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Kakkar M, Rogawski ET, Abbas SS, Chaturvedi S, Dhole TN, Hossain SS, Krishnan SK, 2013. Acute encephalitis syndrome surveillance, Kushinagar district, Uttar Pradesh, India, 2011–2012. Emerg Infect Dis 19: 1361–1367.
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2.
Ranjan P, Gore M, Selvaraju S, Kushwaha KP, Srivastava DK, Murhekar M, 2014. Changes in acute encephalitis syndrome incidence after introduction of Japanese encephalitis vaccine in a region of India. J Infect 69: 200–202.
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3.
Mittal M, Kushwaha K, 2014. AES: clinical presentation and dilemmas in critical care management. J Commun Dis 46: 50–65.
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4.
Kumari R, Joshi PL, 2012. A review of Japanese encephalitis in Uttar Pradesh, India. WHO South-East Asia Journal of Public Health 1: 374–395.
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5.
Murhekar MV et al. 2016. Acute encephalitis syndrome in Gorakhpur, Uttar Pradesh, India – role of scrub typhus. J Infect J Infect 73: 623–626.
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6.
Blacksell SD et al. 2016. Diagnostic accuracy of the InBios scrub typhus detect enzyme-linked immunoassay for the detection of IgM antibodies in northern Thailand. Clin Vaccine Immunol 23: 148–154.
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7.
Chrispal A et al. 2010. Scrub typhus: an unrecognized threat in south India – clinical profile and predictors of mortality. Trop Doct 40: 129–133.
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8.
Rahi M, Gupte MD, Bhargava A, Varghese GM, Arora R, 2015. DHR-ICMR guidelines for diagnosis and management of rickettsial diseases in India. Indian J Med Res 141: 417–422.
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9.
Todd SR, Dahlgren FS, Traeger MS, Beltrán-Aguilar ED, Marianos DW, Hamilton C, McQuiston JH, Regan JJ, 2015. No visible dental staining in children treated with doxycycline for suspected Rocky Mountain spotted fever. J Pediatr 166: 1246–1251.
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Scrub Typhus as an Etiology of Acute Febrile Illness in Gorakhpur, Uttar Pradesh, India, 2016
Jeromie Wesley Vivian Thangaraj
Jeromie Wesley Vivian Thangaraj
National Institute of Epidemiology, Chennai, India;
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Mahima Mittal
Mahima Mittal
Department of Pediatrics, BRD Medical College, Gorakhpur, India;
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Valsan Philip Verghese
Valsan Philip Verghese
Pediatric Infectious Diseases, Christian Medical College, Vellore, India;
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C. P. Girish Kumar
C. P. Girish Kumar
National Institute of Epidemiology, Chennai, India;
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Winsley Rose
Winsley Rose
Pediatric Infectious Diseases, Christian Medical College, Vellore, India;
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R. Sabarinathan
R. Sabarinathan
National Institute of Epidemiology, Chennai, India;
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Ashok Kumar Pandey
Ashok Kumar Pandey
National Institute of Virology, Gorakhpur Unit, Gorakhpur, India;
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Nivedita Gupta
Nivedita Gupta
Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Delhi, India
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Manoj Murhekar
Manoj Murhekar
National Institute of Epidemiology, Chennai, India;
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Seasonal outbreaks of acute encephalitis syndrome (AES) with high mortality occur every year in Gorakhpur region of Uttar Pradesh, India. Earlier studies indicated the role of scrub typhus as the important etiology of AES in the region. AES cases were hospitalized late in the course of their illness. We established surveillance for acute febrile illness (AFI) (fever ≥ 4 days duration) in peripheral health facilities in Gorakhpur district to understand the relative contribution of scrub typhus. Of the 224 patients enrolled during the 3-month period corresponding to the peak of AES cases in the region, about one-fifth had immunoglobulin M (IgM) antibodies against Orientia tsutsugamushi. Dengue and leptospira accounted for 8% and 3% of febrile illness cases. Treating patients with AFI attending the peripheral health facilities with doxycycline could prevent development of AES and thereby reduce deaths due to AES in Gorakhpur region.
Author Notes
Financial support: The study was funded by the Indian Council of Medical Research, New Delhi.
Authors’ addresses: Jeromie Wesley Vivian Thangraj, C. P. Girish Kumar, and R. Sabarinathan, National Institute of Epidemiology, Ayapakkam, Chennai, Tamil Nadu, India, E-mails: stanjeromie@nieicmr.org.in, girishmicro@gmail.com, and sabari193@gmail.com. Mahima Mittal, BRD Medical College, Department of Pediatrics, Gorakhpur, India, E-mail: mahima_mittal@hotmail.com. Valsan Philip Verghese and Winsley Rose, Christian Medical College and Hospital Vellore, Pediatric Infectious Diseases, Paediatrics Unit-III, CMC Hospital, Vellore, India, E-mails: valsan@cmcvellore.ac.in and winsleyrose@cmcvellore.ac.in. Ashok Kumar Pandey, National Institute of Virology, Gorakhpur Unit, Gorakhpur, India, E-mail: ashokpandey10@gmail.com. Nivedita Gupta, Indian Council of Medical Research, Epidemiology and Communicable Diseases, New Delhi, India, E-mail: ngupta@icmr.org.in. Manoj Murhekar, National Institute of Epidemiology, Field Epidemiology Training Programme, Ayapakkam, Ambattur, Chennai, Tamilnadu, India, E-mail: mmurhekar@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Kakkar M, Rogawski ET, Abbas SS, Chaturvedi S, Dhole TN, Hossain SS, Krishnan SK, 2013. Acute encephalitis syndrome surveillance, Kushinagar district, Uttar Pradesh, India, 2011–2012. Emerg Infect Dis 19: 1361–1367.
-
2.
Ranjan P, Gore M, Selvaraju S, Kushwaha KP, Srivastava DK, Murhekar M, 2014. Changes in acute encephalitis syndrome incidence after introduction of Japanese encephalitis vaccine in a region of India. J Infect 69: 200–202.
-
3.
Mittal M, Kushwaha K, 2014. AES: clinical presentation and dilemmas in critical care management. J Commun Dis 46: 50–65.
-
4.
Kumari R, Joshi PL, 2012. A review of Japanese encephalitis in Uttar Pradesh, India. WHO South-East Asia Journal of Public Health 1: 374–395.
-
5.
Murhekar MV et al. 2016. Acute encephalitis syndrome in Gorakhpur, Uttar Pradesh, India – role of scrub typhus. J Infect J Infect 73: 623–626.
-
6.
Blacksell SD et al. 2016. Diagnostic accuracy of the InBios scrub typhus detect enzyme-linked immunoassay for the detection of IgM antibodies in northern Thailand. Clin Vaccine Immunol 23: 148–154.
-
7.
Chrispal A et al. 2010. Scrub typhus: an unrecognized threat in south India – clinical profile and predictors of mortality. Trop Doct 40: 129–133.
-
8.
Rahi M, Gupte MD, Bhargava A, Varghese GM, Arora R, 2015. DHR-ICMR guidelines for diagnosis and management of rickettsial diseases in India. Indian J Med Res 141: 417–422.
-
9.
Todd SR, Dahlgren FS, Traeger MS, Beltrán-Aguilar ED, Marianos DW, Hamilton C, McQuiston JH, Regan JJ, 2015. No visible dental staining in children treated with doxycycline for suspected Rocky Mountain spotted fever. J Pediatr 166: 1246–1251.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 567 | 450 | 53 |
| Full Text Views | 578 | 14 | 0 |
| PDF Downloads | 235 | 12 | 0 |