Contributed by: Rachana Arya
Scrub Typhus — the ‘Mystery Fever’ has recently plagued several states of India, causing widespread panic and fear. Before we take a look at various misconceptions surrounding this infection, let’s understand what exactly is scrub typhus.
What is scrub typhus?
According to the Centers for Disease Control and Prevention (CDC), scrub typhus, also known as bush typhus, is a mite-borne illness that is spread by infected chiggers (larval mites). It is caused by a bacteria called Orientia tsutsugamushi. The name “scrub” refers to the type of vegetation that harbors the vector (terrain between woods and clearings).
Signs and symptoms of scrub typhus
The disease affects critical functions of the body, such as the central nervous system, cardiovascular system, renal system, respiratory system, and gastrointestinal system. Symptoms usually begin to manifest within 10 days of being bitten. The most common signs and symptoms of the disease include:
- Fever and chills
- Body aches
- Muscular pains
- Mental disorientation
- Nausea and vomiting
If left untreated, scrub typhus can cause serious and even deadly complications. Its progression may manifest as:
Time to delve into the myths about scrub typhus and bust them from the inside out
Myth #1: Scrub typhus is not a serious illness
Scrub typhus is probably the single most prevalent, under-recognized, neglected, and severe illness. If undiagnosed or diagnosed late, it may prove to be a life-threatening disease. Without treatment, the illness has a fatality rate as high as 50%.
Myth #2: It’s a newly discovered disease
During World War II, severe epidemics of the disease struck troops in Burma and Ceylon. Scrub typhus was previously found in various parts of China, Japan, Indonesia, Malaysia, Thailand, Pakistan, Korea, northern Australia, and the western Pacific and Indian Ocean islands. Currently, scrub typhus is endemic in Asia-Pacific. Recently, because of its re-emergence and rising occurrence in previously undiscovered places, this ancient disease is currently gaining more attention.
Myth #3: Scrub typhus is contagious
This is not true. Scrub typhus cannot spread from person to person in the same way that a cold or the flu does. Neither can it be transmitted through unscreened blood transfusions and unhygienic needles. It is a zoonosis (an animal disease that can spread to humans) infection and has no human-to-human transmission vectors.
Myth #4: It is an uncommon illness
Approximately one million cases of scrub typhus occur each year, and over one billion people are at risk of being exposed to this disease.
Myth #5: Scrub typhus cannot be cured
The disease is easily curable using antibiotics, but any delay in diagnosis can result in delayed treatment and lead to severe complications.
Myth #6: Chiggers bite you the same way as the mosquitoes do?
One of the most common chigger misconceptions is that they can burrow through your skin and suck your blood. This leads to the common chigger therapy of suffocating the chiggers by applying transparent nail paint to the bites. This ‘therapy’ isn’t essential because chiggers don’t truly burrow under your skin.
In reality, Chiggers don’t bite you in the way that mosquitoes do. Instead, they attach themselves to your skin and inject digestive enzymes into your saliva, which aid in the breakdown of your skin cells, which the chigger then consumes. The itching rash is caused by these enzymes.
Myth #7: Medicines aren’t available to treat scrub typhus
Early treatment with antibiotics is very effective against scrub typhus. Doxycycline is currently the drug of choice for this illness. Chloramphenicol and macrolides have also been administered successfully for their treatment. Azithromycin has also been advocated as an alternative agent to cure this illness.
Although if the antibiotics are not taken for a long enough time, relapses may develop. Patients who are extremely unwell and unable to swallow pills may be given intravenous (IV) antibiotics.
Preventive measures against scrub typhus
Currently, no vaccine or preventive medication is available against scrub typhus. Health agencies, therefore, recommend that travelers who engage in hiking, camping, or similar outdoor activities in endemic regions should avoid overly bushy areas.
Some appropriate measures to avoid contact with infected chiggers include:
- While trekking, walk in the middle of the trail and stay away from tall grasses and shrubs
- In endemic areas, wear protective clothing like long shirts and slacks with socks tucked in.
- Do not sit on bare ground or grass; use a mat while sitting or lying down on the ground.
- If you have a baby or child, dress them in clothing that covers their arms and legs.
- Use mosquito netting to cover the kids’ cot, stroller, and baby carrier.
- Do not use insect repellent on a child’s hands, eyes, or mouth, or on cuts or irritated skin.
- If you’re traveling to a region where scrub typhus is endemic, talk to your doctor before the visit.
Wrapping it up
Since the early symptoms of scrub typhus are not specific, its diagnosis becomes more challenging. If you think you might have been exposed to this disease, or if you notice sudden chills, fever, severe headache, and muscular aches and pains, get in touch with your doctor immediately. Laboratory testing is needed for confirming the diagnosis. If your doctor thinks you have typhus, he will order a blood test to check for typhus bacteria.
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