Traub R, Wisseman C L
Bull World Health Organ. 1968;39(2):209-18.
Scrub typhus infection is now known to occur in geographical and ecological areas where its presence was hitherto unsuspected-north and west of the Indus River and in south-eastern Siberia; in semi-desert, montane desert, and alpine terrain high in the Himalayas, as well as in primary jungle. Additional data are presented to support the hypothesis that "ecological islands", containing basically similar faunas of rodents and ectoparasites, exist on scattered mountains in the Pakistan Himalayas, despite the intervening "barriers" of desert, broad rivers and massive peaks. Since scrub typhus has been demonstrated in some of these isolated areas, it is felt that the infection may exist, unrecognized, in neighbouring countries as well.A number of larval trombiculid mites, largely species of the subgenus Leptotrombidium, are believed to be vectors, in addition to the well-known L. (L.) deliense and L. (L.) akamushi. The host-range of natural infection in ground-dwelling small mammals, especially rodents, is very broad in endemic areas. An important factor of time, and not only of space, may be involved in an endemic locus, the disease undergoing a sequential evolution involving different chiggers and rodents over a period of years. It is pointed out that new irrigation schemes, road construction, and agricultural projects may introduce scrub typhus into an area or greatly increase its endemicity if the infection is already present.
现在已知恙虫病感染发生在以前未被怀疑存在该病的地理和生态区域——印度河以北和以西以及西伯利亚东南部；在半沙漠、山地沙漠和喜马拉雅山脉高处的高山地带，以及原始丛林中。本文提供了更多数据来支持这样一种假说，即尽管存在沙漠、宽阔河流和巨大山峰等“屏障”，但在巴基斯坦喜马拉雅山脉的分散山区仍存在“生态岛”，其中包含基本相似的啮齿动物和体外寄生虫动物群。由于在其中一些孤立地区已证实存在恙虫病，因此认为邻国可能也存在未被识别的感染情况。除了广为人知的地里纤恙螨和红纤恙螨外，一些幼虫恙螨，主要是纤恙螨亚属的物种，也被认为是传播媒介。在流行地区，地面栖息的小型哺乳动物，尤其是啮齿动物的自然感染宿主范围非常广泛。一个重要的因素可能是时间，而非仅仅是空间，可能与一个地方病疫源地有关，这种疾病在数年时间里会经历一个涉及不同恙螨和啮齿动物的连续演变过程。文中指出，如果已经存在感染，新的灌溉计划、道路建设和农业项目可能会将恙虫病引入一个地区或大大增加其流行程度。
