Scrub Typhus

March 13, 2025

Scrub typhus is an infectious disease affecting rural populations in India. Recent research marks its prevalence and impact on health. Conducted by the Christian Medical College, Vellore, and the London School of Hygiene and Tropical Medicine, the study examined over 32,000 individuals in Tamil Nadu. It revealed that scrub typhus is often overlooked as a cause of fever hospitalisations.

What Is Scrub Typhus?

Scrub typhus is caused by the bacterium Orientia tsutsugamushi.
It belongs to the rickettsia family and is transmitted through the bite of infected larval mites, commonly known as chiggers.
These mites thrive in grassy and soil-rich environments, particularly in rural Asia.

Symptoms

Symptoms typically appear 10 days post-infection. Common signs include fever, headache, body aches, and rash. Due to its nonspecific symptoms, scrub typhus is frequently misdiagnosed. Diagnostic tests are available in major hospitals but are scarce in rural communities.

Incidence and Hospitalisation

The study indicated that scrub typhus accounts for nearly 30% of fever-related hospitalisations. Severe cases can lead to acute respiratory distress syndrome, shock, meningitis, and kidney failure. Among those infected, 8 to 15% required intensive care.

Geographic and Temporal Patterns

Scrub typhus is predominantly found in rural areas of India and Southeast Asia. Infections peak between August and February. The study showed a high incidence of both symptomatic and asymptomatic infections, with some individuals experiencing multiple infections within two years.

Public Health Implications

Despite its commonality, scrub typhus remains under-recognised. The absence of awareness in communities contributes to delayed diagnosis and treatment. Five deaths were reported in the study population due to scrub typhus, contrasting with no fatalities from malaria, dengue, or typhoid fever, which are typically associated with severe fevers.

Recommendations for Awareness and Treatment

The lead researcher emphasised the need for increased public awareness about scrub typhus. Enhancing diagnostic capabilities in rural areas is essential for timely treatment. This could reduce unnecessary hospitalisations and prevent fatalities.

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