Scrub Typhus: A Neglected Tropical Disease and A Potential Threat in North India

Abstract

Scrub typhus is a rickettsial disease. It presents clinically with non-specific febrile signs and symptoms and is often under diagnosed. It is a major public health threat. Due to non- specificity of presentation and lack of awareness, there is delay in treatment. The changing epidemiology of scrub typhus should be kept in mind while attending patients with acute febrile illness. This study was undertaken to find the prevalence rate of scrub typhus at our centre and presenting features among cases. This study was done prospectively for a period of six month (July 2017- December 2017). All the patients presenting with fever, chills,headache, myalgia , breathlessness, encephalitis of more than 5 days duration were included in the study. Detection was done using rapid immune-chromatography (Scrub Typhus Rapid Kit, SD). All positive samples were reconfirmed by the Scrub Typhus Detect ELISA system for IgG/ Ig Mantibodies (In Bios International Inc., Seattle, WA, USA). As per inclusion criteria a total of 134 samples were received in laboratory. Of 134 samples 38 (28%) were positive for Scrub Typhus. Most of the cases were male and belonged to age group 31-60yrs age. Co infection was also seen in 18% of cases. A high index of suspicion should be made, and an early diagnosis and treatment is warranted to prevent disease complications. If left untreated, it can prove fatal. Multi-organ dysfunction especially respiratory impediment and shock are the important dangerous complications that lead to higher case fatality rates.

Keywords

• rickettsial disease
• scrub typhus
• orientia tsutsugamushi