Affiliations: Department of Microbiology, Mahatma Gandhi Medical
College and Research Institute, Pondicherry, India | Department of Pediatrics, Mahatma Gandhi Medical
College and Research Institute, Pondicherry, India | Krishna Hospital and Research Foundation, Cuddalore,
India
Note: [] Correspondence: Selvaraj Stephen, Professor of Microbiology,
Mahatma Gandhi Medical College and Research Institute, Pondicherry, 607 402,
India. Tel.: +91 09894383368; Fax: +91 0413 2615457; E-mail:
[email protected]
Abstract: Contrary to the earlier view that Scrub Typhus (ST) is a disease of
the Far East, it is now known to be more widely prevalent. In India, ST has now
been reported from several areas where it was previously unknown. An outbreak
of ST involving 40 children in a small hamlet in Southern India during five
cooler months, November, 2011 to March, 2012 is described in this paper. The
clinical suspicion was based on fever along with features such as presence of
an eschar, hepatomegaly, thrombocytopenia, raised hepatic enzymes, etc. A
presumptive diagnosis of ST was made when the rapid immunochromatography test
(RICT) for ST IgM/IgG/IgA was positive. All but two samples (95%) were later
found positive by conventional ELISA for ST IgM, with many showing agglutinins
for Proteus OXK antigen with varying titers. Children responded well to
treatment with azithromycin (37) or doxycycline (3) with defervescence within
one to three days. Most children were in the age group of 0–5 years
(47.5%) and boys (67.5%) outnumbered girls. We recommend that ST has to be
considered in the differential diagnosis when investigating outbreaks of
unexplained fever in children in India.
Keywords: Scrub Typhus, Orientia tsutsugamushi, R. orientalis
