48 cases of scrub typhus in Delhi since July
Forty-eight cases of scrub typhus, the bacterial infection that had killed 16 persons and hospitalised 70 in Nagpur, have been treated in four large hospitals in Delhi since July.Updated: Sep 12, 2018 02:32 IST
Forty-eight cases of scrub typhus, the bacterial infection that had killed 16 persons and hospitalised 70 in Nagpur, have been treated in four large hospitals in Delhi since July.
Diagnosis of scrub typhus is often missed as the infection mimics symptoms of common monsoon infections, such as dengue and chikungunya. The infection can be fatal if not treated on time with antibiotics, which are not prescribed for dengue and chikungunya.
Ten people tested positive for scrub typhus in August and September at All India Institute of Medical Sciences (AIIMS). Safdarjung hospital, one of the biggest government hospitals in the city, reported 11 cases of scrub typhus in just the first nine days of September. In August, the hospital had treated 15 such cases.
Sir Ganga Ram hospital, a 675-bed private hospital in the city, has treated around 10 cases in the last one month. Another private hospital, Moolchand Medicity, also reported three cases.
“The number of infection goes up during the monsoons every year. Between January and July this year, around 2% of the samples that were tested were found to be positive. In August and September, this jumped to 10%. Over the years, the number of cases being detected has gone up in Delhi because of increasing awareness and more physicians testing for the disease,” said Rama Chaudhary, professor of microbiology at AIIMS.
Her observation is supported by a 2012-study from the National Centre of Disease Control, which showed that 8.2% of the patients with fever of unknown origins tested positive for rickettsial diseases. However, when a rickettsial disease was considered as a differential diagnosis, the seropositivity increased to 33.3%.
“Earlier, patients at AIIMS were tested for scrub typhus only after they tested negative for the usual seasonal fevers. Now, a fever patient is tested for it on day 1,” said Chaudhary. Scrub typhus is one of a group of diseases caused by the organism rickettsiae and is transmitted by mites, tics, lice and fleas.
The symptoms of scrub typhus and other rickettsial infections include high fever, skin rashes, respiratory problems, red eyes and unconsciousness. Some of the patients also develop joint pains, which is characteristic of chikungunya. The infection can lead to respiratory distress, inflammation of the brain and the lungs, kidney failure and then multi-organ failure, ultimately leading to death.
“The treatment is simple but often missed. We recently treated a boy who was being treated for fever for two weeks at another hospital. He was brought with multiple organ involvement. We diagnosed him for scrub typhus and started antibiotics. He recovered quickly thereafter,” said Atul Gogia, consultant of medicine at Sir Ganga Ram hospital.
Looking for an eschar or a dry dark scab on the body can help in telling scrub typhus apart from other seasonal fevers. “These eschars appear on 40 - 50% of all scrub typhus patients,” he said.
The disease was thought to be found in the hilly regions because the areas have the vegetation to support the proliferation of the vectors, like tics and mites. Now, more cases are being detected in the plains. This could simply be because more people are getting tested, Chaudhary said.
Contacted, a Delhi government official, however, denied that any cases of the disease had been reported from the city so far.