Lay summary
Scrub typhus is a severe tropical infectious disease caused by a germ that usually lives in rodents but can be transmitted to people by insects called mites that feed on both rodents and people in scrublands. Scrub typhus causes a fever illness, sometimes with a rash, that is fatal in 6% of those infected. It is difficult to diagnose and requires specific antibiotics to prevent death. In Vanuatu, scrub typhus was a major cause of illness in troops during World War II and research in the 1970s showed it was common among Ni-Vanuatu. To improve treatment and outcomes for patients with scrub typhus in Vanuatu, we will describe how common it is in patients with fever; characterise local strains to improve locally-appropriate diagnostic tests; and identify risk factors for infection to inform prevention messages. We will work with Ni-Vanuatu seasonal workers in New Zealand to disseminate public health messages.