First Fatal Case of Scrub Typhus, Taiwan, 2016

DOI: 10.6525/TEB.20161004.32(19).002

Hsin-Yi Wei, Pei-Hsuan Chang, Tzsi-Yi Lin, Yu-Fang Tsai,Hsiao-Ping Tung, Jer-Jea Yen

2016 Vol.32 NO.19

Correspondence Author: Hsin-Yi Wei

  • Taipei Regional Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


On May 9, 2016, a 37-year-old female suspected of scrub typhus, dengue virus infection, Q fever and leptospirosis was reported to Taipei Regional Center, Taiwan Centers for Disease Control (TCDC), and she died on the same day. Scrub typhus was later laboratory-confirmed by TCDC. This is the first fatal case of scrub typhus over the past 3 years. Mortality of scrub typhus was low in Taiwan and there has been no death from scrub typhus since 2014. The patient, a foreign tourist, had sought medical help several times after developing symptoms but was not promptly diagnosed and treated. Early diagnosis and treatment is the key to decrease mortality of scrub typhus. Clinical presentations of scrub typhus were similar to many other infectious diseases and it is, nevertheless, difficult to differentiate from other diseases. Clinicians should consider adding scrub typhus into differential diagnosis if one presents unknown fever with outdoor activities. As there are growing numbers of foreign travelers visiting Taiwan, we recommend clinicians collect complete information of TOCC history (Travel, occupation, contact, and cluster) when seeing travelers/foreign visitors with suggestive symptoms.  

Keywords:Scrub typhus, Fatal case, Differential diagnosis, TOCC, Travel history