ArticleBMC infectious diseases2021
An outbreak investigation of scrub typhus in Nepal: confirmation of local transmission.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 34 citations in OpenAlex.
- Scrub Typhus-Associated Inflammatory Oligoarthritis Mimicking Tubercular Arthritis in an Endemic Setting.Cureus · 2026Article
- Article
- Estimating the Seroprevalence of Scrub Typhus in Nepal.Pathogens (Basel, Switzerland) · 2024Article
- The impact of meteorological parameters on the scrub typhus incidence in Baoshan City, western Yunnan, China.Frontiers in public health · 2024Article
- Host-response transcriptional biomarkers accurately discriminate bacterial and viral infections of global relevance.Scientific reports · 2023Article
- Epidemiology, clinical characteristics, diagnosis, and complications of scrub typhus infection in Nepal: a systematic review.Annals of medicine and surgery (2012) · 2023Review
- Scrub Typhus among Febrile Patients Admitted to the Department of Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2023Article
- Scrub typhus among patients with acute febrile illness in Bhutan: A cross-sectional study.Public health challenges · 2023Article
- Co-infection of dengue, scrub typhus, and typhoid during dengue outbreak in Nepal, 2022: A case report.Clinical case reports · 2023Article
- The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction.Microorganisms · 2023Review
- Impact of wars and natural disasters on emerging and re-emerging infectious diseases.Frontiers in public health · 2023Review
- Clinical profile and biochemical abnormalities in Scrub Typhus: A cross-sectional study.Annals of medicine and surgery (2012) · 2022Article
- Hemophagocytic Lymphohistiocytosis secondary to Rickettsial infection: A case report.Clinical case reports · 2022Article
- Purpura fulminans in probable scrub typhus group of rickettsioses from hilly region in Nepal - A case report.Annals of medicine and surgery (2012) · 2022Article
- Scrub typhus in a primary health care center of Nepal: A case series.Annals of medicine and surgery (2012) · 2022Article
- A suspected surgical case of acute abdomen: A case report of scrub typhus.Annals of medicine and surgery (2012) · 2022Article
- Dengue and scrub typhus co-infection causing septic shock.Oxford medical case reports · 2021Article
- Review
- Outbreak prone communicable diseases of public health importance in the northern districts of West Bengal - Current status & the way forward.The Indian journal of medical research · 2021Review
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundScrub typhus is a largely ignored tropical disease and a leading cause of undifferentiated febrile illness in the areas of tsutsugamushi triangle caused by Orientia tsutsugamushi. It is frequently diagnosed in South Asian countries, although clear epidemiological information is not available from Nepal. After the 2015 earthquake in Nepal, a sudden upsurge in scrub typhus cases was reported. The objective of this study was to investigate epidemiology of scrub typhus and its causative agents in humans, animals, and chigger mites to understand the ongoing transmission ecology.
methodsScrub typhus cases with confirmed diagnosis throughout the country were included in the analysis. Studies were concentrated in the Chitwan district, the site of a major outbreak in 2016. Additional nation-wide data from 2015 to 2017 available from the government database included to analyse the disease distribution by geographical mapping.
resultsFrom 2015 to 2017, 1239 scrub typhus cases were confirmed with the largest outbreak occurring in 2016 with 831 (67.1%) cases. The case fatality rate was 5.7% in 2015 which declined to 1.1% in 2017. A nationwide outbreak of scrub typhus was declared as the cases were detected in 52 out of the 75 districts of Nepal. Seasonal trend was observed with a peak during August and September. In addition to the human cases, the presence of O. tsutsugamushi was also confirmed in animals (rodents) and chigger mites (Leptotrombidium imphalum) from the outbreak areas of southern Nepal.
conclusionThe detection of O. tsutsugamushi in humans, animals, and chigger mites from outbreak locations and wide-spread reports of scrub typhus throughout the country consecutively for 3 years confirms the ongoing transmission of O. tsutsugamushi with a firmly established ecology in Nepal. The country's health system needs to be strengthened for systematic surveillance, early outbreak detection, and immediate actions including treatment and preventive measures.
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