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A Review of Scrub Typhus (Orientia tsutsugamushi and Related Organisms): Then, Now, and Tomorrow

Department of Biology, Shippensburg University, Shippensburg, PA 17202, USA
Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA
Department of Evolution, Ecology and Organismal Biology, The Ohio State University, Columbus, OH 43210, USA
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2018, 3(1), 8;
Received: 19 December 2017 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 17 January 2018
(This article belongs to the Special Issue The Past and Present Threat of Rickettsial Diseases)
Scrub typhus and the rickettsial diseases represent some of the oldest recognized vector-transmitted diseases, fraught with a rich historical aspect, particularly as applied to military/wartime situations. The vectors of Orientia tsutsugamushi were once thought to be confined to an area designated as the Tsutsugamushi Triangle. However, recent reports of scrub typhus caused by Orientia species other than O. tsutsugamushi well beyond the limits of the Tsutsugamushi Triangle have triggered concerns about the worldwide presence of scrub typhus. It is not known whether the vectors of O. tsutsugamushi will be the same for the new Orientia species, and this should be a consideration during outbreak/surveillance investigations. Additionally, concerns surrounding the antibiotic resistance of O. tsutsugamushi have led to considerations for the amendment of treatment protocols, and the need for enhanced public health awareness in both the civilian and medical professional communities. In this review, we discuss the history, outbreaks, antibiotic resistance, and burgeoning genomic advances associated with one of the world’s oldest recognized vector-borne pathogens, O. tsutsugamushi. View Full-Text
Keywords: Orientia tsutsugamushi; Orientia; scrub typhus; mites; chiggers; rickettsia Orientia tsutsugamushi; Orientia; scrub typhus; mites; chiggers; rickettsia
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Luce-Fedrow, A.; Lehman, M.L.; Kelly, D.J.; Mullins, K.; Maina, A.N.; Stewart, R.L.; Ge, H.; John, H.S.; Jiang, J.; Richards, A.L. A Review of Scrub Typhus (Orientia tsutsugamushi and Related Organisms): Then, Now, and Tomorrow. Trop. Med. Infect. Dis. 2018, 3, 8.

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