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Scrub Typhus as an Etiology of Acute Febrile Illness in Gorakhpur, Uttar Pradesh, India, 2016
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.