{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T01:46:54Z","timestamp":1793065614087,"version":"4.5.0"},"reference-count":217,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T00:00:00Z","timestamp":1516147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Military Infectious Diseases Research Program","award":["A1230"],"award-info":[{"award-number":["A1230"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>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\u2019s oldest recognized vector-borne pathogens, O. tsutsugamushi.<\/jats:p>","DOI":"10.3390\/tropicalmed3010008","type":"journal-article","created":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T12:17:11Z","timestamp":1516191431000},"page":"8","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":190,"title":["A Review of Scrub Typhus (Orientia tsutsugamushi and Related Organisms): Then, Now, and Tomorrow"],"prefix":"10.3390","volume":"3","author":[{"given":"Alison","family":"Luce-Fedrow","sequence":"first","affiliation":[{"name":"Department of Biology, Shippensburg University, Shippensburg, PA 17202, USA"},{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcie","family":"Lehman","sequence":"additional","affiliation":[{"name":"Department of Biology, Shippensburg University, Shippensburg, PA 17202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8713-9886","authenticated-orcid":false,"given":"Daryl","family":"Kelly","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"},{"name":"Department of Evolution, Ecology and Organismal Biology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Mullins","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Maina","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Biology, Shippensburg University, Shippensburg, PA 17202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Ge","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"John","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju","family":"Jiang","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Richards","sequence":"additional","affiliation":[{"name":"Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA"},{"name":"Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,1,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (1999). 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