Scrub Typhus a Re-emerging Disease in Children’s Hospital

Abstract

Scrub typhus is a form of typhus caused by the intracellular parasite Orientia tsutsugamushi a gram-negative alpha protea bacterium of the family rickettsiaceae first isolated and identified in 1930 in Japan. It is frequently diagnosed in South Asian countries including Nepal. After the earthquake in Nepal, a sudden upsurge in scrub typhus cases was reported. it is a mild to life-threatening disease with a case fatality rate without treatment as high as 50%. Disease presentation consists of abrupt high fever, severe headache, lymphadenopathy, generalized myalgia, eschar, and rashes. Diagnosis is generally made on clinical grounds alone, The cheapest and most easily available serological test is the Weil- Felix test but this is notoriously unreliable. Without treatment, the disease is often fatal since the use of antibiotics case fatalities have decreased from 4-40% to less than 2%. Commonly used is doxycycline or tetracycline but chloramphenicol is an alternative. No known vaccine is available to date.