International Journal of Contemporary Medicine

Scrub Typhus is known to be present in India for several decades. Initial reporting of outbreaks amongst troops followed by hospital based reporting indicates spread of the disease only. Cases have been reported from 20 states since 1960s. Cases have been reported almost regularly in last couple of decades. Most of these are hospital based reports and does truly reflect the disease burden in the population.

However, interest of professionals and policy makers about the disease appear to have decreased over the decades. Whereas way back in 1933 Army followed a policy of investigating all fever cases by Wiel- Felix test and formed Field Typhus Research teams, today there in no active surveillance of the disease. Passive surveillance also is inadequate. IDSP does not include the disease in their routine reporting. Only outbreak reporting is made by IDSP. NVBDCP and IVM do not include this disease.

A concrete strategy for control of the disease is required and may be integrated with the existing NVBDCP. Since the bionomics of the vector of Scrub Typhus (L. delience) is totally different from that of mosquito. It can not be integrated with IVM except for manpower, lab services, insecticide spraying in high risk areas. Vector specific measures are required.

A strategy for the high risk areas (which has reported cases in last ten years) is suggested as: Early detection and management (including strengthening of lab services at primary care level and introducing RDT kit), Capacity building (at primary care level), Surveillance (including rodent survey and sero survey immediately before the known transmission season), personal protection, Limited use of insecticide and Communication change behavior.