Abstract
Scrub typhus is a rickettsial disease that is usually transmitted by mite exposure. Infected patients may present with a fever, fatigue, headache, and muscle pain. A blackish skin lesion, called eschar, is pathognomic. The mortality rate in untreated cases is high. The first case of scrub typhus in Taiwan was reported in 1908 during the Japanese colonization. In this article, using the National Infectious Disease Statistics System (NIDSS) from the Taiwan CDC, we analyzed the dynamic incidence of scrub typhus from 2016 to 2021, both seasonally and geographically. In addition, we asked whether the recent travel restrictions and social distancing policy in Taiwan (19 May to 27 July 2021), implemented due to the COVID-19 outbreak, would change the incidence of scrub typhus. The results showed that scrub typhus was most common in summer, with an incidence almost twofold greater than that in winter or spring. Most cases were identified in rural regions. Interestingly, there was a significant 52% reduction in the summer incidence in 2021, compared to the average summer incidence of the past 5 years. This reduction coincided with the countrywide lockdown measures and travel restrictions. The restricted measures for outdoor activities may have contributed to the reduced incidence of scrub typhus.
Highlights
Orientia tsutsugamushi naturally survives in mite populations by transmission from females to eggs, eggs to larvae, and to adults
We first asked in which season scrub typhus was the most common
Scrub typhus is more common in summer than in the other seasons in Taiwan
Summary
Its clinical manifestation includes a fever, headache, chills, arthralgias, and myalgias. A specific cutaneous lesion, eschar, and centrifugal maculopapular rash become recognized as the disease evolves [1]. Orientia tsutsugamushi, belonging to the family Rickettsiaceae, is the pathogen responsible for scrub typhus. This bacterium was first reported by Hakuju Hashimoto in Japan in 1810 [2]. Orientia tsutsugamushi naturally survives in mite populations by transmission from females to eggs, eggs to larvae, and to adults. The mite larvae, called chiggers, are natural ectoparasites of rodents [3]. When infected chiggers bite humans, the bacteria are transferred
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