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Scrub Typhus Seropositivity, Clinical Manifestations, and Outcomes in Jodhpur: A Hospital-based Study

Haripriya Sivakumar1, Vidhi Jain2, Ravisekhar Gadepalli3

  • 1Junior Resident, Department of Microbiology, AIIMS, Jodhpur, Rajasthan, India.

Indian Journal of Public Health
|September 18, 2025
PubMed
Abstract

Insights

Scrub typhus, a mite-borne illness, affected 5.5% of febrile patients in Jodhpur over five years. Early diagnosis and treatment with doxycycline or azithromycin are crucial, though under-reporting remains a challenge.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Scrub typhus is an acute febrile illness caused by *Orientia tsutsugamushi*, transmitted by chigger bites.
  • Its epidemiology in India is poorly understood due to under-reporting.

Purpose of the Study:

  • To determine the seropositivity, clinical features, and treatment response of scrub typhus in Jodhpur, Rajasthan.
  • To provide the first formal seropositivity data for scrub typhus in this region.

Main Methods:

  • Prospective study of patients with febrile illness (>5 days) from 2019-2023.
  • Screening based on Department of Health Research-Indian Council of Medical Research (DHR-ICMR) 2015 guidelines.
  • Serological confirmation using *Orientia tsutsugamushi* IgM ELISA; positive cases reported to the Integrated Diseases Surveillance Programme.

Main Results:

  • Out of 1497 screened patients, 83 (5.5%) tested positive for *Orientia tsutsugamushi* IgM.
  • Classical signs (eschar, rash, lymphadenopathy) were less frequent; non-specific symptoms (myalgia, headache, malaise) were common.
  • Cases peaked in winter; patients responded well to doxycycline or azithromycin. Three deaths occurred before treatment initiation.

Conclusions:

  • This is the first study in Jodhpur to document scrub typhus occurrence using DHR-ICMR guidelines.
  • Low clinical suspicion, limited diagnostics, and under-reporting contribute to the obscure epidemiology of scrub typhus in India.
  • Despite being a reportable disease, effective surveillance and diagnosis remain critical challenges.
Keywords:
Emerging diseasesurveyvector borne disease

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