Of the 150 tested for scrub typhus, a bacterial infection that causes symptoms very similar to chikungunya, 33 tested positive in the last two months at All India Institute of Medical Sciences (AIIMS).
“As the symptoms of the disease are similar to that of chikungunya, which is circulating in the city this year, doctors do not suspect scrub typhus or any of the other rickettsial diseases (diseases caused by a group of microorganisms called rickettsiae) in fever patients,” said Dr Rama Chaudhary, professor of microbiology at AIIMS.
Chikungunya, a mosquito borne viral illness, has affected more than 2,600 in Delhi, according to official figures.
The symptoms of scrub typhus begin with high fever, skin rashes, respiratory problems, red eyes and unconsciousness. Some of the patients also develop joint pains, which is characteristic of chikungunya.
These symptoms may progress on to respiratory distress, pneumonitis (inflammation of lung tissue), encephalitis (inflammation of the brain), kidney failure and then multi-organ failure. If untreated, it can kill.
Two of the people, who came to AIIMS for treatment – a 16-year-old girl from Uttarakhand and 21-year-old man from Delhi – died due to the infection, according to a hospital official. “They came to the hospital in a very critical condition with organ failure and had to be put on ventilator immediately,” the source said.
Another reason why doctors may not suspect scrub typhus is that it is usually spread by mites, which are commonly found in hilly areas. But, it can also be spread by fleas, lice and tics too.
A lot of precious treatment time is wasted because of this. “The samples were sent to the bacterial lab only after dengue and chikungunya had been ruled out. To get the test for chikungunya, a patient has o wait for at least six days to get accurate results, this means we get to test the sample more than a week after the symptom appear,” said Dr Chaudhary.
The disease, if diagnosed on time, can be completely cured just with antibiotics. “Dengue and chikungunya are self-limiting viral diseases that do not have any treatment, apart from management of symptoms. In scrub typhus, however, administering antibiotics on time can save lives,” she said.
What is scrub typhus?
A disease caused by Rickettsia bacteria. Fleas, mites (chiggers), lice, or ticks transmit it when they bite you. It cannot be transmitted from person to person.
Incubation period (time between bite and beginning of symptoms): 10 – 14 days
Fatality: 30-45 per cent, if untreated
Symptoms: Headache, fever, chills, rash, cough, red lesion at the site of the bite
Diagnosis: •skin biopsy - sample of the skin from your rash will be tested in a lab
•Western blot - test to identify presence of typhus bacteria
•immunofluorescence test - using fluorescent dyes to detect typhus in samples of mucus
•blood test – blood sample tested for the presence of infection
Treatment: Administration of antibiotics like doxycycline, cholramphenicol, ciprofloxacin
Complications: •hepatitis (infection of the liver)
•gastrointestinal hemorrhage (bleeding inside the intestines)
•hypovolaemia (decrease in blood volume)