title: Outbreak investigation of scrub Typhus in Himachal Pradesh (India).
abstract: Scrub Typhus outbreak investigation was undertaken during September 2003 in the three worst affected districts Shimla, Solan and Sirmaur in Himachal Pradesh (India). A total of 113 cases and 19 deaths (17.27 percent case fatality rate) were reported from the eight districts, which were reporting cases. Cases were prevalent in all age groups and in both the sexes among the persons frequenting forest for occupational work. 35.7 percent of the patients serum samples showed a titer of > 1: 80 against OX 19 and OXK antigen is suggestive of Scrub Typhus. Entomologically Rattus rattus (39.5 per cent) was the most prevalent species followed by Suncus murinus (22.91 percent), Bandicoota bengalensis (29.16 percent) and Bandicoota indica and Mus musculus (4.16 percent each). Vector species Leptotrombidium deliense and Gahrliepia (schoengastilla) sp. were recorded. The chigger index 23.0 was found to be highest in Vill. Baldian and 5.0 in Vill. Bhatakuffer (Shimla) and 1.0 in Vill. Rebon (Solan), which is above the critical limit of 0.69 per rodents. Other mite species, ixodid ticks, fleas and lice have been recorded.
authors.affiliation: National Institute of Communicable Diseases, 22 Sham Nath Marg,Delhi-110 054.
authors.forename: Kaushal
authors.initials: K
authors.lastname: Kumar
authors.forename: V K
authors.initials: VK
authors.lastname: Saxena
authors.forename: T G
authors.initials: TG
authors.lastname: Thomas
authors.forename: Shiv
authors.initials: S
authors.lastname: Lal
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004478:Ectoparasitic Infestations / Q000453:epidemiology / Q000469:parasitology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D018884:Ixodes; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000276:immunology*; D008003:Phthiraptera; D012376:Rodent Diseases / Q000453:epidemiology / Q000469:parasitology; D012612:Scrub Typhus / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005423:Siphonaptera; D014324:Trombiculidae
chemical_list: D000907:Antibodies, Bacterial