Scrub typhus is a disease caused by Orienta tsutsugamushi.It is endemic in South east asia and some other places.More than one million cases are reported annually.This infection is transmitted to man through the bite of infected trombiculid mite larvae (chiggers).
The incubation period of scrub typhus is about 9 days.
It is common to see mild or sub-clinical cases.In many patients eschar develops.Eschar are typical necrotic lesion of skin at the site of larval bite.The disease is not directly transmitted from person to person.The symptoms are acute in onset with high grade fever(104-105 degree fahrenheit),headache,often retro-orbital,malaise,weakness and a macular rash.If left untreated,it can progress to hemorrhage,jaundice,pneumonia,multi-organ dysfunction syndrome and paralysis.
Doxycycline is the drug of choice in scrub typhus fever.It can be given to patients of any age.With proper therapy,the prognosis is excellent.
Application of insecticides and clearance of vegetations where rats and mice live helps to control the outbreak of scub typhus.It is best to avoid risk of infection by reducing contact with chiggers.While travelling to endemic places,it is advised to avoid places with bushes and lots of vegetations.There is no vaccine against scrub typhus till date.Impregnating clothes with miticial chemicals is advised if we cannot avoid going to those areas.
SCRUB TYPHUS IN NEPAL
More than one thousand cases of scrub typhus were found in Nepal from 2015 to 2017.The case fatality has decreased over years due to better understanding of the disease and clinical diagnosis and prompt treatment.The infection is seen to be at peak during August and September.
