Scrub typhus is caused by the bacteria Orientia tsutsugamushi and is transmitted to humans through bites from infected trombiculid mites. The disease was first reported in Japan and India. Symptoms include fever, rash, and formation of eschar lesions on the skin. Diagnosis is confirmed through tests like the Weil-Felix test and immunofluorescence. Complications can include pneumonia, hepatitis, and multi-organ failure if left untreated. Treatment is with doxycycline or chloramphenicol antibiotics. Prevention focuses on vector control and personal protection measures.

1. SCRUB TYPHUS
Tsutsugamushi Disease

2. Contents
Distribution
Epidemiological determinants
Mode of Transmission
Clinical Features
Investigations
Complications
Management
Prognosis
Prevention

3. INFECED REGIONS

4.  First in Japan
 First in India during world war II
 Common among millitants

5. Epidemiological determinants
Agent: Orientia tsutsugamushi.
Reservoir: Trombiculid mite.
Leptotrombidium deliensis- India.
Leptotrombidium akamushi- Japan.

7. Chigger
reservoir
Larval stage
vector

8. Mode of Transmission
Mite
Rats & Mice
Humans
Mite


No direct person to person transmission
Mite Islands
(Accidental host)

9. Clinical Features
 Incubation peroid: 1-3 wks(usually6-21 days)
 Fever(104-105°F) with chills,malaise,conjunctival
Irritation.
 Maculopapular rash
 Lymphadenopathy,Lymphocytosis
 Headache, Cough, Myalgia
 Gastrointestinal symptoms
 Typical “Eschar formation”(5th day of illness)

10. Punched out
lesions with black
scab

11. Investigations
• Weil-feilx test positive-proteus strain oxk
• Indirect immunofluorescence.
• PCR for Orientia tsutsugamushi from blood of
feverish patients.
• Some studies have used PCR (polymerase chain reaction) on
specimens obtained from eschars.

12. Complications
 Pneumonitis
 Hepatitis
 Myocarditis
 Meningoencephalitis
 Disseminated intravascular coagulation
 Multi organ failure

13. Management
• Drug of choice: Tetracycline
Doxycycline orally or Chloramphenicol in
more severe cases.
Azithromycin has been used in resistant
cases and may be better than doxycycline -
especially in children and pregnant women.

14. Prognosis
 Fatality of untreated cases is between 5 - 10 %
and is even higher in adults.

15. PreventionVector control:
 Application of insecticides eg: lindane
or chlordane to ground and vegetation.
 Environmental control
 Personal protection

16. Thank you