{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:58:35Z","timestamp":1792688315717,"version":"4.5.0"},"reference-count":9,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11,8]]},"abstract":"<jats:p>Seasonal outbreaks of acute encephalitis syndrome (AES) with high mortality occur every year in Gorakhpur region of Uttar Pradesh, India. Earlier studies indicated the role of scrub typhus as the important etiology of AES in the region. AES cases were hospitalized late in the course of their illness. We established surveillance for acute febrile illness (AFI) (fever \u2265 4 days duration) in peripheral health facilities in Gorakhpur district to understand the relative contribution of scrub typhus. Of the 224 patients enrolled during the 3-month period corresponding to the peak of AES cases in the region, about one-fifth had immunoglobulin M (IgM) antibodies against <jats:italic>Orientia tsutsugamushi<\/jats:italic>. Dengue and leptospira accounted for 8% and 3% of febrile illness cases. Treating patients with AFI attending the peripheral health facilities with doxycycline could prevent development of AES and thereby reduce deaths due to AES in Gorakhpur region.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0135","type":"journal-article","created":{"date-parts":[[2017,8,15]],"date-time":"2017-08-15T07:00:30Z","timestamp":1502780430000},"page":"1313-1315","source":"Crossref","is-referenced-by-count":23,"title":["Scrub Typhus as an Etiology of Acute Febrile Illness in Gorakhpur, Uttar Pradesh, India, 2016"],"prefix":"10.4269","volume":"97","author":[{"given":"Jeromie Wesley","family":"Vivian Thangaraj","sequence":"first","affiliation":[{"name":"National Institute of Epidemiology, Chennai, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahima","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, BRD Medical College, Gorakhpur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valsan Philip","family":"Verghese","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, Christian Medical College, Vellore, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. P. Girish","family":"Kumar","sequence":"additional","affiliation":[{"name":"National Institute of Epidemiology, Chennai, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winsley","family":"Rose","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, Christian Medical College, Vellore, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sabarinathan","sequence":"additional","affiliation":[{"name":"National Institute of Epidemiology, Chennai, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok Kumar","family":"Pandey","sequence":"additional","affiliation":[{"name":"National Institute of Virology, Gorakhpur Unit, Gorakhpur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nivedita","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Murhekar","sequence":"additional","affiliation":[{"name":"National Institute of Epidemiology, Chennai, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Emerg Infect Dis","first-page":"1361","article-title":"Acute encephalitis syndrome surveillance, Kushinagar district, Uttar Pradesh, India, 2011\u20132012","volume":"19","author":"Kakkar","year":"2013"},{"key":"b2","series-title":"J Infect","first-page":"200","article-title":"Changes in acute encephalitis syndrome incidence after introduction of Japanese encephalitis vaccine in a region of India","volume":"69","author":"Ranjan","year":"2014"},{"key":"b3","series-title":"J Commun Dis","first-page":"50","article-title":"AES: clinical presentation and dilemmas in critical care management","volume":"46","author":"Mittal","year":"2014"},{"key":"b4","series-title":"WHO South-East Asia Journal of Public Health","first-page":"374","article-title":"A review of Japanese encephalitis in Uttar Pradesh, India","volume":"1","author":"Kumari","year":"2012"},{"key":"b5","series-title":"J Infect J Infect","first-page":"623","article-title":"Acute encephalitis syndrome in Gorakhpur, Uttar Pradesh, India \u2013 role of scrub typhus","volume":"73","author":"Murhekar","year":"2016"},{"key":"b6","series-title":"Clin Vaccine Immunol","first-page":"148","article-title":"Diagnostic accuracy of the InBios scrub typhus detect enzyme-linked immunoassay for the detection of IgM antibodies in northern Thailand","volume":"23","author":"Blacksell","year":"2016"},{"key":"b7","series-title":"Trop Doct","first-page":"129","article-title":"Scrub typhus: an unrecognized threat in south India \u2013 clinical profile and predictors of mortality","volume":"40","author":"Chrispal","year":"2010"},{"key":"b8","series-title":"Indian J Med Res","first-page":"417","article-title":"DHR-ICMR guidelines for diagnosis and management of rickettsial diseases in India","volume":"141","author":"Rahi","year":"2015"},{"key":"b9","series-title":"J Pediatr","first-page":"1246","article-title":"No visible dental staining in children treated with doxycycline for suspected Rocky Mountain spotted fever","volume":"166","author":"Todd","year":"2015"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/97\/5\/article-p1313.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/97\/5\/article-p1313.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/97\/5\/article-p1313.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T16:45:17Z","timestamp":1722444317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/97\/5\/article-p1313.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,8]]},"references-count":9,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.17-0135","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,8]]}}}