Scrub typhus: A fever found in hilly regions spreads to plains

Most of the patients had fever,cough and myalgia,he adds.

Says Dr Rajesh Kumarm,head of the Department of Community Medicine,PGIMER,“There can be various reasons for the disease to spread here in plains. First,there are climatic changes. Secondly,the agricultural practices in Punjab and Haryana have also changed and the habitat may have been conducive for the mite to breed here and thus find a favourable habitat. Also,residents keep migrating from one place to another and someone infected with the disease came here in contact of the mite here and then the infection spread from one mite to another. Indeed it is an unusual finding in the past few years.”

The disease recently took lives of 14 patients from different regions in Himachal Pradesh,says Dr Ramesh,deputy medical superintendent,Indira Gandhi Medical College and Hospital,Shimla. “At present,we have 30 patients admitted to the hospital,and on average,we had been receiving over 100 cases a day from various districts of Himachal Pradesh in our hospital in the past couple of days,” he adds.

Explaining its health complications,Dr Sethi says severe scrub typhus usually presents as multiple-organ damage including carditis,acute respiratory distress syndrome hepatitis renal failure encephalitis,disseminated intravascular coagulopathy (DIC) and septic shock.

The disease is caused due to bacteria known as Orientia tsutsugamushi that lives primarily in mites (the primary reservoir) belonging to the species Leptotrombidium akamushi (chiggers mite).

The infection is called scrub typhus because it generally occurs after exposure to areas with secondary (scrub) vegetation. It has recently been found,however,that the disease can also be prevalent in such areas as sandy beaches,mountain deserts,and equatorial rain forests,according to Dr Sethi.

Human beings are infected accidentally,usually during rainy season. The site bitten by mite forms an eschar. The eschar resembles skin burn of a cigarette butt. The lesions are painless and without any itching sensation in most cases,causing the infection to be undetected by most patients. Scrub typhus can mimic acute abdomen which sometimes can lead to even surgery.