Outbreak of scrub typhus in southern India during the cooler months
Outbreak of scrub typhus in southern India during the cooler months
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DOI：
10.1111/j.1749-6632.2003.tb07391.x
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发表时间：
2003-01-01
期刊：
影响因子：
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通讯作者：
Raoult, D
中科院分区：
文献类型：
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作者：
Mathai, E;Rolain, JM;Raoult, D
恙虫病东方体是恙虫病的病原体，是一种严格的细胞内细菌，在包括印度在内的亚洲许多地区都有发现。在过去几年中，立克次体感染和恙虫病患者数量有所增加，特别是在较凉爽的月份。我们在这项研究中报道了最近在较冷的月份（2001 年 10 月至 2002 年 2 月）期间，在我们医院收治的患有急性发热性疾病（伴有多种体征和症状）的患者中爆发的丛林斑疹伤寒疫情。总体而言，28 名患者经临床和血清学证实患有恙虫病。发烧超过一周是唯一常见的表现。肌痛是第二常见的特征 (52%)，只有 22% 的病例出现皮疹。 17 名接受多西环素治疗的患者以及 2 名接受氯霉素治疗的患者在 1 至 3 天内康复。接受环丙沙星治疗的五名患者五天后发烧才消退。最终三名患者（10.7%）死亡，其中一名接受强力霉素治疗的患者。这些数据表明，恙虫病是印度重新出现的一种传染病，可能产生耐药性。这种重新出现强调需要进一步的前瞻性研究来设计有效的控制措施。
Orientia tsutsugamushi, the agent of scrub typhus, is a strict intracellular bacterium which is found in many parts of Asia including India. During the past few years, the number of patients with rickettsial infection and scrub typhus has increased, especially during the cooler months. We report in this study a recent outbreak of scrub typhus recorded during the cooler months (October 2001 to February 2002) in patients admitted to our hospital with acute febrile illness associated with diverse signs and symptoms. Overall, 28 patients were clinically and serologically confirmed to have scrub typhus. Fever for more than one week was the only common manifestation. Myalgias was the next most common feature (52%), and rash was observed in only 22% of the cases. Seventeen patients treated with doxycycline recovered in 1 to 3 days, as well as two patients who received chloramphenicol. In five patients who received ciprofloxacin, fever subsided only after five days. Finally three patients (10.7%) died, including one patient treated with doxycycline. These data indicate that scrub typhus is a reemerging infectious disease in India with a possibility of drug resistance. This reemergence emphasizes the need for further prospective studies to design effective control measures.