Why Scrub Typhus deaths worry Kerala during monsoon

Why Scrub Typhus deaths worry Kerala during monsoon

Scrub Typhus is transmitted by chigger (larval mites) bites.

The first casualty was reported on June 8—a 15-year-old girl, Ashwathi, from Cherunniyoor village, who died at the Government Medical College in Parippally. Clinical investigations suggest she got infected from a pet dog. Another patient died on June 12. Subitha, 39, had been undergoing treatment for two weeks at the Thiruvananthapuram Medical College.

Why Scrub Typhus deaths worry Kerala during monsoon
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"The health department ordered clinical investigation in both cases due to the prevalence of Scrub Typhus in the state. In the first case, there was presence of bacterium in the pet dog of the deceased. But health officials could not identify the source of infection in the second case," Health minister Veena George told media. "We have issued clinical protocols for treatment and alerted the local bodies to undertake operations to maintain hygiene." The minister added that there was no cause for alarm and appealed to the people to maintain hygiene and take precautions while handling pets or working in bushy areas.

Scrub Typhus is transmitted by chigger (larval mites) bites. The onset is typically marked by symptoms such as fever, chills, headache, bodyache, scab at the chigger bite site on the body, and rashes. Severe patients may develop bleeding and organ failure. According to medical experts, the symptoms begin to show with 10 days of a chigger bite.

Kerala has been reporting Scrub Typhus infection since 2009. The last time the infection claimed lives in the state was in 2020 when nine deaths occurred. The first Scrub Typhus fatality reported in the state was in 2009, of a 45-year-old farmer in Kozhikode. He had suffered from high-grade fever, headache and recurrent vomiting for two weeks.

"There is nothing to panic. Thiruvananthapuram has been reporting Scrub Typhus infection during the pre-monsoon and monsoon periods. So far, the state had reported less than 10 deaths annually. Hygiene, both personal and in the surroundings, helps contain the infection," said Jose G. D'Cruz, district medical officer, Thiruvananthapuram.

According to Dr K. Saifudheen, a neurologist who did studies on Scrub Typhus infections in Kerala and published an article in the journal Annals of Indian Academy of Neurology in 2012, most of the deaths occur due to delay in hospitalisation or misdiagnosis. Pointing to how life-threatening the disease can be, Dr Saifudheen told INDIA TODAY: "In the first case of Scrub Typhus casualty in Kerala (in 2009), we found that in spite of the best supportive care and broad-spectrum antibiotic coverage, the patient succumbed on the 12th day of hospitalisation due to respiratory failure."

Scrub Typhus patients are treated with the antibiotic doxycycline. Since no vaccine is available for the infection, the only way to reduce the risk is to avoid contact with infected chiggers and ensuring no delay in hospitalisation once infected.

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