Re-Emergence of Scrub Typhus as a Public Health Problem in India: Its Spatial and Temporal Distribution Based on Analysis of 15-Year Data of the National Integrated Disease Surveillance Programme

Rina Tilak; Vivek Anand; Mohan  D Gupte; Ravi  Devarakonda; Rajpal  S Yadav

Rina Tilak PhD, Armed Forces Medical College, Pune, India (retired) https://orcid.org/0000-0003-3781-0210
Vivek Anand MD, Armed Forces Medical Services, Guwahati, India
Mohan D Gupte MD, National Institute of Epidemiology, Chennai, India (retired)
Ravi Devarakonda MD, Armed Forces Medical Services, Chennai, India
Rajpal S Yadav PhD, Academy of Public Health Entomology, Udaipur, India

Keywords: Descriptive Study, India, Integrated Disease Surveillance Programme, Outbreak, Rickettsial Diseases, Scrub Typhus

Abstract

Introduction: The Integrated Disease Surveillance Programme (IDSP) in India monitors trends in epidemic-prone diseases for an early response to outbreaks. Being the only authentic programmatic source of national scrub typhus data, we analysed the burden of this disease and assessed the sufficiency of the IDSP system to control the disease.
Method: In this descriptive study, we analysed all 7564 IDSP weekly reports since its inception in 2009 until 2023, and assessed disease burden, mortality, clinical features, diagnostic modalities, treatment protocols, and prevention and control measures undertaken.
Results: Among the 756 IDSP weekly outbreak reports, 127 scrub typhus outbreaks were reported with 3751 cases and 93 deaths (case fatality rate: 2.48%). Thirty-two reports were excluded from the analysis that listed scrub typhus under outbreaks of other diseases or as co-illnesses with unclear diagnoses. The highest number of outbreaks, cases, and deaths were reported in the north-eastern zone of India, but most deaths were in Rajasthan state in the western zone. The outbreaks occurred year-round but mostly in the wet season from July to September.
Conclusions: The IDSP data represents only a partial picture of the true burden of scrub typhus in India. It reported limited or no information on vectors, antigenic strains of Orientia tsutsugamushi, risk factors, clinical presentations, diagnostic tests, treatment, and preventive and control measures undertaken by health services. This warrants improving the performance and functionality of the system.

How to cite this article:
Tilak R, Anand V, Gupte M D, Devarakonda R, Yadav R S. Re-Emergence of Scrub Typhus as a Public Health Problem in India: Its Spatial and Temporal Distribution Based on Analysis of 15-Year Data of the National Integrated Disease Surveillance Programme. J Commun Dis. 2024;56(2):70-93.

DOI: https://doi.org/10.24321/0019.5138.202440

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