Coinfection of H1N1 Influenza and Scrub Typhus-A Review.

The H1N1 influenza infection usually coincides with the typical scrub typhus season in North India. This leads to diagnostic difficulties due to their similar and non-specific symptoms. We describe three patients with confirmed co-infection of pandemic (H1N1) influenza and scrub typhus who had presented with acute respiratory distress syndrome. A systematic review of database yielded one case of scrub typhus and H1N1 influenza co-infection reported from South Korea. Co-infection of influenza with tropical infections may not be uncommon in endemic countries and hence a high index of suspicion on the part of physicians coupled with appropriate investigations are needed. The true burden of co-infections needs to be evaluated during outbreaks of influenza in a systematic manner.