Scrub typhus update: A re‑emerging global threat beyond the Tsutsugamushi Triangle and the physiological ramifications of scrub typhus infection (Review)

Scrub typhus, caused by Orientia tsutsugamushi, is a mite-borne zoonotic disease endemic to Asia and the Pacific.The prevalence of Orientia tsutsugamushi, originating from the Tsutsugamushi Triangle, is increasingly globally.The present review delves into the intricate mechanisms of bacterial-host interactions and immune responses within dendritic cells, blood vessels and kidney endothelial cells.Additionally, it provides an in-depth discussion of the scrub typhus life cycle and its associated organ system diseases.It presents with flu-like symptoms, including fever, rash and eschar formation, but can progress to severe complications, such as acute encephalitis syndrome and multi-organ dysfunction syndrome.The disease has affected vulnerable populations in India, China, Thailand, Malaysia, Korea, and other countries with outbreaks reported across various states.The diagnosis of scrub typhus has evolved from the outdated Weil-Felix test to more accurate techniques, such as the use of PCR and ELISA.Early treatment with antibiotics, such as doxycycline or azithromycin markedly reduces morbidity and mortality rates.The disease remains neglected in a number of regions despite the growing number of cases.Preventive measures, primarily the use of insect repellent, are essential, as no licensed vaccine exists to date.Content 1. Introduction 2. Scrub typhus in various regions in Asia 3. Seasonal variations and factors controlling the spread of scrub typhus 4. Life cycle and transmission of Orientia tsutsugamushi 5. Clinical manifestations of scrub typhus 6. Association of various body systems with scrub typhus 7. Laboratory methods for the detection of scrub typhus 8. Immune response in scrub typhus 9. Therapeutic and prevention strategies for scrub typhus 10.