Is Delhi an Emerging Scrub Typhus Hotspot? An Entomological and Zoonotic Exploration of a Scrub Typhus Outbreak

  • Rina Tilak Scientist G, Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India
  • Reema Mukherjee Professor, Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India
  • Ajay Malik Professor, Armed Forces Medical Services, Delhi, India.
  • Vijay Kumar Bhatti Professor, Armed Forces Medical Services, Delhi, India.
  • Kapil Pandya Associate Professor, Armed Forces Medical Services, Delhi, India.
  • Urmila B Wankhade Junior Scientific Assistant, Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
Keywords: Scrub Typhus Outbreak, Tick Typhus, Endemic Typhus, Leptotrombidium, Schoengastiella, Ascoschoengastia

Abstract

Background: Scrub typhus is an emerging public health challenge in India with increasing evidence of its activity being reported from all over the country. An outbreak of scrub typhus was reported from an area of South West Delhi, India hitherto not known for scrub typhus activity which prompted this zoonotic and entomological investigation.
Methods: Zoonotic and entomological investigations were undertaken in five residential areas of South West Delhi, India located in the vicinity of the reporting hospital to determine the rodent hosts, vector mite diversity, and rickettsial activity in rodents. The rickettsial activity was ascertained using Weil-Felix test.
Results: Palam area of Delhi, India is a hotspot of scrub typhus with evidence of tick and endemic typhus activity as well. This study reports the presence of known vectors of scrub typhus viz. Leptotrombidium deliense and Schoengastiella ligula, besides enriching the database of mite fauna of Delhi with an addition of a total of five new records, three of Leptotrombidium - vietzi, bhattipadense, fulmentum, and two records of Ascoschoengastia indica and Walchia lupella.
Conclusion: The study reports Delhi as a scrub typhus hotspot. In Delhi, Palam was the most affected and had the highest number of cases and deaths, presence of the vectors of scrub typhus and evidence of tick and endemic typhus activity amongst rodents. The mite database of Delhi has been updated with the addition of five new trombiculid mite records.

How to cite this article:
Tilak R, Mukherjee R, Malik A, Bhatti VK, Pandya K, Wankhade UB. Is Delhi an Emerging Scrub Typhus Hotspot? An Entomological and Zoonotic Exploration of a Scrub Typhus Outbreak. J Commun Dis. 2022;54(1):100-106.

DOI: https://doi.org/10.24321/0019.5138.202256

References

Tilak R, Kunte R. Scrub typhus strikes back: are we ready? Med J Armed Forces India. 2019 Jan;75(1):8-17.[PubMed] [Google Scholar]

Xu G, Walker DH, Jupiter D, Melby PC, Arcari CM. A review of the global epidemiology of scrub typhus. PLoS Negl Trop Dis. 2017 Nov;11(11):e0006062. [PubMed] [Google Scholar] 3. Singhi S, Rungta N, Nallasamy K, Bhalla A, Peter JV, Chaudhary D, Mishra R, Shastri P, Bhagchandani R, Chugh TD; for Indian Society of Critical Care Medicine Research Group. Tropical fevers in Indian intensive care units: a prospective multicenter study. Indian J Crit Care Med. 2017 Dec;21(12):811-8. [PubMed] [Google Scholar]

Gupta N, Chaudhry R, Kabra SK, Lodha R, Mirdha BR, Das BK, Wig N, Sreenivas V. In search of scrub typhus: a prospective analysis of clinical and epidemiological profile of patients from a tertiary care hospital in New Delhi. Adv Infec Dis. 2015;5:140-7. [Google Scholar]

Mittal V, Gupta N, Bhattacharya D, Kumar K, Ichhpujani RL, Singh S, Chhabra M, Rana U. Serological evidence of rickettsial infections in Delhi. Indian J Med Res. 2012 Apr;135:538-41. [PubMed] [Google Scholar]

Prakash A, Acharya AS, Jain N, Bhattacharya D, Chhabra M. Scrub typhus-an emerging public health problem in Delhi! Indian J Med Spec. 2014 Jan 1;5(1):68-72. [Google Scholar]

Chaudhry R, Thakur CK, Gupta N, Sagar T, Bahadur T, Wig N, Sood R, Misra MC. Mortality due to scrub typhus - report of five cases. Indian J Med Res. 2019 Jun;149(6):790-4. [PubMed] [Google Scholar]

Bhattar S, Mehra B, Singh I, Bhalla P. Is scrub typhus a cause of febrile illness among paediatric population of Delhi? J Clin Diagn Res. 2015 Mar;9(3):DL02. [PubMed] [Google Scholar]

Fernandez S, Kulkarni SM. Studies on the trombiculid mite fauna of India [dissertation]. Savitribai Phule Pune University; 2003. [Google Scholar]

Candasamy S, Ayyanar E, Paily K, Karthikeyan PA, Sundararajan A, Purushothaman J. Abundance & distribution of trombiculid mites & Orientia tsutsugamushi, the vectors & pathogen of scrub typhus in rodents & shrews collected from Puducherry & Tamil Nadu, India. Indian J Med Res. 2016 Dec;144(6):893-900. [PubMed] [Google Scholar]

Tilak R, Kunwar R, Wankhade UB, Tilak VW. Emergence of Schoengastiella ligula as the vector of scrub typhus outbreak in Darjeeling: has Leptotrombidium deliense been replaced? Indian J Public Health. 2011 Apr-Jun;55(2):92-9. [PubMed] [Google Scholar]

Sharma AK, Kumar K. Entomological surveillance for rodent and their ectoparasites with special reference to potential of scrub typhus at Kolkata port trust (KPT), Kolkata (India). J Paramed Sci. 2014;5(2):2-6. [Google Scholar]

Sharma AK. Entomological surveillance for rodent and their ectoparasites in scrub typhus affected areas of Meghalaya (India). J Entomol Zool Stud. 2013;1(6):27-9. [Google Scholar]

Kumar K, Saxena VK, Thomas TG, Lal S. Outbreak investigation of scrub typhus in Himachal Pradesh (India). J Commun Dis. 2004 Dec;36(4):277-83. [PubMed] [Google Scholar]

Mathai E, Rolain J M, Verghese GM, Abraham OC, Mathai D, Mathai M, Raoult D. Outbreak of scrub typhus in Southern India during the cooler months. Ann N Y Acad Sci. 2003 Jun;990:359-64. [PubMed] [Google Scholar]

Tanskul P, Strickman D, Eamsila C, Kelly DJ. Rickettsia tsutsugamushi in chiggers (Acari: Trombiculidae) associated with rodents in central Thailand. J Med Entomol. 1994 Mar;31:225-30. [PubMed] [Google Scholar]

Audy JR, Harrison JL, Thomas HM. A collection of trombiculid mites from Manipur and lower Burma. J Zool Soc India. 1953;5:1-162.

Bhattacharya D, Mittal V, Gupta N, Dhariwal AC, Bahl A. Scrub typhus and other rickettsiosis. CD Alert (National Centre for Disease Control (NCDC) Newsletter). 2009;13:1-8.

Rahi M, Gupte MD, Bhargava A, Varghese GM, Arora R. DHR-ICMR guidelines for diagnosis and management of rickettsial diseases in India. Indian J Med Res. 2015 Apr;141(4):417-22. [PubMed] [Google Scholar]

Published
2022-03-31