Scrub Typhus: Uncovering the Hidden Dangers and How to Protect Yourself - Dr Spoorthi Arun

Scrub Typhus, an Orientia Tsutsugamushi bacterium-inflicted disease, has come up as a serious concern for all in Tamil Nadu and other regions of India.

What makes this disease even more devastating is that it is spread through the bite of infected mites. This fatal disease is reported on a large scale in rural and semi-urban regions, especially during monsoons.

What is Scrub Typhus?

Scrub typhus is a rickettsial infection which presents as an acute febrile illness. It is endemic in countries such as India, Japan, and Australia, within the "tsutsugamushi triangle."

The World Health Organization states that there are more than one billion at risk worldwide, with almost one million cases reported per annum.

The incubation period for scrub typhus is 6 to 21 days. The symptoms of the disease vary in intensity and include - high fever and chills, severe headache, muscle aches, rash, enlarged lymph nodes, presence of eschar (a black, scab-like lesion).

Scrub typhus can result in organ dysfunction, acute respiratory distress syndrome, and even death if left untreated in severe cases.

How is it transmitted?

Chigger mites are the larval stage of mites and are vectors for scrub typhus. They thrive in areas with dense vegetation, such as farmlands, gardens, and forests.

The infection occurs when these mites bite humans while feeding on their skin.

Scratch Typhus Diagnosis

Scrub typhus often begins with fever, headache, and body aches that mimic common viral illnesses, but it may also present with an eschar – a black, scab-like lesion at the bite site – and in some cases, serious complications like respiratory distress or organ dysfunction if left untreated.

The infection can be fatal, so prompt recognition and appropriate medical care are critical.

Epidemiology and Recent Trends

In Tamil Nadu, scrub typhus cases are reported to be increasing lately. Such cases have been reported in Chennai, Tirunelveli, and Coimbatore districts. Increased awareness and advanced diagnostic capabilities contribute to this rising trend.

During the monsoon season, this disease is seen more frequently, since humid conditions favour the multiplication of chigger mites.

Diagnosis and Treatment

Early detection is very important to ensure proper management of scrub typhus. For diagnostic purposes, techniques include serological tests like the Weil-Felix test and molecular techniques such as polymerase chain reaction (PCR).

Antibiotics including doxycycline and azithromycin are effective if given in time. Timely initiation of antibiotics can save lives and prevent severe complications like multi-organ failure.

Prevention of Scrub Typhus

Prevention is the best way to reduce the number of scrub typhus cases. Here are some practical recommendations:

Wear Protective Clothing: Long-sleeved shirts, pants, and closed shoes must be worn, especially in places with heavy grass and bushes.

Use Insect Repellents: DEET-based repellents must be applied on the skin and clothing.

Maintain Hygiene: Clothes and bedding used outdoors must be washed frequently.

Clear Vegetation: Grass and bushes that have grown over time must be removed, as these are where mites breed.

Do not sit on the ground; In endemic areas, sit with mats or barriers around.