Chigger bites. Credit score: Kambrose123/Wikimedia Commons, CC BY-SA
A examine of greater than 32,000 individuals dwelling in Tamil Nadu, India, suggests scrub typhus an infection could have an effect on as much as 10% of rural populations yearly and is a number one but under-recognized reason for hospitalizations for fever throughout India.
The examine, revealed within the New England Journal of Medication, was carried out as a part of a collaboration between the London College of Hygiene & Tropical Medication (LSHTM) and the Christian Medical School Vellore, India.
Scrub typhus is a doubtlessly life-threatening an infection brought on by the bacterium Orientia tsutsugamushi, which belongs to the rickettsia household. It’s unfold to people by means of the chunk of contaminated larval mites or chiggers. Chiggers are discovered on grass, plant litter and naked soil throughout rural areas of Asia, and often feed on small mammals corresponding to rats and shrews.
Signs, corresponding to fever, headache, physique aches and rash, often start round 10 days after an infection. The tissue round chigger bites will even sometimes flip black, which might help medical doctors with analysis.
If left untreated, extreme sickness from scrub typhus an infection can result in acute respiratory misery syndrome (ARDS), shock, meningitis and kidney failure, which will be deadly. Instances will be handled utilizing the antibiotics doxycycline and azithromycin however there’s at present no vaccine to forestall an infection.
The examine enrolled greater than 32,000 individuals dwelling throughout 37 rural villages in Tamil Nadu, India. As scrub typhus is understood to be endemic within the space, the pattern represented a typical rural Indian inhabitants liable to an infection. The group visited households each six to eight weeks from August 2020 to July 2022, to gather blood samples and document any signs of sickness they could have skilled. Blood samples taken from individuals who reported fever have been then examined for scrub typhus an infection.
The researchers discovered a excessive incidence of scrub typhus throughout the two-year examine interval, with virtually 10% of the inhabitants contaminated yearly. Most of those infections have been asymptomatic, however of those that have been contaminated, between 8% and 15% developed a fever that usually required hospitalization and intensive care because of extreme an infection. A complete of 5 individuals died from scrub typhus-associated problems through the examine.
The researchers say that under-reporting of fever is a vital limitation of the examine and that it is seemingly extra instances of scrub typhus could have occurred over the two-year interval. The examine was additionally carried out through the COVID-19 pandemic, the place quarantine measures have been in place within the space.
Wolf-Peter Schmidt, principal investigator of the examine and Medical Assistant Professor on the London College of Hygiene & Tropical Medication (LSHTM), mentioned, “India is a rustic notably affected by scrub typhus, and infections sometimes happen between August and February.
“Over a period of two years, we found a high incidence of asymptomatic and symptomatic infection, with some people getting infected twice in as many years. It is not clear why some infections become severe or even life-threatening. While five cases in our study population died of scrub typhus, we did not record any deaths from malaria, dengue or typhoid fever, which are usually thought of as the main causes of severe fever in India.”
Carol Devamani, lead writer and MD in Group Medication primarily based on the Christian Medical School Vellore, mentioned, “After COVID, scrub typhus was an important reason for fever in our examine, accounting for nearly 30% of fever hospitalizations.
“Regardless of instances being quite common and treatable, scrub typhus is usually missed as a attainable trigger when sufferers current with a fever. Diagnostic checks can be found at main hospitals however not locally.
“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 hospitalizations and fatal cases.”
Extra info:
Incidence of Scrub Typhus in Rural South India, New England Journal of Medication (2025).
Supplied by
London College of Hygiene & Tropical Medication
Quotation:
‘Missed’ scrub typhus could have an effect on 1 in 10 in rural India and be a number one reason for hospitalizations for fever (2025, March 12)
retrieved 12 March 2025
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