Emergence of Schoengastiella ligula as the vector of scrub typhus outbreak in Darjeeling: Has Leptotrombidium deliense been replaced.

ABSTRACT

Background: Following a suspected outbreak of scrub typhus in Kurseong, Darjeeling, the Armed Forces Medical College, Pune was requested by the National Institute of Epidemiology and the State authorities to undertake investigation of the ongoing scrub typhus outbreak and suggest containment measures. Materials and Methods:The epidemic team undertook clinical, entomological and serological studies to understand the local disease pattern and delineate high risk areas, host diversity by rodent trapping using Sherman traps, mite fauna diversity, abundance and vector species identification by phase contrast microscopy for preparation of electronic database and rodent and human serological studies by Weil Felix and PCR. Results:The results indicate no association of scrub typhus with age and sex (P=0.37 and 0.74 respectively). The maximum cases occurred amongst the tea garden workers (73%) in the age group of 25-44 years. The predominant clinical presentation was fever (100%) with headache (75%), lymphadenopathy (45%) and presence of eschar (76.7%). The dominant host species (50% of trapped rodents) was shrew Suncus murinus, the index animal for scrub typhus, which contributed maximally to the vector abundance (52.96%) with a chigger index of 61.56. The trombiculid mite Schoengastiella ligula was the vector species much against the expected mite vector Leptotrombidium deliense, in the area. The study found the presence and abundance of vector species which corroborated well with the occurrence of cases in the various localities within the subdivisions. Conclusion:The study thus establishes Schoengastiella ligula as the vector of scrub typhus outbreak in Kurseong, Darjeeling. Preventive and containment measures with emphasis on reduction of man - vector contact were suggested to the state authorities to contain the outbreak.