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Year : 2016  |  Volume : 34  |  Issue : 1  |  Page : 114-

Recent outbreak of scrub typhus in North Western part of India

JH Park 
 Department of Preventive Medicine, Dongguk University, College of Medicine, Geyongju, South Korea

Correspondence Address:
J H Park
Department of Preventive Medicine, Dongguk University, College of Medicine, Geyongju
South Korea

How to cite this article:
Park J H. Recent outbreak of scrub typhus in North Western part of India.Indian J Med Microbiol 2016;34:114-114

How to cite this URL:
Park J H. Recent outbreak of scrub typhus in North Western part of India. Indian J Med Microbiol [serial online] 2016 [cited 2020 Aug 15 ];34:114-114
Available from: http://www.ijmm.org/text.asp?2016/34/1/114/167682

Full Text

Dear Editor,

With great interest, I have gone through a paper entitled, 'Recent outbreak of scrub typhus in North Western part of India' published in the July 2014 issue of IJMM.[1] Scrub typhus has been highly prevalent in South Korea, and I would like to share our experiences of scrub typhus.

The proportion of patients with eschars is different between countries. In South Korea, most of the patients of scrub typhus occurred during autumn (September to November), and the proportion of patients with eschars is high over 70%.[2] As for the patients in India, the presence of eschars varies in different localities and eschars were not even detected in the study conducted by Sinha, et al.[1] However, a study for the scrub typhus patient in southern part of India showed that eschars were found among 55% patients.[3] Therefore, eschars could be a useful diagnostic tool in some parts of India.

Most scrub typhus patients could be recovered without complications if appropriate antibiotic treatment is administered early. In South Korea, although a total of 30,478 cases of scrub typhus were reported during 2008–2012, the mortality rate of scrub typhus was very low about 0.1%.[2] Inspecting undressed patients who suspected of scrub typhus are recommended to detect eschars on the patients' body. Additionally, presence of lymphadenopathy could be of help in finding escahrs because of the correlation between sites of eschars and lymphadenopathy.[4]

Considering that scrub typhus is severely under-diagnosed in India, the authors' opinion to suggest empirical treatment with doxycycline carries significant implications. Also, it is important to endeavour to find eschars on patients to diagnose scrub typhus early. In addition to these, using repellents or wearing long clothes must be recommended in endemic areas to decrease infection of scrub typhus.

References

1Sinha P, Gupta S, Dawra R, Rijhawan P. Recent outbreak of scrub typhus in North Western part of India. Indian J Med Microbiol 2014;32:247-50.
2Park JH, Kim SJ, Youn SK, Park K, Gwack J. Epidemiology of scrub typhus and the eschars patterns in South Korea from 2008 to 2012. Jpn J Infect Dis 2014;67:458-63.
3Varghese GM, Janardhanan J, Trowbridge P, Peter JV, Prakash JA, Sathyendra S, et al. Scrub typhus in South India: Clinical and laboratory manifestations, genetic variability, and outcome. Int J Infect Dis 2013;17:e981-7.
4Kim DM. Clinical features and diagnosis of scrub typhus. Infect Chemother 2009;41:315-22. (in Korean).