Emerging threat of scrub typhus: A call for greater awareness and research

Scrub typhus is a re-emerging infectious disease of significant public health concern in tropical and subtropical regions, caused by Orientia tsutsugamushi and transmitted by infected chigger mites, it can lead to severe complications if untreated. Scrub typhus, once thought to be confined to the 'Tsutsugamushi Triangle' encompassing parts of South and Southeast Asia and northern Australia, is now recognized as a global health concern with emerging cases beyond its traditional range. However, it remains underrecognized and frequently misdiagnosed due to its nonspecific clinical presentation and similarity to other febrile illnesses. Recent research highlights its capacity to trigger autoimmune responses, complicating both diagnosis and management. Current treatment relies heavily on antibiotics such as doxycycline and azithromycin, but diagnostic challenges, limited access to confirmatory tests, and a lack of long-lasting immunity hamper effective control. Promising vaccine candidates are under development, yet they require further validation. This review emphasizes the urgent need for improved awareness, enhanced diagnostic infrastructure, targeted vaccine research, and integrated public health strategies to mitigate the growing global impact of scrub typhus.