Scrub typhus is an epidemic disease in Nepal caused by the intracellular parasite Orientia tsutsugamushi, which is transmitted through the bites of chigger mites. The disease presents with severe headache, fever, myalgia and rash, and if untreated can have a 7% fatality rate. Diagnosis is made through serological tests and PCR, while early treatment with doxycycline or chloramphenicol antibiotics leads to full recovery in 3-4 days. Prevention involves using insect repellents, controlling rodent populations, and protective clothing to avoid chigger bites.

1. Scrub typhus being epidemic in Nepal
SubhasChandraAryal[msc medical microbiology]
Goldengate international college
www.Facebook.com/ThesubhasChandra
subasaryal98@gmail.com
Nalang-3 dhading
Scrub typhus was 1st isolated and identified in 1930 in Japan.It is caused by intracellular parasite Orientia
tsutsugamushi,formerly known as Rickettsia tsutsugamushi which is a gram negative alpha-proteobacterium of family
Rickettsiaceae.
The disease is transmitted bylarval form oftropicalmite [Leptotrombidium akamushi,L deliense].The parasitic larvae[chiggers]
occur in their habitats[Rodents,Birds]inareacoveredwithscrubvegetation.Human infectionoccurs following bite by infected
Mite,Louse,Flea or Ticks.
Scrub typhus is mildand self-limiting disease,but if untreated it has a fatality of 7%.The condition manifests with severe
headache,fever[upto 105 degree Fahrenheit],myalgia and maculo papular rash[initially on trunk and later on the
limbs].Splenomegaly,CNS complications,generalized lymphadenopathy,hepatitis,gastrointestinal
hemorrhage,hypovalaemia,kidney failure,heart failure are the complications of this condition.
In laboratory, manyserological tests like Weil-felis test,indirect immunofluorescence test,IFA test and other tests like
PCR,western blot can be done in identification of disease.
Not anylicencedeffective vaccinesagainst thisbacteria are available till the date. But the earlytreatment with antibiotics like
Tetracyclines,Doxycycline{100mg twice a day},Chloramphenicol{250-500mgevery6 hours}orallyor intravenously ,patient get
fully recovered within 3-4 days.Azithromycin has been advocated as an alternative agent in special circumstances.
Use of insects andtickrepellants,controllingthe rodents populations and wearing protective clothings to avoid exposure to
chiggers prevent the disease.