Classification: ICD-9 081.2; ICD-10 A75.3
Syndromes and synonyms: Tsutsugamushi disease, mite-borne typhus fever, chigger-borne rickettsioses, coastal fever (Australia).
Agent: Orientia tsutsugamushi, obligate intracellular bacterium, before 1995 known as Rickettsia tsutsugamushi. In 2010, a new species that can cause scrub typhus was discovered in Dubai, O. chuto.
Reservoir: Larval stage mites, so-called chiggers from the genus Leptotrombidium. A number of small rodents, particularly wild rats, are the natural hosts for scrub typhus without apparent disease.
Vector: Larval mites. Nymphs and adults do not feed on vetebrate hosts. The vector has adapted to various ecologies, including mountainous and tropical regions.
Transmission: Bite of infected larval mites (chiggers). There is no direct person-to-person transmission.
Cycle: The mites are infected by feeding on reservoir animals (small rodents), and maintain the infection throughout their life stages. The infection is passed on by transovarial transmission. O. tsutsugamushi are present in the salivary glands of the larvae and injected into the host during feeding.
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