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Scrub typhus in suburban Bangkok: first cases
C Eamsila1, P Buranakitjaroen, P Tanskul
1Division of Research, Royal Thai Army Component, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok.
Summary
This study confirms the first cases of scrub typhus in Bangkok, transmitted by Rickettsia tsutsugamushi. Increased surveillance is recommended due to potential underreporting in the region.
Area of Science:
- Infectious Diseases
- Medical Entomology
- Public Health
Background:
- Scrub typhus, caused by Orientia tsutsugamushi, is a significant public health concern in Asia.
- Limited data exists on scrub typhus epidemiology in Metropolitan Bangkok.
Observation:
- Three patients presented with severe febrile illness, two with eschars, suggestive of scrub typhus.
- Immunofluorescence assay (IFA) confirmed elevated IgG and IgM antibodies to R. tsutsugamushi in all patients.
- Cases resided in distinct areas of western Bangkok with fruit trees and limited travel history.
Findings:
- Rickettsia tsutsugamushi was isolated from a rodent (rat) collected near a patient's residence.
- Known mite vectors of scrub typhus were identified in the surveyed areas.
- These findings represent the first confirmed instances of scrub typhus transmission within Metropolitan Bangkok.
Implications:
- Scrub typhus may be more prevalent in Bangkok than previously reported.
- Widespread antibiotic self-medication and diagnostic challenges may contribute to underreporting.
- Enhanced diagnostic capabilities and public health surveillance are crucial for managing scrub typhus in urban and peri-urban settings.