Endemic Scrub Typhus in South America

N Engl J Med. 2016 Sep 8;375(10):954-61. doi: 10.1056/NEJMoa1603657.


Scrub typhus is a life-threatening zoonosis caused by Orientia tsutsugamushi organisms that are transmitted by the larvae of trombiculid mites. Endemic scrub typhus was originally thought to be confined to the so called "tsutsugamushi triangle" within the Asia-Pacific region. In 2006, however, two individual cases were detected in the Middle East and South America, which suggested that the pathogen was present farther afield. Here, we report three autochthonous cases of scrub typhus caused by O. tsutsugamushi acquired on Chiloé Island in southern Chile, which suggests the existence of an endemic focus in South America. (Funded by the Chilean Comisión Nacional de Investigación Científica y Tecnológica and the Wellcome Trust.).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Arachnid Vectors
  • Chile
  • Endemic Diseases*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orientia tsutsugamushi* / genetics
  • Orientia tsutsugamushi* / isolation & purification
  • Phylogeny
  • Scrub Typhus* / diagnosis
  • Scrub Typhus* / microbiology
  • Scrub Typhus* / transmission
  • Trombiculidae / microbiology