Background & objectives: Scrub typhus, caused by Orientia tsutsugamushi , is an emerging cause of acute febrile illness (AFI) in India, transmitted by chigger mites in rural and semi-urban areas. Due to its nonspecific symptoms and limited diagnostic access, it is often underdiagnosed, leading to severe complications. Early detection and prompt treatment are essential to reduce morbidity and mortality. Methods: This retrospective study at the Virus Research and Diagnostic Laboratory (VRDL), Banaras Hindu University, analyzed data from acute febrile cases referred between December 2023 and February 2025. Results: Diagnostic testing identified Leptospira IgM (13.1%) and Scrub Typhus (ST) IgM (9.5%) as the most common infections among all the AFI cases, with co-infections accounting for 85% of total ST-positive cases. Although a higher proportion of ST-positive cases were observed in males (57%), positivity rates were higher in females. The 25-61 years age group had the highest positivity (17.81%), followed by 13-25 years (15.33%) and the lowest in 0-1 years (4.35%). The 25-61 years group was 1.71 times more likely, and 13-25 years 1.49 times more likely, to contract ST than those ≥61 years. ST infections peaked during the monsoon and post-monsoon seasons, with the highest positivity in November (25.7%) and October (24.6%). Interpretation & conclusion: The study concludes that Uttar Pradesh and Bihar are endemic for scrub typhus, and it has a major part in the aetiology of acute febrile illness, influenced by environmental factors like rains, humidity, dense vegetation and poor sanitation.
Shukla et al. (Wed,) studied this question.