Scrub typhus reinfection

Abstract

Scrub typhus (ST), a mite-borne rickettsial disease, has increased in frequency in India, among other countries, in recent years.1,2 It is most commonly characterised as a febrile disease with a range of varying symptoms. This disseminated multi-organ disease may be life-threatening if not treated early during the illness and relapses with early cessation of treatment are common.3 Approximately 1 million ST cases occur annually, although surveillance statistics are poor in many coun-tries. However, potentially > 1 billion people are at the risk of infection.4 The chigger vectors themselves act as the disease reservoirs and man is an accidental host. Agriculturalists residing in and travellers visiting the endemic area (the tsutsugamushi triangle) during activ-ities such as rafting, hiking and trekking are at the greatest risk of the disease.