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Scrub Typhus

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What is Scrub Typhus?

MVSAT 2024

Scrub Typhus is an acute infectious disease spread among human beings through bites of infected chiggers or trombiculid mites, which is mainly caused by the parasite family Rickettsiaceae. The bacteria Orientia tsutsugamushi belongs to the Rickettsiaceae family is responsible for spreading the disease called Scrub Typhus. The bacterium R.tsutsugamushi acts as a causative agent of Scrub Typhus. The Leptotrombidium (Trombicula) akamushi and L. deliens are staying as vectors of the disease. The Scrub Typhus is also known as bush typhus. 

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Origin of Scrub Typhus 

Scrub Typhus originated from Southeast Asia. This disease was first described in 1899, and scientists researched and investigated scrub typhus in 1906-1932. This disease invaded Japanese troops and killed thousands of troops during world war II. Scrub Typhus created much impact in the pacific region. 


Types of Typhus 

The Typus is a bacterial infection, mainly caused by rickettsia or orientia bacteria. It spreads to human beings through infected mites, fleas, or lice and creates typhus eschar. There are three types of Typhus. They are.

Murine Typhus

It is mainly caused by infected fleas and bites of rats. Most of the cases are reported from the United states. 

Epidemic Typhus

Epidemic typhus, also called louse-borne typhus. This is one of the rarely spread infections, mainly caused due to the infected lice body. Another type of epidemic typhus spreads from infected squirrels. 

Scrub Typhus

Scrub Typhus is mainly spread through infected chiggers or mites. Many cases are recorded from Southeast Asia, China, Japan, India, and northern Australia. 


How Does Scrub Typhus Spread?

The Scrub Typhus is not transmitted from one person to another like, cough or cold. The bacteria Orientia tsutsugamushi is transmitted to the larva of mites in their early stages. When infected louse, flea, tick, or mite feed the blood from human being Scrub Typhus are transmitted. The infection gets spread throughout the body in 10-12 days. 


The children affected by tsutsugamushi scrub easily recover.  The malnourished adults will get affected soon. People with diabetes mellitus, alcoholism or renal disorders face huge risk due to orientia tsutsugamushi. This increases the mortality rate.  The epidemic typhus undergoes untreated and mortality rate ranges from 10 to 60 percent, and untreated scrub typhus mortality ranges stand at 30 percent.


Scrub Typhus Symptoms 

The person who got infected has Scrub Typhus symptoms within 2 weeks. They can absorb the following symptoms.

  1. Fever

  2. Chills

  3. Headache

  4. Muscular pain

  5. Body pain

  6. Red or pink rashes

  7. Loss of appetite

  8. Stomach Pain

  9. Vomiting

  10. Enlarged lymph nodes

A person who got infected with scrub typhus will require 10 to 12 days for developing symptoms even after biting an infected mite. Reddish or pinkish spots, which are known as typhus eschar, start appearing. The person begins to experience typhus fever scrub, headache, chills, and general pains, along with enlargement of lymph glands. After a week, a pinkish rash starts to develop over the skin of the trunk and may extend to the arms and legs. These symptoms may last for one to two weeks. But at the unusual stage, it may take three or four weeks to end up the cause.  The person at the severe stage may experience impairment of heart and circulatory function which may result in organ damage and bleeding. 


Diagnosis and Testing Scrub Typhus

The diagnosis of Scrub Typhus is quite difficult, as the scrub typhus symptoms are the same as other diseases like Dengue, Malaria, and Brucellosis. The physician will diagnose this disease only with the patient’s travel history, essential blood test, biopsy tests. 

Tests to Find Scrub Typhus 

To find the tsutsugamushi scrub’s infection, the following tests can be undergone. 

Skin Biopsy:  A sample of infected skin send for testing 

Western Blot:  A test to identify the presence of typhus in infected skin

Immunofluorescence Test: Technician use fluorescent dyes to detect typhus antigen in samples of serum taken from infected person’s bloodstream

Other Blood Tests: To analyze the presence of bacteria from infected bloodstreams.

 

Scrub Typhus Treatment 

Scrub Typhus is a curable disease. It requires simple scrub typhus treatment, dose medication and care for a few weeks. Doxycycline is a perfect antibiotic, which can be prescribed to many age groups. Ciprofloxacin is the best alternative for adults, who cannot intake Doxycycline. Chloramphenicol will also provide fast recovery, but cannot be prescribed to pregnant women. 


Complications of Typhus 

The person who is experiencing Scrub Typhus treatment dose may also face some complications like Hepatitis, Gastrointestinal Hemorrhage, and Hypovolem. 


Prevention Methods

  1. There is no vaccine for Tsutsugamushi scrub

  2. Offen applying insect repellent is the best method to avoid typhus eschar 

  3. People can avoid contact with Tsutsugamushi scrub  infected chiggers for escaping from risk 

  4. Maintaining adequate personal hygiene

  5. Can take necessary measures to control the rodent population. 

  6. Must avoid travelling to the affected area.

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FAQs on Scrub Typhus

1. Is Scrub Typhus Curable?

Ans: Usually, it is difficult for the physician to diagnose typhus. Only after analyzing the clear history of an infected person, doctors will start Scrub Typhus treatment. Typhus Eschar is completely recoverable. It required intensive care and periodic medication for perfect recovery. According to one’s medical history doctors prescribe antibiotics. It requires two to four weeks for complete recovery. 

2. How Long Does it Take to Recover from Scrub Typhus?

Ans: The effective medicine to treat tsutsugamushi scrub is antibiotics. The most commonly prescribed medicines are doxycycline, ciprofloxacin, and chloramphenicol. Doctors will prescribe scrub typhus treatment dose according to once infection rate. It requires 14-21 days for getting a perfect recovery from the disease. This period may get extended depends on one’s infection rate. Chronic infections bring several complications like circulatory collapse, interstitial pneumonia, congestive heart failure, pulmonary edema, and a wide array of signs and symptoms of central nervous system dysfunction, confusion, including delirium, and seizures.

3. Can Typhus Spread from Person to Person?

Ans: Scrub Typhus is a non-communicable disease. Scrub Typhus will not transmit from one person to other like cold, flu. It will get transmitted from infected larval mites to human beings. There are three types of Typhus.  Different types of bacteria are responsible for spreading each typhus disease. It causes reddish or pink rashes throughout the entire body of an infected person.  The chronic infection leads to bleeding into the skin,  hypotension, delirium, stupor, etc. 


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