly in eastern Taiwan and its offshore islands. Read More