Scrub typhus update: A re‑emerging global threat beyond the Tsutsugamushi Triangle and the physiological ramifications of scrub typhus infection (Review)

Vashishtha,Ankur; Kumar,Vivek; Panwar,Gautam; Kausik,Gaurav; Baig,Samaniya; Sharma,Prigya; Yadav,Rajesh

doi:10.3892/wasj.2025.322

Scrub typhus update: A re‑emerging global threat beyond the Tsutsugamushi Triangle and the physiological ramifications of scrub typhus infection (Review)

Authors:
- Ankur Vashishtha
- Vivek Kumar
- Gautam Panwar
- Gaurav Kausik
- Samaniya Baig
- Prigya Sharma
- Rajesh Yadav
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Affiliations: Department of Medical Laboratory Technology, Sharda School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201310, India, Department of Nursing, IIMT University, Meerut, Uttar Pradesh 250001, India, Glocal College of Paramedical Science and Research Centre, Glocal University, Saharanpur, Uttar Pradesh 247121, India, Department of Medical Laboratory Technology, IIMT University, Meerut, Uttar Pradesh 25000, India, Department of Biotechnology, Sharda School of Basic Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh 201310, India, Department of Dialysis Technology, Sharda School of Allied Health Sciences, Sharda University, Greater Noida, Uttar Pradesh 201310, India
Published online on: February 6, 2025 https://doi.org/10.3892/wasj.2025.322
Article Number: 34
Copyright : © Vashishtha et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Scrub typhus, caused by Orientia tsutsugamushi, is a mite‑borne zoonotic disease endemic to Asia and the Pacific. The prevalence of Orientia tsutsugamushi, originating from the Tsutsugamushi Triangle, is increasingly globally. The present review delves into the intricate mechanisms of bacterial‑host interactions and immune responses within dendritic cells, blood vessels and kidney endothelial cells. Additionally, it provides an in‑depth discussion of the scrub typhus life cycle and its associated organ system diseases. It presents with flu‑like symptoms, including fever, rash and eschar formation, but can progress to severe complications, such as acute encephalitis syndrome and multi‑organ dysfunction syndrome. The disease has affected vulnerable populations in India, China, Thailand, Malaysia, Korea, and other countries with outbreaks reported across various states. The diagnosis of scrub typhus has evolved from the outdated Weil‑Felix test to more accurate techniques, such as the use of PCR and ELISA. Early treatment with antibiotics, such as doxycycline or azithromycin markedly reduces morbidity and mortality rates. The disease remains neglected in a number of regions despite the growing number of cases. Preventive measures, primarily the use of insect repellent, are essential, as no licensed vaccine exists to date.

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