Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login  
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 521       
REVIEW ARTICLE
Year : 2021  |  Volume : 153  |  Issue : 3  |  Page : 375-381

Investigations of seasonal outbreaks of acute encephalitis syndrome due to Orientia tsutsugamushi in Gorakhpur region, India: A One Health case study


1 ICMR-National Institute of Epidemiology, Chennai, India
2 ICMR-Vector Control Research Centre, Puducherry, India
3 All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
4 Division of Epidemiology and Communicable Diseases Division , Indian Council of Medical Research, New Delhi, India
5 Christian Medical College, Vellore, Tamil Nadu, India
6 ICMR-National AIDS Research Institute, Pune, Maharashtra, India
7 ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
8 ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu; Division of Epidemiology and Communicable Diseases Division , Indian Council of Medical Research, New Delhi, India

Correspondence Address:
Manoj V Murhekar
ICMR- National Institute of Epidemiology, Chennai 600 077, Tamil Nadus
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_625_21

Rights and Permissions

Gorakhpur division consisting of Gorakhpur and neighboring districts Deoria, Kushinagar and Maharajganj in Uttar Pradesh, India, have been witnessing seasonal outbreaks of acute encephalitis syndrome (AES) among children for the last three decades. Investigations conducted during 2005 identified Japanese encephalitis (JE) virus as an aetiology of AES. With the introduction of JE vaccination and other control strategies, the incidence of JE in the region declined, however, outbreaks of acute febrile illness with neurological manifestations continued to occur. Subsequent investigations identified Orientia tsutsugamushi, as the major aetiology of AES outbreaks in the region. This review details clinical, epidemiological, animal and entomological investigations conducted for AES due to O. tsutsugamushi during 2015 and 2017 in Gorakhpur region. Surveillance of acute febrile illness among children attending peripheral health facilities identified scrub typhus as an important aetiology of febrile illness during monsoon and post-monsoon months. Population-based serosurveys indicated high endemicity of scrub typhus. Entomological studies demonstrated natural infection of O. tsutsugamushi in small animal hosts and vector mites. Children acquired this infection through recent exposure to outdoor environment, while playing, or visiting fields or defecating in open fields. A few of the children with scrub typhus progress to develop CNS manifestations. Hence, early administration of appropriate antibiotics is crucial in preventing progression of AFI due to scrub typhus to AES. The investigations conducted by the multi-disciplinary team helped understand the transmission dynamics of scrub typhus in Gorakhpur division and recommend strategies for its control.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed286    
    Printed0    
    Emailed0    
    PDF Downloaded106    
    Comments [Add]    

Recommend this journal