New Delhi: Rural communities are at high risk of potentially life-threatening scrub typhus infections, according to a study by researchers from the Christian Medical College (CMC) Vellore released on Thursday.
Scrub typhus is a potentially life-threatening infection caused by the bacterium Orientia tsutsugamushi, which belongs to the rickettsia family. It is spread to humans through the bite of infected larval mites or chiggers.
The study of 32,000 people in rural areas of Tamil Nadu, shows scrub typhus to be a leading yet under-recognised cause of hospitalisations for fever.
The study, published in the New England Journal of Medicine, conducted in collaboration with the London School of Hygiene & Tropical Medicine (LSHTM), found a high incidence of scrub typhus across the two-year study period, with almost 10 per cent of the population infected annually.
Most of these infections were asymptomatic, but of those who were infected, between 8 per cent and 15 per cent developed a fever that often required hospitalisation and intensive care due to severe infection.
“After Covid, scrub typhus was the most important cause of fever in our study, accounting for almost 30 per cent of fever hospitalisations,” said lead author Carol Devamani, MD in Community Medicine based at CMC Vellore.
“Despite cases being very common and treatable, scrub typhus is often overlooked as a possible cause when patients present with a fever. Diagnostic tests are available at major hospitals but not in the community,” she added.
Symptoms of scrub typhus include fever, headache, body aches, and rash. These usually begin around 10 days after infection. The tissue around chigger bites will also typically turn black, which can aid doctors with diagnosis.
If left untreated, severe illness from scrub typhus infection can lead to acute respiratory distress syndrome (ARDS), shock, meningitis, and kidney failure, which can be fatal.
Cases can be treated using the antibiotics doxycycline and azithromycin but there is currently no vaccine to prevent infection.
During the study, five people died from scrub typhus-associated complications.
The researchers said that under-reporting of fever is an important limitation of the study.
“Our study highlights a need to inform communities about the possible dangers of scrub typhus infection, and to improve diagnostic capabilities in the community for timely treatment. Only by doing so will we reduce the number of unnecessary hospitalisations and fatal cases,” Devamani said.
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