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Outbreak investigation of scrub Typhus in Himachal Pradesh (India)

Kaushal Kumar1, V K Saxena, T G Thomas

  • 1National Institute of Communicable Diseases, 22 Sham Nath Marg,Delhi-110 054.

The Journal of Communicable Diseases
|March 2, 2006
PubMed

Insights

A 2003 Scrub Typhus outbreak in Himachal Pradesh affected 113 people, causing 19 deaths. Rodent and mite surveillance identified key vectors, informing public health responses to this infectious disease.

Area of Science:

  • Epidemiology
  • Medical Entomology
  • Public Health

Background:

  • Scrub typhus, a zoonotic disease caused by Orientia tsutsugamushi, poses a significant public health threat in endemic regions.
  • Limited data exists on the entomological aspects and epidemiological patterns of scrub typhus outbreaks in Himachal Pradesh, India.

Purpose of the Study:

  • To investigate a scrub typhus outbreak in Himachal Pradesh, India, during September 2003.
  • To identify the etiological agents, epidemiological characteristics, and entomological vectors associated with the outbreak.

Main Methods:

  • Conducted an outbreak investigation in Shimla, Solan, and Sirmaur districts.
  • Collected and analyzed patient serum samples for serological evidence of scrub typhus.
  • Performed entomological surveys to identify rodent species and potential mite vectors.

Main Results:

  • 113 cases and 19 deaths (17.27% case fatality rate) were reported.
  • Serological tests showed significant titers (> 1:80) against OX 19 and OXK antigens in 35.7% of patients.
  • Rattus rattus was the most prevalent rodent species; Leptotrombidium deliense and Gahrliepia (schoengastilla) sp. were identified as vector species.
  • High chigger indices were recorded in affected villages, exceeding the critical limit for rodents.

Conclusions:

  • The investigation confirmed scrub typhus as the cause of the outbreak.
  • Rodent and mite populations play a crucial role in the transmission dynamics of scrub typhus in the region.
  • Findings highlight the need for targeted vector control and public health interventions.

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