Burden of Scrub Typhus in a tertiary level Hospital in year 2018 with special reference to its seasonal trend: A record base Study

The term “scrub” is used because of the type of vegetation (terrain between woods and clearings) that harbors the vector. The word “typhus” is derived from the Greek word “typhus,” which means “fever with stupor” or smoke. 1 

Scrub typhus is an important cause of acute undifferentiated febrile illness in several parts India.2 Orientia tsutsugamushi, the etiological agent of scrub typhus is an obligate intracellular Gramnegative coccobacilli belonging to the family rickettsiae., The larvae of trombiculid mites are the implicated vector and reservoir of the bacteria and can efficiently transmit it to their offspring transovarially.3 

Scrub typhus is also a acute febrile illness like as malaria, enteric fever, dengue, leptospirosis, infectious mononucleosis etc.4 This disease is may result in severe complications such as acute respiratory distress syndrome, septic shock and multisystem organ failure often culminating in death in morbid patients if remains untreated. Acute kidney failure associated with scrub typhus has also been reported in the tropics.5 

Globally, over one billion people are at risk for scrub typhus and an estimated one million cases occur annually.4 The disease is largely prevalent to southeastern and eastern parts of Asia i.e. in India, Pakistan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and other islands in the region.5 

In India, it is present in whole of the Shivalik ranges from Kashmir to Assam, Eastern and Western Ghats, and the Vindhyachal and Satpura ranges in the central part of India. There are many outbreak time to time in Darjeeling, South East Himalayan region etc.6,7,8,9 

This disease is also prevalent in areas such as sandy beaches, mountain deserts, and equatorial rain forests. Certain areas such as forest clearings, riverbanks, and grassy regions provide optimal conditions for the infected mites to thrive. These small geographic regions are high-risk areas for humans and have been called scrub typhus islands.