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VIII.153 - Typhus, Scrub (Tsutsugamushi)

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Tsutsugamushi, like epidemic typhus, has been known in the Orient for centuries. In 1810 the Japanese Hakuju Hashimoto described a tsutsuga (disease) along the tributaries of the Shinano River. A similar disease, thought to be carried by mites, or mushi in Japanese, had also been known at least since the sixteenth century in southern China. Sometimes called Japanese flood fever, tsutsugamushi is more commonly known in the United States as scrub typhus – a name used widely by English-speaking troops during World War II. The disease exhibits characteristic typhuslike symptoms of high fever, headache, duration of 2 weeks, and a widespread rash.

Distribution and Incidence

The geographic boundaries of this malady are defined by the range of its vectors, primarily the trombiculid mites, Lentotrombidium akamushi and Leototrombidium deliensis, and their vertebrate hosts. They extend from India and Pakistan in the West, to Japan and the northern portions of Australia, including all the countries of Southeast Asia, southern China, Korea, the Philippines, and Indonesia, as well as additional islands in the Pacific Ocean (see Map VIII. 153.1). During World War II, the incidence of scrub typhus rose dramatically among military troops, reaching 900 per 1,000 personnel in some areas. It continues to remain a problem in isolated, rural areas.

Etiology and Epidemiology

The etiologic agent of scrub typhus, Rickettsia tsutsugamushi, is a natural infection of several trombiculid mites, most commonly L. deliensis. Maintained in nature by generational transmission through the eggs of the female, the disease is communicated to humans only during the larval stage of the mite’s life cycle.

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Publisher: Cambridge University Press
Print publication year: 1993

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References

Blake, Francis G., et al. 1945. Studies on tsutsugamushi disease (scrub typhus, mite-born typhus) in New Guinea and adjacent islands: Epidemiology, clinical observations, and etiology in the Dobadura area. American Journal of Hygiene 41.Google Scholar
Kawamura, Rinya. 1926. Studies on tsutsugamushi disease (Japanese flood fever). Bulletin of the College of Medicine of the University of Cincinnati 4 (special Nos.1 and 2):.Google Scholar
Philip, Cornelius B. 1964. Scrub typhus and scrub itch. In Preventive medicine in World WarII, Vol. 7: Communicable diseases: Arthropodborne diseases other than malaria. Medical Department, U.S. Army.Google Scholar
Santana, Frederick J., et al. 1976. Annotated bibliography of scrub typhus in Taiwan and the Pescadores Islands (1911–1975). A special publication of U.S. Naval Medical Research Unit No. 2. Taipei, Taiwan.Google Scholar
Smadel, Joseph E., and Elisberg, Bennett L.. 1965. Scrub typhus rickettsia. In Viral and rickettsial infections of man, 4th edition, ed. Horsfall, Frank L. Jr., and Tamm, Igor. Philadelphia.Google Scholar

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