At least 150 people have been diagnosed with the scrub
typhus disease at Thenzawl town in Serchhip district, Mizoram health department
officials said on Wednesday. The officials said that the scrub typhus outbreak
began in November 2018, as reported by NDTV.
Scrub typhus, also known as tsutsugamushi disease or Bush
typhus, presents as an acute febrile illness.
Here are few salient points about scrub typhus.
·
Scrub typhus is a mite-borne infectious disease caused by
Orientia tsutsugamushi (previously called Rickettsia tsutsugamushi).
·
It is a gram-negative coccobacillus.
·
Scrub typhus may begin insidiously with headache,
anorexia, and malaise, or start abruptly with chills and fever. As the illness
evolves, most patients develop high fever, worsening of headache severity, and
myalgias. An eschar or rash may develop in a subset of patients.
·
The severity of infection can range from mild symptoms
and signs to multiorgan failure.
·
Elderly patients and those with delays in therapy are
more likely to develop complications.
·
Scrub typhus may cause spontaneous abortions in pregnant
women.
·
Diagnostic methods for confirmation of O. tsutsugamushi
infection include serology, biopsy, culture and polymerase chain reaction
(PCR).
·
The differential diagnosis of scrub typhus includes
malaria, dengue, leptospirosis and other rickettsial diseases.
·
Doxycycline shortens the clinical illness and the
incidence of relapse of infection.
·
Azithromycin is an alternative drug to treat scrub
typhus, which has an acceptable safety profile in pregnant women.
·
Chemoprophylaxis with doxycycline is effective when used
by nonimmune individuals living or working in areas in which scrub typhus is
endemic.
·
Insect repellants and miticides are highly effective when
applied to both clothing and skin.
·
Permethrin and benzyl benzoate are also useful agents
when applied to clothing and bedding.
Scrub typhus is a re-emerging zoonotic disease in India.
It is endemic in the country and is especially prevalent in the sub-Himalayan
belt, from Jammu to Nagaland.
Suspect scrub typhus in all cases of fever around that
area.
Doxycycline is the empirical antibiotic of choice in
cases of fever with scrub typhus as differential diagnosis.
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations
in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA
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