Résumé
Scrub typhus, caused by the bacterium Orientia tsutsugamushi, is a major cause of fever in tropical and subtropical Asia. Symptoms can be similar to other common infections such as malaria, dengue, leptospirosis or typhoid, making it difficult to diagnose. Laboratory tests to diagnose scrub typhus are often unavailable, inaccurate, impractical, or too costly. Consequently, the true burden of scrub typhus disease remains unknown. Here, we collected data on the number of reported cases of scrub typhus in Thailand for 2003–2018 from the national surveillance system. There were 103,345 cases reported with incidence rising significantly over the study period. More men than women were affected, agricultural workers were the main occupational group (45%) and most cases (72%) were in adults of working age. The disease was seasonal with the cases mainly occurring during the rainy season from June to November. Five northern provinces were particularly affected with Chiangrai being the province with the highest number of cases. In Chiangrai, agricultural activity, elevation, rainfall, temperature and land cover factors contribute to disease burden. These results improve our understanding of the distribution and burden of scrub typhus in Thailand and help to identify factors that may contribute to disease incidence.