Scrub typhus-an emerging entity: A study from a tertiary care hospital in North India

Scrub typhus is a tropical febrile zoonotic disease caused by Orientia tsutsugamushi of the rickettsial family. These are obligate; intracellular Gram-negative coccobacilli transmitted by the bite of infected mites. It is usually under-diagnosed in India due to its varied and nonspecific clinical presentation, limited awareness, and low index of suspicion among clinicians and lack of diagnostic facilities. This study was planned to monitor the level of scrub typhus-specific antibodies among febrile patients in a tertiary care hospital over a period of 1 year for which a rapid qualitative immunochromatographic assay (Standard Diagnostics, Korea) was introduced for the detection of IgM, IgG and IgA antibodies to O. tsutsugamushi from the serum of suspected febrile patients. A total of 98 out of 772 fever patients (12.69%) tested positive for the presence of antibodies against O. tsutsugamushi. Persistent high-grade fever was the defining characteristic in all the cases with the presence of an eschar in only 10.2% (10/98) of cases. Three patients died during the study period while the rest responded to treatment with doxycycline.