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Historical epidemics of scrub typhus in Queensland and Papua New Guinea

G D Shanks1,2

  • 1Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Queensland, Australia.

Internal Medicine Journal
|August 20, 2023
PubMed

Insights

Scrub typhus, a mite-transmitted illness, caused significant military casualties and remains an occupational disease in rural Queensland. Early diagnosis and antibiotic treatment are crucial for this treatable infection.

Area of Science:

  • Infectious Diseases
  • Tropical Medicine
  • Medical Entomology

Background:

  • Undifferentiated febrile illnesses in North Queensland were linked to mite-transmitted rickettsial infections, specifically scrub typhus (tsutsugamushi fever).
  • Scrub typhus posed a significant threat to military personnel in Papua New Guinea during WWII, causing more fatalities than malaria pre-antibiotics.
  • It is recognized as an occupational disease among rural workers in North Queensland, particularly near Cairns and Innisfail.

Purpose of the Study:

  • To highlight the historical and ongoing relevance of scrub typhus in North Queensland.
  • To emphasize the under-recognition of scrub typhus in the civilian population due to its non-reportable status.
  • To advocate for increased serological testing for febrile illnesses in endemic areas.

Main Methods:

  • Historical review of medical records and epidemiological investigations.
  • Analysis of disease patterns in military operations and rural worker populations.
  • Discussion of diagnostic challenges and treatment efficacy.

Main Results:

  • Scrub typhus was identified as a cause of significant morbidity and mortality, particularly in military contexts.
  • The disease persists as an occupational hazard in specific regions of North Queensland.
  • Small outbreaks continue to occur, especially during military exercises.

Conclusions:

  • Scrub typhus remains an underdiagnosed infection in civilian communities in North Queensland.
  • Increased awareness and utilization of serological testing are essential for prompt identification.
  • Early diagnosis allows for effective treatment with antibiotics, improving patient outcomes.
Keywords:
Papua New GuineaQueenslandhistorical epidemiologymilitaryscrub typhus

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