Background

Scrub typhus is a potentially fatal vector-borne illness caused by the obligate intracellular bacteria from the genus Orientia. It is a leading cause of nonmalarial fever in South and South East Asia. Previous reports have documented scrub typhus  cases and the existence of its vector and reservoir in   [1-3]. It is likely that scrub typhus is causing considerable morbidity and mortality. However, we do not have a clear picture of how big the problem is as data remain scarce. In the face of diagnostic challenges in resource-limited settings, understanding the distribution and risk of acquiring scrub typhus is essential in ensuring early diagnosis and prompt treatment. Scrub transmission is reportedly highly focal in nature, occurring within narrowly specific habitats and optimal climatic conditions [4]. Palm oil plantations in Southeast Asia have been identified as also likely foci of scrub typhus transmission [4-6]. On the other hand, there are also more and more data on the emergence of endemic scrub typhus in urban area [7-10].