Scrub typhus: A prospective, observational study during an outbreak in Rajasthan, India

Area of Science:

• Infectious Diseases
• Rickettsial Infections
• Public Health

Background:

• Scrub typhus is a severe rickettsial infection endemic to India, caused by Orientia tsutsugamushi.
• It typically manifests as acute febrile illness with multi-organ involvement.
• Limited data exists from the Hadoti region, Rajasthan, necessitating local investigation.

Purpose of the Study:

• To investigate the epidemiological and clinical profile of scrub typhus in Rajasthan.
• To document clinico-radiological findings and outcomes in affected patients.
• To understand the disease burden in a tertiary care setting during an outbreak.

Main Methods:

• A descriptive study was conducted over four months (July-October 2014).
• Patients diagnosed with scrub typhus via positive IgM antibodies against O. tsutsugamushi were included.
• Data on epidemiological, clinical, radiological, and laboratory parameters were collected and analyzed.

Main Results:

• Fever was universal; breathlessness, hemoptysis, and oliguria were common symptoms.
• Eschar and lymphadenopathy were infrequent.
• Acute respiratory distress syndrome was the most common radiological finding, with high rates of respiratory, renal, and hepatic complications.
• The overall mortality rate was 21.2%.

Conclusions:

• Scrub typhus is a significant cause of febrile illness in the Hadoti region, presenting diverse clinical features.
• The absence of eschar does not rule out scrub typhus.
• Prompt diagnosis and intervention are vital to reduce scrub typhus mortality.