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Scrub typhus reemergence in the Maldives
Michael D Lewis1, Abdul Azeez Yousuf, Kriangkrai Lerdthusnee
1Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand. michael.lewis14@us.army.mil
Emerging Infectious Diseases
|January 15, 2004
Summary
A 2002 outbreak of febrile illness in the Maldives was identified as scrub typhus, caused by Orientia tsutsugamushi. This investigation marked the first recorded cases in the region since World War II, resulting in 168 illnesses and 10 deaths.
Area of Science:
- Epidemiology
- Infectious Diseases
- Tropical Medicine
Background:
- An unusual febrile illness outbreak occurred in the Maldives during summer 2002.
- The outbreak persisted through April 2003, with significant case numbers and fatalities.
- This event represented the first documented occurrence of scrub typhus in the Maldives since World War II.
Purpose of the Study:
- To identify the causative agent of the febrile illness outbreak in the Maldives.
- To investigate the epidemiology and characteristics of the scrub typhus cases.
- To confirm the re-emergence of scrub typhus in the Maldives after a long interval.
Main Methods:
- Case ascertainment and data collection by Maldivian health officials.
- Laboratory confirmation of Orientia tsutsugamushi by the Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok.
- Joint epidemiological investigation conducted by AFRIMS and the Ministry of Health, Maldives.
Main Results:
- A total of 168 cases of febrile illness were recorded.
- Ten deaths were associated with the outbreak.
- Laboratory analysis confirmed the presence of Orientia tsutsugamushi, identifying the illness as scrub typhus.
Conclusions:
- The 2002-2003 outbreak in the Maldives was confirmed as scrub typhus.
- The findings highlight the re-emergence of this vector-borne disease in the region.
- Public health surveillance and control measures for scrub typhus are warranted in the Maldives.