SkiptomaincontentAdvertisementSearchallBMCarticlesSearchDownloadPDFResearcharticleOpenAccessPublished:18February2021AnoutbreakinvestigationofscrubtyphusinNepal:confirmationoflocaltransmissionMeghnathDhimal1 na1,ShyamPrakashDumre2,3 na1,GunaNidhiSharma4,5,PratikKhanal1,6,KamalRanabhat6,7,LalanPrasadShah7,BibekKumarLal4,RunaJha8,BishnuPrasadUpadhyaya8,BhimAcharya4,SanjayaKumarShrestha9,SilasA.Davidson10,PiyadaCharoensinphon10&KhemB.Karki1,6 BMCInfectiousDiseasesvolume 21,Article number: 193(2021)Citethisarticle2809Accesses2CitationsMetricsdetailsAbstractBackgroundScrubtyphusisalargelyignoredtropicaldiseaseandaleadingcauseofundifferentiatedfebrileillnessintheareasoftsutsugamushitrianglecausedbyOrientiatsutsugamushi.ItisfrequentlydiagnosedinSouthAsiancountries,althoughclearepidemiologicalinformationisnotavailablefromNepal.Afterthe2015earthquakeinNepal,asuddenupsurgeinscrubtyphuscaseswasreported.Theobjectiveofthisstudywastoinvestigateepidemiologyofscrubtyphusanditscausativeagentsinhumans,animals,andchiggermitestounderstandtheongoingtransmissionecology.MethodsScrubtyphuscaseswithconfirmeddiagnosisthroughoutthecountrywereincludedintheanalysis.StudieswereconcentratedintheChitwandistrict,thesiteofamajoroutbreakin2016.Additionalnation-widedatafrom2015to2017availablefromthegovernmentdatabaseincludedtoanalysethediseasedistributionbygeographicalmapping.ResultsFrom2015to2017,1239scrubtyphuscaseswereconfirmedwiththelargestoutbreakoccurringin2016with831(67.1%)cases.Thecasefatalityratewas5.7%in2015whichdeclinedto1.1%in2017.Anationwideoutbreakofscrubtyphuswasdeclaredasthecasesweredetectedin52outofthe75districtsofNepal.SeasonaltrendwasobservedwithapeakduringAugustandSeptember.Inadditiontothehumancases,thepresenceofO.tsutsugamushiwasalsoconfirmedinanimals(rodents)andchiggermites(Leptotrombidiumimphalum)fromtheoutbreakareasofsouthernNepal.ConclusionThedetectionofO.tsutsugamushiinhumans,animals,andchiggermitesfromoutbreaklocationsandwide-spreadreportsofscrubtyphusthroughoutthecountrycons