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Scrub typhus
- 1. ( CHIGGER BORNETYPHUS) SCRUB TYPHUS 1CHIGGER
- 2. Scrub typhus-MICRO MGMC&H,Jaipur 2 RICKETTSIACEAE RICKETTSIA R.prowazekii R.typhi R.rickettsii R.conori R.australis R.siberica R.akari ORIENTIA O.tsutsugamushi FAMILY GENUS SPECIES DISEASE • True bacteria • Obligate intracellular parasite Mostly by ticks mites Epidemic typhus Brill-Zinsser disease Endemic typhus Rocky-mountain spotted fever Boutonneuse fever Australian tick typhus Siberian tick typhus Rickettsial pox Scrub typhus
- 3. INTRODUCTION- Caused byO.tsutsugamushi “tsutsuga”-dangerous “mushi”-mite Occurs in Japan, Sumatra, Australia and islands along the Western Pacific coast. Disease transmitted by- larval form of Mite (Trombicula deliensis) Incubation period-7-10 days Case fatality-10-60% Scrub typhus-MICRO MGMC&H, Jaipur 3 O.tsutsugamushi
- 4. INFECTION- Larval formis known as chiggers. Found in areas of suitable climate, plenty of moisture and scrub vegetation. Microbes are transmitted transovarianlly in all mites. Various rodents and birds also act as reservoirs. Scrub typhus-MICRO MGMC&H, Jaipur 4 CHIGGER
- 5. Scrub typhus-MICRO MGMC&H,Jaipur 5 Four factors are essential for the establishment of infection, namely, co- existence and intimate relationship among-
- 6. CLINICAL FEATURES- Anecrotic lesion (eschar) occurs at the site of bite in the skin. Severe headache Chills Fever Conjunctivitis Maculopapular rash Enlarged spleen and lymph nodes Severe cases –encephalitis and pneumonia Scrub typhus-MICRO MGMC&H, Jaipur 6 MACULOPAPULAR RASH ESCHAR
- 7. LABORATORY DIAGNOSIS • SPECIMENS • DIRECTMICROSCOPY • CULTURE (ISOLATION OF ORGANISM) • SEROLOGY • MOLECULAR METHODS Scrub typhus-MICRO MGMC&H, Jaipur 7
- 8. PRE REQUISITE - Theyare highly infectious, their isolation should be attempted only in labs equipped with appropriate safety measures. UNABLE TO GROW ON CELL FREE MEDIA. Scrub typhus-MICRO MGMC&H, Jaipur 8
- 9. SPECIMENS- For culture- Blood Tissue For serological test serum Scrub typhus-MICRO MGMC&H, Jaipur 9
- 10. DIRECT MICROSCOPY GIEMSA STAIN Purple colored basophilic inclusions MACHIAVELLO’S STAIN Red colored inclusions Scrub typhus-MICRO MGMC&H, Jaipur 10
- 11. ISOLATION - Scrub typhus-MICROMGMC&H, Jaipur 11 Blood clot in skimmed milk is inoculated intraperitoneally in male mice. Animals are to be observed for 3-4 weeks. Temperatures are recorded daily. RESULT- animal becomes ill and develop ASCITIS.
- 12. Demonstration- Smears aretaken from peritoneum, tunica and spleen of infected animals. Stained by- GIEMSA STAIN Culture used- 1. YOLK SAC OF CHICK EMBRYO 2. TISSUE CULTURE 3. Vero and MRC5 CELL CULTURES (not suitable for primary inoculation) Identified by- IMMUNOFLUOESCENCE TEST Scrub typhus-MICRO MGMC&H, Jaipur 12 TISSUE CULTURE
- 13. SEROLOGY Weil felix test Scrubtyphus-MICRO MGMC&H, Jaipur 13 Others- • Compliment fixation test • Latex agglutination test • Enzyme immune assay
- 14. Weil-Felix Test Developedby Weil and Felix in 1916. Some Proteus (OX19, OX2, OXK) strains are agglutinated by sera of patients with rickettsial infections. This is due to the antigenic sharing between species of proteus and rickettsia. It is an eg. of heterophile agglutination test. Scrub typhus-MICRO MGMC&H, Jaipur 14 DISEASE AGGLUTINATION WITH PROTEUS STRAIN OX19 OX2 OXK Scrub typhus - - +++
- 15. Scrub typhus-MICRO MGMC&H,Jaipur 15Treatment- Tetracyclines and chloramphenicol General measures- Control of vectors and animal reservoir. Vaccination- There is no safe and effective vaccine.
- 16.