Epidemiology of scrub typhus in eastern Taiwan, 2000-2004

The epidemiology of scrub typhus in eastern Taiwan was studied by analyzing the data from the CDC Web reporting system. A total of 1,396 cases with 403 confirmed cases were reported in the period of 2000 to 2004. The cases were commonly found in all counties with the highest number in Yuli Township, Hualien County (53 cases) and Taitung City, Taitung County (40 cases). Monthly changes in the number of cases showed epidemic periods in the spring with a peak in May, and again in the fall, with an October-November peak. The occurrence of disease varied with age, gender, and occupation. Our results showed that the infection rates in the elderly (50-69 years old), males (62.8%), and farmers (25.6%) were higher than those in other age groups, females, and other occupations. Five major clinical symptoms, fever, headache, eschar, rash, and lymphadenopathy, were observed in 90.1, 61.9, 23.1, 21.6, and 10.7% of the cases, respectively. Almost 90% (89.3%) of the cases showed 1-3 clinical symptoms and some showed 4-5 symptoms (10%). Only one patient with no symptoms (0.8%) was found. This paper reports the status of scrub typhus in eastern Taiwan, and suggests that a health education program could train individuals to self-recognize the disease symptoms.