How Is Scrub Typhus Diagnosed and Treated?
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.
Fever
Chills
Headache
Muscular pain
Body pain
Red or pink rashes
Loss of appetite
Stomach Pain
Vomiting
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
There is no vaccine for Tsutsugamushi scrub
Offen applying insect repellent is the best method to avoid typhus eschar
People can avoid contact with Tsutsugamushi scrub infected chiggers for escaping from risk
Maintaining adequate personal hygiene
Can take necessary measures to control the rodent population.
Must avoid travelling to the affected area.
FAQs on Scrub Typhus: Causes, Symptoms, and Prevention
1. What is scrub typhus and what is its main cause?
Scrub typhus, also known as tsutsugamushi disease, is an acute febrile illness. The main cause is a bacterium called Orientia tsutsugamushi. This bacterium is transmitted to humans not by direct contact but through the bite of infected larval mites, commonly known as chiggers, which are found in areas with dense vegetation.
2. What are the primary symptoms of scrub typhus?
The primary symptoms of scrub typhus typically appear within 10 days of being bitten and are important for a correct diagnosis. They include:
- Sudden onset of high fever with chills.
- A severe headache and body aches.
- A characteristic dark, scab-like lesion called an eschar at the site of the chigger bite (though not always present).
- A rash that usually appears on the trunk and spreads to the limbs.
- Enlarged lymph nodes and profound tiredness.
3. How is scrub typhus transmitted to humans?
Scrub typhus is a zoonotic disease, meaning it is transmitted from animals (typically rodents) to humans via a vector. The transmission cycle involves the bacterium Orientia tsutsugamushi infecting larval mites (chiggers). When an infected chigger bites a human, it injects the bacteria into the skin, causing the infection. It is not passed from person to person.
4. Is scrub typhus contagious from person to person?
No, scrub typhus is not contagious and cannot be spread directly from one person to another. The infection can only be acquired through the bite of an infected chigger. It is not transmitted through touch, coughing, or sharing personal items with an infected individual.
5. What is the standard treatment for scrub typhus and how long is the recovery?
The standard treatment for scrub typhus is a course of antibiotics, with doxycycline being the most effective and commonly prescribed drug. Treatment should be started as soon as the disease is suspected for the best outcome. With prompt antibiotic therapy, fever usually subsides within 48 hours. Full recovery typically takes about one to two weeks, but this can be longer in more severe cases.
6. How can one prevent getting infected with scrub typhus?
Prevention focuses on avoiding chigger bites, especially in endemic areas with grass, bushes, and forests. Key preventive measures include:
- Wearing protective clothing, such as long sleeves and pants.
- Applying an insect repellent containing DEET to exposed skin and clothing.
- Avoiding sitting or lying directly on the ground in grassy or scrubby areas.
- Clearing bushes and overgrown vegetation around homes to reduce mite habitats.
7. What is an eschar and why is it important for diagnosing scrub typhus?
An eschar is a dark, painless, scab-like lesion that forms at the site where an infected chigger bit the skin. It is a crucial clinical sign for diagnosing scrub typhus because it is highly characteristic of the disease. While not all patients develop an eschar, its presence provides strong evidence for a doctor to suspect scrub typhus and begin treatment immediately, which is vital for preventing complications.
8. What are the potential complications if scrub typhus is not treated promptly?
If scrub typhus is left untreated or diagnosis is delayed, it can lead to severe and life-threatening complications. The bacteria can spread throughout the body, causing systemic inflammation. Potential complications include interstitial pneumonia, acute respiratory distress syndrome (ARDS), myocarditis (inflammation of the heart muscle), kidney failure, meningitis, and multi-organ failure, which can be fatal.
9. Why is scrub typhus considered a re-emerging disease in some regions?
Scrub typhus is considered a re-emerging disease for several reasons. Changes in land use, such as deforestation and increased agricultural activity, bring humans into closer contact with rodent and chigger habitats. Additionally, improved surveillance and diagnostic tools are leading to better detection of cases that might have been previously misdiagnosed. Climate change may also be expanding the geographic range of the mite vectors, contributing to outbreaks in new areas.
