Scrub Typhus

Patient Education

What is Scrub Typhus?

Scrub typhus is an infectious disease caused by a bacteria called Orientia tsustugamushi. It is spread through the mite larvae or chiggers, on which these bacteria reside. The infection is transferred to humans after a bite of an infected Leptotrombidium mite.

What is the incidence of Scrub Typhus?

Scrub typhus infection is common in the Asia-Pacific region. It is prevalent in India and approximately 25.3% individuals with Acute undifferentiated febrile illness were found to be infected with Scrub typhus.

The incidence of this infection is increasing and said to be due to urbanization, population explosion and increased case detection.

What are the symptoms of Scrub Typhus?

After the bite of an infected mite, patients present with flu-like symptoms, fever and a rash. The bite mark can present with an eschar appearance which is characteristic for this infection. Other symptoms include nausea, vomiting, abdominal pain, muscle aches and fatigue.

It starts by infecting the vessels of the body by causing vasculitis or the inflammation of the vessels. It can affect multiple organ systems by the vasculitis and inflammation surrounding the vessels.

It can spread to the brain, nerves, heart, kidney and even lungs by this method and cause inflammation to these organs leading to their damage.

In children, it can turn into a serious disease. It can cause complications in the second week of infection like ARDS, pneumonia, Meningoencephalitis, AKI and even bleeding.

How is Scrub Typhus diagnosed?

It is important to diagnose Scrub typhus in order to prevent the dangerous complications it poses. Since the initial symptoms are non-specific, it is important to diagnose it accurately and start treatment effectively.

A blood sample testing for IgM antibody against the scrub typhus bacteria is the best method to diagnose Scrub typhus. IgG antibodies are tested in cases of re-infection.

Other tests include ELISA and PCR which test for the antibodies rapidly and effectively. Weil-Felix test is still used but it is not as specific or sensitive.

What are the treatment options available?

The mainstay treatment of Scrub typhus remains to be antibiotics.

Oral Doxycycline for 7-14 days and Oral Azithromycin are commonly used antibiotics against Scrub typhus infections. IV Chloramphenicol can be given for severe patients and children who cannot tolerate feed.