KOHIMA, OCTOBER 23 : Called the ‘killer bite,’ Scrub Typhus is an acute fever-causing infectious illness caused by a bacteria called Orientia Tsutsugamushi, a disease of the mountainous regions, sandy beaches, deserts, and equatorial rain forests.
The first case of scrub typhus in Nagaland was reported in 2011, when in September there was reportedly an outbreak of fever, of unknown cause. It led to three deaths at Poilwa village in Peren district.
The State Rapid Response Team of the Integrated Disease Surveillance Project of Nagaland had conducted an investigation in said village. Since then, with the detection of Scrub Typhus from various pockets of the state, 113 cases and 8 deaths have been reported from September till November 2011.
Of late, there has been a resurgence of scrub typhus cases in the state, with people being admitted to hospitals with fever, many of whom have succumbed to the killer bite.
According to data provided by the Naga Hospital of Kohima to Eastern Mirror, 1, 497 patients came in with scrub typhus-like symptoms during January-September 2016. 242 cases were registered at the hospital.
The data also shows that this year there were 32 deaths within 24 hours due to scrub typhus. This indicated a mortality rate at 42%.
Talking to this correspondent, the hospital’s senior specialist (anaesthesia) Dr Sentimeren Ao said that the pathogen that causes scrub typhus is transmitted to humans through the bite of an infected chigger (mites). Rats, especially field rats are the ‘reservoir host’ and humans the ‘accidental host’ who are infected.
Explaining the route of scrub typhus, Dr Ao said that infection begins when an infected chigger bites while feeding and inoculates, which is painless and unnoticed; the incubation period lasts 6-20 days.
Saying that there were no specific symptoms for a person to identify if they had scrub typhus, Dr Ao said fever begins during 8-10 days of the bite. The fever reaches 40-40.5°C (104 -105°F) in temperature, and which will not respond to any antibiotic.
Patients complain of headaches, chills and rigor; lymphadenopathy (swelling of lymph nodes), conjunctival (membranes lining the eyelid) redness; anorexia, and general apathy; appearance of rash in the first week. The painless papule gradually enlarges which develops ‘Eschar’—falling away of dead skin.
Dr Ao said scrub typhus was 100% curable if detected on time with cheap and easy treatment. However, he cautioned that if treatment was not administered on time, there could be complications that would affect major organs of the body including the brain and the heart. It would be irreversible then, he said.
Stating early detection and treatment to be very important, Dr Ao said it was mandatory for any person with fever of a few days to seek blood test. ‘Time is very important here,’ he said. ‘If delayed for two weeks, mortality rate is very high with the bacteria spreading to the bloodstream and eating away all the cells in the body.’
Also, the medical officer said scrub typhus was most common among those that frequented fields, jungles and forests, or were settled in ‘areas of heat and moisture.’ He suggested wearing protective clothing and using insects repellent when venturing into jungles.
Dr Ao added that personal hygiene was very important to prevent scrub typhus. With the increase in the number of patients with scrub typhus of late, he said public awareness programmes would help reduce its spread.
