Scrub typhus-an emerging entity: a study from a tertiary care hospital in North India

Area of Science:

• Tropical Medicine
• Infectious Diseases
• Bacteriology

Background:

• Scrub typhus, caused by Orientia tsutsugamushi, is a significant tropical febrile zoonotic disease.
• Under-diagnosis in India stems from non-specific symptoms, low clinician suspicion, and limited diagnostics.
• Orientia tsutsugamushi are obligate intracellular Gram-negative coccobacilli transmitted by infected mites.

Purpose of the Study:

• To assess the prevalence of scrub typhus-specific antibodies in febrile patients at a tertiary care hospital.
• To evaluate the utility of a rapid immunochromatographic assay for diagnosing scrub typhus.
• To monitor scrub typhus antibody levels over a one-year period.

Main Methods:

• A rapid qualitative immunochromatographic assay was used to detect IgM, IgG, and IgA antibodies to O. tsutsugamushi.
• Serum samples were collected from 772 suspected febrile patients over one year.
• Positive cases were identified based on antibody detection.

Main Results:

• Out of 772 patients, 98 (12.69%) tested positive for O. tsutsugamushi antibodies.
• Persistent high-grade fever was a common symptom; eschars were present in only 10.2% of positive cases.
• Three patients died; the remaining positive cases responded to doxycycline treatment.

Conclusions:

• The rapid assay is effective in detecting scrub typhus antibodies among febrile patients.
• Scrub typhus is a notable cause of febrile illness in the study population.
• Early diagnosis and treatment with doxycycline are crucial for managing scrub typhus.