‘Six deaths due to scrub typhus in Nagpur divn’

Source: The Hitavada      Date: 30 Aug 2018 10:21:13


Staff Reporter,

Government is all set to tackle the disease

People need not panic as all corrective measures have been initiated in the State, says Dr Deepak Sawant

Maharashtra Health Minister Dr Deepak Sawant on Wednesday has confirmed the deaths of six patients in Nagpur division because of Scrub Typhus. Due to change in weather in monsoon, entire Maharashtra state is under the grab of diseases like Dengue, Leptospirosis, Gastroenteritis and H1N1 flu. In addition to these diseases, outbreak of Scrub Typhus has been found in Nagpur division, he added.

Dr Sawant was in city to review the status of scrub typhus and dengue in Nagpur region.Deputy Director of Health Services, Dr Sanjiv Jaiswal; Assistant Director (Malaria) Dr Milind Ganveer; Dr Yogendra Bansod and other senior officials of health department attended the review meeting.
After discussing with the health officials at the office of Deputy Director of Health Services, Dr Sawant while talking to the media persons said, till date 24 patients suffering from Scrub Typhus have been admitted in Government Medical College and Hospital (GMCH) and Indira Gandhi Government Medical College and Hospital (IGGMC).

Six patients died because of Scrub Typhus, he added.Dr Sawant said, Government machinery is all set to tackle these life threatening diseases. Scrub typhus is under diagnosed, due to non specific clinical presentation, limited awareness, low index of clinical suspicion, and lack of diagnostic facilities.

Scrub Typhus is a bacterial infection spreads at the onset of monsoon season and in some places in winter. The disease occurs when a Chigger Mite, a very tiny insect bites a person. These insects are found in grass and bushes. Immediate treatment is needed after the bite. Early diagnosis and treatment helps to reduce mortality and complications associated with disease. The health department is ready to tackle the infection as medicines and diagnostic tests are available with the department, he added.

Ample medicines available Doxycycline 200 mg daily or tetracycline 500 mg 6 hourly is treatment of choice. The duration of treatment is 7- 14 days. Treatment of less than a week is initially curative but may be followed by relapse. Chloramphenicol 500mg four times a day is an alternative. These antibiotics are bacteriostatic and they merely slow the multiplication of the organism while patient develop protective immune response. Resistance to tetracycline has been noted in some areas and rifampicin should be used in areas where there is poor response to Doxycycline alone. Azithromycin has been shown to be effective in the treatment of scrub typhus in pregnancy and has shown favorable outcome in pregnancy, Dr Sawant stated.

All these anti-biotics are available in market as well in Government Hospitals. In addition, injections of these medicines are available. Therefore, people should not be panic over the disease, he appealed.

Diagnostic tests are available
Serological tests are main tools for diagnosis. Indirect immunoflorescence assay, latex agglutination, indirect haemagglutination, indirect immunoperoxidase assay, and enzyme linked immunosorbent assay are various serological tests available at different centres, Dr Sawant stated.

Differentiating scrub typhus from other form of rickettsial infection, dengue, Leptospirosis, typhoid fever, infectious mononucleosis, malaria and meningococcal infection may be difficult in early stages. The most common symptom and signs are similar. The clinical features of organ dysfunction may vary depending on severity of illness. The exact diagnosis is made by serology and classification of organism by smear or culture depending on the disease.
The presence of eschar and rash supports the diagnosis but is variably present. However eschar and rash are also seen in other rickettsial infection which needs to be differentiated, he added.

Prevention, public awareness are must

Dr Sawant mentioned that the health department has started public awareness campaign about these diseases. Case detection, public education, rodent control and habitat modification are aimed at controlling the infection of scrub typhus in the region. Clearing of vegetation and chemical treatment of soil may help to break cycle of transmission from chiggers and humans to other chiggers.

Control of the rodent and marsupial reservoirs may also assist to prevent chigger coming into areas where humans are living or working. Involvement of community based organization in prevention and control of scrub typhus is important, he added.