Scrub typhus in the northern provinces of Vietnam: an observational study of admissions to a national referral hospital.

Behzad Nadjm,Van D Trang,Le Dang Ha,Heiman F Wertheim,Nguyen V Kinh,Pham T Thuy

doi:10.1093/trstmh/tru145

Abstract

BackgroundScrub typhus is a common cause of fever in parts of South East and Southern Asia. Little is known about the disease burden in Vietnam.MethodsA 2-year observational study of scrub typhus at a tertiary referral hospital in northern Vietnam was carried out. Diagnosis was based on a single serological test in patients with suggestive clinical symptoms.ResultsScrub typhus was diagnosed in 3.5% (251/7226) of admissions. Cases occurred throughout the year, with incidence highest in the summer. Although complications were common, mortality was low (1.2%; 3/251).ConclusionsThese data suggest that scrub typhus is common, with a seasonal distribution in northern Vietnam.

Highlights

Scrub typhus, a zoonosis transmitted by trombiculid mites is caused by Orientia tsutsugamushi (Family: Rickettsiaceae), previously known as Rickettsia tsutsugamushi
We report results of a 2-year study into the frequency, clinical features and outcome of scrub typhus in patients admitted to a tertiary referral hospital in Hanoi, which received referrals from hospitals and health centres throughout northern Vietnam
Adults and children admitted to the Infectious Disease Department of Bach Mai hospital, between 2001 and 2003, had serological testing performed for scrub typhus by ELISA (Panbio, Melbourne, Australia) or Tsutsugamushi rapid test (SD Bioline, Kionggi, South Korea), if they presented with either fever with eschar, lymphadenopathy and rash or fever with no signs of pneumonia, urinary infection or other confirmed infections

Summary

Background

Scrub typhus is a common cause of fever in parts of South East and Southern Asia. Little is known about the disease burden in Vietnam. Methods: A 2-year observational study of scrub typhus at a tertiary referral hospital in northern Vietnam was carried out. Diagnosis was based on a single serological test in patients with suggestive clinical symptoms. Results: Scrub typhus was diagnosed in 3.5% (251/7226) of admissions. Cases occurred throughout the year, with incidence highest in the summer. Conclusions: These data suggest that scrub typhus is common, with a seasonal distribution in northern Vietnam

Introduction

Materials and methods

Results and Discussion