title: Scrub typhus in Darjeeling, India: opportunities for simple, practical prevention measures.
abstract: To identify risk factors for scrub typhus in Darjeeling, India, we compared 62 scrub typhus cases (acute fever with eschar and specific IgM) with 62 neighbourhood controls. Cases were more likely to live close to bushes [matched odds ratio (MOR) 10; 95% CI 2.3-63] and wood piles (MOR 3.5; 95% CI 1.5-9.5), to work on farms (MOR 10; 95% CI 2.7-63), to observe rodents at home (MOR 3.6; 95% CI 1.4-11) and at work (MOR 9; 95% CI 2.4-57), and to rear domestic animals (MOR 2.4; 95% CI 1.1-5.7). Cases were less likely to wash after work (MOR 0.4; 95% CI 0.1-0.9) and change clothes to sleep (MOR 0.2; 95% CI 0.1-0.5). A cleaner, rodent-controlled environment may prevent exposure to scrub typhus. Personal protection measures and better hygiene could further reduce individual risk.
authors.affiliation: Field Epidemiology Training Programme, National Institute of Epidemiology, Indian Council of Medical Research, R 127 Third Avenue, Tamil Nadu Housing Board Phase I and II, Ayapakkam, Chennai, Tamil Nadu 600077, India.
authors.forename: Puran K
authors.initials: PK
authors.lastname: Sharma
authors.forename: R
authors.initials: R
authors.lastname: Ramakrishnan
authors.forename: Y J F
authors.initials: YJ
authors.lastname: Hutin
authors.forename: A K
authors.initials: AK
authors.lastname: Barui
authors.forename: P
authors.initials: P
authors.lastname: Manickam
authors.forename: M
authors.initials: M
authors.lastname: Kakkar
authors.forename: V
authors.initials: V
authors.lastname: Mittal
authors.forename: M D
authors.initials: MD
authors.lastname: Gupte
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004199:Disease Vectors; D005260:Female; D006801:Humans; D006920:Hygiene; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012111:Residence Characteristics; D012307:Risk Factors; D012612:Scrub Typhus / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial