Understanding Scrub Typhus

Dr. Vivek Sharma
“It is said that during NAPOLEON”s retreat from Moscow, a great number of soldiers were killed by typhus than by the Russian Army.”
What is Scrub Typhus?
Scrub Typhus is an infectious disease with symptoms of similar to any viral fever. However it is not caused by a virus but a parasite called ORIENTIA TSUTSUGAMUSHI which is transmitted by the bite of infected mite larvae in soil containing scrub vegetations. The disease is also known as Bush typhus because the mite that causes it reside in vegetations predominantly comprising small scrubs.
The disease is more common during the wet season when the mites lay eggs. The time between bite and beginning of symptoms is 10-14 days.
What causes scrub Typhus?
Scrub Typhus is caused by a bacteria called orientia TSUTSUGAMUSHI, which is introduced in our bodies from the bite of the infected larvae of a certain kind of mite. the adult mite do not bite, and the larvae which are too small to the seen by naked eye do so in a painful manner.
These larvae are present on the blades of grass, small bushes, shrubs, and usually bite rats, scrubs or even birds. We become accidental victims during the course of a range of activity in cutting grass, collecting fuel wood, walking bare foot or sitting on the grass.
Thus even city dwellers are at risk of infection if there happen to be rats around, and if the grass in their lawns or parks is inherited by these mite larvae, which explains why some of the occupants of posh colonies develops scrub typhus.
* Abdominal Pain
* Backache
* Dull red rash that begins on the middle of the body and spreads
* Fever can be extremely high, upto 105o F, that may last upto two weeks
* Dry Cough
* Headache
* Joint and Muscle Pain
* Nausea and Vomiting
Risk factors for Scrub Typhus
* Farmers, forest workers and gardeners are more prone
* Living at the edge of the village
* Wearing short sleeves
* Working bare hands in gardens
* Immune deficiency
* Avoid places where mites are proven to be present in large numbers.
* Wear protective clothing when travelling to an endemic area. Long sleeved clothes have been shown to be preventive factor from getting infected.
* Apply mite repellants to exposed skin e.g. diethyl toluaimide.
* People who have risk factor and who have to work in an endemic area can be given once weekly dose of doxycycline (in consultation with a doctor)
No vaccine is available to prevent scrub thyphus. Reduce your risk of getting scrub typhus by avoiding contact with infected chiggers when handling to area where scrub typhus is common, avoid areas with lots of vegetations and bush where chiggers may be found.
(The writer is a consultant paediatrician based in Jaipur)