Mites, monsoon and multisystem mayhem: clinico-demographic profile of scrub typhus at a tertiary care centre in upper Assam
DOI:
https://doi.org/10.18203/2320-6012.ijrms20262627Keywords:
Scrub typhus, Orientia tsutsugamushi, Northeast India, Eschar, Multi-organ dysfunction, Upper AssamAbstract
Background: Scrub typhus, caused by Orientia tsutsugamushi and transmitted via larval trombiculid mite bites, is a re-emerging public health threat in Northeast India. Data from upper Assam remain sparse. This study characterises the clinico-demographic profile of confirmed scrub typhus patients at a tertiary hospital in Dibrugarh.
Methods: A hospital-based, cross-sectional observational study was conducted at the Department of Medicine, Assam Medical College and Hospital (AMCH), Dibrugarh over one year (October 2024–September 2025). Eighty patients with confirmed scrub typhus (IgM ELISA and/or quantitative real-time PCR) were enrolled. Demographic, clinical, laboratory, and radiological data were analysed using descriptive statistics and Chi-square tests.
Results: The 31–40-year age group was most affected (33.75%; mean age 40.25±14.74 years). Male predominance was significant (67.5%; M: F=2.08:1; p=0.002). Three-quarters of patients (76.25%) were from rural backgrounds, and farmers comprised the largest occupational group (37.5%). Fever (100%), headache (92.5%), and jaundice (45%) were the commonest symptoms. Eschar was detected in 35% of patients. Near-universal transaminase elevation (100%), thrombocytopenia (96.25%), hypoalbuminaemia (97.5%), and elevated creatinine (87.5%) reflected multi-organ tropism. Peak incidence occurred in March–April (42.5%). Mortality was 8.75%.
Conclusions: Scrub typhus in upper Assam disproportionately affects rural male farmers with a distinctive spring-season peak. Multi-organ involvement is the rule. Early IgM ELISA-based diagnosis and prompt doxycycline initiation remain paramount. Community awareness and vector control are essential to reduce the regional disease burden.
References
Mahajan SK. Neuropsychiatric manifestations of scrub typhus. J Neurosci Rural Pract. 2017;8(3):421.
Xu G, Walker DH, Jupiter D, Melby PC, Arcari CM. A review of the global epidemiology of scrub typhus. PLoS Negl Trop Dis. 2017;11(11):e0006062.
Devasagayam E, Dayanand D, Kundu D, Kamath MS, Kirubakaran R, Varghese GM. The burden of scrub typhus in India: a systematic review. PLoS Negl Trop Dis. 2021;15(7):e0009619.
Olson JG, Bourgeois AL. Rickettsia tsutsugamushi infection and scrub typhus incidence among Chinese military personnel in the Pescadores Islands. Am J Epidemiol. 1977;106:172-5.
Ngulani KS, Kakati S, Hussain S, Singh MU, Kaguilan K. Outbreak of scrub typhus in Manipur: Experience at a tertiary care hospital. Assam J Intern Med. 2021;11(1):23-8.
Watt G, Parola P. Scrub typhus and tropical rickettsioses. Curr Opin Infect Dis. 2003;16(5):429-36.
Vivekanandan M, Mani A, Priya YS, Singh AP, Jayakumar S, Purty S. Outbreak of scrub typhus in Pondicherry. J Assoc Physicians India. 2010;58:24-8.
Takhar RP, Bunkar ML, Arya S, Mirdha N, Mohd A. Scrub typhus: a prospective, observational study during an outbreak in Rajasthan, India. Natl Med J India. 2017;30(2):69-72.
Wangrangsimakul T, Elliott I, Nedsuwan S. The neglected scrub typhus: burden, diagnostic issues, and management challenges in Asia. Clin Infect Dis. 2019;69(9):1474-80.
Varghese GM, Abraham OC, Mathai D, Thomas K, Aaron R, Kavitha ML, et al. Scrub typhus among hospitalised patients with febrile illness in South India: magnitude and clinical predictors. J Infect. 2006;52(1):56-60.
Konyak BM, Singh TS, Devi KS. Scrub typhus in Northeast India: epidemiology, clinical manifestations, and challenges. Trans R Soc Trop Med Hyg. 2024;118(2):73-81.
Van Ramliana C, Malsawmzuali JC, Lalruatfela BC. Clinico-epidemiological profile of scrub typhus in Mizoram: a retrospective study. J Evid Based Med Healthc. 2020;7(44):2618-22.
Roopa KS, Karthika K, Sugumar M, Bammigatti C, Shamanna SB, Harish BN. Serodiagnosis of scrub typhus at a tertiary care hospital from Southern India. JCDR. 2015;9(11):DC05.
Paris DH, Shelite TR, Day NPJ, Walker DH. Unresolved problems related to scrub typhus: a seriously neglected life-threatening disease. Am J Trop Med Hyg. 2013;89(2):301-7.
Narlawar UW, Lilare RR, Gawande BS. Epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India. Int J Community Med Public Health. 2019;6(11):4867-9.
Narvencar KP, Rodrigues S, Nevrekar RP, Dias L, Dias A, Vaz M, et al. Scrub typhus in patients reporting with acute febrile illness at a tertiary health care institution in Goa. Indian J Med Res. 2012;136(6):1020-4.
Chrispal A, Boorugu H, Gopinath KG, Prakash JA, Chandy S, Abraham OC, et al. Scrub typhus: an unrecognised threat in South India — clinical profile and predictors of mortality. Trop Doct. 2010;40(3):129-33.
Pathania M, Malik P, Rathaur VK. Scrub typhus: overview of demographic variables, clinical profile, and diagnostic issues in the sub-Himalayan region of India. J Fam Med Prim Care. 2019;8(3):1189-95.
Kamath SD, Kumari S, Sunder A. A study of the profile of scrub typhus in a tertiary care hospital in Jharkhand: an underestimated problem. Cureus. 2022;14(7):e26503.
Kaur M, Singh R. Radiological manifestations of scrub typhus. Eur J Radiol. 2014;83(8):1490-7.
Liu YX, Feng D, Suo JJ, Xing YB, Liu G, Liu LH, et al. Clinical characteristics of the autumn-winter type scrub typhus cases in south of Shandong province, northern China. BMC Infect Dis. 2009;9(1):82.
Downloads
Published
How to Cite
Issue
Section
