Scrub Typhus: an Update*

Scrub typhus has recently assumed public importance. This article expounds current understanding of the epidemiology, clinical features, diagnosis, treatment, and control. It is a zoonotic disease caused by several strains of the rickettsial bacterium Orientia tsutsugamushi and is spread by the bite of larvae of Leptotrombidium mites. Until recent times, the disease was confined to rural areas in the “tsutsugamushi triangle,” but now it is reported beyond it also. Pathogenesis involves endothelial injury with consequent vasculitis and systemic inflammatory response. It presents as fever with or without a wide range of complications. Multiorgan dysfunction carries high mortality. There are a number of accurate diagnostic modalities, and treatment of choice is doxycycline with several alternatives. There are concerns regarding emergence of drug resistance, and no vaccine is available. Scrub typhus is resurging infection, and development of an effective control program and sensitization of medical community is the need of the hour.