Seroprevalence of Scrub Typhus Infection in Arunachal Pradesh, India.

Abstract

Scrub typhus is a major reason for febrile illness, caused by a bacterium Orientia tsutsugamushi, a rickettsial pathogen. Few outbreaks of scrub typhus have been reported from Arunachal Pradesh in recent past. However, there is lack of seroprevalence data from the region. In this regard, this study was undertaken using archival serum sample available from seven districts of Arunachal Pradesh. This serological study was conducted in Regional Medical Research Center for NE Region, Dibrugarh. Reactivity to IgG class of antibodies against scrub typhus was done using Scrub typhus detect IgG ELISA kit as per manufacturer's protocol. Seroprevalence of scrub typhus in seven districts of Arunachal Pradesh was found to be 40% (120/300). The age-specific scrub typhus seroprevalence rose steadily from 5.6% in children <10 years of age to 61.8% in persons aged ≥40 years (p = 0.0001). Prevalence is lowest in Papumpare (25.9%) and highest in East Siang (72.5%) (p = 0.0001). The seroprevalence in males and females was very similar, however, the female prevalence increases from age group ≥30 years (p = 0.053). Moreover, among the farmers, the seroprevalence is higher (58.3%) (p = 0.0001). As clinical symptoms overlap with other viral/bacterial infections, scrub typhus infection should be considered in differential diagnosis of any acute febrile illness in this part of the country. In view of the high prevalence, empirical therapy of doxycycline/azithromycin may be done in cases of undiagnosed fever. Active surveillance has to be done to understand exact magnitude, epidemiological aspects, and distribution of vector and disease of this reemerging neglected tropical disease.